The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...

Char and colleagues provide a useful conceptual framework for the proactive identification of ethical issues arising throughout the lifecycle of machine learning applications in healthcare. Th...

If you’ve ever had a time where your smartwatch buzzed to say you’ve completed your daily steps while you were actually just brushing your hair, you’ll know our data aren’t perfect. Every day, we c...

The authors offer their sincere thanks to all of the commentators for taking the time to comment on our work ; one of the advantages of the AJOB format is immediate feedback,...

Clinicians such as Sir William Osler reinvented Hippocrates and built the image of a noble, lone, professional man replete with black bag, minister...

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been _incapable_ of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead (...) that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon _agential demotion_. (shrink)

This Element considers Kant's account of the sublime in the context of his predecessors both in the Anglophone and German rationalist traditions. Since Kant says with evident endorsement that 'we call sublime that which is absolutely great' and nothing in nature can in fact be absolutely great, Kant concludes that strictly speaking what is sublime can only be the human calling to perfect our rational capacity according to the standard of virtue that is thought through the moral law. The Element (...) takes account of the difference between respect and admiration as the two main varieties of sublime feeling, and concludes by considering the role of Stoicism in Kant's account of the sublime, particularly through the channel of Seneca. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

Where do our ideas about politics come from? What can we learn from the Greeks and Romans? How should we exercise power? Melissa Lane teaches politics at Princeton University, and previously taught political thought at the University of Cambridge, where she was a Fellow of King's College. She has received a Guggenheim Fellowship in the field of classics, and the historian Richard Tuck called her book Eco-Republic 'a virtuoso performance by one of our best scholars of ancient philosophy.'.

This article rejects the claim made by other scholars that Plato in the Statesman, by employing the so-called ‘architect’ (ὁ ἀρχιτέκτων) in one of the early divisions leading to the definition of political expertise, prefigured and anticipated the architectonic conception of political expertise advanced by Aristotle. It argues for an alternative reading in which Plato in the Statesman, and in the only other of his works (Gorgias) in which the word appears, closely tracks the existing social role of the architektōn, (...) who was designated as such only in virtue of appointment by a city to a role that was crucially defined as epitactic, involving overseeing the workers on site engaged in constructing some civic building works. It is this epitactic dimension of the role on which Plato relies in the Statesman, as opposed to the kind of claim to overarching integrative expertise that Aristotle would use the figure of architectonic political knowledge to make. (shrink)

Here we examine the hypothesis that symbolic understanding across domains is mediated by a fundamental ‘symbolizing’ ability in young children. We tested 30 children aged 2–4 years on symbolic tasks assessing iconic and non-iconic word-referent and picture-referent understanding and administered standardised tests of symbolic play and receptive language. Children showed understanding of the symbol-referent relation earlier for pictures than written words, and performance within domains was correlated and, importantly, predicted by a marker of general symbolic ability. Performance on picture and (...) written word tasks was also unrelated to language comprehension. Thus, symbolic abilities in specific domains are underpinned by a general symbolizing ability which arises early in development. (shrink)

Ethics researchers advise managers of organizations to link rewards and punishments to ethical and unethical behavior, respectively. We build on prior research maintaining that organizations operate at Kohlbergs stages of moral reasoning, and explain how the over-reliance on rewards and punishments encourages employees to operate at Kohlbergs lowest stages of moral reasoning. We advocate designing organizations as ethical communities and relying on different assumptions about employees in order to foster ethical reasoning at higher levels. Characteristics associated with ethical communities are (...) identified and AES Corporation and Semco S/A serve as examples of corporations exhibiting the design characteristics and assumptions of ethical organizations. (shrink)

I respond to a dilemma for Causal Decision Theory (CDT) under determinism, posed in Adam Elga's paper “Confessions of a Causal Decision Theorist”. The treatment I present highlights (i) the status of laws as predictors, and (ii) the consequences of decision dependence, which arises natively out of Jeffrey Conditioning and CDT's characteristic equation.My argument leverages decision dependence to work around a key assumption of Elga's proof: to wit, that in the two problems he presents, the CDTer must employ subjunctive-suppositional (rather (...) than evidential) transformations of a shared prior. (shrink)

