The article is based on research conducted at the actual radiology department. It presents a range of descriptions and analyses of concrete operations performed by radiologists during their daily professional routine. After careful ethnographic observations, phenomenological analysis is employed with a view to examining the enactive cognition in the radiologist’s “life-world”. The paper uses both ethnography and phenomenology in order to reveal the essential regularities and sedimentations of everyday radiological processes, and the “everyday background” of certain scientific-cognitive operations. The (...) method of research includes “enactive proofs”— observations and analysis of the externalization of a radiologist’s professional memory through the enaction of medical imaging and imageconsciousness. The findings of this research have much to offer to both philosophy and radiological praxis. While the observations strongly support the development of enactive phenomenology, critique of representationalism, primacy of inference in cognition, and shared intentions, they also provide insight into concrete operations in coping with radiology’s paraphernalia, habituality, the origin of mistakes, multilayered communication, and improving professional praxis. (shrink)

It has been argued extensively that diagnostic services are a general good, but that it is offered in excess. So what is the problem? Is not “too much of a good thing wonderful”, to paraphrase Mae West? This article explores such a possibility in the field of radiological services where it is argued that more than 40% of the examinations are excessive. The question of whether radiological examinations are excessive cries for a definition of diagnostic futility. However, no such definition (...) is found in the literature. As a response, this article addresses the issue of diagnostic futility in five steps. First, it investigates whether the concept of therapeutic futility can be adapted to diagnostics. A closer analysis of the concept of therapeutic futility reveals that this will not do the trick. Second, the article scrutinizes whether there are sources for clarifying diagnostic futility in the extensive debate on excessive radiological examination. Investigating the debate’s terms and definitions reveals a disparate terminology and no clear concepts. On the contrary, the study uncovers that quite different and incompatible issues are at stake. Third, the article examines a procedural approach, which is widely used for settling controversies over utility by focusing on the role of the professionals. On scrutiny however, a procedural approach will not solve the problem in diagnostics. Fourth, a value analysis reveals how we have to decide on the negative value of excessive examinations before we can measure excess. The final and constructive part presents a definition of diagnostic futility drawing upon the lessons from the previous analytical steps. Altogether, too much radiological examination is not a good thing. This is simply because radiological examinations are not unanimously good. Excessive radiological examinations can be defined, but not by one simple general and value-neutral definition. We have to settle with contextually framed value-related definitions. Such definitions will state how bad “too much of a good thing” is and make it possible to assess how much of the bad thing there is. Hence we have to know how bad it is before we can tell how much of it there is in the world. (shrink)

Recent years have witnessed intensive efforts to specify which requirements ethical artificial intelligence (AI) must meet. General guidelines for ethical AI consider a varying number of principles important. A frequent novel element in these guidelines, that we have bundled together under the term explicability, aims to reduce the black-box character of machine learning algorithms. The centrality of this element invites reflection on the conceptual relation between explicability and the four bioethical principles. This is important because the application of general ethical (...) frameworks to clinical decision-making entails conceptual questions: Is explicability a free-standing principle? Is it already covered by the well-established four bioethical principles? Or is it an independent value that needs to be recognized as such in medical practice? We discuss these questions in a conceptual-ethical analysis, which builds upon the findings of an empirical document analysis. On the example of the medical specialty of radiology, we analyze the position of radiological associations on the ethical use of medical AI. We address three questions: Are there references to explicability or a similar concept? What are the reasons for such inclusion? Which ethical concepts are referred to? (shrink)

Artificial intelligence (AI) will drastically change the healthcare system. Radiology is one speciality that is most affected as AI algorithms are increasingly used in diagnostic imaging. AI‐enhanced health technologies will, inter alia, increase workflow efficiency, improve diagnostic accuracy, reduce healthcare‐related costs, and help alleviate medical personnel shortages in under‐resourced settings. However, the development of AI‐enhanced technologies in healthcare is fraught with legal, ethical, and human rights concerns. Currently, the use of AI in South African healthcare is not governed by (...) sui generis legislation or ethical guidance focused exclusively and specifically on AI, although various provisions and principles from law and ethics find application. This article outlines these normative principles and explains their relationship with the extant legal obligations and regulatory framework as applied to the use of AI in radiology services in South Africa. The article concludes with three key recommendations for radiology practitioners using AI in South Africa. These are the need for: vigilant monitoring of AI use in practice, reforms to the liability framework, and appropriate guidance from local regulators and the Health Professions Council of South Africa on the ethical use of AI. (shrink)

