Healthcare has emerged as a key setting where expectations are rising for the potential benefits of artificial intelligence (AI), encompassing a range of technologies of varying utility and benefit. This paper argues that, even as the development of AI for healthcare has been pushed forward by a range of public and private actors, insufficient attention has been paid to a key contradiction at the center of AI for healthcare: that its pursuit to improve health is necessarily accompanied by environmental costs (...) which pose risks to human and environmental health—costs which are not necessarily directly borne by those benefiting from the technologies. This perspective paper begins by examining the purported promise of AI in healthcare, contrasting this with the environmental costs which arise across the AI lifecycle, to highlight this contradiction inherent in the pursuit of AI. Its advancement—including in healthcare—is often described through deterministic language that presents it as inevitable. Yet, this paper argues that there is need for recognition of the environmental harm which this pursuit can lead to. Given recent initiatives to incorporate stakeholder involvement into decision-making around AI, the paper closes with a call for an expanded conception of stakeholders in AI for healthcare, to include consideration of those who may be indirectly affected by its development and deployment. (shrink)

Discussion around the increasing use of AI in healthcare tends to focus on the technical aspects of the technology rather than the socio-technical issues associated with implementation. In this paper, we argue for the development of a sustained societal dialogue between stakeholders around the use of AI in healthcare. We contend that a more human-centred approach to AI implementation in healthcare is needed which is inclusive of the views of a range of stakeholders. We identify four key areas to support (...) stakeholder involvement that would enhance the development, implementation, and evaluation of AI in healthcare leading to greater levels of trust. These are as follows: (1) aligning AI development practices with social values, (2) appropriate and proportionate involvement of stakeholders, (3) understanding the importance of building trust in AI, (4) embedding stakeholder-driven governance to support these activities. (shrink)

Morally speaking, what should one do when one is morally uncertain? Call this the Moral Uncertainty Question. In this paper, I argue that a non-ideal moral theory provides the best answer to the Moral Uncertainty Question. I begin by arguing for a strong ought-implies-can principle---morally ought implies agentially can---and use that principle to clarify the structure of a compelling non-ideal moral theory. I then describe the ways in which one's moral uncertainty affects one's moral prescriptions: moral uncertainty constrains the set (...) of moral prescriptions one is subject to, and at the same time generates new non-ideal moral reasons for action. I end by surveying the problems that plague alternative answers to the Moral Uncertainty Question, and show that my preferred answer avoids most of those problems. (shrink)

The literature on cross-sector partnerships has increasingly focused attention on broader systemic or system-level change. However, research to date has been partial and fragmented, and the very idea of systemic change remains conceptually underdeveloped. In this article, we seek to better understand what is meant by systemic change in the context of cross-sector partnerships and use this as a basis to discuss the contributions to the Thematic Symposium. We present evidence from a broad, multidisciplinary systematized review of the extant literature, (...) develop an original definition of systemic change, and offer a framework for understanding the interactions between actors, partnerships, systemic change, and issues. We conclude with some suggestions for future research that we believe will enhance the literature in its next phase of development. (shrink)

There are cases in which, intuitively, an agent’s action is both morally right in one sense, and morally wrong in another sense. Such cases (along with other intuitions about blameless wrongdoing and action-guidance) support distinguishing between the objective moral ‘ought’ and the subjective moral ‘ought.’ This chapter argues against drawing this distinction, on the grounds that the prescriptions delivered by an adequate objective moral theory must be sensitive to the mental states of agents. Specifically, an adequate theory of the objective (...) moral ‘ought’ must respect a strong ought-implies-can principle—morally ought implies agentially can—in order to prescribe actions to real-life agents. An agent’s mental states determine what is agentially possible for that agent; thus, what an agent objectively morally ought to do is in part determined by the agent’s mental states. This chapter describes the structure of a compelling non-ideal moral theory that is both objective and mental state-sensitive. This non-ideal theory illuminates the shortcomings of extant objectivist and subjectivist moral theories, and illustrates how we can dispense with the subjective moral ‘ought.’. (shrink)

The field of artificial intelligence (AI) ethics has exploded in recent years, with countless academics, organizations, and influencers rushing to consider how AI technology can be developed and im...

