Notwithstanding the fact that care ethics has received increased attention, it has also faced much criticism. One of the focal points of critics is the normativity of care. Only when the objective normative basis of care is sufficiently clarified can care practices be evaluated and optimized from an ethical point of view. We emphasize that two levels of normativity can be identified: the context level and the foundational anthropology level. The personalist approach to care ethics is normatively stronger, at least (...) on one level, namely the foundational anthropology level. This personalist approach to care ethics indicates in which direction action must be taken so that human action may be considered ethically sound. (shrink)

To generate empathy in the care of vulnerable older persons requires care providers to reflect critically on their care practices. Ethics education and training must provide them with tools to accomplish such critical reflection. It must also create a pedagogical context in which good care can be taught and cultivated. The care-ethics lab ‘sTimul’ originated in 2008 in Flanders with the stimulation of ethical reflection in care providers and care providers in training as its main goal. Also in 2008, sTimul (...) commenced the organization of empathy sessions as an attempt to achieve this goal by simulation. The empathy session is a practical and fairly straightforward way of working to provoke care providers and care providers in training to engage in ethical reflection. Characteristic of the empathy session in the care-ethics lab is the emphasis on experience as a basis for ethical reflection. (shrink)

Providing good care requires nurses to reflect critically on their nursing practices. Ethics education must provide nurses with tools to accomplish such critical reflection. It must also create a pedagogical context in which a caring attitude can be taught and cultivated. To achieve this twofold goal, we argue that the principles of a right-action approach, within which nurses conform to a number of minimum principles, must be integrated into a virtue ethics approach that cultivates a caring attitude. Ethics education that (...) incorporates both the `critical companionship' method and the use of codes of ethics contributes positively to cultivating critical reflection by nurses. (shrink)

In recent approaches to ethics, the personal involvement of health care providers and their empathy are perceived as important elements of an overall ethical ability. Experiential working methods are used in ethics education to foster, inter alia, empathy. In 2008, the care-ethics lab ‘sTimul’ was founded in Flanders, Belgium, to provide training that focuses on improving care providers' ethical abilities through experiential working simulations. The curriculum of sTimul focuses on empathy sessions, aimed at care providers' empathic skills. The present study (...) provides better insight into how experiential learning specifically targets the empathic abilities of care providers. Providing contrasting experiences that affect the care providers' self-reflection seems a crucial element in this study. Further research is needed to provide more insight into how empathy leads to long-term changes in behaviour. (shrink)

In recent decades, care has played an increasingly crucial role in the self-understanding of the human being in the West. Nevertheless, there is a great deal of confusion and uncertainty surrounding the notion of care. One of the focal points of critics is the normativity of care. To what extent does care have an obligatory character? Only when the objective normative basis of care is sufficiently clarified, care practices can be evaluated and optimised from an ethical perspective. In this contribution (...) we explain how the anthropology of personalism could bring us closer to the normative core of care. The paper starts with a general overview of the contribution of care ethics in healthcare and the problems in relation to the normativity of care. Thereafter, we set the viewpoints of the Louvain tradition of personalism apart en show that this view on the human person is in keeping with a few basic principles of care ethics. Next, we describe how a personalist approach to care ethics can indeed indicate in which direction action must be taken so that human action may be considered ethically sound. (shrink)

