Background Given that AI-driven decision support systems (AI-DSS) are intended to assist in medical decision making, it is essential that clinicians are willing to incorporate AI-DSS into their practice. This study takes as a case study the use of AI-driven cardiotography (CTG), a type of AI-DSS, in the context of intrapartum care. Focusing on the perspectives of obstetricians and midwives regarding the ethical and trust-related issues of incorporating AI-driven tools in their practice, this paper explores (...) the conditions that AI-driven CTG must fulfill for clinicians to feel justified in incorporating this assistive technology into their decision-making processes regarding interventions in labor. Methods This study is based on semi-structured interviews conducted online with eight obstetricians and five midwives based in England. Participants were asked about their current decision-making processes about when to intervene in labor, how AI-driven CTG might enhance or disrupt this process, and what it would take for them to trust this kind of technology. Interviews were transcribed verbatim and analyzed with thematic analysis. NVivo software was used to organize thematic codes that recurred in interviews to identify the issues that mattered most to participants. Topics and themes that were repeated across interviews were identified to form the basis of the analysis and conclusions of this paper. Results There were four major themes that emerged from our interviews with obstetricians and midwives regarding the conditions that AI-driven CTG must fulfill: (1) the importance of accurate and efficient risk assessments; (2) the capacity for personalization and individualized medicine; (3) the lack of significance regarding the type of institution that develops technology; and (4) the need for transparency in the development process. Conclusions Accuracy, efficiency, personalization abilities, transparency, and clear evidence that it can improve outcomes are conditions that clinicians deem necessary for AI-DSS to meet in order to be considered reliable and therefore worthy of being incorporated into the decision-making process. Importantly, healthcare professionals considered themselves as the epistemic authorities in the clinical context and the bearers of responsibility for delivering appropriate care. Therefore, what mattered to them was being able to evaluate the reliability of AI-DSS on their own terms, and have confidence in implementing them in their practice. (shrink)

Priority setting in health care means making distributional decisions, which inherently involves limiting access to some health services. Public health ethics involves many ethical principles like efficiency, equity and individual choice, which are frequently appealed to but rarely analysed. How these concepts are understood and applied impacts on healthcare planning and delivery policies. This article discusses findings of a research study undertaken in the context of the Iranian health system in which two main ethical values appear to be operating: (...) equity and personal choice. It asserts that the pro-market perspective, driven by individual choice appears to be dominant as it is influenced by the powerful medical profession. This is despite egalitarian intentions proclaimed in the Constitution and the majority of national laws. The study argues that the market influence in healthcare priority setting is unlikely to diminish because of weak implementation of existing laws. In conclusion, the article suggests that the private health sector could help to achieve the state’s proclaimed egalitarian goals only if new regulatory systems and new systems of governance are implemented. Such measures should be aimed at monitoring and controlling the performance of the private sector, to better manage and harness its capacities. (shrink)

The inclusion of morally binding values such as religious—or in a broader sense, spiritual—values fundamentally alter organizational decision-making and ethical behavior. Family firms, being a particularly value-driven type of organization, provide ample room for religious beliefs to affect family, business, and individual decisions. The influence that the owning family is able to exert on value formation and preservation in the family business makes religious family firms an incubator for value-driven and faith-led decision-making and (...) behavior. They represent a particularly rich and relevant context to re-assess the relationship between ethical beliefs, decision-making processes and behaviors in business organizations at the interface between family and professional logics. This Special Issue is dedicated to deepening our understanding of the role religious values and spirituality play in the formation of organizational ethical practices in faith-led family firms and resulting organizational and family-related outcomes. In this editorial, we introduce the 10 papers included in this Special Issue, which investigate the relationship between religion or spirituality and family firm ethical behavior in various geographical, cultural and religious contexts, using a multitude of qualitative and quantitative methodologies. By focusing on the effects of religious or spiritual orientations on both the business and the family, as well as on the values, norms and goals present in the family business system, further research can gain a more nuanced understanding of the relationship between religious and spiritual believes, and sustainable ethical behavior in family firms. (shrink)

In this paper, we demonstrate (1) how harnessing stochasticity can be the basis of creative agency; (2) that such harnessing can resolve the apparent conflict between reductionist (micro-level) accounts of behaviour and behaviour as the outcome of rational and value-driven (macro-level) decisions; (3) how neurophysiological processes can instantiate such behaviour; (4) The processes involved depend on three features of living organisms: (a) they are necessarily open systems; (b) micro-level systems therefore nest within higher-level systems; (c) causal interactions must (...) occur across all the boundaries between the levels of organization. The higher levels constrain the dynamics of lower levels. The experimental evidence and theoretical arguments are shown to be consistent with previous research on the neuronal mechanisms of conscious choice, and with the interconnected multi-level processes by which organisms harness stochasticity, whether conscious or unconscious. (shrink)

Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions and (...) changing behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