Although there is consensus on the fact that ionizing radiation used in radiological examinations can affect health, the stochastic nature of risk makes it difficult to anticipate and assess specific health implications for patients. The issue of radiation protection is peculiar as any dosage received in life is cumulative, the sensitivity to radiation is highly variable from one person to another, and between 20 % and 50 % of radiological examinations appear not to be necessary. In this context, one might (...) reasonably assume that information and patient consent would play an important role in regulating radiological practice. However, there is to date no clear consensus regarding the nature and content of—or even need for—consent by patients exposed to ionizing radiation. While law and ethics support the same principles for respecting the dignity of the person, in the context of radiology practice, they do not provide a consistent message to guide clinical decision-making. This article analyzes the issue of healthcare professionals’ duty to inform and obtain patient consent for radiological examinations. Considering that both law and ethics have as one of their aims to protect vulnerable populations, it is important that they begin to give greater attention to issues raised by the use of ionizing radiation in medicine. While the situation in Canada serves as a backdrop for a reflective analysis of the problem, the conclusions are pertinent for professional practice in other jurisdictions because the principles underlying health law and jurisprudence are fairly general. (shrink)

In this paper I argue that radiological attempts to elucidate the properties of self -- an endeavor currently popular in the social neurosciences -- are fraught with conceptual difficulties. I first discuss several philosophical criteria that increase the chances we are posing the “right” questions to nature. I then discuss whether these criteria are met when empirical efforts are directed at one of the central constructs in the social sciences – the human self. In particular, I consider whether recent attempts (...) to map the neural correlates of self and its assumed properties using brain scanning technology satisfy the conceptual conditions minimally required to ask well-formed, theoretically satisfying questions of nature. I conclude that much theoretical work remains to be done. (shrink)

There has been a significant increase in the use of radiological services in the past 30 years. There are many reasons for this, but one has received little attention: the increased role of patient autonomy in healthcare. Patients demand x rays, CT scans, MRI, and positron emission tomography scans. The key question in this article is how a moral principle, such as respect for patient autonomy, can influence the extension of radiological services. A literature review reveals how patient autonomy is (...) acknowledged in radiology, and how it is used both to explain and to justify the increase in radiological examinations. Furthermore, it also shows how the premises favouring patients’ exercise of their autonomy are not always present, which makes patient autonomy subject to adverse side effects and even abuse. Patient autonomy can be used to reduce the professionals’ responsibility for radiological examinations , to increase the popularity of the profession , to increase the income of the professionals or their institutions, and to promote professional activity. Patient autonomy intended to reduce paternalism, to legitimise otherwise morally unjustifiable actions , and to protect patients, can easily be used as a moral means for opposite ends. These adverse effects are not peculiar to radiology. However, they emerge particularly clearly in explanations and justifications of the substantial increase in radiological services, as well as in debates on overuse of radiological services. (shrink)

Ionizing radiation is present in various situations in the contemporary world. Defining the quantities and units for this field is a complex scientific task, especially the quantities used in radiological protection (RP) to estimate the damage caused to individuals exposed to radiation (detriment). This article highlights the lack of consensus in the scientific RP community regarding the quantities and units employed in practice from the perspective of the philosophy of science. The basic concepts related to the system of quantities are (...) presented, followed by the problems and criticisms addressed by experts in the field. Several reasons for these problems are identified. The article discusses the scant interest on the part of philosophy of science in RP. The philosophy of science is still dominated by an analytical–conceptual perspective that pays little attention to the actual influence of certain structures better understood when considered from the institutional viewpoint, which is here exemplified by the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA). (shrink)

Ionizing radiation is present in various situations in the contemporary world. Defining the quantities and units for this field is a complex scientific task, especially the quantities used in radiological protection (RP) to estimate the damage caused to individuals exposed to radiation (detriment). This article highlights the lack of consensus in the scientific RP community regarding the quantities and units employed in practice from the perspective of the philosophy of science. The basic concepts related to the system of quantities are (...) presented, followed by the problems and criticisms addressed by experts in the field. Several reasons for these problems are identified. The article discusses the scant interest on the part of philosophy of science in RP. The philosophy of science is still dominated by an analytical–conceptual perspective that pays little attention to the actual influence of certain structures better understood when considered from the institutional viewpoint, which is here exemplified by the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA). (shrink)