Since 2008, in Flanders, we organize immersion sessions in a simulated context with the aim of stimulating student nurses and health professionals to learn virtuous caring. In this contribution, we first outline the purpose of this experiential learning: the cultivation of moral character. We come to the core of what we mean by moral character for care. We refer to Joan Tronto and Stan van Hooft to claim that caring is central to all aspects of nursing practice and is the (...) basis of its moral quality. We also stipulate that caring involves the integration of action with emotions, motivations, and knowledge. Second, we briefly explain how the immersion sessions in the care ethics lab take place and, in particular, reflect on what it yields in terms of experiences for the participants who take on the role of simulant patients in this experiential learning process. We focus on the significant role contrast experiences play in these experiences. Especially the negative contrast experiences do not wear off easily; care professionals remember even long after the immersion session and continue to carry them with them as a “corporeal built-in alarm.” Third, we discuss the role of contrast experiences in cultivating moral character for care. In particular, we explore the role of the body in the kind of knowing it cultivates and, by extension, its role in cultivating virtuous caring. By referring to specific philosophical ideas of Gabriël Marcel, Hans Jonas and Emmanuel Levinas, we try to understand how contrast experiences bring about an integration of virtuous action into knowledge, motivation, and emotion. We conclude that we need more space for contrast experiences in cultivating moral character. More attention should be paid to the role of the body in this learning process. (shrink)

The need for dignity is frequently mentioned in policy documents relating to the care of the elderly. It is also described as an important value in professional codes. Yet concerns about the standards of care for an important number of elderly people abound, despite global ageing being a challenging phenomenon. Not least among these is how to ensure that the elderly will be able to live out their days with dignity.In the present paper, we begin with an empirical exploration of (...) the meaning of human dignity as experienced by older Europeans and their professional caregivers. Thereafter, we discuss the meaning and relevance of these empirical research findings from a care ethics perspective. (shrink)

This article discusses the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences. Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that shed light on a care ethical approach toward the role of emotions in care practices, and may be used by practitioners and (...) facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise. The authors emphasize the importance of allowing emotions to exist, to acknowledge them and to not repress them, so that they can serve as a vehicle for ethical behavior in care practices. They stress the difference between acknowledging emotions and expressing them limitlessly. Formational practices and transformational research practices are being proposed to create moral space in care institutions and to support health care professionals to approach the emotionally turbulent practices they encounter in a way that contributes to good care for all those involved. (shrink)

Artificial intelligence (AI) systems are increasingly adopted to make decisions in domains such as business, education, health care, and criminal justice. However, such algorithmic decision systems can have prevalent biases against marginalized social groups and undermine social justice. Explainable artificial intelligence (XAI) is a recent development aiming to make an AI system’s decision processes less opaque and to expose its problematic biases. This paper argues against technical XAI, according to which the detection and interpretation of algorithmic bias can be handled (...) more or less independently by technical experts who specialize in XAI methods. Drawing on resources from feminist epistemology, we show why technical XAI is mistaken. Specifically, we demonstrate that the proper detection of algorithmic bias requires relevant interpretive resources, which can only be made available, in practice, by actively involving a diverse group of stakeholders. Finally, we suggest how feminist theories can help shape integrated XAI: an inclusive social-epistemic process that facilitates the amelioration of algorithmic bias. (shrink)

This article opens by reviewing the state of the knowledge on the most current worldwide facts about suicide in older people. Next, a number of values that have a role in this problem are considered. Having a clear and current understanding of suicide and of the related self-held and social values forms the framework for a number of clinical–ethical recommendations for care practice. An important aspect of caring for older people with suicidal tendencies is to determine whether their primary care (...) fosters self-esteem and affirms their dignity. In addition to providing a timely and appropriate diagnosis and treatment of suicidality, the caregiver is responsible for helping the patient to cope with stressful conditions, and for treating the patient with respect and consideration, thereby supporting the patient’s dignity and giving the patient a reason to live. Paying attention to these central points will foster caring contact with suicidal older people. (shrink)

At a Body Worlds exhibition, human corpses are displayed as museum pieces for educational purposes. The bodies are preserved by plastination, a technique invented by Gunther von Hagens and engineered at the Institute for Plastination in Heidelberg, Germany. Because of the wide controversy surrounding the displays, it is necessary to study how justice obtains. Understood from a Thomistic perspective, the use of a plastinate by Body Worlds is unjust because it dishonors the donor. The goodness of that use fails in (...) terms of object, end, and circumstance. National Catholic Bioethics Quarterly 10.4 (Winter 2010): 667–676. (shrink)

