In 2008 a young man committed suicide while his webcam was running. 1,500 people apparently watched as the young man lay dying: when people finally made an effort to call the police, it was too late. This closely resembles the case of Kitty Genovese in 1964, where 39 neighbours supposedly watched an attacker assault and did not call until it was too late. This paper examines the role of internet mediation in cases where people may or may not have been (...) good Samaritans and what their responsibilities were. The method is an intuitive one: intuitions on the various potentially morally relevant differences when it comes to responsibility between offline and online situations are examined. The number of onlookers, their physical nearness and their anonymity have no moral relevance when it comes to holding them responsible. Their perceived reality of the situation and ability to act do have an effect on whether we can hold people responsible, but this doesn’t seem to be unique to internet mediation. However the way in which those factors are intrinsically connected to internet mediation does seem to have a diminishing effect on responsibility in online situations. (shrink)

Moral enhancement can be an attractive proposal, but contrary to cognitive enhancement, it is hard to define what kind of intervention would constitute moral enhancement. In an ongoing debate about the subject, Douglas argued that biomedically decreasing countermoral emotions would do so and would be morally permissible in particular cases. Harris disagreed, and one of his arguments is that failing to address the intellectual aspects of moral decisions—and simply targeting countermoral emotions—would effectively undermine our freedom by reducing our options to (...) act immorally. In a consequent paper, Douglas defended his position. In this paper, I examine Douglas' response to Harris concern about the loss of freedom with biomedical moral enhancement. I argue that Douglas' framework for moral reasoning on which he bases his argument that biomedical intervention is in some cases permissible lacks soundness, and that it apparently undermines morality. Harris insists that morality requires freedom of choice, yet Douglas and Harris have different conceptions of freedom of choice. Douglas' focus on quantity in his defence does not engage with Harris focus on quality of choice. Thus, the kind of biomedical enhancement that Douglas defends is not moral—nor immoral—but amoral enhancement. (shrink)

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem (...) to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Providing healthcare services frequently involves cognitively demanding tasks, including diagnoses and analyses as well as complex decisions about treatments and therapy. From a global perspective, ethically significant inequalities exist between regions where the expert knowledge required for these tasks is scarce or abundant. One possible strategy to diminish such inequalities and increase healthcare opportunities in expert-scarce settings is to provide healthcare solutions involving digital technologies that do not necessarily require the presence of a human expert, e.g., in the form of (...) artificial intelligent decision-support systems (AI-DSS). Such algorithmic decision-making, however, is mostly developed in resource- and expert-abundant settings to support healthcare experts in their work. As a practical consequence, the normative standards and requirements for such algorithmic decision-making in healthcare require the technology to be at least as explainable as the decisions made by the experts themselves. The goal of providing healthcare in settings where resources and expertise are scarce might come with a normative pull to lower the normative standards of using digital technologies in order to provide at least some healthcare in the first place. We scrutinize this tendency to lower standards in particular settings from a normative perspective, distinguish between different types of absolute and relative, local and global standards of explainability, and conclude by defending an ambitious and practicable standard of local relative explainability. (shrink)

The global city is a new frontier zone. Deregulation, privatization, and new fiscal and monetary policies create the formal instruments to construct their equivalent of the old military “fort”. The city is also a strategic frontier zone for those who lack power, and allows the making of informal politics. At the same time the border is a mix of regimes, marked by protections and opportunities for corporations and high-level professionals, and implies confinement, capture and detention for migrants. The essay discusses (...) the transformation of the city in a frontier zone and analyses the separation between the capabilities entailed by territoriality and the geographic territory tout court. The analysis focuses on the effects of neoliberal policies that, far from making this a borderless world, have actually multiplied the bordered spaces that allow firms and markets to move across conventional borders. Cities are therefore one of the key sites where new neoliberal norms are made and where new identities emerge. (shrink)