The focus of this article is on multi-organizational cross-sector social partnerships (CSSP), an increasingly common means of addressing complex social and ecological problems that are too extensive to be solved by any one organization. While there is a growing body of literature on CSSP, there is little focus on collaborative strategic management, especially where implementation and outcomes are concerned. This study addresses these gaps by offering a conceptual model of collaborative strategic management, which is then tested through the use of (...) two qualitative empirical cases of collaborative regional sustainable development strategies (CRSDS). The model augments previous collaboration models by highlighting two levels of implementation (the collaboration and the organizational levels) and by considering the different types of outcomes, and the feedback loops. (shrink)

Systems change requires complex interventions. Cross-sector partnerships face the daunting task of addressing complex societal problems by aligning different backgrounds, values, ideas and resources. A major challenge for CSPs is how to link the type of partnership to the intervention needed to drive change. Intervention strategies are thereby increasingly based on Theories of Change. Applying ToCs is often a donor requirement, but it also reflects the ambition of a partnership to enhance its transformative potential. The current use of ToCs in (...) partnering efforts varies greatly. There is a tendency for a linear and relatively simple use of ToCs that does limited justice to the complexity of the problems partnerships aim to address. Since partnership dynamics are already complex and challenging themselves, confusion and disagreement over the appropriate application of ToCs is likely to hamper rather than enhance the transformative potential of partnerships. We develop a complexity alignment framework and a diagnostic tool that enables partnerships to better appreciate the complexity of the context in which they operate, allowing them to adjust their learning strategy. This paper applies recent insights into how to deal with complexity from both the evaluation and theory of change fields to studies investigating the transformative capacity of partnerships. This can serve as a check to define the challenges of partnering projects and can help delineate the societal sources and layers of complexity that cross-sector partnerships deal with such as failure, insufficient responsibility taking and collective action problems at four phases of partnering. (shrink)

In this paper, I argue that the fetishism objection to moral hedging fails. The objection rests on a reasons-responsiveness account of moral worth, according to which an action has moral worth only if the agent is responsive to moral reasons. However, by adopting a plausible theory of non-ideal moral reasons, one can endorse a reasons-responsiveness account of moral worth while maintaining that moral hedging is sometimes an appropriate response to moral uncertainty. Thus, the theory of moral worth upon which the (...) fetishism objection relies does not, in fact, support that objection. (shrink)

This essay interrogates the common assumption that good care is necessarily human care. It looks to disruptive fictional representations of robot care to assist its development of a theory of posthuman care that jettisons the implied anthropocentrism of ethics of care philosophy but retains care’s foregrounding of entanglement, embodiment and obligation. The essay reads speculative representations of robot care, particularly the Swedish television programme Äkta människor (Real Humans), alongside ethics of care philosophy and critical posthumanism to highlight their synergetic critiques (...) of neoliberal affective economies and humanist hierarchies that treat some bodies and affects as more real than others. These texts and discourses assist me in proposing a theory of care that regards vulnerability as the normative effect of posthuman vital embodiment, as opposed to an anomalous state that can be overcome or corrected via neoliberal practice. (shrink)

When considering the introduction of AI to support medical decision-making, one must take an end-to-end, holistic approach to development, evaluation, integration and governance. (Cabitza and Zeito...

Woody Allen’s uneasy relationship with organized religions, as represented in his entire work, has often drawn accusations of atheism and ethnic self-hatred, just as his personal behavior, as represented in the media, has stirred a series of allegations of immorality. However, Woody Allen’s exploration of religion, faith, and morality is far more complex and epitomizes the experience of modern man, living in a disenchanted universe. While most scholars focused on discussing the provocative debates over faith and religion in Woody Allen’s (...) films, the main purpose of this paper is to investigate what underlies Woody Allen’s obsessive preoccupation with the existence of divinity, as expressed in that part of his work which received little critical attention, namely his short fiction. The purpose of such an analysis is not to clear Woody Allen’s vexed reputation, but to understand the relevance of his individual ideology for the religious and moral conundrums of modern man. The corpus selected for this analysis consists of a series of relevant short stories and essays published in the 1991 edition of The Complete Prose of Woody Allen , a volume which gathers the texts published in three other short story collections. (shrink)

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

Recent research shows that in reasoning tasks, subjects usually produce an initial intuitive answer, accompanied by a metacognitive experience, which has been called feeling of rightness. This paper is aimed at exploring the complimentary experience of feeling of error, that is, the spontaneous, subtle sensation of cognitive uneasiness arising from conflict detection during thinking. We investigate FOE in two studies with the “bat-and-ball” reasoning task, in its standard and isomorphic control versions. Study 1 is a generation study, in which participants (...) are asked to generate their own response. Study 2 is an evaluation study, in which participants are asked to choose between two conflicting answers. In each study, the FOE is measured by the FOE questionnaire. Results show that the FOE is significantly present in the standard B&B task when participants give a wrong answer, that our questionnaire can measure it, and furthermore, that it is diagnostic of genuine error. (shrink)

BackgroundBioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do so, these conversations also need to reflect on the issue of diversity within the field of bioethics across the globe. This study aims to examine current gender representation and diversity at medical ethics and humanities institutes in Germany, the German-speaking areas of Switzerland, and Austria.MethodsA total of (...) forty-nine medical ethics and humanities institutes from Germany (n=42), the German-speaking areas of Switzerland (n=5), and Austria (n=2) were included in the study. Institutes websites were reviewed in the first week of March 2021 and the details of each staff member listed on the website recorded.ResultsOverall, a total of 964 staff members were identified at the forty-nine German-speaking medical ethics and humanities institutes. Just over half (530/964; 55%) of all staff were female. There were significant differences between gender in some staff positions: 64.6 per cent (31/48) of directors were male (χ2(1)=4.1, P=.04); 62.7 per cent (84/134) of student assistants were female (χ2(1)=8.6, P=.003); and 83.7 per cent (77/92) of administrative staff were female (χ2(1)=41.8, P<.001). There were no significant differences between staff gender for researchers and lecturers, or associated researchers. In addition, 65.5 per cent (19/29) of researchers and lecturers who had a professor title were male, but the difference between genders was not found to be significant. However, significantly more of the researchers and lecturers who had completed a habilitation were male (75.8% (25/33); χ2(1)=8.8, P=.003). When comparing the institute director’s gender presentation with staff gender presentation, it was found that male-led institutes had 53.4 per cent (286/536) female staff overall but had 52.7 per cent (136/258) male researchers and lecturers. However, the difference between genders were not found to be significant. On the other hand, female-led institutes had significantly more female staff overall (59.9% (223/372); χ2(1)=14.7, P<.001) and also significantly more female researchers and lecturers (58.9% (119/202; χ2(1)=6.4, P=.01).ConclusionsThere has been a significant push to address gender diversity in German-speaking academia, and this study finds overall good gender parity in medical ethics and humanities institutes. However, there has not been a similar openness to discussing issues of systemic racism or how other forms of inequality affect academic diversity. Taking diversity seriously requires opening up conversations around intersectionality, including difficult conversations around race and cultural background that have long been taboo in German-speaking countries. (shrink)

English interpretations, appropriations, and transpositions of the figure of Don Quixote play a pivotal role in eighteenth-century constructions of so-called English national character. A corpus of quixotic narratives worked to reinforce the centrality of Don Quixote and the practice of quixotism in the national literary landscape. They stressed the man from La Mancha’s eccentricity and melancholy in ways inextricable from English self-constructions of these traits.2 This is why Stuart Tave is able to write that eighteenth-century Britons could “recast” Don Quixote (...) in a fashion that followed “national pride” in the “freedom” of their humors.1 However, Don Quixote’s integral place in patriotic self-constructions was troubled by gender. While national character was construed as masculine by default, quixotism’s association with masculinity was complicated by the potential passive penetrability of quixotism and the proliferation of narratives about female quixotic readers. This essay will analyze these tensions. Henry Fielding’s Joseph Andrews (1742) and Laurence Sterne’s Tristram Shandy (1759–67) are key examples of quixotic texts that respond to the figure of the female quixote by interrogating the relationship between Englishness, masculinity, and quixotism. (shrink)

In its expansion to genomic, epidemiological and biomedical research, citizen science has been promoted as contributing to the democratisation of medical research and healthcare. At the same time, it has been criticised for reinforcing patterns of exclusion in health and biomedicine, and sometimes even creating new ones. Although citizen science has the potential to make biomedical research more inclusive, the benefits of current citizen science initiatives are not equally accessible for all people—in particular those who are resource-poor, located outside of (...) traditional networks of healthcare services, or members of minorities and marginalised groups. In view of growing public investments in participatory research endeavours, we argue that it should be considered more explicitly if, and how, citizen science could help make research more inclusive, contribute to the public good, and possibly even lead to better and more equitable healthcare. Reflecting on emerging ethical concerns for scientific conduct and best medical practice, we propose a set of relevant considerations for researchers, practitioners, bioethicists, funders and participants who seek to advance ethical practices of citizen-led health initiatives, and address profound differences in position, privilege and power in research. (shrink)

