Ernest Sosa has recently argued that the knowledge we get from instruments and the knowledge we get from testimony is similar in important ways. Most importantly, the justification that supports it is similar in kind – both instrumental justification and justification from testimony is to be understood in terms of reliability. I argue that Sosa’s theory is problematic. Specifically, I argue that we can take certain attitudes towards people that we cannot coherently take towards instruments. This, I argue, grounds a (...) distinction between the kind of justification that testimony can make available and the kind of justification that instruments can make available. The result is that reliability cannot provide a complete explanation of the justification that testimony makes available. (shrink)

This paper proposes freedom as the condition of possibility for the construction of trust in human relationships. The methodology used is a review of the scientific literature of the most recent moral and political philosophy. As a result of the dialogue between different positions, it is discovered that freedom, despite being present in the act of trust, is forgotten in the discussion around trust, a forgetfulness that has as its main causes the assumption that trust is natural and the confusion (...) between the propensity to trust and the act of trusting. All this leads to proposing an approach of the act of trusting that starts from the freedom of the trustee and the trustor. (shrink)

Trust is a core feature of the physician-patient relationship, and risk is central to trust. Patients take risks when they trust their providers to care for them effectively and appropriately. Not all patients take these risks: some medical relationships are marked by mistrust and suspicion. Empirical evidence suggests that some patients and families of color in the United States may be more likely to mistrust their providers and to be suspicious of specific medical practices and institutions. Given both historical and (...) ongoing oppression and injustice in American medical institutions, such mistrust can be apt. Yet it can also frustrate patient care, leading to family and provider distress. In this paper, I propose one way that providers might work to reestablish trust by taking risks in signaling their own trustworthiness. This interpersonal step is not meant to replace efforts to remedy systemic injustice, but is an immediate measure for addressing mistrust in occurrent cases. (shrink)

Research involving adults who lack capacity to consent relies on proxy (or surrogate) decision making. Proxy decisions about participation are ethically complex, with a disparity between normative accounts and empirical evidence. Concerns about the accuracy of proxies’ decisions arise, in part, from the lack of an ethical framework which takes account of the complex and morally pluralistic world in which proxy decisions are situated. This qualitative study explored the experiences of family members who have acted as a research proxy in (...) order to develop an understanding of the ethical concepts involved, and the interactions between those concepts. Proxies described a complex process of respecting the wishes and preferences of the person they represented, whist integrating preferences with what they viewed as being in the interests of the person. They aimed to make a decision that was ‘best’ for the person and protected them from harm; they also aimed to make the ‘right’ decision, viewed as being authentic to the person’s values and life. Decisions were underpinned by the relationship between the person and their proxy, in which both trust and trustworthiness were key. Proxies’ decisions, based both on respect for the person and the need to protect their interests, arose out of their dual role as both proxy and carer. The findings raise questions about accounts which rely on existing normative assumptions with a focus on accuracy and discrepancy, and which fail to take account of the requirement for proxies to make authentic decisions that arise out of their caring obligations. (shrink)

Richard Thaler and Cass Sunstein’s Nudge advances a theory of how designers can improve decision-making in various situations where people have to make choices. We claim that the moral acceptability of nudges hinges in part on whether they can provide an account of the competence required to offer nudges, an account that would serve to warrant our general trust in choice architects. What needs to be considered, on a methodological level, is whether they have clarified the competence required for choice (...) architects to prompt subtly our behaviour toward making choices that are in our best interest from our own perspectives. We argue that, among other features, an account of the competence required to offer nudges would have to clarify why it is reasonable to expect that choice architects can understand the constraints imposed by semantic variance. Semantic variance refers to the diverse perceptions of meaning, tied to differences in identity and context, that influence how users interpret nudges. We conclude by suggesting that choice architects can grasp semantic variance if Thaler and Sunstein’s approach to design is compatible with insights about meaning expressed in science and technology studies and the philosophy of technology. (shrink)

Richard Thaler and Cass Sunstein’s Nudge advances a theory of how designers can improve decision-making in various situations where people have to make choices. We claim that the moral acceptability of nudges hinges in part on whether they can provide an account of the competence required to offer nudges, an account that would serve to warrant our general trust in choice architects. What needs to be considered, on a methodological level, is whether they have clarified the competence required for choice (...) architects to prompt subtly our behaviour toward making choices that are in our best interest from our own perspectives. We argue that, among other features, an account of the competence required to offer nudges would have to clarify why it is reasonable to expect that choice architects can understand the constraints imposed by semantic variance. Semantic variance refers to the diverse perceptions of meaning, tied to differences in identity and context, that influence how users interpret nudges. We conclude by suggesting that choice architects can grasp semantic variance if Thaler and Sunstein’s approach to design is compatible with insights about meaning expressed in science and technology studies and the philosophy of technology. (shrink)