At conceptual and linguistic levels of cognition, events are said to be represented in terms of abstract categories, for example, the sentence Jackie cut the bagel with a knife encodes the categories Agent (i.e., Jackie) and Patient (i.e., the bagel). In this paper, we ask whether entities such as the knife are also represented in terms of such a category (often labeled “Instrument”) and, if so, whether this category has a prototype structure. We hypothesized the Proto-instrument is a tool: a (...) physical object manipulated by an intentional agent to affect a change in another individual or object. To test this, we asked speakers of English, Dutch, and German to complete an event description task and a sentence acceptability judgment task in which events were viewed with more or less prototypical instruments. We found broad similarities in how English, Dutch, and German partition the semantic space of instrumental events, suggesting there is a shared concept of the Instrument category. However, there was no evidence to support the specific hypothesis that tools are the core of the Instrument category—instead, our results suggest the most prototypical Instrument is the direct extension of an intentional agent. This paper supports theoretical frameworks where thematic roles are analyzed in terms of prototypes and suggests new avenues of research on how instrumental category structure differs across linguistic and conceptual domains. (shrink)

Migration policy is a product and producer of identities and values. This article argues that discourses and policies on family reunification participate in the politics of belonging, and that gender and family norms play a crucial role in this production of collective identities, i.e. in defining who ‘we’ are and what distinguishes ‘us’ from ‘the others’. Tracing the development of political debates and policy-making about ‘fraudulent’ and ‘forced’ marriages in the Netherlands since the 1970s, the authors examine how categories of (...) gender and ethnicity interact with ‘other’ transnational marriages and the women who engage in them. These practices of ‘othering’ legitimize restrictive reforms of marriage migration policies. Also, and no less importantly, they serve the symbolic function of defining Dutch identity, and show that the government protects this identity. (shrink)

This paper explores the role and resolution of disagreements between physicians and their diagnostic AI-based decision support systems. With an ever-growing number of applications for these independently operating diagnostic tools, it becomes less and less clear what a physician ought to do in case their diagnosis is in faultless conflict with the results of the DSS. The consequences of such uncertainty can ultimately lead to effects detrimental to the intended purpose of such machines, e.g. by shifting the burden of proof (...) towards a physician. Thus, we require normative clarity for integrating these machines without affecting established, trusted, and relied upon workflows. In reconstructing different causes of conflicts between physicians and their AI-based tools—inspired by the approach of “meaningful human control” over autonomous systems and the challenges to resolve them—we will delineate normative conditions for “meaningful disagreements”. These incorporate the potential of DSS to take on more tasks and outline how the moral responsibility of a physician can be preserved in an increasingly automated clinical work environment. (shrink)

What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...) continue to receive support for their devices (e.g., battery and component replacements, software updates, etc.). Others, when safe, have their neural implants removed through surgical explantation. Still others continue to live with a deactivated neural implant embedded in their body. In the United States, there are no uniform requirements to provide services, of any kind, after an neural implant study ends, and other nations are similarly facing this challenge. The existence of a post-trial gap in an expanding neural implant research ecosystem invites obvious questions: What is owed to neural implant research participants post-trial, and why has providing it been so difficult to accomplish in practice? To take a step forward on this difficult issue, we assembled one group of stakeholders – researchers funded for neuroethics grants by the National Institutes of Health – to explore possible starting points on one topic: ethical guidance for post-trial care of research participants in neural implant trials. Based on shared concerns discussed in the expert workshop the current paper is a call to action. It reports the key areas of convergence from the meeting and highlights important next steps towards developing much needed guidance. (shrink)

Domain experts regularly teach novice students how to perform a task. This often requires them to adjust their behavior to the less knowledgeable audience and, hence, to behave in a more didactic manner. Eye movement modeling examples (EMMEs) are a contemporary educational tool for displaying experts’ (natural or didactic) problem‐solving behavior as well as their eye movements to learners. While research on expert‐novice communication mainly focused on experts’ changes in explicit, verbal communication behavior, it is as yet unclear whether and (...) how exactly experts adjust their nonverbal behavior. This study first investigated whether and how experts change their eye movements and mouse clicks (that are displayed in EMMEs) when they perform a task naturally versus teach a task didactically. Programming experts and novices initially debugged short computer codes in a natural manner. We first characterized experts’ natural problem‐solving behavior by contrasting it with that of novices. Then, we explored the changes in experts’ behavior when being subsequently instructed to model their task solution didactically. Experts became more similar to novices on measures associated with experts’ automatized processes (i.e., shorter fixation durations, fewer transitions between code and output per click on the run button when behaving didactically). This adaptation might make it easier for novices to follow or imitate the expert behavior. In contrast, experts became less similar to novices for measures associated with more strategic behavior (i.e., code reading linearity, clicks on run button) when behaving didactically. (shrink)