Within the ethical debate on Machine Learning-driven decision support systems (ML_CDSS), notions such as “human in the loop” or “meaningful human control” are often cited as being necessary for ethical legitimacy. In addition, ethical principles usually serve as the major point of reference in ethical guidance documents, stating that conflicts between principles need to be weighed and balanced against each other. Starting from a neo-Kantian viewpoint inspired by Onora O'Neill, this article makes a concrete suggestion of how to (...) interpret the role of the “human in the loop” and to overcome the perspective of rivaling ethical principles in the evaluation of AI in health care. We argue that patients should be perceived as “fellow workers” and epistemic partners in the interpretation of ML_CDSS outputs. We further highlight that a meaningful process of integrating (rather than weighing and balancing) ethical principles is most appropriate in the evaluation of medical AI. (shrink)

Scholars and practitioners across domains are increasingly concerned with algorithmic transparency and opacity, interrogating the values and assumptions embedded in automated, black-boxed systems, particularly in user-generated content platforms. I report from an ethnography of infrastructure in Wikipedia to discuss an often understudied aspect of this topic: the local, contextual, learned expertise involved in participating in a highly automated social–technical environment. Today, the organizational culture of Wikipedia is deeply intertwined with various data-driven algorithmic systems, which Wikipedians rely on to help (...) manage and govern the “anyone can edit” encyclopedia at a massive scale. These bots, scripts, tools, plugins, and dashboards make Wikipedia more efficient for those who know how to work with them, but like all organizational culture, newcomers must learn them if they want to fully participate. I illustrate how cultural and organizational expertise is enacted around algorithmic agents by discussing two autoethnographic vignettes, which relate my personal experience as a veteran in Wikipedia. I present thick descriptions of how governance and gatekeeping practices are articulated through and in alignment with these automated infrastructures. Over the past 15 years, Wikipedian veterans and administrators have made specific decisions to support administrative and editorial workflows with automation in particular ways and not others. I use these cases of Wikipedia’s bot-supported bureaucracy to discuss several issues in the fields of critical algorithms studies; critical data studies; and fairness, accountability, and transparency in machine learning—most principally arguing that scholarship and practice must go beyond trying to “open up the black box” of such systems and also examine sociocultural processes like newcomer socialization. (shrink)

Purpose The purpose of this paper is to explore the epistemological tensions embedded within big data and data-driven technologies to advance a socio-political reconsideration of the public dimension in the assessment of their implementation. Design/methodology/approach This paper builds upon (and revisits) the European Union’s (EU) normative understanding of artificial intelligence (AI) and data-driven technologies, blending reflections rooted in philosophy of technology with issues of democratic participation in tech-related matters. Findings This paper proposes the conceptual design of sectorial and/or (...) local-level e-participation platforms to ignite an ongoing discussion – involving experts, private actors, as well as cognizant citizens – over the implementation of data-driven technologies, to avoid siloed, tech-solutionist decisions. Originality/value This paper inscribes the EU’s normative approach to AI and data-driven technologies, as well as critical work on the governance of these technologies, into a broader political dimension, suggesting a way to democratically and epistocratically opening up the decisional processes over the development and implementation of these technologies and turn such processes into a systemic civic involvement. (shrink)

The main philosophical question of the contemporaneity consists in that how far mankind is capable to change "direction of development" and to provide itself a Sustainable Future. Today it is obvious that any planetary actions driven by values of modern technocratic (material) civilization assume great risk and can lead tothe global ecological catastrophe. Consequently, the search for new values of civilization development has a truly decisive importance for man and mankind. In our opinion, Sustainable Development and Environmental Ethics are (...) the main components of a new value paradigm of civilization’s transformation. To emphasize fundamental novelty of the above-named value basics of a future civilization and its alternative character with respect to the modern technocraticculture, we introduce the concept of "ecological civilization". We imagine the ecological civilization as the ideal form of integrity preservation of the Whole-Life-System with a view to provide sustainable future for mankind. This is spiritually oriented and highly moral society because the ecological imperative, as a matter of fact, coincides with the ideal of spirituality. We connect prospects of ecological (spiritual) civilization with forming of planetary value consciousness on principles of Environmental Ethics. (shrink)

"Ethical Leadership" in modern multicultural corporations is first the consideration of different personal and cultural value systems in decision-making processes. Second, it is the assignment of responsibility either to individual or organisational causalities. The task of this study is to set the stage for a distinction between rational entities and the arbitrary preferences of individuals in economic decision making processes.Defining rational aspects of behaviour in economics will lead to the formal structures of organisational systems, which are independent (...) of concrete but varying values. Luhmann''s Theory of systems of communication describes the internal dynamic forces of economic communication processes in terms of formal structures. On the other hand Habermas'' Theory of discourse integrates the previous relationship between individual subjectivity and rational behaviour. Habermas gives an indication of how to separate subjective values and meaning from rational arguments in rational communication processes. The translation of these theoretical structures into practical applications for decision making processes and decision taking acts links the ethical, or value-oriented, context precisely to both individual and organisational areas of responsibility. (shrink)

