The literature on self-driving cars and ethics continues to grow. Yet much of it focuses on ethical complexities emerging from an individual vehicle. That is an important but insufficient step towards determining how the technology will impact human lives and society more generally. What must complement ongoing discussions is a broader, system level of analysis that engages with the interactions and effects that these cars will have on one another and on the socio-technical systems in which they are embedded. To (...) bring the conversation of self-driving cars to the system level, we make use of two traffic scenarios which highlight some of the complexities that designers, policymakers, and others should consider related to the technology. We then describe three approaches that could be used to address such complexities and their associated shortcomings. We conclude by bringing attention to the “Moral Responsibility for Computing Artifacts: The Rules”, a framework that can provide insight into how to approach ethical issues related to self-driving cars. (shrink)

Soil is fragile and nonrenewable but the most basic of natural resources. It has a capacity to tolerate continuous use but only with proper management. Improper soil management and indiscriminate use of chemicals have contributed to some severe global environmental issues, e.g., volatilization losses and contamination of natural waters by sediments and agricultural fertilizers and pesticides. The increasing substitution of energy for labor and other cultural inputs in agriculture is another issue. Fertilizers and chemicals account for about 25% of the (...) production energy investment in agriculture. An additional 60% is accounted for by machinery, gasoline, electricity, and power-related inputs. Fertilizer additions to cropland are not utilized fully and significant amounts, depending on conditions, are either lost in surface runoff or leached into the ground water. The annual discharge of dissolved solids from agricultural lands to the waterways in the USA is substantial. The increasing use of herbicides in agriculture is a threat to the quality of surface and ground water, although this threat is dependent upon both the chemistry of the compound and the ecosystem in which it is used. Especially within the Third World, development of an environmental ethic and environmental laws have not kept pace with the increase in pesticide use. Above all is the severe and global problem of soil degradation currently occurring at the rate of five to seven million hectares per year. The policy and moral aspects of these issues are discussed. (shrink)

BackgroundSarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life especially physical and functional wellbeing. Adolescent and young adult patients are an underrepresented population in cancer research and have differing factors influencing QoL.MethodsRetrospective analysis of Young Adult patients enrolled in the Sarcoma Tissue Repository at (...) University of Iowa. QoL was assessed using the self-report FACT-G questionnaire at enrollment and 12 months post-diagnosis; overall scores and the 4 wellbeing subscales were calculated. Linear mixed effects models were used to measure the association between the rate of change in FACT-G subscale scores and baseline clinical, comorbidity, and treatment characteristics.Results49 patients were identified. 57.1% of patients had a malignancy involving an extremity. Mean FACT-G scores of overall wellbeing improved from baseline to 12 months. Social and emotional wellbeing did not differ significantly between baseline and 12 months. Physical wellbeing and functional wellbeing scores improved from baseline to 12 months. No difference was seen for FACT-G overall scores for age, sex, laterality, marital status, performance status, having children, clinical stage, limb surgery, chemotherapy, or tumor size. A difference was demonstrated in physical wellbeing scores for patients with baseline limitation compared to those with no baseline limitation. A difference was demonstrated in social wellbeing based on anatomical site.ConclusionYoung adults with sarcoma treated at a tertiary center had improvements in overall reported QoL at 12 months from diagnosis. Overall baseline QoL scores on FACT-G were lower than the general adult population for YA patients with sarcoma but at 12 months became in line with general population norms. The improvements seen merit further investigation to evaluate how these change over the continuum of care. Quality of life changes may be useful outcomes of interest in sarcoma trials. (shrink)