Domain experts regularly teach novice students how to perform a task. This often requires them to adjust their behavior to the less knowledgeable audience and, hence, to behave in a more didactic manner. Eye movement modeling examples (EMMEs) are a contemporary educational tool for displaying experts’ (natural or didactic) problem‐solving behavior as well as their eye movements to learners. While research on expert‐novice communication mainly focused on experts’ changes in explicit, verbal communication behavior, it is as yet unclear whether and (...) how exactly experts adjust their nonverbal behavior. This study first investigated whether and how experts change their eye movements and mouse clicks (that are displayed in EMMEs) when they perform a task naturally versus teach a task didactically. Programming experts and novices initially debugged short computer codes in a natural manner. We first characterized experts’ natural problem‐solving behavior by contrasting it with that of novices. Then, we explored the changes in experts’ behavior when being subsequently instructed to model their task solution didactically. Experts became more similar to novices on measures associated with experts’ automatized processes (i.e., shorter fixation durations, fewer transitions between code and output per click on the run button when behaving didactically). This adaptation might make it easier for novices to follow or imitate the expert behavior. In contrast, experts became less similar to novices for measures associated with more strategic behavior (i.e., code reading linearity, clicks on run button) when behaving didactically. (shrink)

The COVID-19 pandemic in 2020 has had a lasting impact on all areas of personal life. However, the political, economic, legal and healthcare system, as well as the education system have also experienced the effects. Universities had to face new challenges and requirements in teaching and examinations as quickly as possible in order to be able to guarantee high-quality education for their students.This study aims to examine how the German-speaking medical faculties of the Umbrella Consortium of Assessment Network have dealt (...) with the challenges but also the opportunities that the outbreak of the COVID-19 pandemic created in medical education and whether digitalisation has been driven forward as a result. In an initial online-survey we focused our questions on the current teaching situation with regard to digitised teaching content, the support or establishment of adequate framework conditions by the medical faculties and IT facilities and also the execution of examinations during the summer semester 2020.Between August and September 2020, a total of 88 examiners, educators, dean of study and/or technical admins from 32 partner faculties took part in the survey. Students were not included in our survey. Most respondents stated that a switch to a digital semester had worked, the use of e-learning increased compared to previous semesters and that most courses could be converted, with the exception of practical courses, which were largely cancelled. The respondents also indicated that most examinations could still be taken, with the exception of practical examination formats, like Objective Structured Clinical Examinations. However, in the case of face-to-face examinations, strict distance and hygiene conditions had to be obeyed or there had to be a switch to distance-online examinations, which raised many open issues such as equal opportunities of students and attempts at deception.In conclusion, we identified several issues regarding the rapid transition to a digital semester due to COVID-19 which were categorised into the following topics: Face-to-face teaching could not take place, know-how of educators, integrity aspects, technical aspects, additional personnel required, additional time and effort required for implementation of digital teaching. Our study shows that a switch to digital teaching and distance online examinations is feasible, but many problems were encountered concerning academic integrity and basic ethical principles still need to be solved. In order to investigate whether above mentioned issued could be solved one year after the transition to a digital semester, we conducted a second survey in which the 32 initially surveyed institutions were questioned again. (shrink)

In an attempt to solve some serious economic and environmental problems, the Netherlands has embarked on an unique experiment over the past few decades. Based on a tradition of cooperation, consensus building, and democratic self-rule, the Dutch have revitalized a corporatist approach to economic and environmental planning. They refer to the polder model to describe the particular characteristics of this approach. Although the polder model is rooted in the past (i.e., the Golden Age of the 17th-century Dutch Republic), (...) its more recent application in planning efforts finds its start with the Wassenaar Accord in economic planning in 1982. A similar approach was used in environmental planning with the introduction of the first National Environmental Policy Plan in 1989. The key feature of the environmental plan is a covenant between business and government. In this article, the author compares the application of the polder model in both areas and concludes that there are serious challenges ahead for its survival. The article attempts to assess whether the model would work in the United States and why the approach used by the Dutch is the favored approach of Environmental Protection Agency chief Christie Whitman. (shrink)