Health information technology in hospitals can be approached as a tool to reduce health care costs and improve hospital efficiency and profitability, increase the quality of healthcare services, and make the transition to patient-centered healthcare. A hospital’s efficiency and profitability depends on linking IT with the knowledge and motivation of medical personnel. It is important to design and execute a knowledge management strategy as a part of the implementation of IT in hospital management. A Diagnosis-Related Groups system was introduced (...) in Poland in 2008 as a basis for settlements between hospitals and the National Health Fund. The importance and role of a DRG system in management of healthcare entities was emphasized based on a survey of medical professionals from two hospitals in the Lubelskie province. The goal of a survey is to assess the knowledge of medical professionals about the DRG system and how the medical personnel uses the DRG system in order to achieve the strategic goals of the organization. A newly developed survey was used to assess the medical personnel’s knowledge of DRG, using 12 closed and 5 open questions. The survey was conducted on 160 medical employees from two hospitals in the Lubelskie province. In conclusion, medical personnel’s DRG knowledge unambiguously contributes to reducing hospital costs and increasing profitability. The DRG related knowledge enables personnel to obtain value from data by applying DRG data-driven decisions. (shrink)

This paper highlights the emergence of different ‘vocabularies’ that describe various values-driven business functions within large organizations and argues for improved horizontal alignment between them. We investigate two established functions that have long-standing organizational histories: Ethics and Compliance and Corporate Social Responsibility. By drawing upon research on organizational alignment, we explain both the need for and the potential benefit of greater alignment between these values-driven functions. We then examine the structural and socio-cultural dimensions of organizational systems through which (...) E&C and CSR horizontal alignment can be coordinated to improve synergies, address tensions, and generate insight to inform future research and practice in the field of Business and Society. The paper concludes with research questions that can inform future scholarly research and a practical model to guide organizations’ efforts towards inter-functional, horizontal alignment of values-driven organizational practice. (shrink)

Algorithms influence every facet of modern life: criminal justice, education, housing, entertainment, elections, social media, news feeds, work… the list goes on. Delegating important decisions to machines, however, gives rise to deep moral concerns about responsibility, transparency, freedom, fairness, and democracy. Algorithms and Autonomy connects these concerns to the core human value of autonomy in the contexts of algorithmic teacher evaluation, risk assessment in criminal sentencing, predictive policing, background checks, news feeds, ride-sharing platforms, social media, and election interference. Using (...) these case studies, the authors provide a better understanding of machine fairness and algorithmic transparency. They explain why interventions in algorithmic systems are necessary to ensure that algorithms are not used to control citizens' participation in politics and undercut democracy. This title is also available as Open Access on Cambridge Core. (shrink)

This contribution discusses the development of the Data Ethics Decision Aid (DEDA), a framework for reviewing government data projects that considers their social impact, the embedded values and the government’s responsibilities in times of data-driven public management. Drawing from distinct qualitative research approaches, the DEDA framework was developed in an iterative process (2016–2018) and has since then been applied by various Dutch municipalities, the Association of Dutch Municipalities, and the Ministry of General Affairs (NL). We present the DEDA (...) framework as an effective process to moderate case-deliberation and advance the development of responsible data practices. In addition, by thoroughly documenting the deliberation process, the DEDA framework establishes accountability. First, this paper sheds light on the necessity for data ethical case deliberation. Second, it describes the prototypes, the final design of the framework, and its evaluation. After a comparison with other frameworks, and a discussion of the findings, the paper concludes by arguing that the DEDA framework is a useful process for ethical evaluation of data projects for public management and an effective tool for creating awareness of ethical issues in data practices. (shrink)

This paper introduces a refined single-valued neutrosophic set (RSVNS) and presents a similarity measure of RSVNSs. Then a multicriteria decision-making method with RSVNS information is developed based on the similarity measure of RSVNSs. By the similarity measure between each alternative and the ideal solution (ideal alternative), all the alternatives can be ranked and the best one can be selected as well. Finally, an actual example on the selecting problems of construction projects demonstrates the application and effectiveness of the proposed (...) method. (shrink)

The COVID-19 pandemic poses a major challenge to policy makers on how to encourage compliance to social distancing and personal protection rules. This paper compares the effectiveness of two policies that aim to increase the frequency of responsible health behavior using smartphone-tracking applications. The first involves enhanced alert capabilities, which remove social externalities and protect the users from others’ reckless behavior. The second adds a rule enforcement mechanism that reduces the users’ benefit from reckless behavior. Both strategies should be effective (...) if agents are expected-value maximizers, risk averse, and behave in accordance with cumulative prospect theory or in accordance with the Cognitive Hierarchy model. A multi-player trust-game experiment was designed to compare the effectiveness of the two policies. The results reveal a substantial advantage to the enforcement application, even one with occasional misses. The enhanced-alert strategy was completely ineffective. The findings align with the small samples hypothesis, suggesting that decision makers tend to select the options that lead to the best payoff in a small sample of similar past experiences. In the current context, the tendency to rely on a small sample appears to be more consequential than other deviations from rational choice. (shrink)

This paper was published in an issue of the ANTW, Dutch General Journal of Philosophy, dedicated to the work of Paul Churchland. It criticizes Churchland for neglecting the relationships of animals to their environments and their innate subjectivity, which guides them through their environment. The concept of an emotional a priori is introduced, 'the innate structures of experience', analogue to Kant's cognitive a priori. Subjectivity is an evolved property which enables organisms to adapt their genetic interests to a particular environment.

