Background eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. Purpose to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the (...) COVID-19 pandemic. Methods A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. Ethical considerations Permission to conduct the study was obtained from the Institutional Review Board. Results Participants stated that “eHealth enabled compassionate care during the pandemic” by ensuring patient care availability and accessibility. They shared experiences of “communicating compassionate care via eHealth” with suggestions of addressing patients’ needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended “setting realistic mutual expectations” considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered “low eHealth literacy hinders compassion.” Additionally, they recommended the need for “institutional/system-level support to foster compassionate care.” Conclusion Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients. (shrink)

Decision-making is an integral part of business meetings in an organization. Research has suggested that a participant’s engagement in the decision-making process has direct relevance to his or her role in the team or organization. This study extends the investigation of communicative behavior in decision-making to a special meeting setting where all participants assume similar organizational roles and where there is no designated chair. In particular, it draws on conversation analytic methods and a recently developed framework of participant roles to (...) examine discursive strategies and discourse roles on a moment-by-moment basis in the process of consensus negotiation. Findings show that participants’ choices of discursive strategies and the display of discourse roles vary as the discussion proceeds. A limited range of discursive strategies and discourse roles are identified when the discussion fails to lead to consensus. Our analysis also suggests that certain discourse roles appear to have a greater impact on reaching consensus decisions. (shrink)

Science is the study of our world, as it is in its messy reality. Nonetheless, science requires idealization to function—if we are to attempt to understand the world, we have to find ways to reduce its complexity. Idealization and the Aims of Science shows just how crucial idealization is to science and why it matters. Beginning with the acknowledgment of our status as limited human agents trying to make sense of an exceedingly complex world, Angela Potochnik moves on to (...) explain how science aims to depict and make use of causal patterns—a project that makes essential use of idealization. She offers case studies from a number of branches of science to demonstrate the ubiquity of idealization, shows how causal patterns are used to develop scientific explanations, and describes how the necessarily imperfect connection between science and truth leads to researchers’ values influencing their findings. The resulting book is a tour de force, a synthesis of the study of idealization that also offers countless new insights and avenues for future exploration. (shrink)

A number of philosophers have recently argued that we should interpret the debate over moral responsibility as a debate over the conditions under which it would be “fair” to blame a person for her attitudes or conduct. What is distinctive about these accounts is that they begin with the stance of the moral judge, rather than that of the agent who is judged, and make attributions of responsibility dependent upon whether it would be fair or appropriate for a moral judge (...) to react to the agent in various (negative) ways. This is problematic, I argue, because our intuitions about whether and when it would be fair to react negatively to another are sensitive to a host of considerations that appear to have little or nothing to do with an agent’s responsibility or culpability for her attitudes or behavior. If this is correct, then theories which make attributions of responsibility dependent upon the appropriateness of our reactions as moral judges will turn out to be fundamentally misguided. (shrink)

Using data collected at two phases, this study examines why and how ethical leadership behavior influences employees’ evaluations of organization-focused justice, i.e., procedural justice and distributive justice. By proposing ethical leaders as moral agents of the organization, we build up the linkage between ethical leadership behavior and the above two types of organization-focused justice. We further suggest trust in organization as a key mediating mechanism in the linkage. Our findings indicate that ethical leadership behavior engenders employees’ trust in their employing (...) organization, which in turn promotes their justice perceptions toward the organization. The theoretical and practical implications of these findings are discussed, and some directions for future research are suggested. (shrink)

ABSTRACTIt has recently become fashionable among those who write on questions of moral responsibility to distinguish two different concepts, or senses, of moral responsibility via the labels ‘responsibility as attributability’ and ‘responsibility as accountability’. Gary Watson was perhaps the first to introduce this distinction in his influential 1996 article ‘Two Faces of Responsibility’ , but it has since been taken up by many other philosophers. My aim in this study is to raise some questions and doubts about this distinction and (...) to argue that it has led to confusion rather than clarification in debates over moral responsibility. In place of the attributability/accountability distinction, I propose that there is a single concept of moral responsibility underlying our actual moral practices. This core notion of moral responsibility, which I call ‘responsibility as answerability’, is well positioned to explain thos.. (shrink)

