In a landmark essay, Andreas Matthias claimed that current developments in autonomous, artificially intelligent systems are creating a so-called responsibility gap, which is allegedly ever-widening and stands to undermine both the moral and legal frameworks of our society. But how severe is the threat posed by emerging technologies? In fact, a great number of authors have indicated that the fear is thoroughly instilled. The most pessimistic are calling for a drastic scaling-back or complete moratorium on AI systems, while the optimists (...) aim to show that the gap can be bridged nonetheless. Contrary to both camps, I argue against the prevailing assumption that there is a technology-based responsibility gap. I show how moral responsibility is a dynamic and flexible process, one that can effectively encompass emerging technological entities. (shrink)

Our ability to locate moral responsibility is often thought to be a necessary condition for conducting morally permissible medical practice, engaging in a just war, and other high-stakes endeavors. Yet, with increasing reliance upon artificially intelligent systems, we may be facing a wideningresponsibility gap, which, some argue, cannot be bridged by traditional concepts of responsibility. How then, if at all, can we make use of crucial emerging technologies? According to Colin Allen and Wendell Wallach, the advent of so-called ‘artificial moral (...) agents’ (AMAs) is inevitable. Still, this notion may seem to push back the problem, leaving those who have an interest in developing autonomous technology with a dilemma. We may need to scale-back our efforts at deploying AMAs (or at least maintain human oversight); otherwise, we must rapidly and drastically update our moral and legal norms in a way that ensures responsibility for potentially avoidable harms. This paper invokes contemporary accounts of responsibility in order to show how artificially intelligent systems might be held responsible. Although many theorists are concerned enough to develop artificial conceptions ofagencyor to exploit our present inability to regulate valuable innovations, the proposal here highlights the importance of—and outlines a plausible foundation for—a workable notion ofartificial moral responsibility. (shrink)

The emergence of ethical concerns surrounding artificial intelligence (AI) has led to an explosion of high-level ethical principles being published by a wide range of public and private organizations. However, there is a need to consider how AI developers can be practically assisted to anticipate, identify and address ethical issues regarding AI technologies. This is particularly important in the development of AI intended for healthcare settings, where applications will often interact directly with patients in various states of vulnerability. In this (...) paper, we propose that an ‘embedded ethics’ approach, in which ethicists and developers together address ethical issues via an iterative and continuous process from the outset of development, could be an effective means of integrating robust ethical considerations into the practical development of medical AI. (shrink)

Moral distress in healthcare has been an increasingly prevalent topic of discussion. Most authors characterize it as a negative phenomenon, while few have considered its potentially positive value. In this essay, I argue that moral distress can reveal and affirm some of our most important concerns as moral agents. Indeed, the experience of it under some circumstances appears to be partly constitutive of an honorable character and can allow for crucial moral maturation. The potentially positive value, then, is twofold; moral (...) distress carries both aretaic and instrumental value. Granted, this position is not without its caveats, but by making these clear, I provide a novel framework for policy recommendations regarding when, if ever, we should work to reduce moral distress. (shrink)

Medical errors are all too common. Ever since a report issued by the Institute of Medicine raised awareness of this unfortunate reality, an emerging theme has gained prominence in the literature on medical error. Fears of blame and punishment, it is often claimed, allow errors to remain undisclosed. Accordingly, modern healthcare must shift away from blame towards a culture of safety in order to effectively reduce the occurrence of error. Against this shift, I argue that it would serve the medical (...) community well to retain notions of individual responsibility and blame in healthcare settings. In particular, expressions of moral emotions—such as guilt, regret and remorse—appear to play an important role in the process of disclosing harmful errors to patients and families. While such self-blaming responses can have negative psychological effects on the individual practitioner, those who take the blame are in the best position to offer apologies and show that mistakes are being taken seriously, thereby allowing harmed patients and families to move forward in the wake of medical error. (shrink)

The experience of ‘moral distress’ is an increasing focal point of contemporary medical and bioethics literature, yet it has received little attention in discussions intersecting with ethical theory. This is unfortunate, as it seems that the peculiar phenomenon may well help us to better understand a number of issues bearing both practical and theoretical significance. In this article, I provide a robust psychological profile of moral distress in order to shed a newfound light upon the longstanding problem of ‘dirty hands’. (...) I argue that moral distress offers evidence of the existence of dirty hands situations. By examining moral distress and its relationship to cases of dirty hands, it appears that few of us are completely immune to susceptibility to these sorts of troubling experiences. With this concern in mind, I provide various recommendations to help alleviate our morally distressing personal and professional lives. (shrink)

