Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

There has been a rising interest in the study of Mary Wollstonecraft (1759-1797) in philosophy, political theory, literary studies and the history of political thought in recent decades. The Wollstonecraftian Mind seeks to provide a comprehensive survey of her work, not only placing it in its historical context but also exploring its contemporary significance. Comprising 38 chapters by a team of international contributors this handbook covers: the background to Wollstonecraft’s work Wollstonecraft’s major works the relationship between Wollstonecraft and other major (...) philosophers Wollstonecraftian philosophy Wollstonecraft’s legacy Essential reading for students and researchers in philosophy, Wollstonecraft’s work is central to the study of political philosophy, literature, French studies, political thought, and feminism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Thus Spake Howard Roark:Nietzschean Ideas in The FountainheadLester H. HuntIThe position I will be taking here will seem very peculiar to many people. I will be treating a novel as a discussion of the work of a philosopher—namely, Friedrich Nietzsche. Worse yet, I will be treating it as a discussion that is philosophically penetrating and deserves to be taken seriously. Still worse, the novel is Ayn Rand's early novel (...) The Fountainhead. I think it is safe to say that her reputation, among academics who discuss the works of philosophers, is very low. If the reader will only bear with me, though, I think I can make a case that Rand opens a line of inquiry about Nietzsche's ideas and values that is not only quite interesting in itself but one that ought to be pursued further by others.There has always been ample reason to associate Nietzsche with The Fountainhead.1 He is after all, the only philosopher who is more or less directly quoted in the book.2 Beyond that, Rand's novel has many other passages that students of Nietzsche instantly recognize as conscious references to him or deliberate echoes of his style. In addition, she revealed, in an introduction written for the twenty-fifth anniversary edition, that the following quotation from Beyond Good and Evil had originally stood at the head of the book when it was still in manuscript:It is not the works, but the belief which is here decisive and determines the order of rank to—employ once more an old religious formula with a new and deeper meaning—it is some fundamental certainty which a noble soul has about itself, something which is not to be sought, is not [End Page 79] to be found, and perhaps, also, is not to be lost—The noble soul has reverence for itself.—3She said, in the same introduction, that she removed the quotation (evidently, immediately before publication) for philosophical reasons, because of her "profound disagreement with the philosophy of its author." Nietzsche, she says, was fundamentally "a mystic and irrationalist," and even in this quotation, chosen for its content, insinuates a philosophical position that she regards as erroneous (namely, determinism). Even her statement of what she likes about this passage is rather constrained: "as a poet [ie., not as a philosopher], he projects at times (not consistently) a magnificent feeling for man's greatness, expressed in emotional, not intellectual terms."4It is of course true enough that Rand does disagree with Nietzsche, and for more or less the reasons that she suggests here, but it is also true that the passage she has quoted expresses some ethical themes—nobility, order of rank, the "pathos of distance," and (most obviously) the idea of self-reverence as a characteristic of the ethically good—which are at least as important in The Fountainhead as they are in Nietzsche's writings. Though Rand's spirited disclaimer serves to remind us of her deep differences with Nietzsche, the quotation itself suggests that there might be an interesting philosophical, not merely literary or emotional, connection between The Fountainhead and Nietzsche's ideas. What I would like to show here is that this connection merits a much closer look than it has ever been given heretofore. Not only is the presence of Nietzschean themes in Rand's novel deep and pervasive, but the book actually contains a very interesting and powerful internal critique of one of Nietzsche's most characteristic ideas, a criticism based in large part on values and assumptions that he shares. Before I can set out this critique, I will need to explore some of the positive thematic and philosophical connections.IIOne evening, rather late in the novel, Gail Wynand, the corrupt newspaper publisher and financier, surprises his wife, Dominique, with a present: he has had an architect design a house for them. The architect, she realizes with shock as she sees the drawings for the house, is her former lover, Howard Roark, a man with whom she is still in love. None of this is known to her husband, who innocently tells her that [End Page 80] Roark... (shrink)

Film audiences are no longer in a position to know for certain which images, or features of images they see on the screen were created by photography and which were created in a computer. Yet they are reacting to the advent of computer graphics as if it is merely a technical improvement, not a change in the nature of film itself. This would mean that one of the most influential early theories of film—realism—is wrong. It held that film is by (...) nature photographic and that its unique value is to afford the audience the physical connection with reality that photography, uniquely among pictorial media, brings. I argue that the audience is right about this. Even as applied to purely photographic films, realism was simply a mistake. (shrink)