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

Recently, a number of philosophers have begun to question the commonly held view that choice or voluntary control is a precondition of moral responsibility. According to these philosophers, what really matters in determining a person’s responsibility for some thing is whether that thing can be seen as indicative or expressive of her judgments, values, or normative commitments. Such accounts might therefore be understood as updated versions of what Susan Wolf has called “real self views,” insofar as they attempt to ground (...) an agent’s responsibility for her actions and attitudes in the fact (when it is a fact) that they express who she is as a moral agent. As such, they seem to be open to some of the same objections Wolf originally raised to such accounts, and in particular to the objection that they cannot license the sorts of robust moral assessments involved in our current practices of moral responsibility. My aim in this paper is to try to respond to this challenge, by clarifying the kind of robust moral assessments I take to be licensed by (at least some) non-volitional accounts of responsibility and by explaining why these assessments do not in general require the agent to have voluntary control over everything for which she is held responsible. I also argue that the limited applicability of the distinction between “bad agents” and “blameworthy agents” on these accounts is in fact a mark in their favor. (shrink)

The Humility Thesis is a persistent thesis in contemporary metaphysics. It is known by a variety of names, including, but not limited to, Humility, Intrinsic Humility, Kantian Humility, Kantian Physicalism, Intrinsic Ignorance, Categorical Ignorance, Irremediable Ignorance, and Noumenalism. According to the thesis, we human beings, and any knowers that share our general ways of knowing, are irremediably ignorant of a certain class of properties that are intrinsic to material entities … Continue reading Humility Regarding Intrinsic Properties →.

International research, sponsored by for-profit companies, is regularly criticised as unethical on the grounds that it exploits research subjects in developing countries. Many commentators agree that exploitation occurs when the benefits of cooperative activity are unfairly distributed between the parties. To determine whether international research is exploitative we therefore need an account of fair distribution. Procedural accounts of fair bargaining have been popular solutions to this problem, but I argue that they are insufficient to protect against exploitation. I argue instead (...) that a maximin principle of fair distribution provides a more compelling normative account of fairness in relationships characterised by extreme vulnerability and inequality of bargaining potential between the parties. A global tax on international research would provide a mechanism for implementing the maximin account of fair benefits. This model has the capacity to ensure fair benefits and thereby prevent exploitation in international research. (shrink)

Philosophers traditionally recognize two main features of mental states: intentionality and phenomenal consciousness. To a first approximation, intentionality is the aboutness of mental states, and phenomenal consciousness is the felt, experiential, qualitative, or "what it's like" aspect of mental states. In the past few decades, these features have been widely assumed to be distinct and independent. But several philosophers have recently challenged this assumption, arguing that intentionality and consciousness are importantly related. This article overviews the key views on the relationship (...) between consciousness and intentionality and describes our favored view, which is a version of the phenomenal intentionality theory, roughly the view that the most fundamental kind of intentionality arises from phenomenal consciousness. (shrink)

The concept of ‘ownership’ is increasingly central to debates, in the media, health policy and bioethics, about the appropriate management of clinical data. I argue that the language of ownership acts as a metaphor and reflects multiple concerns about current data use and the disenfranchisement of citizens and collectives in the existing data ecosystem. But exactly which core interests and concerns ownership claims allude to remains opaque. Too often, we jump straight from ‘ownership’ to ‘private property’ and conclude ‘the data (...) belongs to the patient’. I will argue here that private property is only one type of relevant relationship between people, communities and data. There are several reasons to doubt that conceptualising data as private property presents a compelling response to concerns about clinical data ownership. In particular I argue that clinical data are co-constructed, so a property account would fail to confer exclusive rights to the patient. A non-property account of ownership acknowledges that the data are ‘about the patient’, and therefore the patient has relevant interests, without jumping to the conclusion that the data ‘belongs to the patient’. On this broader account of ownership, the relevant harm is the severing of the connection between the patient and their data, and the solution is to re-engage and re-connect patients to the data research enterprise. (shrink)