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

As a natural example of a 1-random real, Chaitin proposed the halting probability Ω of a universal prefix-free machine. We can relativize this example by considering a universal prefix-free oracle machine U. Let [Formula: see text] be the halting probability of UA; this gives a natural uniform way of producing an A-random real for every A ∈ 2ω. It is this operator which is our primary object of study. We can draw an analogy between the jump operator from computability theory (...) and this Omega operator. But unlike the jump, which is invariant under the choice of an effective enumeration of the partial computable functions, [Formula: see text] can be vastly different for different choices of U. Even for a fixed U, there are oracles A =* B such that [Formula: see text] and [Formula: see text] are 1-random relative to each other. We prove this and many other interesting properties of Omega operators. We investigate these operators from the perspective of analysis, computability theory, and of course, algorithmic randomness. (shrink)

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

Conservatives and liberals disagree sharply on matters of morality and public policy. We propose a novel account of the psychological basis of these differences. Specifically, we find that conservatives tend to emphasize the intrinsic value of actions during moral judgment, in part by mentally simulating themselves performing those actions, while liberals instead emphasize the value of the expected outcomes of the action. We then demonstrate that a structural emphasis on actions is linked to the condemnation of victimless crimes, a distinctive (...) feature of conservative morality. Next, we find that the conservative and liberal structural approaches to moral judgment are associated with their corresponding patterns of reliance on distinct moral foundations. In addition, the structural approach uniquely predicts that conservatives will be more opposed to harm in circumstances like the well-known trolley problem, a result which we replicate. Finally, we show that the structural approaches of conservatives and liberals are partly linked to underlying cognitive styles. Collectively, these findings forge a link between two important yet previously independent lines of research in political psychology: cognitive style and moral foundations theory. (shrink)

From computerized medical records to databases of pharmacological interactions and automated provisional EKG readings, the emergence of information technology has significantly altered the practice of medicine. Information technology has been widely used to enhance diagnosis and treatment and to improve communication between providers. The advent of the Internet also brings far-reaching implications for patient–physician communication, challenging physicians, patients, and policymakers to consider its impact on the delivery of medical care and the therapeutic relationship. A new set of practices by patients (...) and physicians is unfolding in cyberspace, ranging from the use of e-mail to communicate between physicians and patients in an existing relationship to one-to-one consultations with an anonymous physician and ongoing online treatment, such as psychotherapy. These practices are emerging in both the for-profit and not-for-profit spheres. (shrink)

Varieties of Ethical Reflection brings together new cultural and religious perspectives—drawn from non-Western, primarily Asian, philosophical sources—to globalize the contemporary discussion of theoretical and applied ethics.

A real is called properly n-generic if it is n-generic but not n+1-generic. We show that every 1-generic real computes a properly 1-generic real. On the other hand, if m > n ≥ 2 then an m-generic real cannot compute a properly n-generic real.

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended (...) to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

A radical, optimistic exploration of how humans evolved to develop reason, consciousness, and free will. Lately, the most passionate advocates of the theory of evolution seem to present it as bad news. Scientists such as Richard Dawkins, Lawrence Krauss, and Sam Harris tell us that our most intimate actions, thoughts, and values are mere byproducts of thousands of generations of mindless adaptation. We are just one species among multitudes, and therefore no more significant than any other living creature. Now comes (...) Brown University biologist Kenneth R. Miller to make the case that this view betrays a gross misunderstanding of evolution. Natural selection surely explains how our bodies and brains were shaped, but Miller argues that it’s not a social or cultural theory of everything. In The Human Instinct, he rejects the idea that our biological heritage means that human thought, action, and imagination are pre-determined, describing instead the trajectory that ultimately gave us reason, consciousness and free will. A proper understanding of evolution, he says, reveals humankind in its glorious uniqueness—one foot planted firmly among all of the creatures we’ve evolved alongside, and the other in the special place of self-awareness and understanding that we alone occupy in the universe. Equal parts natural science and philosophy, The Human Instinct is a moving and powerful celebration of what it means to be human. (shrink)