This paper assesses Brian Barry's attempt in Why Social Justice Matters to argue the importance of social justice. Barry seeks to dismiss the ideological misunderstandings that have prevented recognition of the importance of social justice. He also suggests that a robust conception of social justice will be needed to guide policies that solve the problems of the modern world. I argue that the issue of social justice has suffered neglect because of the influence of different ideas of social justice than (...) Barry's rather than a misunderstanding among politicians and media pundits of generally shared intuitions of justice. These different ideas of justice must be shown to be wanting. In doing this, I argue that any adequate theory of social justice must address the issue of the fairness of starting points in peoples' lives. I point out that any such theory requires such revolutionary change that it contradicts the presuppositions of public policy and thus cannot serve to guide public policy solutions to the problems that Barry wants addressed. I argue that a 'non-ideal' theory of justice and principles for making unjust societies fairer, with more modest proposals for change, will better serve as a guide to public policy. (shrink)

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

_Demons in the Consulting Room: Echoes of Genocide, Slavery and Extreme Trauma in Psychoanalytic Practice_ isthe second of two volumes addressing the overwhelming, often unmetabolizable feelings related to mourning, both on an individual and mass scale. Authors in this volume explore the potency of ghosts, ghostliness and the darker, often grotesque aspects of these phenomena. While ghosts can be spectral presences that we feel protective of, demons haunt in a particularly virulent way, distorting experience, our sense of reality and our (...) character. Bringing together a collection of clinical and theoretical papers, _emons in the Consulting Room_, reveals how the most extreme types of trauma can continue to have effects across generations, and how these effects manifest in the consulting room. Essays in this volume consider traumas that have affected multiple generations of people, such as the Holocaust, experiences in the gulags, and the experience of slavery. Authors here consider the clinical challenges of working with the demonic force in severe childhood abuse and the effects of serious and prolonged physical injury and illness. Inevitably, there is in such difficult clinical work, the combined effects of hauntings in the analysts and in patients and often in the surrounding culture. In this book, distinguished psychoanalysts explore the myriad forms of ghosts and the demonic, which interfere and disrupt the endlessly difficult psychic work of mourning. It will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. _emons in the Consulting Room _ill appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

The paper investigates whether imaginative states about propositions can be assessed in terms of fittingness (also known as correctness, appropriateness, aptness). After characterizing propositional imaginings and explaining the idea of fittingness, I present some considerations in favour of the no conditions view: imagining seems to be the sort of action that cannot be done unfittingly, and imaginings have no external cognitive nor conative goals in light of which they could be unfitting. I then examine the local conditions view, that there (...) can be fittingness conditions on imaginings, but that these are inherited from the mental projects in which imaginings can play a role. Given that there are virtues of the imagination such as creativity and spontaneity, and given that imaginings are subject to purposive mechanisms, and given that there are cases in which it is unfitting to fail to imagine, I endorse the general conditions view, on which imaginings have a goal, and therefore fittingness conditions, even outside the context of mental projects. I then examine 4 versions of the general conditions view and argue that imaginings aim to make contents available to mental projects. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Miss Koch probes the essential meaning of Madison's political philosophy to locate his distinctive angle of vision. She considers three controlling themes in his political thought--liberty, justice, and union--and presents a profile of his mind and heart. The material in the book was originally presented as the Whig-Clio Bicentennial Lectures at Princeton University. Originally published in 1966. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. (...) These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Put relationship-centered communication at the forefront of care Today, physicians face a hypercompetitive marketplace in which they must meet unique and complex patient needs as efficiently as possible. But in a culture prioritizing clinical outcomes above all, there can be a tendency to lose sight of one of the most critical aspects of providing effective care: the communication skills that build and foster physician-patient relationships. Studies have shown that good communication between doctors and patients and among all caregivers who interface (...) with patients directly results in better clinical outcomes, reduced costs, greater patient satisfaction, and lower rates of physician burnout. In Communication the Cleveland Clinic Way, Dr. Adrienne Boissy and her team tell the story of how Cleveland Clinic created and applied the R.E.D.E. to Communicate: Foundations of Healthcare program, making the world-renowned hospital system a leader in relationship-centered care. They provide a step-by-step guide for healthcare leaders and decision-makers to design, develop, and implement communication skills training in their own institutions. Learn how to: • Craft an effective, colleague-supported communication skills program to include veteran physicians, residents, and medical students • Leverage creative program design and data transparency to engage and facilitate staff physicians and advanced care providers • Identify common misperceptions and myths in healthcare communication and respond to them successfully • Cultivate a true sense of empathy—with patients and fellow caregivers alike—while maintaining professionalism In a field where difficult conversations and stressful relationships are commonplace, clinicians need a structured approach to enable them to deliver the best care possible. Communication the Cleveland Clinic Way is the blueprint for establishing a relationship-centered program that will improve patient experience, reinvigorate doctors’ passion for their work, and elevate any organization. (shrink)