There is increasing attention to the centrality of idealization in science. One common view is that models and other idealized representations are important to science, but that they fall short in one or more ways. On this view, there must be an intermediary step between idealized representation and the traditional aims of science, including truth, explanation, and prediction. Here I develop an alternative interpretation of the relationship between idealized representation and the aims of science. In my view, continuing, widespread idealization (...) calls into question the idea that science aims for truth. I argue that understanding must replace truth as the ultimate epistemic aim of science. Additionally, science has a wide variety aims, epistemic and non-epistemic, and these aims motivate different kinds of scientific products. Finally, I show how these diverse aims---all rather distant from truth---result in the expanded influence of social values on science. (shrink)

The concept of hierarchical organization is commonplace in science. Subatomic particles compose atoms, which compose molecules; cells compose tissues, which compose organs, which compose organisms; etc. Hierarchical organization is particularly prominent in ecology, a field of research explicitly arranged around levels of ecological organization. The concept of levels of organization is also central to a variety of debates in philosophy of science. Yet many difficulties plague the concept of discrete hierarchical levels. In this paper, we show how these difficulties undermine (...) various implications ascribed to hierarchical organization, and we suggest the concept of scale as a promising alternative to levels. Investigating causal processes at different scales offers a way to retain a notion of quasi-levels that avoids the difficulties inherent in the classic concept of hierarchical levels of organization. Throughout, our focus is on ecology, but the results generalize to other invocations of hierarchy in science and philosophy of science. (shrink)

In this paper I discuss two questions. What does Kant understand by mechanical explanation in the Critique of judgment? And why does he think that mechanical explanation is the only type of the explanation of nature available to us? According to the interpretation proposed, mechanical explanations in the Critique of judgment refer to a particular species of empirical causal laws. Mechanical laws aim to explain nature by reference to the causal interaction between the forces of the parts of matter and (...) the way in which they form into complex material wholes. Just like any other empirical causal law, however, mechanical laws can never be known with full certainty. The conception according to which we can explain all of nature by means of mechanical laws, it turns out, is based on what Kant calls ‘regulative’ or ‘reflective’ considerations about nature. Nothing in Kant’s Critique of judgment suggests that these considerations can ever be justified by reference to how the natural world really is. I suggest that what, upon first consideration, appears to be a thoroughly mechanistic conception of nature in Kant is much more limited than one might have expected. (shrink)

Two groups of scientists have just announced what is being described as a leap forward in human stem cell research.1–3 Both have found ways of producing what are being called “induced pluripotent cells” , stem cells that they hope will demonstrate the same key properties of regeneration and unrestricted differentiation that human embryonic stem cells possess, but which are derived from skin cells not from embryos. In simple terms, these scientists have succeeded in reprogramming skin cells to behave like hESCs.Stem (...) cell research has been hailed as one of the most important and exciting areas of science, because it is believed that these types of cells will not only play an important part in regenerative medicine, but also yield valuable scientific information. These latest developments in cell reprogramming represent a milestone for stem cell science. No longer does the paradigm of irreversible cell specialisation hold true; instead, almost any type of cell might have the potential to become any other.The advent of techniques for producing these iPCs has also been hailed as an ethical breakthrough. Up until now, the production of hESCs has required a process which involves the destruction of embryos. Many of these embryos are available as by-products of IVF; but in addition, the process of somatic cell nuclear transfer to produce cloned embryonic stem cells requires a supply of human oocytes, which must currently be harvested from female donors at no insignificant cost. In a nutshell, iPCs seem to enable us to produce “embryo-free” human pluripotent stem cells, and in a “gender-neutral” way—that is, without the need for human oocytes.The response from the scientific community, ethical commentators and the public has, however, reflected an inherent confusion over the ethical significance of this research. The anti-embryo …. (shrink)

The purpose of this article is to show that animal rights are not necessarily at odds with the use of animals for research. If animals hold basic moral rights similar to those of humans, then we should consequently extend the ethical requirements guiding research with humans to research with animals. The article spells out how this can be done in practice by applying the seven requirements for ethical research with humans proposed by Ezekiel Emanuel, David Wendler and Christine Grady to (...) animal research. These requirements are i) social value, ii) scientific validity, iii) independent review, iv) fair subject selection, v) favorable risk-benefit ratio, vi) informed consent, and vii) respect for research subjects. In practice, this means that we must reform the practice of animal research to make it more similar to research with humans, rather than completely abolish the former. Indeed, if we banned animal research altogether, then we would also deprive animals of its potential benefits – which would be ethically problematic. (shrink)