With candid, witty, and compelling experiences of yoga from renowned memoirists, including Cheryl Strayed (author of the number-one New York Times bestseller Wild), Claire Dederer (author of national bestseller Poser: My Life in 23 Yoga Poses), Dinty W. Moore (author of The Accidental Buddhist), Neal Pollack (author of Stretch: The Making of a Yoga Dude) and many others, Going Om shares a range of observations about this popular practice. Unlike books on yoga that provide instruction on technique, Going Om is (...) a unique collection of personal narratives from celebrated authors. This anthology of original material values the quality of writing over the authors' flexibility. Ira Sukrungruang shares his heartbreaking struggle as a 375 pound yoga student discovering self-worth on his mat; Gloria Munoz explores the practice of stillness with lyrical elegance in the midst of her busy mind; Neal Pollack's signature sarcasm leads to surprising turns at yoga class with his dad; Elizabeth Kadetsky uses yogic wisdom while coping with her mother's devastating Alzheimer's. (shrink)

Many prescriptions offered in the literature for enhancing creativity and innovation in organizations raise ethical concerns, yet creativity researchers rarely discuss ethics. We identify four categories of behavior proffered as a means for fostering creativity that raise serious ethical issues: (1) breaking rules and standard operating procedures; (2) challenging authority and avoiding tradition; (3) creating conflict, competition and stress; and (4) taking risks. We discuss each category, briefly identifying research supporting these prescriptions for fostering creativity and then we delve into (...) ethical issues associated with engaging in the prescribed behavior. These four rubrics illustrate ethical issues that need to be incorporated into the creativity and innovation literature. Recommendations for how organizations can respond to the ethical issues are offered based on practices of exemplary organizations and theories of organizational ethics. A research agenda for empirically investigating the ethical impact these four categories of behavior have on organizations concludes the article. (shrink)

Discrimination and inequalities in healthcare can be experienced by many patients due to many characteristics ranging from the obviously visible to the more subtly noticeable, such as race and ethnicity, legal status, social class, linguistic fluency, health literacy, age, gender and weight. Discrimination can take a number of forms including overt racist statement, stereotyping or explicit and implicit attitudes and biases. This paper presents the case study of a complex transcultural clinical encounter between the mother of a young infant in (...) a highly vulnerable social situation and a hospital healthcare team. In this clinical setting, both parties experienced difficulties, generating explicit and implicit negative attitudes that heightened into reciprocal mistrust, conflict and distress. The different factors influencing their conscious and unconscious biases will be analysed and discussed to offer understanding of the complicated nature of human interactions when faced with vulnerability in clinical practice. This case vignette also illustrates how, even in institutions with long-standing experience and many internal resources to address diversity and vulnerability, cultural competence remains a constant challenge. (shrink)

Journal of Philosophy of Education, EarlyView.

Programs, policies, and technologies — particularly those concerned with health equity — are often designed with justice envisioned as the end goal. These policies or interventions, however, frequently fail to recognize how the beneficiaries have historically embodied the cumulative effects of marginalization, which undermines the effectiveness of the intended justice. These well-meaning attempts at justice are bounded by greater socio-historical constraints. Bounded justice suggests that it is impossible to attend to fairness, entitlement, and equity when the basic social and physical (...) infrastructures underlying them have been eroded by racism and other historically entrenched isms. Using the case of Brazil’s National Health Policy for the Black Population, this paper proposes that bounded justice can contribute to justice discourses by serving as a concept, a proffering to a multi-disciplinary conceptual framework, and a potential analytic for those interested in the design of policy, technology, and programmatic interventions towards health equity. (shrink)

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

In recent essays, Jürgen Habermas endorses an account of political liberalism much like John Rawls'. Like Rawls, he argues that laws and public policies should be justified only in neutral terms, i.e. in terms of reasons that people holding conflicting world-views could accept. Habermas also, much like Rawls, distinguishes reasonable religious citizens, whose views should be included in public discourse, from unreasonable citizens in his expectation that religious citizens self-modernize. But in sharing these Rawlsian features, Habermas is vulnerable to some (...) of the same objections posed to Rawls. In this article I assess Habermas' ability to overcome two objections frequently posed to Rawls: (1) that religious citizens are unfairly expected to split their identities in public discourse, and (2) that the burdens of citizenship are asymmetrically distributed. I conclude that while he may be able to overcome the second, the first remains a problem for him. (shrink)