First responders to chemical, biological, radiological, or nuclear (CBRN) events face decisions having significant human consequences. Some operational decisions are supported by standard operating procedures, yet these may not suffice for ethical decisions. Responders will be forced to weigh their options, factoring-in contextual peculiarities; they will require guidance on how they can approach novel (indeed unique) ethical problems: they need strategies for “on the spot” ethical decision making. The primary aim of this paper is to examine how first responders should (...) approach on the spot ethical decision-making amid the stress and uncertainty of a CBRN event. Drawing on the long-term professional CBRN experience of one of the authors, this paper sets out a series of practical ethical dilemmas potentially arising in the context of a large-scale chemical incident. We propose a broadly consequentialist approach to on the spot ethical decision-making, but one which incorporates ethical values and rights as “side-constraints”. (shrink)

The referral is the key source of information that enables radiologists and radiographers to provide quality services. However, the frequency of suboptimal referrals is widely reported. This research reviews the literature to illuminate the challenges suboptimal referrals present to the delivery of care in radiology departments. The concept of suboptimal referral includes information, that is; missing, insufficient, inconsistent, misleading, hard to interpret or wrong. The research uses the four ethical principles ofnon-maleficence, beneficence, AutonomyandJusticeas an analytic framework.Suboptimal referrals can causeharmby (...) hindering safe contrast-media administration, proper radiation protection by justification of procedures, and compassionate patient care. Suboptimal referrals also hinder promoting patientbenefitsfrom the correct choice of imaging modality and protocol, an optimal performed examination, and an accurate radiology report. Additionally, patientautonomyis compromised from the lack of information needed to facilitate benefit–risk communication. Finally, suboptimal referrals challengejusticebased on lack of reasonable patient prioritising and the unfairness caused by unnecessary examinations.These findings illuminate how suboptimal referrals can inhibit good health and well-being for patients in relation to safety, missed opportunities, patient anxiety and dissatisfaction. The ethical challenges identified calls for solutions. Referral-decision support tools and artificial intelligence may improve referral quality, when implemented. Strategies addressing efforts of radiology professionals are inevitable, including gatekeeping, shared decision-making and inter-professional communication; thereby raising awareness of the importance of good referral quality and promoting commitment to ethical professional conduct. (shrink)

BackgroundPatients’ satisfaction arises from their appraisal of experience in hospital services and measuring patients’ satisfaction in hospital has become a global phenomenon. To improve on patients’ satisfaction, radiographers have to imbibe the right ethical attitude in their conduct while discharging duties to patients during radiological examination. The objective of this study is to understand from the patients’ perspective the ethical conduct of radiographers and radiology nurses that constitute factors in patient satisfaction during routine radiological examination. The rationale of the (...) study is to use the findings to improve radiological service delivery and improve on patient satisfaction.MethodsThis is a cross-sectional descriptive study in which 300 respondents in two hospitals were surveyed to ascertain their satisfaction with the ethical conduct of radiographers and services provided by radiology nurses in the department. The data was analyzed using descriptive statistics at 95 % confidence interval for mean scores and Z-values.ResultsThree hundred patients responded to the survey which comprised of 145 patients from the public hospital and 155 patients from the private hospital. Radiographers fell short in some ethical/professional conduct as in informed consent before treatment ; radiographers’ not explaining his/her experience, expectation, knowledge and equipment procedure. However, they did well in some aspects including observation of professional boundaries with patients during treatment and equity in treatment for the patients during the radiological examination. Some services provided by staff members in the department also fell short of patients’ expectation and satisfaction including explanation of what to expect during the exam, whereas they did well in their level of courtesy to patients. There was a significant difference in the satisfaction level experienced by patients at both hospitals in favour of the private hospital.ConclusionsThere is an urgent need for improved ethical/professional conduct of radiographers and general service delivery in the radiology departments of the hospitals where this investigation was carried out to enhance patient satisfaction. Government has to improve the curricular of service providers in radiology service in the university to include ethical/professional conduct and patient/provider relationship. (shrink)

