According to Kant’s Universal Law Formula, maxims that cannot be conceived as universal laws denote duties of perfect obligation. In the recent literature, two versions of the Contradiction in Conception test have received the most attention. When acting on a maxim would violate a perfect duty, according to the Logical Contradiction Interpretation (LCI), universalizing the maxim would make it literally impossible to perform the action as described in the original maxim. According to the Practical Contradiction Interpretation (PCI), the locus (...) of the contradiction is as follows: the agent acts on the maxim in order to achieve some purpose, but were the agent’s maxim universalized, the purpose would be unattainable. Having examined the most widely accepted versions of both interpretations, I argue that i) PCI cannot generate contradictions for the maxims of any actions that violate perfect duties beyond those generated by LCI, ii) despite claims of its proponents, PCI cannot solve the vexing problem of relevant descriptions that Kant’s account faces, and iii) other arguments in favor of PCI are at best inconclusive. I therefore conclude that since LCI better coheres with the text, sympathetic interpreters should focus their efforts on LCI, not PCI. (shrink)

In the Australian state of Victoria, legislation allowing voluntary assisted dying (VAD) passed through parliament in November 2017. There was then an eighteen-month period before the start date for patient access to VAD, referred to as the “implementation period.” The implementation period was intended to allow time for the relevant government department and affected organizations to develop processes before the Act came into effect in June 2019. This qualitative interview study investigates the perspectives of a multidisciplinary sample of twelve clinicians (...) from a single metropolitan hospital during this implementation period. Maximum variation sampling was utilized to ensure breadth across discipline (medical, nursing, allied health), speciality, and stated level of support for the VAD legislation. Four key themes were identified from the interview data: preparing for the unknown, ethical diversity within the organization, building a respectful culture, and concerns about the inability of the legislated approach to capture clinical nuances. Overall, these clinicians’ workplace experiences during the implementation period were shaped by the ethical diversity within their organization and a sense of uncertainty about how the VAD legislation would integrate with the practical realities of their clinical setting. The concept of “ethical diversity” could be a useful one for supporting staff in an organization during a VAD implementation period. (shrink)

A number of philosophers have claimed that we should take not just empirical uncertainty but also fundamental moral uncertainty into account in our decision-making, and that, despite widespread moral disagreement, doing so would allow us to draw robust lessons for some issues in practical ethics. In this article, I argue that, so far, the implications for practical ethics have been drawn too simplistically. First, the implications of moral uncertainty for normative ethics are far more wide-ranging (...) than has been noted so far. Second, one can't straightforwardly argue from moral uncertainty to particular conclusions in practical ethics, both because of ‘interaction’ effects between moral issues, and because of the variety of different possible intertheoretic comparisons that one can reasonably endorse. (shrink)

A shared presumption among practice-dependent theorists is that a principle of justice is dependent on the function or aim of the practice to which it is supposed to be applied. In recent contributions to this debate, the condition of epistemic uncertainty plays a significant role for motivating and justifying a practice-dependent view. This paper analyses the role of epistemic uncertainty in justifying a practice-dependent approach. We see two kinds of epistemic uncertainty allegedly playing this justificatory role. What (...) we call ‘normative epistemic uncertainty’ emerges from dealing with the problem of value uncertainty in justifying applied principles when our higher-level principles are open-textured, that is, when their content is too vague or unclear to generate determinate prescriptions. What we call ‘descriptive epistemic uncertainty’ emerges from dealing with uncertainty about empirical facts, such as the problem of moral assurance, that is, the problem that the requirements of justice cannot go beyond arrangements that we can know with reasonable confidence that we can jointly establish and maintain. In both cases, practice-dependent theorists conclude that the condition of epistemic uncertainty justifies a practice-dependent approach, which puts certain restrictions on theorizing regulative principles and has wide-ranging practical implications for the scope of justice. Our claim in this paper is that neither kind of epistemic uncertainty justifies a practice-dependent approach. (shrink)