Video surveillance is an omnipresent phenomenon in today’s metropolitan life. Mainly intended to solve crimes, to prevent them by realtime-monitoring or simply as a deterrent, video surveillance has also become interesting in economical contexts; e.g. to create customer profiles and analyse patterns of their shopping behaviour. The extensive use of video surveillance is challenged by legal claims and societal norms like not putting everybody under generalised suspicion or not recording people without their consent. In this work we propose a technological (...) solution to balance the positive and negative effects of video surveillance. With automatic image recognition algorithms on the rise, we suggest to use that technology to not just automatically identify people but blacken their images. This blackening is done with a cryptographic procedure allowing to revoke it with an appropriate key. Many of the legal and ethical objections to video surveillance could thereby be accommodated. In commercial scenarios, the operator of a customer profiling program could offer enticements for voluntarily renouncing one’s anonymity. Customers could e.g. wear a small infrared LED to signal their agreement to being tracked. After explaining the implementation details, this work outlines a multidisciplinary discussion incorporating an economic, ethical and legal viewpoint. (shrink)

A fundamental task for any prospective cognitive architecture is information control: routing information to the relevant mechanisms to support a variety of tasks. Jerry Fodor has argued that the Massive Modularity Hypothesis cannot account for flexible information control due to its architectural commitments and its reliance on heuristic information processing. I argue instead that the real trouble lies in its commitment to nativism—recent massive modularity models, despite incorporating mechanisms for learning and self-organization, still cannot learn to control information flexibly enough. (...) After defending this position, I close the paper by discussing wider implications for control and cognitive architecture. (shrink)

§1. Introduction. Asymptotic cones of metric spaces were first invented by Gromov. They are metric spaces which capture the ‘large-scale structure’ of the underlying metric space. Later, van den Dries and Wilkie gave a more general construction of asymptotic cones using ultrapowers. Certain facts about asymptotic cones, like the completeness of the metric space, now follow rather easily from saturation properties of ultrapowers, and in this survey, we want to present two applications of the van den Dries-Wilkie approach. Using ultrapowers (...) we obtain an explicit description of the asymptotic cone of a semisimple Lie group. From this description, using semi-algebraic groups and non-standard methods, we can give a short proof of the Margulis Conjecture. In a second application, we use set theory to answer a question of Gromov.§2. Definitions. The intuitive idea behind Gromov's concept of an asymptotic cone was to look at a given metric space from an ‘infinite distance’, so that large-scale patterns should become visible. In his original definition this was done by gradually scaling down the metric by factors 1/nfornϵ ℕ. In the approach by van den Dries and Wilkie, this idea was captured by ultrapowers. Their construction is more general in the sense that the asymptotic cone exists for any metric space, whereas in Gromov's original definition, the asymptotic cone existed only for a rather restricted class of spaces. (shrink)

Patients who are incompetent need a surrogate decision maker to make treatment decisons on their behalf. One of the main ethical questions that arise in this context is what standard ought to govern such decision making. According to the Substituted Judgment Standard, a surrogate ought to make the decision that the patient would have made, had he or she been competent. Although this standard has sometimes been criticized on the grounds of being difficult to apply, it has found wide appeal, (...) since it it is alleged to protect incompetent patients? right to autonomy. The main purpose of the thesis is to evaluate SJS, from a conceptual and ethical perspective. It argues that the traditional formulation of SJS is seriously incomplete, and discusses alternative ways of completing it. Moreover, it questions the received view on how SJS should be morally justified, by offering arguments against the view that decision making in accordance with this standard extends the patient's opportunities for self-determination. Instead it suggests a virtue-ethical approach according to which the moral point of SJS-based decision making is not to protect the patient's interests, but to express respect for person. The thesis also critically assesses empirical studies according to which surrogates often fail to correctly predict patients? actual treatment preferences. It is shown that such results cannot, for a number of reasons, support the conclusion drawn that surrogates are ill-equipped to make decisions that comply with SJS. (shrink)