This book provides a current analysis of the legal and ethical challenges in preparing for and responding to chemical, biological, radiological, nuclear and explosive crises. From past events like the Chernobyl nuclear incident in Russia or the Bhopal chemical calamity in India, to the more recent tsunami and nuclear accident in Japan or the Ebola crisis in Africa, and with the on-going threat of bioterrorism, the need to be ready to respond to CBRNE crises is uncontroversial. What is controversial is (...) whether we are on a path that adequately prepares us for the next event. The ethical and legal scholars in this volume hold that much work remains to be done and offer this book to stimulate further reflection and dialogue around CBRNE crises. This is an indispensable book for both students and scholars of bioethics, international law, public health, as well as for regulators and administrators developing policy and legislation related to public health planning and emergency responses. (shrink)

Shortly after X-ray technology was discovered, it was utilized in war medicine. In this paper, the authors consider how the challenging context of war created fertile conditions for learning, as early radiologists were forced to find solutions to the unique problems posed during wartime. The “battlefield” became the “classroom” where radiologists constructed knowledge in X-ray instrumentation, methods, and education, as well as in medicine generally. Through an examination of two broad historical wartime examples, the authors illustrate how X-rays were used (...) as part of war medicine and offer a detailed sketch of instances of knowledge construction in war radiology. With a sociology of knowledge perspective, they conclude that the knowledge generated in war belongs also to civilian medicine. An understanding of war radiology’s role as a “springboard” for knowledge construction is thus crucial for a complete understanding of the history of radiology. (shrink)

Shortly after X-ray technology was discovered, it was utilized in war medicine. In this paper, the authors consider how the challenging context of war created fertile conditions for learning, as early radiologists were forced to find solutions to the unique problems posed during wartime. The “battlefield” became the “classroom” where radiologists constructed knowledge in X-ray instrumentation, methods, and education, as well as in medicine generally. Through an examination of two broad historical wartime examples, the authors illustrate how X-rays were used (...) as part of war medicine and offer a detailed sketch of instances of knowledge construction in war radiology. With a sociology of knowledge perspective, they conclude that the knowledge generated in war belongs also to civilian medicine. An understanding of war radiology’s role as a “springboard” for knowledge construction is thus crucial for a complete understanding of the history of radiology. (shrink)

In this paper, I discuss the International Commission on Radiological Protection’s (ICRP’s) ethical principles of radiological protection - and in particular their recent proposal to revise the recommendations based on those principles - from a particular point of view; namely, that of an outsider. I do this for two reasons. First, it seems to me that there is a strange mismatch between what the commission’s principles seem, from the outside, to demand, and how they have actually been interpreted. Second, understanding (...) this mismatch sheds some light on the controversy surrounding the recent proposals. (shrink)

The main objective of this study is to continue an open dialogue between representatives of the nuclear industry and the interested public concerned about the ethics of decision-making in nuclear energy. The authors consider these problems from the perspective of integral philosophy differentiating levels of consciousness. The study consists of two parts. The first one aimed to analyse ethical platforms of radiological protection and the principles of biomedical ethics using the level approach [6]. The summary table of ethical correlates of (...) radiation safety and principles of bioethics is presented. The second part described in this paperis contains a system analysis of the public acceptability of radiation risks depending on the ethical platforms of both decision makers and those for whom decisions are made. (shrink)

Con la investigación se constató que la adecuada relación médico-paciente depende en gran medida de la calidad del proceso diagnóstico. La Imagenología como especialidad médica en el marco de la Revolución Científico Técnica ilustra el complejo escenario en que se desenvuelve la relación médico-paciente al evidenciar nuevas expectativas, posibilidades y contradicciones. El trabajo tiene como objetivos destacar los rasgos distintivos de la relación médico-paciente en el ámbito de la Imagenología; contribuir a la formación ética de estos profesionales y significar la (...) responsabilidad social acorde con los principios más humanitarios en la atención de salud. (shrink)

In situations with limited medical resources, be they personnel, equipment, or time, clinicians use “triage” to determine which patients receive treatment. What type of treatment a patient receives depends on the triage “lottery” rules in place. Although these rules for sorting patients and distributing resources are standardized for most situations, they must be somewhat altered after overwhelming, nonstandard disasters.

