According to the Collingridge dilemma, technology is easy to control when its consequences are not yet manifest; once they appear, the technology is difficult to control. This article examines the development of keyboard layout design from the perspective of the Collingridge dilemma. For this purpose, unlike related studies that focus on a limited period of time, the history of keyboard development is explored from the invention of the typewriter and the QWERTY to brain–computer interfaces. Today, there is no mechanical problem (...) of the typewriter for which the QWERTY was designed. On the other hand, better layouts have been designed for various situations so far, that can be easily implemented especially on virtual keyboards, but QWERTY has not been replaced. The present study shows how various factors as heterogeneous engineering have shaped QWERTY, prevented the prevalence of superior layouts, and led to Lock-in. Then, unlike other studies related to the Collingridge dilemma, which provide a qualitative description of it, a quantitative description is proposed that helps to better understand the Collingridge dilemma and Lock-in. Finally, the case study of the QWERTY keyboard illustrates that the theory of human-technology co-construction can provide a more comprehensive explanation of technology development, while the Collingridge dilemma can better provide some details of technology development. (shrink)

There is a profound paradox in modern medical knowledge production: The more we know, the more we know that we (still) do not know. Nowhere is this more visible than in diagnostics and early detection of disease. As we identify ever more markers, predictors, precursors, and risk factors of disease ever earlier, we realize that we need knowledge about whether they develop into something experienced by the person and threatening to the person’s health. This study investigates how advancements in science (...) and technology alter one type of uncertainty, i.e., temporal uncertainty of disease diagnosis. As diagnosis is related to anamnesis and prognosis it identifies how uncertainties in all these fields are interconnected. In particular, the study finds that uncertainty in disease diagnosis has become more subject to prognostic uncertainty because diagnosis is more connected to technologically detected indicators and less closely connected to manifest and experienced disease. These temporal uncertainties pose basic epistemological and ethical challenges as they can result in overdiagnosis, overtreatment, unnecessary anxiety and fear, useless and even harmful diagnostic odysseys, as well as vast opportunity costs. The point is not to stop our quest for knowledge about disease but to encourage real diagnostic improvements that help more people in ever better manner as early as possible. To do so, we need to pay careful attention to specific types of temporal uncertainty in modern diagnostics. (shrink)

The number of diagnoses and the number of persons having diagnoses have increased substantially, and studies indicate that diagnoses are given or upheld even if they are unwarranted, that is, that they do not satisfy professionally accepted diagnostic criteria. In this article, the authors investigate the ethics of withholding and withdrawing unwarranted diagnoses. First, they investigate ethical aspects that make it difficult to withhold and to withdraw such diagnoses. Second, they scrutinize whether there are psychological factors, both in persons/patients and (...) healthcare professionals, making it difficult to withdraw and withhold unwarranted diagnoses. Lastly, they use recent elements of the withholding-versus-withdrawing treatment debate in medical ethics to investigate whether there are any differences between withholding and withdrawing treatment and withdrawing and withholding unwarranted diagnoses. The authors conclude that it is crucial to acknowledge and address all these issues to reduce and avoid unwarranted diagnoses. (shrink)

Given that biases can distort bioethics work, it has received surprisingly little and fragmented attention compared to in other fields of research. This article provides an overview of potentially relevant biases in bioethics, such as cognitive biases, affective biases, imperatives, and moral biases. Special attention is given to moral biases, which are discussed in terms of (1) Framings, (2) Moral theory bias, (3) Analysis bias, (4) Argumentation bias, and (5) Decision bias. While the overview is not exhaustive and the taxonomy (...) by no means is absolute, it provides initial guidance with respect to assessing the relevance of various biases for specific kinds of bioethics work. One reason why we should identify and address biases in bioethics is that it can help us assess and improve the quality of bioethics work. (shrink)