In light of recent advances in machine learning for medical applications, the automation of medical diagnostics is imminent. That said, before machine learning algorithms find their way into clinical practice, various problems at the epistemic level need to be overcome. In this paper, we discuss different sources of uncertainty arising for clinicians trying to evaluate the trustworthiness of algorithmic evidence when making diagnostic judgments. Thereby, we examine many of the limitations of current machine learning algorithms (with deep learning in (...) particular) and highlight their relevance for medical diagnostics. Among the problems we inspect are the theoretical foundations of deep learning (which are not yet adequately understood), the opacity of algorithmic decisions, and the vulnerabilities of machine learning models, as well as concerns regarding the quality of medical data used to train the models. Building on this, we discuss different desiderata for an uncertainty amelioration strategy that ensures that the integration of machine learning into clinical settings proves to be medically beneficial in a meaningful way. (shrink)

Regulatory science, which generates knowledge relevant for regulatory decision?making, is different from standard academic science in that it is oriented mainly towards the attainment of non?epistemic (practical) aims. The role of uncertainty and the limits to the relevance of academic science are being recognized more and more explicitly in regulatory decision?making. This has led to the introduction of regulation?specific scientific methodologies in order to generate decision?relevant data. However, recent practical experience with such non?standard methodologies indicates that they, (...) too, may be subject to important limitations. We argue that the attainment of non?epistemic values and aims (like the protection of human health and the environment) requires not only control of the quality of the data and the methodologies, but also the selection of the level of regulation deemed adequate in each specific case (including a decision about which of the two, under?regulation or over?regulation, would be more acceptable). (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a qualitative approach (...) to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

Explores the ethical issues faced by GPs in their everyday practice, addressing two central themes; the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities.

Volume 75, Issue 5-6, 2019, Page 376-380.

The article discusses the theoretical status of the category of uncertainty. Instead of the classical definitions of uncertainty as an ontological or epistemological concept, a composite theoretical construct is proposed. In classical science, the objectivist representation of the subject of research was preferred. With the nonclassical type of rationality, there rises problem of including subjective elements in a theoretical description. Attention to subject-subject-object methodologies is increasing due to the complication of communicative interactions in science and society in the (...) digital era. One of the consequences of active innovative projective activity on a planetary scale and increasing risks is the perception in the public mind of uncertainty as a challenge. The author considers it appropriate to study the uncertainty-certainty as a paired category. The category of uncertainty was considered in philosophy, science, and management. The status of uncertainty as infinity and formlessness was recognized by Greek natural philosophers. Classical science developed the methodology of knowing the “infinite limit” through the construction of theoretical schemes (forms) and types of empirical testing. The paradox served as a means of destroying dogmatic schemes. In the context of increasingly complex communications in science, the importance of cognitive problems in the study of collective thinking and the personal beginning of creativity is increasing. Modern economic positivism is distinguished by its rejection of objective uncertainty, and the installation of the ability to efficiently manage exclusively accurate calculations is brought to extremes. (shrink)

This qualitative social scientific interview study delves into the ways in which professional vision is constructed in clinical ethics consultation (CEC). The data consist of 11 semi-structured interviews that were conducted with clinical ethics consultants currently working in hospitals in one major urban area in the U.S. The interviews were analyzed with the qualitative research method of critical discourse analysis, with a focus on identifying the cultural structures of knowledge that shape CEC as a professional practice. The discourses were first (...) identified as belonging to two higher discourse categories, order and agency. Order was divided into three lower categories, emotional, managerial, and rational order, and discourses of agency into the lower categories of exploration, technique, deliberation, and distancing. An additional discourse of neutral interaction was identified as a bridging discourse, activated to level tensions emerging out of conflicting goals and agencies embedded in CEC practice. This analysis brings out as its main observation that clinical ethics consultants draw on and shift between potentially ideologically conflicting social positions that can create built-in tensions within the professional domain. The study calls attention to these tensions and suggests for the professional group to discuss the possibility of defining priorities between different kinds of order, identified in this study, that shape the CEC domain. (shrink)