Progress in machine learning and artificial intelligence has spurred the widespread adoption of automated decision systems (ADS). An extensive literature explores what conditions must be met for these systems' decisions to be fair. However, questions of legitimacy -- why those in control of ADS are entitled to make such decisions -- have received comparatively little attention. This paper shows that when such questions are raised theorists often incorrectly conflate legitimacy with either public acceptance or other substantive values such as (...) fairness, accuracy, expertise or efficiency. In search of better theories, we conduct a critical analysis of the philosophical literature on the legitimacy of the state, focusing on consent, public reason, and democratic authorisation. This analysis reveals that the prevailing understanding of legitimacy in analytical political philosophy is also ill-suited to the task of establishing whether and when ADS are legitimate. The paper thus clarifies expectations for theories of ADS legitimacy and charts a path for a future research programme on the topic. (shrink)

The countercultural healer's guide for building a sustainable practice: work toward your purpose, grow your client base, and thrive with integrity within an unjust capitalist system.

The focus here is on analytical and instrumental requirements for those collective decision exercises that lend themselves to a judgment-driven resolution. These have not as yet received much concerted technical attention from either of the two main movements in the field. They remain somewhere beyond the purview of the objectively-predicated instruments that mainstream GDSS (Group Decision Support System) designs tend to favour. Yet neither are they so inherently ill-structured as the situations with which the GDNSS (Group (...) Decision and Negotiation Support System) community is concerned, these usually allowing only a subjectively-predicated, compromisive or consensus-based conclusion. If the technical requirements peculiar to judgment-driven decision exercises are to be well met, it will be through the offices of analytical instruments that can help assure the rationality of the resolutions at which they arrive. The primary purpose of these pages is to offer some suggestions about the types of analytical instruments that might serve this end. (shrink)

This study examines an important aspect of energy history and policy: the intertwinement of energy technologies with ideals. Ideals play an important role in energy visions and innovation pathways. Aspirations to realize technical, social, and political ideals indicate a long-term commitment in the design of energy systems, distinguishable from commitment to other abstract goals, such as values. This study offers an analytical scheme that could help to conceptualize these differences and their impact on energy policy. In the proposed model, two (...) spheres of interaction are highlighted: a material sphere in which values and technologies co-evolve, and an imaginary sphere in which ideals interact with idealized technologies. Furthermore, the relation between these two spheres can be understood in different ways. This study examines three cases that are illustrative of the different roles of ideals in the development of energy technologies and visions: (1) the evolution of safety in nuclear reactor design; (2) visions of atomic power in France; (3) the political idealization of a tidal power scheme in the Severn Estuary. Finally, the developed model implies more general insights for the development of sociotechnical systems. Amongst others, it shows why certain projects and technologies remain a political, but not a techno–economic option. (shrink)

BackgroundSystems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology ; “big data” statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems (...) medicine knowledge and clinicians working to apply it.DiscussionThis article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through “big data” approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the “death computer,” to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their “quantified self.”SummaryThis paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care. (shrink)

Many seem to think that AI-induced responsibility gaps are morally bad and therefore ought to be avoided. We argue, by contrast, that there is at least a pro tanto reason to welcome responsibility gaps. The central reason is that it can be bad for people to be responsible for wrongdoing. This, we argue, gives us one reason to prefer automated decision-making over human decision-making, especially in contexts where the risks of wrongdoing are high. While we are not the (...) first to suggest that responsibility gaps should sometimes be welcomed, our argument is novel. Others have argued that responsibility gaps should sometimes be welcomed because they can reduce or eliminate the psychological burdens caused by tragic moral choice-situations. By contrast, our argument explains why responsibility gaps should sometimes be welcomed even in the absence of tragic moral choice-situations, and even in the absence of psychological burdens. (shrink)

Purpose – This paper aims to present an overview of the various ethical, societal and critical issues that micro- and nanotechnology-based small, energy self-sufficient sensor systems raise in different selected application fields. An ethical approach on the development of these technologies was taken in a very large international, multitechnological European project. The authors approach and methodology are presented in the paper and, based on this review, the authors propose general principles for this kind of work. Design/methodology/approach – The authors’ approach (...) is based on a great amount of experience working together in multi-disciplinary teams. Ethical issues have usually been handled in the authors’ work to some degree. In this project, the authors had the opportunity to emphasise the human view in technological development, utilise the authors’ experience from previous work and customise the authors’ approach to this particular case. In short, the authors created a wide set of application scenarios with technical and application field experts in the authors’ research project. The scenarios were evaluated with external application field experts, potential consumer users and ethics experts. Findings – Based on the authors’ experiences in this project and in previous work, the authors suggest a preliminary model for construction activity within technology development projects. The authors call this model the Human-Driven Design approach, and Ethics by Design as a more focussed sub-set of this approach. As all enabling technologies have both positive and negative usage possibilities, and so-called ethical assessment tends to focus on negative consequences, there are doubts from some stakeholders about including ethical perspectives in a technology development project. Research limitations/implications – The authors argue that the ethical perspective would be more influential if it were to provide a more positive and constructive contribution to the development of technology. The main findings related to the ethical challenges based on the actual work done in this project were the following: the main user concerns were in relation to access to information, digital division and the necessity of all the proposed measurements; the ethics experts highlighted the main ethical issues as privacy, autonomy, user control, freedom, medicalisation and human existence. Practical implications – Various technology assessment models and ethical approaches for technological development have been developed and performed for a long time, and recently, a new approach called Responsible Research and Innovation has been introduced. The authors’ intention is to give a concrete example for further development as a part of the development of this approach. Social implications – The authors’ study in this particular case covers various consumer application possibilities for small sensor systems. The application fields studied include health, well-being, safety, sustainability and empathic user interfaces. The authors believe that the ethical challenges identified are valuable to other researchers and practitioners who are studying and developing sensor-based solutions in similar fields. Originality/value – The authors’ study covers various consumer application possibilities of small sensor systems. The studied application fields include health, well-being, safety, sustainability and empathic user interfaces. The findings are valuable to other researchers and practitioners who are studying and developing sensor-based solutions to similar fields. (shrink)