The purpose of this study is to examine how faith-led practices in family firms affect organizational stewardship. Current studies highlight the relevance of religious adherence for family businesses, yet provide limited understanding of how this shapes the key traits of these organizations. Drawing on six autobiographies of family business leaders who openly express their adherence to their faith, and adopting an open-systems analysis of these autobiographies, we demonstrate that faith-led values influence organizational and leadership practices. Overall, our study suggests that (...) the influence of religious beliefs in the organizational practices of family businesses have greater repercussions than previously thought. By introducing a faith-led approach to stewardship, we enrich the theoretical discussion around stewardship and the relevance of religion in family business. (shrink)

The purpose of this study is to examine how faith-led practices in family firms affect organizational stewardship. Current studies highlight the relevance of religious adherence for family businesses, yet provide limited understanding of how this shapes the key traits of these organizations. Drawing on six autobiographies of family business leaders who openly express their adherence to their faith, and adopting an open-systems analysis of these autobiographies, we demonstrate that faith-led values influence organizational and leadership practices. Overall, our study suggests that (...) the influence of religious beliefs in the organizational practices of family businesses have greater repercussions than previously thought. By introducing a faith-led approach to stewardship, we enrich the theoretical discussion around stewardship and the relevance of religion in family business. (shrink)

In this paper, I first outline the view developed in my recent book on the role of idealization in scientific understanding. I discuss how this view leads to the recognition of a number of kinds of variability among scientific representations, including variability introduced by the many different aims of scientific projects. I then argue that the role of idealization in securing understanding distances understanding from truth, but that this understanding nonetheless gives rise to scientific knowledge. This discussion will clarify how (...) my view relates to three other recent books on understanding by Henk de Regt, Catherine Elgin, and Kareem Khalifa. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

Causal accounts of scientific explanation are currently broadly accepted (though not universally so). My first task in this paper is to show that, even for a causal approach to explanation, significant features of explanatory practice are not determined by settling how causal facts bear on the phenomenon to be explained. I then develop a broadly causal approach to explanation that accounts for the additional features that I argue an explanation should have. This approach to explanation makes sense of several aspects (...) of actual explanatory practice, including the widespread use of equilibrium explanations, the formulation of distinct explanations for a single event, and the tight relationship between explanations of events and explanations of causal regularities. (shrink)

I argue for the unity of imagination in two prima facie diverse contexts: experiences of beauty and achievements of understanding. I develop my argument in three steps. First, I begin by describing a type of aesthetic experience that is grounded in a set of imaginative activities on the part of the person having the experience. Second, I argue that the same set of imaginative activities that grounds this type of aesthetic experience also contributes to achievements of understanding. Third, I show (...) that my unified account of imagination has important implications: it sheds light on two puzzling phenomena, the aesthetic value of science and the cognitive value of art. (shrink)

The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of (...) particular value. However, several different terms are used to refer to this value, indicating a lack of conceptual clarity regarding the appropriate test for access to health data for research without consent. In this paper we do three things. First we describe the current confusion and instability in terminology relating to public interest in the context of consent waivers. Second we argue for harmonisation of terminology on the grounds of clarity, transparency and consistency. Third we argue that the term ‘public interest’ best reflects the normative work required to justify consent waivers because it is the broadest of the competing terms. ‘Public interest’ contains within its scope positive and negative implications of a study, as well as welfare, justice and rights considerations. In making this argument, we explain the normative basis for consent waivers, and provide a starting place for further discussion about the precise conditions in which a given study can be said to advance the public interest. Ipsos MORI study found that: … the public would be broadly happy with administrative data linking for research projects provided Those projects have social value, broadly defined. Data are de-identified. Data are kept secure. Businesses are not able to access the data for profit. (shrink)