Uncertainty is recognized as a key issue in water resources research, amongst other sciences. Discussions of uncertainty typically focus on tools and techniques applied within an analysis, e.g. uncertainty quantification and model validation. But uncertainty is also addressed outside the analysis, in writing scientific publications. The language that authors use conveys their perspective of the role of uncertainty when interpreting a claim —what we call here “framing” the uncertainty. This article promotes awareness of (...) class='Hi'>uncertainty framing in four ways. 1) It proposes a typology of eighteen uncertainty frames, addressing five questions about uncertainty. 2) It describes the context in which uncertainty framing occurs. This is an interdisciplinary topic, involving philosophy of science, science studies, linguistics, rhetoric, and argumentation. 3) We analyze the use of uncertainty frames in a sample of 177 abstracts from the Water Resources Research journal in 2015. This helped develop and tentatively verify the typology, and provides a snapshot of current practice. 4) Provocative recommendations promote adjustments for a more influential, dynamic science. Current practice in uncertainty framing might be described as carefully-considered incremental science. In addition to uncertainty quantification and degree of belief (present in ~5% of abstracts), uncertainty is addressed by a combination of limiting scope, deferring to further work (~25%) and indicating evidence is sufficient (~40%) – or uncertainty is completely ignored (~8%). There is a need for public debate within our discipline to decide in what context different uncertainty frames are appropriate. Uncertainty framing cannot remain a hidden practice evaluated only by lone reviewers. (shrink)

Business Ethics: A European Review, EarlyView.

This article explores the question of how scientific uncertainty can be managed in medical decision making using the Advisory Committee on Immunization Practices as a case study. It concludes that where a high degree of technical consensus exists about the evidence and data, decision makers act according to a clear decision rule. If a high degree of technical consensus does not exist and uncertainty abounds, the decision will be based on a variety of criteria, including readily available resources, (...) decision-process constraints, and the available knowledge base, among other things. Decision makers employ a variety of heuristic devices and techniques, thereby employing a pragmatic approach to uncertainty in medical decision making. The article concludes with recommendations for managing scientific uncertainty in medical decision making. (shrink)

The ‘multicultural clinical interaction’ presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges - how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of ‘obsessive compulsive disorder’ (OCD), and how to differentiate ‘normative’ religious or spiritual beliefs, behaviours, and experiences from ‘psychotic’ illnesses. When it comes to understanding service user’s ‘idioms of distress’, beliefs about how culture influences behaviour can create considerable confusion and (...) ‘normative uncertainty’ for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between ‘culture’ and ‘psychopathology’, practitioners have had to rely on their own intuition and seek out possible ‘strategies’ or ‘procedures’ from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users’ experiences may result in the pathologisation of culturally ‘normative’ phenomenon, ‘category fallacy’ errors, and poor health care experiences and outcomes for service users. This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of ‘normality’ or ‘abnormality’. Indeed, issues that arise from dilemmas surrounding the question of ‘culture’ or ‘psychopathology’ are intimately tied to wider cultural ideas about what is considered ‘normal’. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as ‘normal’, ‘abnormal’, or ‘pathological’. Three models for understanding mental ‘abnormality’ are evident in ‘transcultural psychiatry’ (what is now commonly known as ‘cultural psychiatry’), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of human societies. The three models of ‘absolutism’, ‘universalism’ and ‘cultural relativism’ have not only important consequences for the nature and conduct of research enquiry, but also have implications for how the dilemma of ‘culture’ or ‘psychopathology’ is attended to in clinical practice. (shrink)

It has been argued that evolutionary considerations favour utilitarianism by selectively debunking its competitors. However, evolutionary considerations also seem to undermine the practical significance of utilitarianism, since commonsense beliefs about well-being seem like prime candidates for evolutionary debunking. We argue that the practical significance of utilitarianism is not undermined in this way if we understand the requirements of practical rationality as sensitive to normative uncertainty. We consider the view that rational decision-making under normative uncertainty requires (...) maximizing expected choice-worthiness, as well as the possibility that different theories’ choice-worthiness rankings are not all interval-scale measurable or intertheoretically comparable. Finally, we suggest how evolutionary considerations may increase the practical significance of utilitarianism even if belief in utilitarianism is debunked by evolutionary considerations, so long as belief in competing theories is undermined to an even greater extent. (shrink)