Molecular tumour boards (MTBs) offer recommendations for potentially effective, but potentially burdensome, molecularly targeted treatments to a patient's treating physician. In this paper, we discuss the question of who is responsible for ensuring that there is an adequate evidence base for any treatments recommended to a patient. We argue that, given that treating oncologists cannot usually offer a robust evaluation of the evidence underlying an MTB's recommendation, members of the MTB are responsible for ensuring that the evidence level is adequate. (...) We explore two models for how to share responsibility between MTB members. According to the first model, each MTB member, as well as the treating physician, should be held maximally and equally responsible for the recommendations. We argue that this insufficiently accounts for differences in roles and expertise of MTB members. We propose instead that responsibility is delegated via relationships of trust. We argue if these relationships of trust are to be instances of reasonable trust, (a) MTBs should offer a clinical representative to whom a treating physician may delegate the responsibility of ensuring there is sufficient evidence for treatment recommendations, (b) the relationships of trust between the representative and the other MTB members should be clearly defined, and (c) MTB members should be carefully selected. Treating oncologists retain a responsibility to consider general limitations of the evidence for targeted treatments in assessing whether the treatment recommendation offered by an MTB's representative is adequate for a given clinical situation. (shrink)

In “Robots, Trust and War” Simpson claims that victory in counter-insurgency conflicts requires that military forces and their governing body win the ‘hearts and minds’ of civilians. Consequently, forces made up primarily of autonomous robots would be ineffective in these conflicts for two reasons. Firstly, because civilians cannot rationally trust them because they cannot act from a motive based on good character. If they ever did develop this capacity then the purpose of sending them to war in our stead would (...) be lost because there would be no moral saving. Secondly, because if robot forces did offer a moral saving then this would signal that the deploying government could not be trusted to be committed to the conflict. I disagree with both claims. I argue firstly that there are less demanding grounds that could allow robot forces to be trusted sufficiently to be effective whilst still achieving a moral saving over the deployment of human ones. Secondly, that this moral saving would not necessarily signal that the deploying body lacked commitment because its interpretation would be highly context-dependent. I conclude therefore, contra-Simpson, that robot forces could plausibly be effective in counter-insurgency engagements in the foreseeable future. I suggest therefore that there may be a case for developing a more finely grained understanding of the opportunities for, and challenges of, their use. (shrink)

In biomedical research lack of trust is seen as a great threat that can severely jeopardise the whole biomedical research enterprise. Practices, such as informed consent, and also the administrative and regulatory oversight of research in the form of research ethics committees and Institutional Review Boards, are established to ensure the protection of future research subjects and, at the same time, restore public trust in biomedical research. Empirical research also testifies to the role of trust as one of the decisive (...) factors in research participation and lack of trust as a barrier for consenting to research. However, what is often missing is a clear definition of trust. This paper seeks to address this gap. It starts with a conceptual analysis of the term trust. It compares trust with two other related terms, those of reliance and trustworthiness, and offers a defence of Baier’s attribute of ‘good will’ a basic characteristic of trust. It, then, proceeds to consider trust in the context of biomedical research by examining two questions: First, is trust necessary in biomedical research?; and second, do increases in regulatory oversight of biomedical research also increase trust in the field? This paper argues that regulatory oversight is important for increasing reliance in biomedical research, but it does not improve trust, which remains important for biomedical research. It finishes by pointing at professional integrity as a way of promoting trust and trustworthiness in this field. (shrink)

It is widely acknowledged that trust plays an important role for the acceptability of data sharing practices in research and healthcare, and for the adoption of new health technologies such as AI. Yet there is reported distrust in this domain. Although in the UK, the NHS is one of the most trusted public institutions, public trust does not appear to accompany its data sharing practices for research and innovation, specifically with the private sector, that have been introduced in recent years. (...) In this paper, we examine the question of, what is it about sharing NHS data for research and innovation with for-profit companies that challenges public trust? To address this question, we draw from political theory to provide an account of public trust that helps better understand the relationship between the public and the NHS within a democratic context, as well as, the kind of obligations and expectations that govern this relationship. Then we examine whether the way in which the NHS is managing patient data and its collaboration with the private sector fit under this trust-based relationship. We argue that the datafication of healthcare and the broader ‘health and wealth’ agenda adopted by consecutive UK governments represent a major shift in the institutional character of the NHS, which brings into question the meaning of public good the NHS is expected to provide, challenging public trust. We conclude by suggesting that to address the problem of public trust, a theoretical and empirical examination of the benefits but also the costs associated with this shift needs to take place, as well as an open conversation at public level to determine what values should be promoted by a public institution like the NHS. (shrink)