The International Commission on Radiological Protection — whose regularly updated recommendations are routinely adopted as law throughout the globe — recently issued the first-ever ICRP protections for the environment. These draft 2005 proposals are significant both because they offer the commission’s first radiation protections for any non-human parts of the planet and because they will influence both the quality of radiation risk assessment and environmental protection, as well as the global costs of nuclear-weapons cleanup, reactor decommissioning and radioactive waste management. (...) This piece argues that the 2005 recommendations are scientifically and ethically flawed, or gray, in at least three respects: first, in largely ignoring scientific journals while employing mainly “gray literature;” second, in relying on non-transparent dose estimates and models, rather than on actual radiation measurements; and third, in ignoring classical ethical constraints on acceptable radiation risk. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from (...) an ethical perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

This paper aims to trace individual as well as collective aspects of ‘sight styles’ in diagnostic computed tomography. Radiologists need to efficiently translate the visualized data from the living human body into a reliable and significant diagnosis. During this process, their visual thinking and the created images are incorporated into a complex network of other visualizations, communication strategies, professional traditions, and (tacit) visual knowledge. To investigate the interplay of collective as well as individual dimensions of diagnostic seeing, the concept of (...) ‘sight collective’ (Sehkollektiv) is developed. On the one hand, this concept is based on critical reading of Ludwik Fleck’s epistemological writings and his notions of thought collective (Denkkollektiv) and thought style (Denkstil). On the other hand, it is tested by means of qualitative empirical studies in a radiological university clinic (participatory observations and informal interviews). By employing this approach, the paper traces the collective foundations of a certain diagnostic sight. Moreover, it shows how the individual abilities of radiologists to perform stylized seeing rely remarkably on software-based interactions with the processed images and on tacit dimensions of visual knowledge. (shrink)

ObjectiveTo elucidate the clinical, radiologic characteristics of Leber’s hereditary optic neuropathy (LHON) associated with the other diseases.Materials and methodsClinical data were retrospectively collected from hospitalized patients with LHON associated with the other diseases at the Neuro-Ophthalmology Department at the Chinese People’s Liberation Army General Hospital (PLAGH) from December 2014 to October 2018.ResultsA total of 13 patients, 24 eyes (10 men and 3 women; mean age, 30.69 ± 12.76 years) with LHON mitochondrial DNA (mtDNA) mutations, were included in the cohort. 14502(5)11778(4)11778 (...) &11696(1)12811(1)11696(1)3460(1). One patient was positive for aquaporin-4 antibody (AQP4-Ab), and two were positive for myelin oligodendrocyte glycoprotein antibody (MOG-Ab). Three patients were associated with idiopathic optic neuritis (ON). Two patients were with compression optic neuropathy. Three patients were with the central nervous system (CNS) diseases. One patient was with proliferative diabetic retinopathy (PDR) and one with idiopathic orbital inflammatory syndrome (IOIS). At the onset, visual acuity (VA) in eighteen eyes was below 0.1, one eye was 0.5, five eyes were above 0.5, while VA in sixteen eyes was below a 0.1 outcome, three eyes experienced moderate vision loss. MRI images showed T2 lesions and enhancement in nine patients who received corticosteroids treatment; additional immune modulators treatment was performed on two patients. None of the patients had relapse during the follow-up time.ConclusionLeber’s hereditary optic neuropathy can be accompanied with multiple-related diseases, especially different subtypes of ON, which were also exhibited with IOIS and compression optic neuropathy for the first time in this cohort. This condition may be a distinct entity with an unusual clinical and therapeutic profile. (shrink)

Developers are often the engine behind the creation and implementation of new technologies, including in the artificial intelligence surge that is currently underway. In many cases these new technologies introduce significant risk to affected stakeholders; risks that can be reduced and mitigated by such a dominant party. This is fully recognized by texts that analyze risks in the current AI transformation, which suggest voluntary adoption of ethical standards and imposing ethical standards via regulation and oversight as tools to compel developers (...) to reduce such risks. However, what these texts usually sidestep is the question of how aware developers are to the risks they are creating with these new AI technologies, and what their attitudes are towards such risks. This paper asks to rectify this gap in research, by analyzing an ongoing case study. Focusing on six Israeli AI startups in the field of radiology, I carry out a content analysis of their online material in order to examine these companies’ stances towards the potential threat their automated tools pose to patient safety and to the work-standing of healthcare professionals. Results show that these developers are aware of the risks their AI products pose, but tend to deny their own role in the technological transformation and dismiss or downplay the risks to stakeholders. I conclude by tying these findings back to current risk-reduction recommendations with regards to advanced AI technologies, and suggest which of them hold more promise in light of developers’ attitudes. (shrink)