Labyrinths have held the fascination of people since ancient times. Although walking a labyrinth can simply be an interesting recreation, it has increasingly been seen as an intentional tool for personal or spiritual growth. Religious and spiritual experience is generally understood to be a product of the kinds of evidence given within the experience as well as the person’s cognitive and emotional attributions. This article offers a phenomenological perspective which identifies a set of critical elements in the generation of the (...) person’s experience. These include the individual narrative of the participant, the place narrative of the labyrinth, the geometric structure of the place, and the person’s internal and behavioral practice within the place. Through the exploration of each of these elements and their interactions, it is shown that the potential for personal and spiritual experience when walking the labyrinth is related to several processes. The first is simply the walker’s ongoing intentional participation in the experience. The second is the interaction between the place narrative and the individual’s narrative, particularly as it relates to the person’s relevant concern. This interaction affects the person’s expectations and attributions during and after the experience. Two final processes, however, the individual practice and the place geometry, create the evidentiary basis for the labyrinth’s deepest experiences. The embodied, cognitive, and emotional resolution of the unexpected dynamic uncertainty regarding place, movement, and outcome created by the geometric and informational nature of labyrinths, can prove experientially potent. (shrink)

Assessment of error and uncertainty is a vital component of both natural and social science. This edited volume presents case studies of research practices across a wide spectrum of scientific fields. It compares methodologies and presents the ingredients needed for an overarching framework applicable to all.

ABSTRACT This paper reflects on how the issue of climate change and the general state of our planet is, among other causes, a main factor in the paralyzing divisions ailing Western societies. This situation, while unsettling to democracies, is promoting a kind of education in and through fear and I question if education can succeed under these circumstances without becoming indoctrination. This paper does not try to diminish the urgency and the importance of current environmental problems but rather expands today´s (...) perspectives and incorporates research in more constructive ways of thinking and doing. I use scientific contributions in climatology, evolution, environmental conservation, economics, and neuroscience to bring new light to today’s investigations about the human and the non-human world. Finally, I propose Deep Ecology’s principles of deep questioning, deep experience and deep commitment, as a guide for new educational and ecological practices. (shrink)

This paper examines how scientists conceptualize their research methodologies. Do scientists raise concerns about vague criteria and genuine uncertainties in experimental practice? If so, what sorts of issues do they identify as problematic? Do scientists acknowledge the presence of value judgments in scientific research, and do they reflect on the relation between epistemic and non-epistemic criteria for decisionmaking? We present findings from an analysis of qualitative interviews with 63 scientific researchers who talk about their views on good research practice. We (...) argue that analysts of science should care about scientists’ conceptualizations of the criteria and of the practical judgments that scientific inquiry involves. While scientists’ accounts of their own research methodologies alone do not give us a full picture of how science really works, they can point us to areas of concern. They can inspire and direct philosophical reflections about how science works. Throughout the interviews, the participating researchers provided specific examples from their own research contexts as illustrations of their methodological points. These examples reveal that scientists often struggle to evaluate the quality of their data, to figure out whether the available evidence confirms their hypothesis, whether a replication was successful, or to what extent they can rely on peer-reviewed papers. General ideas about good research methods do not directly translate into specific evaluation criteria or strategies that can guide research and help validate empirical data. (shrink)

This paper examines how scientists conceptualize their research methodologies. Do scientists raise concerns about vague criteria and genuine uncertainties in experimental practice? If so, what sorts of issues do they identify as problematic? Do scientists acknowledge the presence of value judgments in scientific research, and do they reflect on the relation between epistemic and non-epistemic criteria for decisionmaking? We present findings from an analysis of qualitative interviews with 63 scientific researchers who talk about their views on good research practice. We (...) argue that analysts of science should care about scientists’ conceptualizations of the criteria and of the practical judgments that scientific inquiry involves. While scientists’ accounts of their own research methodologies alone do not give us a full picture of how science really works, they can point us to areas of concern. They can inspire and direct philosophical reflections about how science works. Throughout the interviews, the participating researchers provided specific examples from their own research contexts as illustrations of their methodological points. These examples reveal that scientists often struggle to evaluate the quality of their data, to figure out whether the available evidence confirms their hypothesis, whether a replication was successful, or to what extent they can rely on peer-reviewed papers. General ideas about good research methods do not directly translate into specific evaluation criteria or strategies that can guide research and help validate empirical data. (shrink)