This paper discusses the epistemology of the Internet of Things [IoT] by focusing on the topic of trust. It presents various frameworks of trust, and argues that the ethical framework of trust is what constitutes our responsibility to reveal desired norms and standards and embed them in other frameworks of trust. The first section briefly presents the IoT and scrutinizes the scarce philosophical work that has been done on this subject so far. The second section suggests that the field of (...) epistemology is not sufficiently capable of dealing with technologies, and presents a possible solution to this problem. It is argued that knowledge is not only social phenomena, but also a technological one, and that in order to address epistemological issues in technology, we need to carefully depart from traditional epistemic analysis and form a new approach that is technological (termed here Techno-Epistemology). The third and fourth sections engage in an epistemic analysis of trust by dividing it in to various frameworks. The last section argues that these various frameworks of trust can be understood to form a trustworthy large-scale socio-technological system, emphasizing the place of ethical trust as constituting our commitment to give proper accounts for all of the other frameworks. (shrink)

On Christopher H. Wellman’s Samaritan account of political legitimacy, the state is justified in coercing its subjects because doing so is necessary to rescue them from the perils of the state of nature. Samaritanism – the principle that we are morally permitted to do what is necessary to rescue someone from serious peril if in doing so we do not impose unreasonable costs on others – only justifies a minimal state, in Wellman’s view. I argue contra Wellman that Samaritanism justifies (...) an extensive, liberal-egalitarian state. (shrink)

Trusting relationships are both valuable and risky. Where the risks are high and the fears of betrayal are also high, it might seem rational to try to mitigate the risks, while still enjoying the benefits of the trusting relationship, by forming a contingency plan. A contingency plan—in the sense I am interested in—involves contingent punishments for defection, which are primarily meant to encourage the trusted partner to act trustworthily. I argue, however, that such contingency plans suffer from an internal tension (...) wherein the contingency planner both seeks and undermines a particular level (or kind) of trust. There are two problems in particular, either of which is sufficient to undermine trusting relationships: one, the planner fails to see the trusted partner as sincerely engaged in the trusting relationship, and two, the planner separates herself out from the trusting relationship by seeing her flourishing as separate from her partner’s (or, even worse, as dependent on her partner’s harm). Continency plans, then, are not just about the future; they cast a moral shadow on what we are doing now. (shrink)

A widespread assumption in debates about trust and trustworthiness is that the evaluative norms of principal interest on the trustor’s side of a cooperative exchange regulate trusting attitudes and performances whereas those on the trustee’s side regulate dispositions to respond to trust. The aim here will be to highlight some unnoticed problems with this asymmetrical picture – and in particular, how it elides certain key evaluative norms on both the trustor’s and trustee’s side the satisfaction of which are critical to (...) successful cooperative exchanges – and to show that a symmetrical, ‘achievement-first’ approach to theorising about trust and trustworthiness (and their relation to each other) has important advantages by comparison. The view I develop is guided by a structural analogy with practical reasoning. Just as practical reasoning is working as it should only when there is realisation (knowledge and action) of states (belief and intention) with reverse directions of fits (mind-to-world and world-to-mind), likewise, cooperation between trustor and trustee is functioning as it should only when there is an analogous kind of realisation on both sides of the cooperative exchange – viz., when the trustor ‘matches’ her achievement in trusting (an achievement in fitting reliance to reciprocity) with the trustee’s achievement in responding to trust (an achievement in fitting reciprocity to reliance). An upshot of viewing cooperation between trustor and trustee as exhibiting achievement-theoretic structure is that we will be better positioned to subsume trustworthiness (and its cognates on the trustee’s side), like trust, under a wider suite of evaluative norms that regulate attempts, dispositions, and achievements symmetrically on both sides of a cooperative exchange, with ‘matching achievements’ as the gold standard. (shrink)

Experimental design is one aspect of a scientific method. A well-designed, properly conducted experiment aims to control variables in order to isolate and manipulate causal effects and thereby maximize internal validity, support causal inferences, and guarantee reliable results. Traditionally employed in the natural sciences, experimental design has become an important part of research in the social and behavioral sciences. Experimental methods are also endorsed as the most reliable guides to policy effectiveness. Through a discussion of some of the central concepts (...) associated with experimental design, including controlled variation and randomization, this chapter will provide a summary of key ethical issues that tend to arise in experimental contexts. In addition, by exploring assumptions about the nature of causation and by analyzing features of causal relationships, systems, and inferences in social contexts, this chapter will summarize the ways in which experimental design can undermine the integrity of not only social and behavioral research but policies implemented on the basis of such research. (shrink)