The paradigmatic assumption that REM sleep is the physiological equivalent of dreaming is in need of fundamental revision. A mounting body of evidence suggests that dreaming and REM sleep are dissociable states, and that dreaming is controlled by forebrain mechanisms. Recent neuropsychological, radiological, and pharmacological findings suggest that the cholinergic brain stem mechanisms that control the REM state can only generate the psychological phenomena of dreaming through the mediation of a second, probably dopaminergic, forebrain mechanism. The latter mechanism (and thus (...) dreaming itself) can also be activated by a variety of nonREM triggers. Dreaming can be manipulated by dopamine agonists and antagonists with no concomitant change in REM frequency, duration, and density. Dreaming can also be induced by focal forebrain stimulation and by complex partial (forebrain) seizures during nonREM sleep, when the involvement of brainstem REM mechanisms is precluded. Likewise, dreaming is obliterated by focal lesions along a specific (probably dopaminergic) forebrain pathway, and these lesions do not have any appreciable effects on REM frequency, duration, and density. These findings suggest that the forebrain mechanism in question is the final common path to dreaming and that the brainstem oscillator that controls the REM state is just one of the many arousal triggers that can activate this forebrain mechanism. The “REM-on” mechanism (like its various NREM equivalents) therefore stands outside the dream process itself, which is mediated by an independent, forebrain “dream-on” mechanism. Key Words: acetylcholine; brainstem; dopamine; dreaming; forebrain; NREM; REM; sleep. (shrink)

Following a boom in investment and overinflated expectations in the 1980s, artificial intelligence entered a period of retrenchment known as the “AI winter.” With advances in the field of machine learning and the availability of large datasets for training various types of artificial neural networks, AI is in another cycle of halcyon days. Although medicine is particularly recalcitrant to change, applications of AI in health care have professionals in fields like radiology worried about the future of their careers and (...) have the public tittering about the prospect of soulless machines making life‐and‐death decisions. Medicine thus appears to be at an inflection point—a kind of Groundhog Day on which either AI will bring a springtime of improved diagnostic and predictive practices or the shadow of public and professional fear will lead to six more metaphorical weeks of winter in medical AI. (shrink)

Studies in the psychology of visual expertise have tended to focus on a limited set of expert domains, such as radiology and athletics. Conclusions drawn from these data indicate that experts use parafoveal vision to process images holistically. In this study, we examined a novel, as-of-yet-unstudied class of visual experts—architects—expecting similar results. However, the results indicate that architects, though visual experts, may not employ the holistic processing strategy observed in their previously studied counterparts. Participants (n = 48, 24 architects, (...) 24 naïve) were asked to find targets in chest radiographs and perspective images. All images were presented in both gaze-contingent and normal viewing conditions. Consistent with a holistic processing model, we expected two results: (1) architects would display a greater difference in saccadic amplitude between the gaze- contingent and normal conditions, and (2) architects would spend less time per search than an undergraduate control group. We found that the architects were more accurate in the perspectival task, but they took more time and displayed a lower difference in saccadic amplitude than the controls. Our research indicates a disjunctive conclusion. Either architects are simply different kinds of visual experts than those previously studied, or we have generated a task that employs visual expertise without holistic processing. Our data suggest a healthy skepticism for across-the-board inferences collected from a single domain of expertise to the nature of visual expertise generally. More work is needed to determine whether holism is a feature of all visual expertise. (shrink)

Definition of the problem The umbrella term “explicability” refers to the reduction of opacity of artificial intelligence (AI) systems. These efforts are challenging for medical AI applications because higher accuracy often comes at the cost of increased opacity. This entails ethical tensions because physicians and patients desire to trace how results are produced without compromising the performance of AI systems. The centrality of explicability within the informed consent process for medical AI systems compels an ethical reflection on the trade-offs. Which (...) levels of explicability are needed to obtain informed consent when utilizing medical AI? Arguments We proceed in five steps: First, we map the terms commonly associated with explicability as described in the ethics and computer science literature, i.e., disclosure, intelligibility, interpretability, and explainability. Second, we conduct a conceptual analysis of the ethical requirements for explicability when it comes to informed consent. Third, we distinguish hurdles for explicability in terms of epistemic and explanatory opacity. Fourth, this then allows to conclude the level of explicability physicians must reach and what patients can expect. In a final step, we show how the identified levels of explicability can technically be met from the perspective of computer science. Throughout our work, we take diagnostic AI systems in radiology as an example. Conclusion We determined four levels of explicability that need to be distinguished for ethically defensible informed consent processes and showed how developers of medical AI can technically meet these requirements. (shrink)