To understand the variations in the financial characteristics, we examine the dynamical behaviors by considering the chaotic financial model with external force. First, the dynamical characteristics are analyzed by introducing the external driven force in the price index with commodity demand. We discover that the presence of an external force causes the alternate occurrence of oscillatory and steady states as a function of time. Interestingly, we find the existence of bifurcation delay during the transition from oscillatory to steady state (...) or vice versa. Bifurcation delay is a phenomenon in which the bifurcation does not occur at the actual bifurcation point but rather at a later time, which is referred to as bifurcation delay. To confirm the delay in bifurcation, we estimate the actual bifurcation point and compare it to the observed bifurcation transition. Furthermore, to understand the variations in the bifurcation delay, we estimate the delay time between each consecutive cycle and find random fluctuations in the BD. Following that, the BD is virtualized via a transformed phase portrait. In addition, we show decreasing the value of average BD while increasing the frequency of external forcing. Second, the presence of BD is explored by incorporating external forces into the investment demand with unit investment cost. We discover the existence of a similar phenomenon with a constant bifurcation delay. (shrink)

This article responds to scholarly calls to engage with diaspora in the context of transnational educational mobilities in global higher education. It maintains that transnational academic mobilities produce a particular kind of academic diaspora, that is often valued by both home and host countries but in ways that vary and serve different interests and aspirations. While the contrasting perspectives on brain circulation and brain drain persist, what this article argues is that systemic inequalities are (re)produced through the processes of transnational (...) academic mobilities, which privilege the mobility of some and not others, and at the same time under-value the home-grown academics and overseas-trained academics that return home. The current diaspora politics is located within this complex, hierarchical, and dynamic cultural, political and economic space. In particular, it pinpoints how the promoted desirability of diasporic brains and talents in policy and practice has co3ntinued to reproduce and consolidate academic inequalities. The article then argues for place-based/at home transnationality, seeing it as productive counter position to help reduce inequalities. The article employs self-study research and is informed by a bricolage of data on Vietnam and its Vietnamese transnational academic diasporas gathered at different points in time and in different contexts. (shrink)

The United States juvenile justice system has primary oversight of youth who come into contact with legal authorities. This system is purposefully distinct from the adult system given the presumption of youths’ reduced culpability for delinquent behavior and increased potential for rehabilitation. Some juvenile court policies and practices are supportive of youth while others may drive youth further into the juvenile justice system. Today, we are at a point in which we can—and should—use information technology to (...) accrue data to unpack the impact of these policies and practices on and across youth. Moreover, technology-driven policies and practices such as electronic monitoring may be detrimental to the well-being of youth, whereas others such as video conferencing could be more widely used to benefit youth. While juvenile courts hold youth accountable for their behavior, courts also need to be accountable to youth by employing data-informed policies and practices that advance the health and well-being of youth. (shrink)

Law 49/2018, of August 14, created the Portuguese legal regime of the assisted decision-making (capacity), thus eliminating the legal institutes of interdiction and disqualification, provided for in the Civil Code (CC). The aim of this legal regime was to embed a new vision of disability based on a model of rights, that grants people with disabilities an independent and autonomous life and reflects the acceptance of the International Convention on the Rights of Persons with Disabilities (CRPD) guidelines. This paper (...) intends to discuss the ‘new’ Portuguese legal system regarding the legal capacity of persons with disabilities and its role in valuing the expression of the real will of people with disabilities. (shrink)

Biobased production has been promoted as a sustainable alternative to fossil resources. However, controversies over its impact on sustainability highlight societal concerns, value tensions and uncertainties that have not been taken into account during its development. In this work, the consideration of stakeholders’ values in a biorefinery design project is investigated. Value sensitive design is a promising approach to the design of technologies with consideration of stakeholders’ values, however, it is not directly applicable for complex systems like biorefineries. (...) Therefore, some elements of VSD, such as the identification of relevant values and their connection to a technology’s features, are brought into biorefinery design practice. Midstream modulation, an approach to promoting the consideration of societal aspects during research and development activities, is applied to promote reflection and value considerations during the design decision making. As result, it is shown that MM interventions during the design process led to new design alternatives in support of stakeholders' values, and allowed to recognize and respond to emerging value tensions within the scope of the project. In this way, the present work shows a novel approach for the technical investigation of VSD, especially for biorefineries. Also, based on this work it is argued that not only reflection, but also flexibility and openness are important for the application of VSD in the context of biorefinery design. (shrink)