Modern health data practices come with many practical uncertainties. In this paper, I argue that data subjects’ trust in the institutions and organizations that control their data, and their ability to know their own moral obligations in relation to their data, are undermined by significant uncertainties regarding the what, how, and who of mass data collection and analysis. I conclude by considering how proposals for managing situations of high uncertainty might be applied to this problem. These emphasize increasing (...) organizational flexibility, knowledge, and capacity, and reducing hazard. (shrink)

In this essay, we explore an issue of moral uncertainty: what we are permitted to do when we are unsure about which moral principles are correct. We develop a novel approach to this issue that incorporates important insights from previous work on moral uncertainty, while avoiding some of the difficulties that beset existing alternative approaches. Our approach is based on evaluating and choosing between option sets rather than particular conduct options. We show how our approach is particularly well-suited (...) to address this issue of moral uncertainty with respect to agents that have credence in moral theories that are not fully consequentialist. (shrink)

Nobody's going to object to the advice "Do the right thing", but that doesn't mean everyone's always going to follow it. Sometimes this is because of our volitional limitations; we cannot always bring ourselves to make the sacrifices that right action requires. But sometimes this is because of our cognitive limitations; we cannot always be sure of what is right. Sometimes we can't be sure of what's right because we don't know the non-normative facts. But sometimes, even if we were (...) to know all of the non-normative facts, we'd still not be sure about what's right, because we're uncertain about the normative reasons those facts give us. In this dissertation, I attempt to answer the question of what we're to do when we must act under fundamentally normative uncertainty. It's tempting to think that, in such circumstances, we should do what we regard as most probably right. I argue that this view is mistaken, for it is insensitive to how degrees of actions' values compare across different normative hypotheses; if an action is probably right, but, if wrong, is terribly, terribly, wrong, it may be rational not to do that action. A better answer is that we should do the action with the highest expected value. I spend the first part of the dissertation providing arguments for and rebutting arguments against this view of action under normative uncertainty. I spend the next part of the dissertation explaining what degrees of value are, and showing how they can be compared across normative hypotheses. In the remaining parts of the dissertation, I consider two questions related to our primary question -- first, what is one required, or obligated, to do under normative uncertainty; and second, what is it rational for one to do when one is not only normatively uncertain in the way we've been discussing, but also uncertain about what it is rational to do under this sort of normative uncertainty. (shrink)

Defenders of deontological constraints in normative ethics face a challenge: how should an agent decide what to do when she is uncertain whether some course of action would violate a constraint? The most common response to this challenge has been to defend a threshold principle on which it is subjectively permissible to act iff the agent's credence that her action would be constraint-violating is below some threshold t. But the threshold approach seems arbitrary and unmotivated: what would possibly determine where (...) the threshold should be set, and why should there be any precise threshold at all? Threshold views also seem to violate ought agglomeration, since a pair of actions each of which is below the threshold for acceptable moral risk can, in combination, exceed that threshold. In this paper, I argue that stochastic dominance reasoning can vindicate and lend rigor to the threshold approach: given characteristically deontological assumptions about the moral value of acts, it turns out that morally safe options will stochastically dominate morally risky alternatives when and only when the likelihood that the risky option violates a moral constraint is greater than some precisely definable threshold (in the simplest case, .5). I also show how, in combination with the observation that deontological moral evaluation is relativized to particular choice situations, this approach can overcome the agglomeration problem. This allows the deontologist to give a precise and well-motivated response to the problem of uncertainty. (shrink)