In this commentary, I reflect on the differences between two independent citizen approaches to monitoring radiological contamination, one in Belarus after the 1986 Chernobyl nuclear accident and the other in Japan following the 2011 Fukushima Daiichi accident. I examine these approaches from the perspective of their contribution to making radiological contamination more publicly visible. The analysis is grounded in my earlier work, where I examined how we have come to know what we know about post–Chernobyl contamination and its effects in (...) Belarus, a former Soviet republic most heavily affected by the fallout. As I described in this study, much of what we know about the consequences of Chernobyl is based on the work of the Belarusian nonprofit Institute of Radiation Safety, “Belrad.” I compare Belrad’s approach to radiological monitoring with the work of the volunteer network Safecast, arguably one of the best-known citizen science projects in the world, which is working to monitor the scope of the post–Fukushima contamination. Through this comparison of approaches, I raise broader questions about a form of sensing practices—data-related practices of citizen science that make environmental hazards publicly in/visible. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Now?Mike AbellThe cry broke the church’s uncomfortable silence. It actually was more of a moan than a cry. It was deeper, coming from her core. I’d heard it only once before and knew it as a sound caused by a loss that will never be recovered. No one in the church had to turn to discover its source. We all knew the mother had entered to say goodbye (...) to her 19–month–old son.We watched as the now composed mother, along side her husband, followed the small casket—a family rendered incomplete. As they passed our pew, my wife clutched my arm and we wept tears of sympathy, guilt and fear.Just 15 months earlier our now, 2–and ½–year–old son, Jun, had been diagnosed with a brain tumor not dissimilar from the child in the casket. The tumor has a different name, but it’s equally complicated, and comparably rare and aggressive.Over nine months, Jun endured two craniotomies, three rounds of induction chemo, three rounds of high dose chemo with stem cell rescue, 28 days of proton radiation, a sub–dural shunt placement, a port placed and removed, a broviac placed and removed and many, many blood and [End Page 16] platelet transfusions. As of his last scan, there was no evidence of tumor.Jun has now been out of treatment for six months. His hair has grown back. He’s stronger. The meals have stopped arriving. And we no longer are the recipients of sad eyes at playgrounds and restaurants.In many ways we have returned to a somewhat normal life. If you didn’t know Jun was in remission for a brain tumor, you wouldn’t know. Despite all this, cancer still strangles us with fear.Brain tumors often come back. Too often. We’ve heard a few different numbers on the likelihood. And while we’ve never paid too much attention to statistics, they are too scary to ignore. Especially knowing that should it recur, there is no cure. This is our day–to–day reality.A lot of our time is spent analyzing, over analyzing and obsessing. We watch him closely. Every time he stumbles, coughs, or sleeps fifteen minutes longer than normal, we wonder if it’s something more. I’ve called our oncologist about a 99–degree temperature. Something I wouldn’t have done during treatment (I usually waited to 100). I’ve questioned whether hiccups are a sign of recurrence. Admittedly, I’ve even Googled that last one just to be sure.All the anxiety builds the closer you get to an MRI date. My son has scans every three months so I’m beginning to recognize the cycle. It starts a couple weeks out. Normally it begins as a twinge the moment the date is set. But each day it grows, occupying more and more of my mind. This is not to say, I don’t think about it everyday. I do. But the thoughts become more paranoid and frequent. Worst–case scenarios play out. It’s different from the time during treatment. We always had the comfort of knowing that there is still more treatment.By the time we reach MRI day, bring Jun back to the machine room, watch the anesthesiologist put him under, and leave him to be scanned for the next two and half hours, I feel close to nauseas. In my mind, at this point, someone knows. I know they may be a technician and are not necessarily trained to read an MRI. But they know. They’ve seen it before.There usually is a waiting period between the time of the scan and the time you can meet with your oncologist or someone else qualified to read and interpret the scan. I do whatever I can to make that window as narrow as possible. I leave radiology with a disc in hand and head directly to the clinic to pass it off. I’ve heard of people waiting days for an appointment. That’s not an option for me. There would be no eating, no sleeping, and no resting heart rate without knowing. Fortunately, our oncologist is... (shrink)