Ethics and Affects in the Fiction of Alice Munro explores the representation of embodied ethics and affects in Alice Munro's writing. The collection illustrates how Munro's short stories powerfully intersect with important theoretical trends in literary studies, including affect studies, ethical criticism, age studies, disability studies, animal studies, and posthumanism. These essays offer us an Alice Munro who is not the kindly Canadian icon reinforcing small-town verities who was celebrated and perpetuated in acts of national pedagogy with her Nobel Prize (...) win; they ponder, instead, an edgier, messier Munro whose fictions of affective and ethical perplexities disturb rather than comfort. In Munro's fiction, unruly embodiments and affects interfere with normative identity and humanist conventions of the human based on reason and rationality, destabilizing prevailing gender and sexual politics, ethical responsibilities, and affective economies. As these essays make clear, Munro's fiction reminds us of the consequences of everyday affects and the extraordinary ordinariness of the ethical encounters we engage again and again. (shrink)

Este artigo tem como objetivo principal identificar no pensamento de Habermas elementos que permitam refletir sobre questões referentes às relações entre teoria e prática presentes no discurso educacional, especialmente as relacionadas à formação de professores. Resulta de inquietações provocadas pelo predomínio de um discurso educacional impregnado pela tendência a privilegiar a prática e, de certo modo, negar a teoria, apoiando-se numa ideia de formação restrita a dimensões puramente instrumentais. O lugar da teoria e da prática nos processos de construção do (...) conhecimento na formação de professores não é consensual nem nos discursos a respeito do tema tampouco na produção acadêmica. É possível identificar algumas tendências nos encaminhamentos das discussões sobre as relações entre teoria e prática no contexto educacional. Uma que, ao mesmo tempo em que reconhece a necessidade da teoria para os processos de formação de professores, entende que a teoria nem sempre se aplica à prática ao afirmar, por exemplo, que a teoria é uma coisa e a prática é outra. Outra defende a supremacia da prática para uma formação mais efetiva; agrupa argumentos como “muita teoria e pouca prática”. A partir das contribuições de Habermas, expressas especialmente em Conhecimento e Interesse e Teoria e Prática, analisam-se as formas de inter-relacionamento entre teoria e prática a partir do papel da autorreflexão enquanto atitude capaz de oferecer condições para a compreensão dos mecanismos que contribuem para a dicotomia não só entre teoria e prática, mas também entre conhecimento e interesse. O diálogo com as contribuições de Habermas convida e, ao mesmo tempo, provoca o campo e o discurso educacional a reverem as formas como pensam e formulam seus projetos de formação. Sobretudo, acerca das condições de essa formação permitir que os sujeitos destinatários participem de forma mais autônoma desse processo e tomem o mundo da vida como ponto de articulação entre conhecimento e interesse, e consequentemente, entre teoria e prática. Nessa perspectiva, o exercício da autorreflexão como metodologia é que permite, de fato, uma visão integradora entre teoria e prática. Palavras-chave: Teoria e prática. Conhecimento e interesse. Formação. Autorreflexão. (shrink)

This essay considers the ways in which graphic caregiving memoirs complicate the idealizing tendencies of ethics of care philosophy. The medium’s “capacious” layering of words, images, temporalities, and perspectives produces “productive tensions... The words and images entwine, but never synthesize”. In graphic memoirs about care, this “capaciousness” allows for quick oscillation between the rewards and struggles of care work, representing ambiguous, even ambivalent attitudes toward care. Graphic memoirs effectively represent multiple perspectives without synthesis, part of a structural and thematic ambivalence (...) that provides a provocative counterpart to the abstract idealism of ethics of care philosophy. (shrink)

How does propaganda differ from the legitimate persuasive practices that animate a healthy democracy? The question is especially salient as digital technologies facilitate new modes of political persuasion and the public square saturates with information factual and fabricated alike. In answer, we propose a typology based on the rhetorical strategies that propaganda and its legitimate counterpart each employ. We argue that the point of contrast between the phenomena turns on two key features: whether the rhetorical strategy sufficiently engages our deliberative (...) capacities, and whether it runs counter to our epistemic interests. While in practice the boundary between the concepts is not always sharp, the account identifies a set of conceptual tools that help better frame and come to grips with propaganda and legitimate political persuasion in an information-dense and increasingly complex media landscape. (shrink)