In ‘Normative Uncertainty as a Voting Problem’, William MacAskill argues that positive credence in ordinal-structured or intertheoretically incomparable normative theories does not prevent an agent from rationally accounting for her normative uncertainties in practical deliberation. Rather, such an agent can aggregate the theories in which she has positive credence by methods borrowed from voting theory—specifically, MacAskill suggests, by a kind of weighted Borda count. The appeal to voting methods opens up a promising new avenue for theories of rational (...) choice under normative uncertainty. The Borda rule, however, is open to at least two serious objections. First, it seems implicitly to ‘cardinalize’ ordinal theories, and so does not fully face up to the problem of merely ordinal theories. Second, the Borda rule faces a problem of option individuation. MacAskill attempts to solve this problem by invoking a measure on the set of practical options. But it is unclear that there is any natural way of defining such a measure that will not make the output of the Borda rule implausibly sensitive to irrelevant empirical features of decision-situations. After developing these objections, I suggest an alternative: the McKelvey uncovered set, a Condorcet method that selects all and only the maximal options under a strong pairwise defeat relation. This decision rule has several advantages over Borda and mostly avoids the force of MacAskill’s objection to Condorcet methods in general. (shrink)

We are sometimes unsure of the moral status of our relationships with other entities. Recent case studies in this uncertainty include our relationships with artificial agents (robots, assistant AI, etc.), animals, and patients with “locked-in” syndrome. Do these entities have basic moral standing? Could they count as true friends or lovers? What should we do when we do not know the answer to these questions? An influential line of reasoning suggests that, in such cases of moral uncertainty, we (...) need meta-moral decision rules that allow us to either minimize the risks of moral wrongdoing or improve the choice-worthiness of our actions. One particular argument adopted in this literature is the “risk asymmetry argument,” which claims that the risks associated with accepting or rejecting some moral facts may be sufficiently asymmetrical as to warrant favoring a particular practical resolution of this uncertainty. Focusing on the case study of artificial beings, this article argues that this is best understood as an ethical-epistemic challenge. The article argues that taking potential risk asymmetries seriously can help resolve disputes about the status of human–AI relationships, at least in practical terms (philosophical debates will, no doubt, continue); however, the resolution depends on a proper, empirically grounded assessment of the risks involved. Being skeptical about basic moral status, but more open to the possibility of meaningful relationships with such entities, may be the most sensible approach to take. (shrink)

Policymakers who seek to make scientifically informed decisions are constantly confronted by scientific uncertainty and expert disagreement. This thesis asks: how can policymakers rationally respond to expert disagreement and scientific uncertainty? This is a work of non-ideal theory, which applies formal philosophical tools developed by ideal theorists to more realistic cases of policymaking under scientific uncertainty. I start with Bayesian approaches to expert testimony and the problem of expert disagreement, arguing that two popular approaches— supra-Bayesianism and the (...) standard model of expert deference—are insufficient. I develop a novel model of expert deference and show how it can deal with many of these problems raised for them. I then turn to opinion pooling, a popular method for dealing with disagreement. I show that various theoretical motivations for pooling functions are irrelevant to realistic policymaking cases. This leads to a cautious recommendation of linear pooling. However, I then show that any pooling method relies on value judgements, that are hidden in the selection of the scoring rule. My focus then narrows to a more specific case of scientific uncertainty: multiple models of the same system. I introduce a particular case study involving hurricane models developed to support insurance decision-making. I recapitulate my analysis of opinion pooling in the context of model ensembles, confirming that my hesitations apply. This motivates a shift of perspective, to viewing the problem as a decision theoretic one. I rework a recently developed ambiguity theory, called the confidence approach, to take input from model ensembles. I show how it facilitates the resolution of the policymaker’s problem in a way that avoids the issues encountered in previous chapters. This concludes my main study of the problem of expert disagreement. In the final chapter, I turn to methodological reflection. I argue that philosophers who employ the mathematical methods of the prior chapters are modelling. Employing results from the philosophy of scientific models, I develop the theory of normative modelling. I argue that it has important methodological conclusions for the practice of formal epistemology, ruling out popular moves such as searching for counterexamples. (shrink)