The vocabulary of wine is large and exceptionally vibrant -- from straight-forward descriptive words like "sweet" and "fragrant", colorful metaphors like "ostentatious" and "brash", to the more technical lexicon of biochemistry. The world of wine vocabulary is growing alongside the current popularity of wine itself, particularly as new words are employed by professional wine writers, who not only want to write interesting prose, but avoid repetition and cliche. The question is, what do these words mean? Can they actually reflect the (...) objective characteristics of wine, and can two drinkers really use and understand these words in the same way?In this second edition of Wine and Conversation, linguist Adrienne Lehrer explores whether or not wine drinkers (both novices and experts) can in fact understand wine words in the same way. Her conclusion, based on experimental results, is no. Even though experts do somewhat better than novices in some experiments, they tend to do well only on wines on which they are carefully trained and/or with which they are very familiar. Does this mean that the elaborate language we use to describe wine is essentially a charade? Lehrer shows that although scientific wine writing requires a precise and shared use of language, drinking wine and talking about it in casual, informal setting with friends is different, and the conversational goals include social bonding as well as communicating information about the wine. Lehrer also shows how language innovation and language play, clearly seen in the names of new wines and wineries, as well as wine descriptors, is yet another influence on the burgeoning and sometimes whimsical world of wine vocabulary. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

The standard foil for recent theories of hope is the belief-desire analysis advocated by Hobbes, Day, Downie, and others. According to this analysis, to hope for S is no more and no less than to desire S while believing S is possible but not certain. Opponents of the belief-desire analysis argue that it fails to capture one or another distinctive feature or function of hope: that hope helps one resist the temptation to despair;2 that hope engages the sophisticated capacities of (...) human agency, such as planning;3 or that hope involves the imagination in ways desire need not.4 Here, I focus on the role of imagination in hope, and discuss its implications for hope’s relation to practical commitment or end-setting. (shrink)

Apologies are strange. They are, in a certain sense, very small. An apology is just a gesture—a set of words, a physical posture, perhaps a gift. But an apology can also be very powerful—this power is implicit in the facts that it can be difficult to offer an apology and that, when we are wronged, we may want an apology very much. More, even we have been severely wronged, we are sometimes willing to forgive or pardon the wrongdoer, if we (...) receive a sincere apology. In this paper, I want to begin to figure out how a mere gesture can be so powerful. The philosophers who discuss apology generally do not go into much detail, and they discuss it almost exclusively in connection with forgiveness. 2 I, too, will discuss apology’s power to provide reason to forgive, but in order to provide the resources to examine another power. Some apologies, I will argue, fail to provide reason to forgive, but nevertheless do provide the recipient a reason to maintain a relationship with the wrongdoer, or to allow the wrongdoer to remain in her community. To be clear: the “powers” I am interested in are reason-giving powers, or powers to make certain beliefs, attitudes, or actions rational. Apologies also, no doubt, have a sort of bare causal power. The sight of a vicious, racist, cruel war criminal on his knees and in tears, sincerely begging forgiveness, may inspire in us pity or even compassion, in spite of what we believe we have reason to feel. “I can’t help but feel sorry for the bastard,” we may say, even while believing that.. (shrink)

When Albert Hunt joined the staff of the Regional College of Art, Bradford, in 1965, he found himself working mostly with ‘non-academic’ students on a fascinating range of games, projects and theatre events outside the main stream of exam-oriented education. In this title, first published in 1976, Albert Hunt describes this experience, and explains how he himself evolved from a conventional grammar school teacher to a radical and experimental educator. In particular, Hunt describes the evolution of new (...) working relationships between teachers and students, which in turn highlight an alternative way of viewing society. _Hopes for Great Happenings_ is not only a vividly interesting account of Albert Hunt’s teaching methods, but is of practical value to anybody involved in the study of liberal arts, theatre studies or in community arts work. (shrink)

People with disabilities use more medical care and see health professionals more often than do those of the same age, ethnic group, or economic class who do not have impairments. An indisputable medical goal is.