This article explores the use of model organisms in studying the cognitive phenomenon of decision-making. Drawing on the framework of biological control to develop a skeletal conception of decision-making, we show that two core features of decision-making mechanisms can be identified by studying model organisms, such as E. coli, jellyfish, C. elegans, lamprey, and so on. First, decision mechanisms are distributed and heterarchically structured. Second, they depend heavily on chemical information processing, such as that involving neuromodulators. We end by discussing (...) the implications for studying distinctively human decision-making. (shrink)

This thesis contributes to a better conceptual understanding of how self-organized control works. I begin by analyzing the control problem and its solution space. I argue that the two prominent solutions offered by classical cognitive science (centralized control with rich commands, e.g., the Fodorian central systems) and embodied cognitive science (distributed control with simple commands, such as the subsumption architecture by Rodney Brooks) are merely two positions in a two-dimensional solution space. I outline two alternative positions: one is distributed control (...) with rich commands, defended by proponents of massive modularity hypothesis; the other is centralized control with simple commands. My goal is to develop a hybrid account that combines aspects of the second alternative position and that of the embodied cognitive science (i.e., centralized and distributed controls with simple commands). Before developing my account, I discuss the virtues and challenges of the first three. This discussion results in a set of criteria for successful neural control mechanisms. Then, I develop my account through analyzing neuroscientific models of decision-making and control with the theoretical lenses provided by formal decision and social choice theories. I contend that neural processes can be productively modeled as a collective of agents, and neural self-organization is analogous to democratic self-governance. In particular, I show that the basal ganglia, a set of subcortical structures, contribute to the production of coherent and intelligent behaviors through implementing “democratic" procedures. Unlike the Fodorian central system—which is a micro-managing “neural commander-in-chief”—the basal ganglia are a “central election commission.” They delegate control of habitual behaviors to other distributed control mechanisms. Yet, when novel problems arise, they engage and determine the result on the basis of simple information (the votes) from across the system with the principles of neurodemocracy, and control with simple commands of inhibition and disinhibition. By actively managing and taking advantage of the wisdom-of-the-crowd effect, these democratic processes enhance the intelligence and coherence of the mind’s final "collective" decisions. I end by defending this account from both philosophical and empirical criticisms and showing that it meets the criteria for successful solution. (shrink)

The so-called Substituted Judgment Standard is one of several competing principles on how certain health care decisions ought to be made for patients who are not themselves capable of making decisions of the relevant kind. It says that a surrogate decision-maker, acting on behalf of the patient, ought to make the decision the patient would have made, had the latter been competent. The most common way of justifying the Substituted Judgment Standard is to maintain that this standard protects patients’ right (...) to autonomy, or self-determination, in the situation where they are no longer able to exercise this right on their own. In this paper we question this justification, by arguing that the most commonly suggested moral reasons for allowing and encouraging people to make their own choices seem not to apply when the patient’s decision-making is merely hypothetical. We end with some brief sketches of possible alternative ways of justifying the Substituted Judgment Standard. (shrink)

§1. Introduction. Asymptotic cones of metric spaces were first invented by Gromov. They are metric spaces which capture the ‘large-scale structure’ of the underlying metric space. Later, van den Dries and Wilkie gave a more general construction of asymptotic cones using ultrapowers. Certain facts about asymptotic cones, like the completeness of the metric space, now follow rather easily from saturation properties of ultrapowers, and in this survey, we want to present two applications of the van den Dries-Wilkie approach. Using ultrapowers (...) we obtain an explicit description of the asymptotic cone of a semisimple Lie group. From this description, using semi-algebraic groups and non-standard methods, we can give a short proof of the Margulis Conjecture. In a second application, we use set theory to answer a question of Gromov.§2. Definitions. The intuitive idea behind Gromov's concept of an asymptotic cone was to look at a given metric space from an ‘infinite distance’, so that large-scale patterns should become visible. In his original definition this was done by gradually scaling down the metric by factors 1/nfornϵ ℕ. In the approach by van den Dries and Wilkie, this idea was captured by ultrapowers. Their construction is more general in the sense that the asymptotic cone exists for any metric space, whereas in Gromov's original definition, the asymptotic cone existed only for a rather restricted class of spaces. (shrink)