Recent medical and bioethics literature shows a growing concern for practitioners’ emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to (...) most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners. Such efforts, however, may be problematic, as moral distress is not adequately understood, nor is there agreement among the leading accounts regarding how to conceptualize the experience. With this article I make clear what a robust account of moral distress should be able to explain and how the most common notions in the existing literature leave significant explanatory gaps. I present several cases of interest and, with careful reflection upon their distinguishing features, I establish important desiderata for an explanatorily satisfying account. With these fundamental demands left unsatisfied by the leading accounts, we see the persisting need for a conception of moral distress that can capture and delimit the range of cases of interest. (shrink)

The experience of ‘moral distress’ is an increasing focal point of contemporary medical and bioethics literature, yet it has received little attention in discussions intersecting with ethical theory. This is unfortunate, as it seems that the peculiar phenomenon may well help us to better understand a number of issues bearing both practical and theoretical significance. In this article, I provide a robust psychological profile of moral distress in order to shed a newfound light upon the longstanding problem of ‘dirty hands’. (...) I argue that moral distress offers evidence of the existence of dirty hands situations. By examining moral distress and its relationship to cases of dirty hands, it appears that few of us are completely immune to susceptibility to these sorts of troubling experiences. With this concern in mind, I provide various recommendations to help alleviate our morally distressing personal and professional lives. (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...

In a critique of my work on ‘taking the blame’ as a response to medical errors, my position on the potential goods of individual responsibility and blame is challenged. It is suggested that medicine is a ‘team sport’ and several rich examples are provided to support the possible harms of practitioner self-blame. Yet, it appears that my critics have misunderstood my demands and to whom they are directed. With this response, I offer several clarifications of my account, as well as (...) a reiteration on the role of self-blame after medical error. (shrink)

Artificial intelligence and robotic technologies have become nearly ubiquitous. In some ways, the developments have likely helped us, but in other ways sophisticated technologies set back our interests. Among the latter sort is what has been dubbed the ‘severance problem’—the idea that technologies sever our connection to the world, a connection which is necessary for us to flourish and live meaningful lives. I grant that the severance problem is a threat we should mitigate and I ask: how can we stave (...) it off? In particular, the fact that some technologies exhibit behavior that is unclear to us seems to constitute a kind of severance. Building upon contemporary work on moral responsibility, I argue for a mechanism I refer to as ‘technological answerability’, namely the capacity to recognize human demands for answers and to respond accordingly. By designing select devices—such as robotic assistants and personal AI programs—for increased answerability, we see at least one way of satisfying our demands for answers and thereby retaining our connection to a world increasingly occupied by technology. (shrink)

H.L.A. Hart’s lost and found essay ‘Discretion’ has provided new insight into the issue of how legal systems can cope with indeterminacy in the law. The so-called ‘open texture’ of law calls for the exercise of judicial discretion, which, I argue, renders judges susceptible to the problem of dirty hands. To show this, I frame the problem as being open to an array of appropriate emotional responses, namely, various senses of guilt. With these responses in mind, I revise an example (...) from Michael Walzer’s original analysis in a way that highlights purely personal sacrifices in solutions to dirty hands situations. I then turn to an account of moral emotions in legal decision-making and show how judges—in failing to advance all interests—might be left with a unique sense of guilt. With an application of this account to Hart’s legal positivism, it can be seen that a judge’s hands are often dirtied in resolving borderline cases. If discretion leaves judges in situations where they must do wrong in order to do right, Hart’s endorsement of a closure view of wrongdoing will lead to difficulties in how he can explain the presence of moral remainders in jurisprudence. (shrink)

Robotic and artificially intelligent (AI) systems are becoming prevalent in our day-to-day lives. As human interaction is increasingly replaced by human–computer and human–robot interaction (HCI and HRI), we occasionally speak and act as though we are blaming or praising various technological devices. While such responses may arise naturally, they are still unusual. Indeed, for some authors, it is the programmers or users—and not the system itself—that we properly hold responsible in these cases. Furthermore, some argue that since directing blame or (...) praise at technology itself is unfitting, designing systems in ways that encourage such practices can only exacerbate the problem. On the other hand, there may be good moral reasons to continue engaging in our natural practices, even in cases involving AI systems or robots. In particular, daily interactions with technology may stand to impact the development of our moral practices in human-to-human interactions. In this paper, we put forward an empirically grounded argument in favor of some technologies being designed for social responsiveness. Although our usual practices will likely undergo adjustments in response to innovative technologies, some systems which we encounter can be designed to accommodate our natural moral responses. In short, fostering HCI and HRI that sustains and promotes our natural moral practices calls for a co-developmental process with some AI and robotic technologies. (shrink)