The British National Institute for Health and Clinical Excellence has recently released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder. Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising (...) uncertainty, NICE risks reifying a controversial category. This is particularly problematical given that the guidelines recommend the identification of individuals “at risk” of raising antisocial children. Although this paper does not argue that NICE is “wrong” in any of its recommendations, more emphasis should have been placed on discussions of the ethical implications of diagnosis and treatment, especially given the multiple uncertainties associated with ASPD. It is proposed that these important issues be examined in more detail in revisions of existing NICE recommendations, and be included in upcoming guidance. This paper thus raises key questions regarding the place and role of ethics within the current and future remit of NICE. (shrink)

The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity (...) and uncertainty as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

This article picks up from William James's pragmatism and metaphysics of experience, as expressed in his “radical empiricism,” and further develops this Jamesian pragmatist approach to uncertainty and ignorance by connecting it to phenomenological thought. The Jamesian pragmatist approach avoids both a “crude naturalism” and an “absolutist rationalism,” and allows for identification of intimations of the sacred in both scientific and religious practices—which all, in their respective ways, try to make sense of a complex world. Analogous to religious practices, (...) emotion and the metaphysics of experience play a central role in science, especially the emotion of wonder. Engaging in scientific or religious practices may create opportunities for individuals to realize that they are co-creators of the world in partnership with God, in full awareness of uncertainty and ignorance and filled with the emotion of wonder. (shrink)

While uncertainty can never be totally eliminated from clinical practice, physicians can at least come to terms with it. In interviews with Canadian physicians in a variety of clinical settings, three sources of uncertainty affecting the allocation of medical resources were identified. Technical uncertainty arises from inadequate scientific data. Personal uncertainty arises from not knowing patients' wishes. Conceptual uncertainty arises from the problem of applying abstract criteria to concrete situations.

The practice of evidence based medicine has changed the role of the physician from information dispenser to gatherer and analyser. Studies and controlled trials that may contain unknown errors, or uncertainties, are the primary sources for evidence based decisions in medicine. These sources may be corrupted by a number of means, such as inaccurate statistical analysis, statistical manipulation, population bias, or relevance to the patient in question. Regardless of whether any of these inaccuracies are apparent, the uncertainty of their (...) presence in physician information should be disclosed to the patient. These uncertainties are not, however, shared by physicians with patients, and have caused a direct increase in patient responsibilities and mistrust. Only when disclosure of uncertainty becomes commonplace in medical practice will the physician/patient relationship evolve to a level of greater understanding and satisfaction for both the physician and patient. (shrink)

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice‐based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt (...) “on the job.” We suggest that learning “on‐the‐job” is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the “invisible learning” which occurs as newly qualified nurses learn to delegate and supervise. (shrink)

This edited volume looks at whether it is possible to be more transparent about uncertainty in scientific evidence without undermining public understanding and trust. With contributions from leading experts in the field, this book explores the communication of risk and decision-making in an increasingly post-truth world. Drawing on case studies from climate change to genetic testing, the authors argue for better quality evidence synthesis to cut through the noise and highlight the need for more structured public dialogue. For (...) class='Hi'>uncertainty in scientific evidence to be communicated effectively, they conclude that trustworthiness is vital: the data and methods underlying statistics must be transparent, valid, and sound, and the numbers need to demonstrate practical utility and add social value to people's lives. Presenting a conceptual framework to help navigate the reader through the key social and scientific challenges of a post-truth era, this book will be of great relevance to students, scholars and policy makers with an interest in risk analysis and communication. (shrink)

Decision-makers face severe uncertainty when they are not in a position to assign precise probabilities to all of the relevant possible outcomes of their actions. Such situations are common—novel medical treatments and policies addressing climate change are two examples. Many decision-makers respond to such uncertainty in a cautious manner and are willing to incur a cost to avoid it. There are good reasons for taking such an uncertainty-averse attitude to be permissible. However, little work has been done (...) to incorporate it into an egalitarian theory of distributive justice. We aim to remedy this lack. We put forward a novel, uncertainty-averse egalitarian view. We analyse when the aims of reducing inequality and limiting the burdens of severe uncertainty are congruent and when they conflict, and highlight practical implications of the proposed view. We also demonstrate that if uncertainty aversion is permissible, then utilitarians must relinquish a favourite argument against egalitarianism. (shrink)

This paper develops a philosophical account of moral disruption. According to Robert Baker, moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the harm account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the qualified harm account, there (...) is no harm in cases where moral uncertainty is related to innovation that is “for the best” in historical perspective or where uncertainty is the expression of a deliberative virtue. The two accounts are compared by applying them to Baker’s historical case of the introduction of mechanical ventilation and organ transplantation technologies, as well as the present-day case of mass data practices in the health domain. (shrink)

The American Buddhist nun and author of the best-selling When Things Fall Apart counsels readers on how to live compassionately and well during times of instability, demonstrating the use of the Three Commitments practice to promote ...