In these collaborative, theoretical and performative pieces our aim is towards radical expansions of various formal parameters in western philosophy through art praxis that de-centres the roles played by the animal subject, industrial technologies, and soil in modernist paradigms. Exceeding these conventions demands pushing against/past blockages (aporias) to broader engagement with whatever refigured subjectivities are called into constellative gathering in the process. The immanent multiplicity of constellative (Soilogic) analysis ‘cuts in all directions’ in its insistence on attempting to ‘upend’ multiple (...) disciplines simultaneously rather than remaining mere cross-disciplinary embellishment between art and philosophy. Opening new ruptures in horizons of interpretation and maintaining them through artistic and philosophical agitation involves a ‘fidelity to the impossible’ (Young), and a reach beyond the known and tried. It is also a reach towards a blurring of Techne and poeisis in the inter(fur)faces of Dawn (a dark Horse), Gladys (a Goat), and the debris field of the zeppelin USS Macon that crashed into the ocean and sank off the coast of Monterey, CA in 1935. Initially we did so by painting portraits of Nietzsche and Benjamin on Dawn, putting them into conversation with each other on the question of Animality. We then attempted to make ‘haptic’ contact with the Macon while posing performative questions about interrelations, telepathies and hauntings among Animalities, Techne and more-than-humanist Materialities. (shrink)

This article focuses on soils as more-than-human subjects who are both living entities and ‘lenses’ through which we may begin to rethink some of the conventional parameters of ecology, communication and even the grounding of some western philosophical traditions on which these boundaries have stood. Just as the very term ‘more-than-human’ potentially exceeds the relegation of both soilogic agents and animalities to subservient status, likewise this discussion embarks from a more-than-humanist (‘posthumanist’) position. As we attempt to interact with living systems (...) and ways of being in broader, more expansive terms, it becomes possible to catch conceptual glimpses of less hierarchical ontologies as they are understood by some more-than-western cultures. I have also drawn inspiration from artistic, theoretical and political movements in the west that have sought to interrupt the primacy of Eurocentric humanism in institutions and philosophical arenas. This presages dirty thinking. (shrink)

Research ethics, once a platform for declaring intent, discussing moral issues and providing advice and guidance to researchers, has developed over time into an extra-legal regulatory system, complete with steering documents (ethics guidelines), overseeing bodies (research ethics committees) and formal procedures (informed consent). The process of institutionalizing distrust is usually motivated by reference to past atrocities committed in the name of research and the need to secure the trustworthiness of the research system. This article examines some limitations of this approach. (...) First, past atrocities cannot provide the necessary justification unless institutionalized distrust is a necessary or efficient means to prevent future ones – and there are several reasons to doubt this. Second, the efficacy of ethics review in safeguarding morally acceptable research depends on the moral competence and integrity of individual researchers – the very qualities that institutionalized distrust calls into question. Third, ethics guidelines cannot, as is sometimes assumed, educate or guide researchers in moral behaviour unless they already possess considerable capacity for moral judgment. Fourth, institutionalized distrust is a potential threat to the moral competence and integrity of researchers by encouraging a blinkered view of ethical issues, inducing moral heteronomy through incentives, and alienating them to research ethics. We conclude that the moral problem posed by inappropriate short-term behaviour on behalf of researchers is dwarfed by the potential long-term consequences if their moral competence is allowed to deteriorate. Measures must therefore be taken to ensure that researchers are equipped to take their individual responsibility and are not obstructed from so doing. (shrink)

I extend Ainslie's core claims with three cortico-striatal models that respectively subserve the key constructs of resolve, suppression, and routine habit. I show that these models suggest a more dynamical and symbiotic relation among the constructs: there are more ways they interact to reinforce willpower, and the temporal dimension of the interactions can often determine the effectiveness of the reinforcement.