The increased presence of medical AI in clinical use raises the ethical question which standard of explainability is required for an acceptable and responsible implementation of AI-based applications in medical contexts. In this paper, we elaborate on the emerging debate surrounding the standards of explainability for medical AI. For this, we first distinguish several goods explainability is usually considered to contribute to the use of AI in general, and medical AI in specific. Second, we propose to understand the value of (...) explainability relative to other available norms of explainable decision-making. Third, in pointing out that we usually accept heuristics and uses of bounded rationality for medical decision-making by physicians, we argue that the explainability of medical decisions should not be measured against an idealized diagnostic process, but according to practical considerations. We conclude, fourth, to resolve the issue of explainability-standards by relocating the issue to the AI’s certifiability and interpretability. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Professional autonomy interferes at a structural level with the various aspects of the health care system. The health care systems that can be distinguished all feature a specific design of professional autonomy, but experience their own governance problems. Empirical health care systems in the West are a nationally coloured blend of ideal type healthcare systems. From a normative perspective, the optimal health care system should consist of elements of all the ideal types. A workable optimum taking national values into account (...) could be attained by governance structures that also introduce elements from other ideal type systems. Thus a normative approach to medical practice guaranteeing an essential degree of professional autonomy for a relationship of trust between the patient and the physician, could be combined with an efficient and equitable allocation of health care resources. (shrink)

This paper discusses different ways of formulating regulation that takes into account a responsibility towards future generations in environmental issues. A rights-based or human-rights based approach, based on notions of intergenerational equity, can be problematic on a conceptual level, and implementation of rights for future generations is challenging. An alternative approach is based on the assignment of duties to present generations rather than rights of future generations. This approach, which is often used in regulation concerning sustainability, uses goal regulation to (...) avoid conceptual problems with rights of future generations while it still provides the opportunity to safeguard their interests and needs. (shrink)

Exponential-constructible functions are an extension of the class of constructible functions. This extension was formulated by Cluckers and Loeser in the context of semi-algebraic and sub-analytic structures, when they studied stability under integration. In this paper, we will present a natural refinement of their definition that allows for stability results to hold within the wider class of [Formula: see text]-minimal structures. One of the main technical improvements is that we remove the requirement of definable Skolem functions from the proofs. As (...) a result, we obtain stability in particular for all intermediate structures between the semi-algebraic and the sub-analytic languages. (shrink)

This brief essay examines emergent spaces for politics and emergent political actors. The particular concern here is with types of politics that do not run through the formal political system, one with shrinking options for a growing number of US citizens and immigrants. Informal political actors and street-level politics in cities are major instances of this. US cities have a long history of street-level politics. The contents, the purposes, the mobilizers and the enactors of these politics have changed over time. (...) Today’s global cities are a very specific type of place because they bring together both the most globalized sectors of capital and the new transnational professionals, on the one hand, and a growing number of immigrants and native minoritized groups in a single, complex space. (shrink)

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

There is a remedy available for many of our ailments: Psychopharmacology promises to alleviate unsatisfying memory, bad moods, and low self-esteem. Bioethicists have long discussed the ethical implications of enhancement interventions. However, they have not considered relevant evidence from psychology and economics. The growth in autonomy in many areas of life is publicized as progress for the individual. However, the broadening of areas at one’s disposal together with the increasing individualization of value systems leads to situations in which the range (...) of options asks too much of the individual. I scrutinize whether increased self-determination and unbound possibilities are really in a person’s best interests. Evidence from psychology and economics challenges the assumption that unlimited autonomy is best in all cases. The responsibility for autonomous self-formation that comes with possibilities provided by neuro-enhancement developments can be a burden. To guarantee quality of life I suggest a balance of beneficence, support, and respect for autonomy. (shrink)

In this paper, we first classify different types of second opinions and evaluate the ethical and epistemological implications of providing those in a clinical context. Second, we discuss the issue of how artificial intelligent could replace the human cognitive labour of providing such second opinion and find that several AI reach the levels of accuracy and efficiency needed to clarify their use an urgent ethical issue. Third, we outline the normative conditions of how AI may be used as second opinion (...) in clinical processes, weighing the benefits of its efficiency against concerns of responsibility attribution. Fourth, we provide a ‘rule of disagreement’ that fulfils these conditions while retaining some of the benefits of expanding the use of AI-based decision support systems in clinical contexts. This is because the rule of disagreement proposes to use AI as much as possible, but retain the ability to use human second opinions to resolve disagreements between AI and physician-in-charge. Fifth, we discuss some counterarguments. (shrink)