In two decisions delivered inFebruary and March 2001, the German FederalConstitutional Court voided the maritalagreements struck between a man and a pregnantwoman on the grounds that they were the productof an inequality of bargaining power betweenthe parties. These findings, involving anapplication of the fundamental rightsprovisions of the German Basic Law to privateagreements, demonstrate the creeping competenceof the F.C.C. into the sphere of contractualrelations and an ongoing questioning ofthe traditional public/private law divide. Exploring some of the implications of applyingpublic values and (...) constitutional reviewstandards to private agreements, this notecontextualises the decisions within the debateupon competing (and ultimately colliding)social systems of the family and the market. (shrink)

Mobile health tools are often said to empower users by providing them with the information they need to exercise control over their health. We aim to bring clarity to this claim, and in doing so explore the relationship between empowerment and autonomy. We have identified three distinct models embedded in the empowerment rhetoric: empowerment as information, empowerment as control, and empowerment as values. Each distinct model of empowerment gives rise to an associated problem. These problems, the Problem of Interpretation, the (...) Value Alignment Problem, and the Priority Problem, show that mobile health tools in their current form are either insufficient for empowerment or are self‐defeating. These digital health technologies encourage users to adopt an individualized conception of autonomy, one that may weaken the doctor–patient relationship and undermine practices in shared decision making, and ultimately may not deliver on improving the health outcomes for those that need it the most. (shrink)

Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and (...) healthcare continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of responsibility (...) and decision-making authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees’ reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians’ responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS. (shrink)

This paper focuses on the individual manager making difficult decisions within the context of the organization in which he or she is a member. It proposes a method for examining the interplay of individual and corporate value systems, offering a value congruence model. Hypotheses are generated concerning the varying nature of the value conflicts faced by managers. These are then evaluated based upon interview data from a cross-section of managers in two organizations. The impact of differing organizational (...) value systems is discussed, as well as the implications of the study for research in this area. (shrink)

Bionic systems, connecting biological tissues with computer or robotic devices through brain–machine interfaces, can be used in various ways to discover biological mechanisms. In this article I outline and discuss a “stimulation-connection” bionics-supported methodology for the study of the brain, and compare it with other epistemic uses of bionic systems described in the literature. This methododology differs from the “synthetic”, simulative method often followed in theoretically driven Artificial Intelligence and cognitive science, even though it involves machine models of biological (...) systems. I also bring the previous analysis to bear on some claims on the epistemic value of bionic technologies made in the recent philosophical literature. I believe that the methodological reflections proposed here may contribute to the piecewise understanding of the many ways bionic technologies can be deployed not only to restore lost sensory-motor functions, but also to discover brain mechanisms. (shrink)

On the basis of the combination of single-valued neutrosophic sets and hesitant fuzzy sets, this article proposes a single-valued neutrosophic hesitant fuzzy set as a further generalization of the concepts of fuzzy set, intuitionistic fuzzy set, single-valued neutrosophic set, hesitant fuzzy set, and dual hesitant fuzzy set. Then, we introduce the basic operational relations and cosine measure function of SVNHFSs. Also, we develop a single-valued neutrosophic hesitant fuzzy weighted averaging operator and a single-valued neutrosophic hesitant fuzzy weighted geometric operator and (...) investigate their properties. Furthermore, a multiple-attribute decision-making method is established on the basis of the SVNHFWA and SVNHFWG operators and the cosine measure under a single-valued neutrosophic hesitant fuzzy environment. Finally, an illustrative example of investment alternatives is given to demonstrate the application and effectiveness of the developed approach. (shrink)

Decision support systems, which incorporate artificial intelligence and big data, are receiving significant attention in the public sector. Decision support systems are sociocultural artefacts that are subject to a mix of technical and political choices, and critical investigation of these choices and the rationales they reflect are paramount since they are inscribed into and may cause harm, violate fundamental rights and reproduce negative social patterns. Applying and merging the concepts of sense-making and translation, this article investigates the rationales, (...) translations and critical reflections that shape the development of a decision support system to support social workers assessing referrals concerning child neglect. It presents findings from a qualitative case study conducted in 2019–2020 at the Citizen Centre Children and Young People, Copenhagen Municipality, Denmark. The analysis shows how key actors through processes of translation construct, negotiate and readjust problem definitions, roles, interests, responsibilities and ideas of ambiguity and accountability. Although technological solutionism is present in these processes, it is not the only rationale invested. Rather, technological and data-driven rationales are adjusted to and merged with rationales of efficiency, return on investment and child welfare. Through continuous renegotiation of roles, responsibilities and problems according to these rationales, the key actors attempt to orchestrate ways of managing the complexity facing child welfare services by projecting images of future potentials of the decision support system that are yet to be realised. (shrink)

Background Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women’s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how (...) professionals’ counselling values and practices may differ between these contexts. Methods In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals. Results Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a “principle” lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as “decision-facilitator” for patients. French interviewees described their approach through a “procedural” lens. Their focus was on formal consent, information, and the healthcare professional as “information-giver”. Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice. Conclusion Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision. (shrink)