[Grace as God’s Self-giving and Respect] Employing the methods of formal and transcendental analysis, the topic is introduced by departing from the experience of love between human beings. Love proves itself to be a unity of self-giving and respect. Both of these related elements of the notion of love are then put to the test in the light of that mode of divine loving called ‘grace’. By studying the history of dogma, this notion of grace is brought to a full (...) definition. (shrink)

The work of general practitioners is infused by norms from several movements, of which evidence based medicine, patient-centredness, and virtue ethics are some of the most influential. Their precepts are not clearly reconcilable, and structural factors may limit their application. In this paper, we develop a conceptual framework that explains how GPs respond, across different fields of interaction in their daily work, to the pressure exerted by divergent norms. Data was generated from unstructured interviews with and observations of sixteen Swedish (...) GPs and family medicine residents between 2015 and 2017. Straussian Grounded Theory was used for analysis. We found that GPs’ maxims of action can be characterised in terms of dichotomous responses to demands from four distinct sets of norms, or “voices”: the situation, the self, the system, and the profession. From the interactions between these voices emerge sixteen clusters of maxims of action. Based on the common features of the maxims in each cluster, we have developed a conceptual framework that appears to be rich enough to capture the meaning of the ethical decisions that GPs make in their daily work, yet has a high enough level of abstraction to be helpful when discussing the factors that influence those decisions. Our four-dimensional model of GPs’ responses to norms is a first step toward a middle-range theory of quality from GPs’ perspective. It brings out the complexity of their practice, reveals tensions that easily remain invisible in more concrete accounts of their actions, and aids the transferability of substantive theories on GPs’ ethical decision making. By explaining the nature of the ethical conflicts that they experience, we provide some clues as to why efforts to improve quality by imposing additional norms on GPs may meet with varying degrees of success. (shrink)

Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, the decision that ought to be made for the incompetent patient is the decision the patient would have made, had he or she been competent. Although the merits of this standard have been extensively debated, some important issues have not been sufficiently explored. One fundamental problem is that the substituted judgment standard, as commonly formulated, is indeterminate in content (...) and thus offers the surrogate little or no guidance. What the standard does not specify is just how competent one should imagine the patient to be, and what else one ought to envision about the patient’s hypothetical outlook and the circumstances surrounding his or her decision making. The article discusses this problem of underdetermined decision conditions. (shrink)

Should people be involved as active participants in longitudinal medical research, as opposed to remaining passive providers of data and material? We argue in this article that misconceptions of ‘autonomy’ as a kind of feat rather than a right are to blame for much of the confusion surrounding the debate of dynamic versus broad consent. Keeping in mind two foundational facts of human life, freedom and dignity, we elaborate three moral principles – those of autonomy, integrity and authority – to (...) better see what is at stake. Respect for autonomy is to recognize the other's right to decide in matters that are important to them. Respect for integrity is to meet, in one's relationship with the other, their need to navigate the intersection between private and social life. Respect for authority is to empower the other – to help them to cultivate their responsibility as citizens. On our account, to force information onto someone who does not want it is not to respect that person's autonomy, but to violate integrity in the name of empowerment. Empowerment, not respect for autonomy, is the aim that sets patient-centred initiatives employing a dynamic consent model apart from other consent models. Whether this is ultimately morally justified depends on whether empowerment ought to be a goal of medical research, which is questionable. (shrink)

The target article focuses on the predictive coding of and something happened and the and response to make. We extend that scope by addressing the aspect of perception and action. Successful interaction with the environment requires predictions of everything from millisecond-accurate motor timing to far future events. The hierarchical framework seems appropriate for timing.