The revelation that menstruation tracking apps share sensitive data with third parties, like Facebook, provoked a sense of violation among users. This case highlights the need to address ethics and governance of health data created outside of traditional healthcare contexts. Commodifying health data breaches trust and entails health and moral risks. Through the metaphor of The Wizard of Oz, we argue that these apps approximate healthcare without the professional competency, fiduciary duties, legal protections and liabilities such care requires and thus (...) represent an innovation in the annals of snake-oil salesmanship and the systematic devaluing of women’s bodies, lives, and work. (shrink)

Sean McKeever and Michael Ridge object that moral particularism ‘flattens the moral landscape’, that is, that particularism treats reasons of different kinds as if they were reasons of the same kind. This objection is misguided in two respects. First, particularists need not say that every feature can be a moral reason. Second, even if particularists were committed to saying that every feature can be a moral reason, they would still not be committed to the view that every feature can have (...) direct moral relevance. The failure of this objection shows that the objection exploits side-constraints that need not be placed on moral particularism. (shrink)

Hugh Baxter’s book Habermas: A Discourse Theory of Law and Democracy not only carefully recounts Habermas’ political and legal theory, but also raises several insightful criticisms of Habermas. Of particular note is Baxter’s criticism of Habermas’ system–lifeworld model originally presented in Theory of Communicative Action. Baxter argues that Habermas ought to discard the concept of the lifeworld because the distinction between lifeworld and system is no longer tenable in the model of political power presented in Habermas’ later work, Between Facts (...) and Norms, which focuses more explicitly on law as a social system. Baxter contends that the lifeworld, which Habermas describes as those parts of our lives that are structured by communicative action and shared norms, is an unhelpful way of understanding our social world because, in reality, most of our interactions are structured both by communicative norms and by the strategic action typical of ‘the system’. I argue, however, that Habermas must retain the theoretical distinction between system and lifeworld, though in everyday practice they are not so neatly disentangled, because without such an element there would be no source of legitimacy for the law. Without a connection to the communicative action of the lifeworld, law and the political structure would be nothing but strategic action. (shrink)

Bioethicists in healthcare institutions have the skills and insights and can and must facilitate and promote measures that address deeply ingrained structural issues that exacerbate health inequity...

Several philosophers have recently argued that decision-theoretic frameworks for rational choice under risk fail to provide prescriptions for choice in cases of moral uncertainty. They conclude that there are no rational norms that are “sensitive” to a decision maker’s moral uncertainty. But this chapter argues that one sometimes has a rational obligation to take one’s moral uncertainty into account in the course of moral deliberation. It first provides positive motivation for the view that one’s moral beliefs can affect what it (...) is rational for one to choose. It then addresses the problem of value comparison, according to which one cannot determine the expected moral value of one’s actions. The chapter argues that we should not infer from the problem of value comparison that there are no rational norms governing choice under moral uncertainty. (shrink)

In this paper, I present an argument that quantitative behavioural analysis can be used in zoosemiotic studies to advance the field of biosemiotics. The premise is that signs and signals form patterns in space and time, which can be measured and analysed mathematically. Whole organism sign processing is an important component of the semiosphere, with individual organisms in their Umwelten deriving signs from, and contributing to, the semiosphere, and vice versa. Moreover, there is a wealth of data available in the (...) traditional ethology literature which can be reinterpreted semiotically and drawn together to make a cohesive biosemiotic whole. For example, isolated signals, such as structural elements of birdsong, are attributed meaning by an interpreter, thus generating new ideas and hypotheses in both biology and semiotics. Furthermore, animal behaviour science has developed numerous test paradigms that with careful adaptation, could be suitable for use within a Peircean tripartite model, and thus give valuable insights into Umwelten of other species. In my conclusion, I suggest that by bringing together traditional ethology and biosemiotics, it is possible to use the Modern Synthesis to provide context to biosemiosis, thus pragmatic meaning to animal signals. On this basis, I propose updating the Modern Synthesis to a Semiotic Modern Synthesis, which focuses on whole-organism signals and their contexts, the latter being derived from neo-Darwinian theory and the ‘Umwelt’. Thus, there need be no dichotomy; the Modern Synthesis can successfully be integrated with biosemiotics. (shrink)

The Printed Reader explores the transformative power of reading in the eighteenth century, and how this was expressed in the fascination with Don Quixote and in a proliferation of narratives about quixotic readers, readers who attempt to reproduce and embody their readings. The collection brings together key debates concerning quixotic narratives, print culture, sensibility, empiricism, book history, and the material text, connecting developments in print technology to gendered conceptualizations of quixotism.