The international debate on the ethics and legality of autonomous weapon systems (AWS) as well as the call for a ban are primarily focused on the nebulous concept of fully autonomous AWS. More specifically, on AWS that are capable of target selection and engagement without human supervision or control. This thesis argues that such a conception of autonomy is divorced both from military planning and decision-making operations as well as the design requirements that govern AWS engineering and subsequently the (...) tracking and tracing of moral responsibility. To do this, this thesis marries two different levels of meaningful human control (MHC), termed levels of abstraction, to couple military operations with design ethics. In doing so, this thesis argues that the contentious notion of ‘full’ autonomy is not problematic under this two-tiered understanding of MHC. It proceeds to propose the value sensitive design (VSD) approach as a means for designing for MHC. (shrink)

AbstractDuring the Covid-19 pandemic, ethicists and researchers proposed human challenge studies as a way to speed development of a vaccine that could prevent disease and end the global public health crisis. The risks to healthy volunteers of being deliberately infected with a deadly and novel pathogen were not low, but the benefits could have been immense. This essay is a history of the three major efforts to set up a challenge model and run challenge studies in 2020 and 2021. The (...) pharmaceutical company Johnson and Johnson, the National Institutes of Health in the United States, and a private-public partnership of industry, university, and government partners in Britain all undertook preparations. The United Kingdom’s consortium began their Human Challenge Programme in March of 2021.Beyond documenting each effort, the essay puts these scientific and ethical debates in dialogue with the social, epidemiological, and institutional conditions of the pandemic as well as the commercial, intellectual, and political systems in which medical research and Covid-19 challenge studies operated. It shows how different institutions understood risk, benefit, and social value depending on their specific contexts. Ultimately the example of Covid-19 challenge studies highlights the constructedness of such assessments and reveals the utility of deconstructing them retrospectively so as to better understand the interplay of medical research and research ethics with larger social systems and historical contexts. (shrink)

Recent work has suggested that conservation efforts such as restoration ecology and invasive species eradication are largely value-driven pursuits. Concurrently, changes to global climate are forcing ecologists to consider if and how collections of species will migrate, and whether or not we should be assisting such movements. Herein, we propose a philosophical framework which addresses these issues by utilizing ecological and evolutionary interrelationships to delineate individual ecological communities. Specifically, our Evolutionary Community Concept recognizes unique collections of species that (...) interact and have co-evolved in a given geographic area. We argue this concept has implications for a number of contemporary global conservation issues. Specifically, our framework allows us to establish a biological and science-driven context for making decisions regarding the restoration of systems and the removal of exotic species. The ECC also has implications for how we view shifts in species assemblages due to climate change and it advances our understanding of various ecological concepts, such as resilience. (shrink)

During my (Hafiz) childhood in Bangladesh, I experienced the negative impact of the educational system. My experiences initiated a process of conscientization leading to values-driven activism through the establishment of Education for Development and Sustainability (EDS), a child-friendly community of practice, with Trine and Alamin. In encounters with Erling and Sigrid, we became aware that our activities were in accordance with action research based on cooperative inquiry (Heron & Reason, 2008). From that point of departure, we developed our (...) own collaborative living theory. In this paper, we explore the research question “How did we become action researchers and what is our driving force?” by using Stoller’s (1989) autobiographical narrative method to analyse selected, lived experiences. Sharing lived experiences and engaging in activism with each other and the EDS children became the base for our conscientization, radical empiricism and contemplating involvement in EDS. Value based activism can create empathic relations and emotions through shared engagement for social justice and the realization that we create a shared reality. Hence, conducting action research with children/youth is in our experience a key to sustainable development. However, to increase the transparency and validity of our research, we needed to explore how our experiences and actions have influenced our values, emotions and decisions to conduct research, our research topic and the research in itself. Therefore, we have engaged co-researchers and participants to critically question the research practice and made it open for discussion and comments in order to see alternative ways of interpreting situations and processes. (shrink)

In the modern world, situations often arise in which the value-based regulation of human activity weakens and the old requirements lose their relevance. The need for analysis is associated with the “normality” of the state of anormativity as an attribute of a new social status relating to the sphere of government. The purpose of this article is to study the dynamics of the development of values and norms as a possible reason for the inefficiency of managerial decisions. The sociocultural (...) method made it possible to consider the individual, the person and society as a single integral system in which the elements are not reducible to each other, as well as to describe the conflict of values and norms as a complex of sociocultural pathologies leading to ineffective managerial decisions. Value analysis was used to reveal the content of the conflict of values and norms and their manifestations in culture and to describe the axiological mechanisms of sociocultural interactions. The hermeneutical method made it possible to identify and study the factors of conflict between values and norms and to form an idea of value consciousness. The structural-functional approach was used to identify elements of society and culture that contribute to the emergence of a conflict of values and norms. The phenomenological method was useful in the analysis of the conflict of values and norms as a pathological state (deformation) of human consciousness. Methods of comparison, analysis, deduction, induction, generalization, analogy, classification, abstraction were also used. Value-normative and institutional analysis made it possible to clarify the nature of the norm and to define a negative value convention. It was found that the change in values is carried out through value consciousness as a special phenomenological feature of a person, the main pathology of which is fragmentation, which leads to a conflict of values and norms. In particular, the idea of interaction between value-normative and institutional analysis was introduced, which made it possible to clarify the nature of the norm, define a negative value convention, and also distinguish between two ways of thinking and behavior as a prerequisite for a conflict of values and norms: based on common axiological attitudes and particular institutions. It was determined that with the help of norms, society leaves a reflection on values, and social actors are able to initiate the normization of certain actions. If these actions do not correspond to norms and values, a process of denormization takes place, as a result of which anormia arise. Norms break away from values and merge with particular institutional rules, forming an agreement on the methods of obtaining benefits – a negative value convention. The practical value of this scientific work lies in the possibility of using its materials in the process of developing decisions to reform the management decision-making system. (shrink)