Digital twinning in medicine refers to the idea of simulating a person’s organs, muscles or perhaps their entire body, in order to arrive more effectively at accurate diagnoses, to make treatment recommendations that reflect chances of success and possible side-effects, and to better understand the long-term trajectory of an individual’s overall condition. Digital twins, in these ways, build on the recent movement toward personalised medicine,1 and they undoubtedly present us with exciting opportunities to advance our health. Of course, the opportunities (...) are accompanied by newfound challenges—a common refrain in discussions surrounding emerging technologies. In a recent article, Matthias Braun surveys numerous problems, including the precision of simulations, ownership and consent to the use of digital models, and issues of justice in assuring equitable access to novel medical systems.2 In particular, he places special emphasis on the notion of representation. According to Braun, proper representation naturally calls for correspondence—namely a precise model offering dynamic, real-time feedback as well as transparency, both for the patient and the practitioner, in terms of the data being employed. While technical challenges remain, these goals are quite clear and relatively uncontroversial. Where a host of questions arise, however, is in the discussion on the interaction between the represented persons and their simulations. Alongside questions regarding ownership of one’s digital twin, Braun raises the concern that ‘giving …. (shrink)

In a current clinical trial for Emergency Preservation and Resuscitation, Dr. Samuel Tisherman of the University of Maryland aims to induce therapeutic hypothermia in order to ‘buy time’ for operating on victims of severe exsanguination. While recent publicity has framed this controversial procedure as ‘killing a patient to save his life’, the US Army and Acute Care Research appear to support the study on the grounds that such patients already face low chances of survival. Given that enrollment in the trial (...) must be non-voluntary, the study has received an exemption from federal standards for obtaining informed consent. How exactly, if at all, is non-voluntary enrollment morally justifiable? In this essay, I appeal to the notable work of Hans Jonas in an effort to defend the EPR trial's use of non-voluntary enrollment. It is often thought and, as I show, it may appear that Jonas has called for the end of experimental medical practice. Still, I derive from Jonas a principle of double-effect upon which physicians may be seen as morally permitted to pursue innovations in emergency medicine but only as a byproduct of pursuing therapeutic success. With this position, I argue that the EPR trial can be granted a stronger philosophical justification than simply waiving the requirement of obtaining informed consent. The double-effect justification would obtain, perhaps regardless of the success of such innovative procedures as therapeutic hypothermia. (shrink)

In a current clinical trial for Emergency Preservation and Resuscitation, Dr. Samuel Tisherman of the University of Maryland aims to induce therapeutic hypothermia in order to ‘buy time’ for operating on victims of severe exsanguination. While recent publicity has framed this controversial procedure as ‘killing a patient to save his life’, the US Army and Acute Care Research appear to support the study on the grounds that such patients already face low chances of survival. Given that enrollment in the trial (...) must be non-voluntary, the study has received an exemption from federal standards for obtaining informed consent. How exactly, if at all, is non-voluntary enrollment morally justifiable? In this essay, I appeal to the notable work of Hans Jonas in an effort to defend the EPR trial's use of non-voluntary enrollment. It is often thought and, as I show, it may appear that Jonas has called for the end of experimental medical practice. Still, I derive from Jonas a principle of double-effect upon which physicians may be seen as morally permitted to pursue innovations in emergency medicine but only as a byproduct of pursuing therapeutic success. With this position, I argue that the EPR trial can be granted a stronger philosophical justification than simply waiving the requirement of obtaining informed consent. The double-effect justification would obtain, perhaps regardless of the success of such innovative procedures as therapeutic hypothermia. (shrink)

It is an understatement to say we live in an exciting time considering the increasingly widespread applications of artificial intelligence (AI). This observation is brought to the fore by Sedlakova...

Against the backdrop of a recent history of ongoing efforts to institutionalize ethics in ways that also target corporate environments, we asked ourselves: How do company representatives at the automatica 2022 trade fair in Munich respond to questions around ethics? To this end, we started an exploratory survey at the automatica 2022 in Munich, asking 22 company representatives at various booths from various industrial sectors the basic question: “Is there somebody in your company working on ethics?” Most representatives were responding (...) positively and tried to connect the term to pre-existing practices, processes, or organizational entities in their respective companies. Mostly, they either located ethics as being relevant to their organization on an institutional level, on a cultural level, on an inter-company level, or on a product level. This exploratory investigation has also shown that the ongoing debates and regulatory efforts about ethics in AI have not yet become a major selling point for company representatives at the trade fair. (shrink)

We see cases of moral luck arising in recent times, as we face the uncertainties of provisional rules for navigating the coronavirus pandemic. How should we respond to rule-breakers, and how should they view themselves, when they cause harm inadvertently? Although some argue that guilt is unnecessary for any harm that may result from luck, this paper takes moral luck seriously and encourages consideration of the benefits to be achieved by expressions of self-blame amidst troubling circumstances, from pure accidents to (...) how we live during pandemics. It argues that rule-breakers in public health crises show us the importance of taking responsibility for our actions. (shrink)