Evaluative judgements have both belief-like and desire-like features. While cognitivists think that they can easily explain the belief-like features, and have trouble explaining the desire-like features, non-cognitivists think the reverse. I argue that the belief-like features of evaluative judgement are quite complex, and that these complexities crucially affect the way in which an agent's values explain her actions, and hence the desire-like features. While one form of cognitivism can, it turns out that non-cognitivism cannot, accommodate all of these complexities. The (...) upshot is that that form of cognitivism can explain both features of evaluative judgements, and that non-cognitivism can explain neither. (shrink)

My focus in this paper is on a type of bad actions, namely actions that appear to be done for reasons that are not good reasons. I take such bad actions to be ubiquitous. But their ubiquity gives rise to a puzzle, especially if we assume that intentional actions are performed for what one believes or takes to be good reasons. The puzzle I aim to solve in this paper is: why do we seem to be getting it wrong so (...) much of the time? I will argue that we can explain the ubiquity of bad action in light of the practical uncertainties that we face. My claim is not just that the more uncertainty we face as agents, the more likely we are to make a mistake about what counts as a good reason for action, although that is certainly one possible effect of practical uncertainty. My main claim is, rather, that practical uncertainty can have an impact on what counts as acting for a good reason for the agent. (shrink)

This paper explores what kind of uncertainty a research program governing solar climate engineering through Stratospheric Aerosol Injection (SAI) needs to account for. Specifically, it tries to answer two central issues with regards to SAI research and it’s ethical evaluation: One, what irreducible uncertainties remain throughout the decision-process, and, two, how do these remaining uncertainties affect the ethical evaluation of SAI research. The main assumption is that decisions on SAI research governance will be made under normative uncertainty, i.e. (...) situations under irreducible knowledge-constraints that arise in concrete, practical decision-contexts. These decision-contexts are multi-lateral and empirically ambiguous, and the decision-makers need to reconcile a plurality of values. While normative uncertainty complicates the ethical evaluation of policy decisions, I argue that moral considerations can be accommodated through the inclusion of recognitional, participatory justice approaches, as well as adaptive and anticipatory governance methods. (shrink)

This paper develops a philosophical account of moral disruption. According to Robert Baker (2013), moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the Harm Account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the Qualified Harm Account, (...) there is no harm in cases where moral uncertainty is related to innovation that is “for the best” in historical perspective, or where uncertainty is the expression of a deliberative virtue. The two accounts are compared by applying them to Baker’s historical case of the introduction of mechanical ventilation and organ transplantation technologies, as well as the present-day case of mass data practices in the health domain. (shrink)

Purpose The purpose of this paper is to explore uncertainty inherent in emotion recognition technologies and the consequences resulting from that phenomenon. Design/methodology/approach The paper is a general overview of the concept; however, it is based on a meta-analysis of multiple experimental and observational studies performed over the past couple of years. Findings The main finding of the paper might be summarized as follows: there is uncertainty inherent in emotion recognition technologies, and the phenomenon is not expressed enough, (...) not addressed enough and unknown by the users of the technology. Practical implications Practical implications of the study are formulated as postulates for the developers, users and researchers dealing with the technologies of automatic emotion recognition. Social implications As technologies that recognize emotions are becoming more and more common, and perhaps more decisions influencing people lives are to come in the next decades, the trustworthiness of the technology is important from a scientific, practical and ethical point of view. Originality/value Studying uncertainty of emotion recognition technologies is a novel approach and is not explored from such a broad perspective before. (shrink)