Within the growing developmental literature on children's testimonial learning, the emphasis placed on children's evaluations of testimonial evidence has shielded from view some of the more collaborative dimensions of testimonial learning. Drawing on recent philosophical work on testimony and interpersonal trust, we argue for an alternative way of conceptualizing the social nature of testimonial learning. On this alternative, some testimonial learning is the result of a jointly collaborative epistemic activity, an activity that aims at the epistemic goal of true belief, (...) but that does so by means of an irreducibly social process. (shrink)

Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as the capacity for rational choice in (...) alignment with one's values and goals). (shrink)

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...) distinguish clinical placebos from standard medical treatments. (shrink)

This chapter contains sections titled: The Laws Conclusion Bibliography.

Civic agriculture is an approach to agriculture and food production that—in contrast with the industrial food system—is embedded in local environmental, social, and economic contexts. Alongside proliferation of the alternative food projects that characterize civic agriculture, growing literature critiques how their implementation runs counter to the ideal of civic agriculture. This study assesses the relevance of three such critiques to urban farming, aiming to understand how different farming models balance civic and economic exchange, prioritize food justice, and create socially inclusive (...) spaces. Using a case study approach that incorporated interviews, participant observation, and document review, I compare two urban farms in Baltimore, Maryland—a “community farm” that emphasizes community engagement, and a “commercial farm” that focuses on job creation. Findings reveal the community farm prioritizes civic participation and food access for low-income residents, and strives to create socially inclusive space. However, the farmers’ “outsider” status challenges community engagement efforts. The commercial farm focuses on financial sustainability rather than participatory processes or food equity, reflecting the use of food production as a means toward community development rather than propagation of a food citizenry. Both farms meet authentic needs that contribute to neighborhood improvement, though findings suggest a lack of interest by residents in obtaining urban farm food, raising concerns about its appeal and accessibility to diverse consumers. Though not equally participatory, equitable, or social inclusive, both farms exemplify projects physically and philosophically rooted in the local social context, necessary characteristics for promoting civic engagement with the food system. (shrink)

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well‐intended actions become public performativity, and trust building will (...) fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept of bounded justice to performative trust acts; and center the works of Black and Indigenous feminist bioethicists to revisit some of the wisdom and valuable lessons they have contributed. Rebuilding trust is hard to do because people and institutions are often not honest about how hard it is and there is no simple box‐checking task that can disentangle our society's injustices, but there are steps to take in this direction. Individuals and institutions can recognize valuable relevant work that has already been written, partake in critical reflection, and then apply insights gained to take both small and sustainable steps toward transformational change and deeper trust. (shrink)

Doctoral students receive many kinds of assistance from faculty members, but much of this support falls short of mentoring. This paper takes the perspective that it is more important to find out what kinds of help students receive from faculty than to assume that students are taken care of by mentors, as distinct from advisors or role models. The findings here are based on both survey and interview data collected through the Acadia Institute’s project on Professional Values and Ethical Issues (...) in the Graduate Education of Scientists and Engineers. The paper describes various kinds of assistance that students receive (or do not receive) from faculty members in their roles as teacher/coach, sponsor, and counselor, It concludes with a section on advisors assigned to doctoral students, notably the extent of their contact with and influence on students. (shrink)

This chapter argues that Kant’s aesthetic theory of the sublime has particular relevance for his ethics of virtue. Kant contends that our readiness to revel in natural sublimity depends upon a background commitment to moral ends. Further lessons about the emotional register of the sublime allow us to understand how Kant can plausibly contend that the temperament of virtue is both sublime and joyous at the same time.

Observers have difficulty detecting visual changes. However, they are unaware of this inability, suggesting that people do not have an accurate understanding of visual processes. We explored whether this error is related to participants’ beliefs about the roles of intention and scene complexity in detecting changes. In Experiment 1 participants had a higher failure rate for detecting changes in an incidental change detection task than an intentional change detection task. This effect of intention was greatest for complex scenes. However, participants (...) predicted equal levels of change detection for both types of changes across scene complexity. In Experiment 2, emphasizing the differences between intentional and incidental tasks allowed participants to make predictions that were less inaccurate. In Experiment 3, using more sensitive measures and accounting for individual differences did not further improve predictions. These findings suggest that adults do not fully understand the role of intention and scene complexity in change detection. (shrink)