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

This paper is a critical analysis of David Rayfield's attempt to distinguish true from correct descriptions of human actions (Inquiry, Vol. 13 [1970], Nos. 1?2). It is argued that the analysis fails to do the job required of it for two reasons. First, the analysis of true descriptions is circular insofar as it turns on the notion of an ?unbound action?. Secondly, and independent of the charge of circularity, it is shown that the basis upon which Rayfield draws the true?correct (...) distinction leads to certain unacceptable consequences for action theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 34.2 (2001) 179-181 [Access article in PDF] Book Review Rethinking the Rhetorical Tradition: From Plato to Postmodernism Rethinking the Rhetorical Tradition: From Plato to Postmodernism. James L. Kastely. New Haven, CT: Yale University Press, 1997. Pp. viii + 293. $30.00. In Rethinking the Rhetorical Tradition, James Kastely presents an alternative to the "standard" rhetorical tradition; he calls this alternative skeptical rhetoric, describes its characteristic activity as (...) refutation, and claims for it special relevance in negotiating postmodern challenges to rhetoric, specifically, that it can serve as a "refutation of postmodernism" (23). This alternative tradition inheres in a canon of works somewhat different from the standard canon, and an examination of key works organizes most of the chapters in this book. To establish and articulate this tradition in the classical era, Kastely examines Plato's Gorgias and Meno, Sophocles' Philoctetes, and Euripides' Hecuba; he then moves to the modern era, and to two works that address themes central to ancient rhetorical skepticism: Jane Austen's Persuasion (1818) and Jean-Paul Sartre's What Is Literature? (1949). Finally, Kastely turns to the two prongs of the postmodern reappropriation of traditional rhetoric, the tropological formalism of Paul de Man and the ideological approaches of Marxist critics such as Terry Eagleton, challenging both of them with the comic skepticism of Kenneth Burke.The skeptical tradition begins with Socrates, of course. It takes as its central problem, not the impossibility or contingency of knowledge, but the existence of injustice. In a political community, the unavoidability of doing inadvertent injury both requires rhetoric and at the same time makes it party to continued injustice: "[D]oing injury is an inescapable aspect of a being who is born into a world that is shaped by a language and by conventional practices that embody a particular set of values" (42). It is these prior commitments and conventional practices that, Kastely argues, lead us to cause injury. Thus, the positive task of rhetoric is not to persuade others away from injustice or to promote remedies; it is to keep us constantly open to refutation, to the possibility of seeing an alternative to the inadvertent wrong we commit. The inherency of injustice is what makes rhetoric a philosophical problem, but refutation is what rhetoric can offer to philosophy (a claim that might surprise philosophers). And in his reading of the Meno, Kastely argues explicitly for a rhetorical, rather than philosophical or logical, understanding of refutation.Overall, Kastely offers us a Plato who is not the enemy of rhetoric, but rather "the most sophisticated and profound rhetorical theorist" (30), who dramatizes in dialogue the philosophical dilemma of rhetoric. In [End Page 179] Sophocles and Euripides, he finds dramatists who illustrate practical forms the dilemma can take, specifically the problem of the unavailable audience. In the Philoctetes, the problem is how to regain the trust and confidence of the marginalized and disenfranchised, how to restore the status of rhetorical audience to one who no longer believes that justice is possible. In the Hecuba, the problem is how a disempowered rhetor can speak to the powerful. In both plays, but especially in Hecuba, the proximity of rhetoric to violence is a practical consequence of the unsolved philosophical problem.Kastely admits that the skeptical legacy from classical rhetoric has had little effect since antiquity. His argument that this alternate tradition deserves recognition is made primarily by his chapters on Austen and Sartre. He sees the works he examines here as raising a question central to rhetorical skepticism: "Can there be a way of speaking and writing that can effectively challenge the marginalization and dehumanization of people in a world in which traditional structures of authority that made discourse coherent have vanished or, at least, are seriously and irretrievably eroded?" (139-40). Both question Enlightenment assumptions about universality