In this paper, we describe four broad ‘meta-methods’ employed in scientific and philosophical research of qualia. These are the theory-centred metamethod, the property-centred meta-method, the argument-centred meta-method, and the event-centred meta-method. Broadly speaking, the theory-centred meta-method is interested in the role of qualia as some theoretical entities picked out by our folk psychological theories; the property-centred meta-method is interested in some metaphysical properties of qualia that we immediately observe through introspection ; the argument-centred meta-method is interested in the role of (...) qualia in some arguments for non-physicalism; the event-centred metamethod is interested in the role of qualia as some natural events whose nature is hidden and must be uncovered empirically. We will argue that the event-centred metamethod is the most promising route to a comprehensive scientific conception of qualia because of the flexibility of ontological and methodological assumptions it can provide. We also reveal the hidden influences of the different meta-methods and in doing so show why consideration of meta-methods has value for the study of consciousness. (shrink)

A common argument against explanatory reductionism is that higher‐level explanations are sometimes or always preferable because they are more general than reductive explanations. Here I challenge two basic assumptions that are needed for that argument to succeed. It cannot be assumed that higher‐level explanations are more general than their lower‐level alternatives or that higher‐level explanations are general in the right way to be explanatory. I suggest a novel form of pluralism regarding levels of explanation, according to which explanations at different (...) levels are preferable in different circumstances because they offer different types of generality, which are appropriate in different circumstances of explanation. (shrink)

Debate about cognitive science explanations has been formulated in terms of identifying the proper level(s) of explanation. Views range from reductionist, favoring only neuroscience explanations, to mechanist, favoring the integration of multiple levels, to pluralist, favoring the preservation of even the most general, high-level explanations, such as those provided by embodied or dynamical approaches. In this paper, we challenge this framing. We suggest that these are not different levels of explanation at all but, rather, different styles of explanation that capture (...) different, cross-cutting patterns in cognitive phenomena. Which pattern is explanatory depends on both the cognitive phenomenon under investigation and the research interests occasioning the explanation. This reframing changes how we should answer the basic questions of which cognitive science approaches explain and how these explanations relate to one another. On this view, we should expect different approaches to offer independent explanations in terms of their different focal patterns and the value of those explanations to partly derive from the broad patterns they feature. (shrink)

Public-private partnerships are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector (...) health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. (shrink)

This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population‐level research and big data because it results in a primary focus on consent (meta‐, broad, dynamic and/or specific consent). Two recent guidelines – the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health‐related research involving humans – both focus on the growing reliance on health data (...) for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Many current and future uses of health data make individual consent impractical, if not impossible. Many of the risks of secondary data use apply to communities and stakeholders rather than individual data subjects. Shifting from a research ethics perspective to a public health lens brings a different set of issues into view: how are the benefits and burdens of data use distributed, how can data research empower communities, who has legitimate decision‐making capacity? I propose that a public health ethics framework – based on public benefit, proportionality, equity, trust and accountability – provides more appropriate tools for assessing the ethical uses of health data. The main advantage of a public health approach for data research is that it is more likely to foster debate about power, justice and equity and to highlight the complexity of deciding when data use is in the public interest. (shrink)

The value of optimality modeling has long been a source of contention amongst population biologists. Here I present a view of the optimality approach as at once playing a crucial explanatory role and yet also depending on external sources of confirmation. Optimality models are not alone in facing this tension between their explanatory value and their dependence on other approaches; I suspect that the scenario is quite common in science. This investigation of the optimality approach thus serves as a case (...) study, on the basis of which I suggest that there is a widely felt tension in science between explanatory independence and broad epistemic interdependence, and that this tension influences scientific methodology. (shrink)

Scientific explanations must bear the proper relationship to the world: they must depict what, out in the world, is responsible for the explanandum. But explanations must also bear the proper relationship to their audience: they must be able to create human understanding. With few exceptions, philosophical accounts of explanation either ignore entirely the relationship between explanations and their audience or else demote this consideration to an ancillary role. In contrast, I argue that considering an explanation’s communicative role is crucial to (...) any satisfactory account of explanation. (shrink)