Increasingly, it is accepted wisdom for agricultural scientists to get feedback from indigenous peoples—peasants—about new improved seeds and biotechnologies before their official release from the experiment station. What is not yet accepted wisdom is the importance of cognitive science to research on farmer decision making, especially of the type “Why don't they adopt.” In this paper, the impact of the cognitive revolution on models of farmer decision making is described, and decision making models before and after the (...) cognitive revolution are contrasted. An example of a decision model after the cognitive revolution is given by the Malawi farmer's decision whether to use chemical fertilizers or organic fertilizers or both. Results of testing the model show that in Malawi, smallholders' lack of capital and credit are more important factors constraining use of chemical fertilizers than are indigenous beliefs in organic fertilizers or fears of a future dependency on chemicals. (shrink)

This study delves into the significant ethical criteria in the context of global standards. It addresses the moral wrongdoings and adverse side effects associated with global value chains as discussed in the business ethics literature. The methodology involves theoretical application and synthesis. The study employs ethical principles from deontology, consequentialism, and political cosmopolitanism to establish normative criteria such as “injustice and harm to others” and “bad outcomes.” It further investigates how these criteria should influence consumers' decisions, actions, and responsibilities. (...) These criteria are then used to examine the moral wrongdoings and negative effects mentioned in global standards. The study explores how global standards implicitly express consumers' roles in governing global value chains. It scrutinizes consumers' actions and decisions by applying ethical frameworks to global standards. The study outlines consumers' individual and political responsibilities in achieving the goals of global standards. The research findings have implications for governments, consumers, and organizations in practicing shared responsibility. The aim of this research is to provide normative guidance for responsible actions. (shrink)

Despite powerful strategic approaches in the health systems in many afTluent countries, the pandemic that has hit us has cascaded beyond the imagination of many civil societies around the world. There is a call for a higher understanding and practice as the contents in the social media reTlected an urgency to understand more on the healing effects of the body, mind and spirit. In fact, contents in social media highlighted many coping mechanisms which were related to religious, cultural and spiritual (...) values. The public expressed information that included remedies for the body, mind and the spiritual aspects of humanity and their interconnectedness with the environment. These narratives were equally as signiTicant as the logistic arrangements, professional and political decision making among the healthcare professions and members of other inter-related health networks. The results of the COVID-19 outbreak has crea ted a deeper unders tanding, o f a higher consciousness as populations around the world recognize that the world works as one large organism trying to balance the ethical and unethical practices rampant in our societies. This paper proposes the integration of “change theory” to explore the various existing elements in narratives of the public and research studies from healthcare practices. An exploratory analysis of contents in social media and the related literature in healthcare and nursing studies has revealed speciTic patterns which helped put the theory in perspective and to formulate a model for future understanding on what common universal values exist in the commonly existing patterns. (shrink)

The need to understand the systems that support ethical health research has long been recognized, but there are limited descriptions of actual health research ethics (HRE) systems. Using participatory network mapping methods, we empirically defined Malaysia's HRE system. 13 Malaysian stakeholders identified 4 overarching and 25 specific HRE system functions and 35 actors internal and 3 external to the Malaysian HRE system responsible for those functions. Functions requiring the most attention were: advising on legislation related to HRE; (...) optimizing research value to society; and defining standards for HRE oversight. Internal actors with the greatest potential for more influence were: the national network of research ethics committees; non-institution-based research ethics committees; and research participants. The World Health Organization, an external actor, had the largest untapped potential for influence overall. In summary, this stakeholder-driven process identified HRE system functions and actors that could be targeted to increase HRE system capacity. (shrink)

This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jönköping, Växjö and Kristianstad in the south of Sweden. A principal component factor analysis (...) (varimax) was performed using data obtained from the students in the spring of 1994 (n = 122) and in the spring of 1996 (n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3% of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term ‘ascendancy’ refers to self-confidence, and ‘vigour’ denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jönköping changed significantly (paired samples t-test) between 1994 and 1996 (p = 0.028), but that for the Växjö and Kristianstad students did not. The mean of Index P was 44.3% at Växjö, which was greater than the international average for college students (42.3%); it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jönköping (p = 0.032) and Kristianstad (p = 0.025). Index P was very heterogeneous for the group of students at Växjö, with the result that the paired samples t-test reached a value close to significance only. (shrink)