and at the same time confront the vacuum left by the erosion of local communal and authority structures. Austen's "active exploration" of a "crisis in discursive practice" (141) and Sartre's concern with the "social responsibility of the writer" and the loss of a public... (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Rhetoric of RHETORIC: The Quest for Effective CommunicationCarolyn R. MillerThe Rhetoric of RHETORIC: The Quest for Effective Communication. Wayne C. BoothMalden, Mass: Blackwell, 2004. Pp. xvi + 206. $20.95, paperback.By using the traditional word rhetoric I want to suggest a whole philosophy of how men succeed or fail in discovering together, in discourse, new levels of truth (or at least agreement) that neither side suspected before.—Wayne C. (...) Booth, 1974Listening-Rhetoric is what I most long to celebrate and practice—the kind that is sadly rare.... Here both sides join in a trusting dispute, determined to listen to the opponent's arguments, while persuading the opponent to listen in exchange.... Both sides are pursuing not just victory but a new reality, a new agreement about what is real.—Wayne C. Booth, 2004By the evidence of these two quotations, the late Wayne Booth sustained a passionate interest in a constructivist, cooperative rhetoric for at least thirty years. His 1974 Modern Dogma and the Rhetoric of Assent first sounds many of the themes that are rearticulated in his 2004 The Rhetoric of RHETORIC, a volume in the Blackwell Manifestos series. Both books were motivated by evident failures of public discourse, the earlier one by those emanating from the Vietnam War, including student protests at the University of Chicago, and the recent one by multiple rhetorical sins of the Bush administration and the national media, especially those concerning the war in Iraq. Indeed, Booth confesses here that his distress dates at least to 1963, when he lamented that "the debate about the [Kennedy] assassination [may be] a greater national disgrace than the assassination itself" (109).What animates Booth in both books is the conviction not that only we can do better in conducting our discursive relationships as a nation, as institutions, as families, but that we must do so. We must do so because our ability to live and progress together depends on our talking rather than resorting to force and on our talking in a way that engenders trust and enables continued debate, rather than provoking mistrust and disrespect. The two enemies he has always in sight are violence and deception. These are two forms of rhetorical failure, but the two become entangled when "violence and the threat of violence corrupt rhetoric," particularly during times of war (118), and when corrupt rhetoric itself becomes a kind of violence (48). [End Page 261]As a "manifesto" addressed to a non-specialist audience, The Rhetoric of RHETORIC is relatively brief, engagingly written, and passionately argued. It includes chapters on definitions of rhetoric (good and bad), the history of rhetorical studies, the difficulties of judging rhetoric (i.e., the disjunction between instrumental and ethical effectiveness), the dispersal of rhetoric to multiple disciplines and forums, the condition of rhetorical education today, the dangers of bad rhetoric in politics and in the media, and a demonstration of how our many intractable debates might be improved with "listening-rhetoric," using as a case example the "warfare" between science and religion. Throughout, Booth dramatizes his ideal of listening-rhetoric by engaging in frequent proleptic questioning and refutation as well as reflexive commentary.Anyone who heard Booth talk at a conference within the past decade or more has first-hand knowledge of his predilection for neologism, and he indulged himself in this book (though he resisted in 1974; see Modern Dogma, 11n5). His term for bad rhetoric, the rhetoric that exacerbates misunderstanding or seeks victory through deception, is "rhetrickery"; his term for the best rhetoric, a kind of critical consciousness that seeks to find common ground and to remove misunderstanding, is "rhetorology." We are also introduced to LR (listening-rhetoric), WR (win-rhetoric), BR (bargain-rhetoric), Rhet-Ed (rhetorical education), P-Rhet (political rhetoric), and MR (media rhetoric).Rhetorology, or listening-rhetoric, is Booth's solution to our rhetorical woes, a solution that admittedly has both philosophical and practical limitations. Rhetorology opposes rhetrickery and some versions of win-rhetoric. He is at some pains to explain and sequester these damaging capabilities so that the unsavory aspects of rhetoric's reputation do not obscure its positive potential. Readers familiar with recent rhetorical theorizing... (shrink)