The debate about the use of robots in the care of older adults has often been dominated by either overly optimistic visions (coming particularly from Japan), in which robots are seamlessly incorporated into society thereby enhancing quality of life for everyone; or by extremely pessimistic scenarios that paint such a future as horrifying. We reject this dichotomy and argue for a more differentiated ethical evaluation of the possibilities and risks involved with the use of social robots. In a critical discussion (...) surrounding the capabilities approach to the ethical evaluation of quality of life, we develop an ethical framework that is more appropriate to the situation of the oldest old. We urge employment of a context-dependent approach to the ethical evaluation of new technologies in the care and therapy of older adults, and using the example of the robotic seal Paro, we show how this can be accomplished in a sensible and practical way. (shrink)

Two of the most influential theories about scientific inference are inference to the best explanation and Bayesianism. How are they related? Bas van Fraassen has claimed that IBE and Bayesianism are incompatible rival theories, as any probabilistic version of IBE would violate Bayesian conditionalization. In response, several authors have defended the view that IBE is compatible with Bayesian updating. They claim that the explanatory considerations in IBE are taken into account by the Bayesian because the Bayesian either does or should (...) make use of them in assigning probabilities to hypotheses. I argue that van Fraassen has not succeeded in establishing that IBE and Bayesianism are incompatible, but that the existing compatibilist response is also not satisfactory. I suggest that a more promising approach to the problem is to investigate whether explanatory considerations are taken into account by a Bayesian who assigns priors and likelihoods on his or her own terms. In this case, IBE would emerge from the Bayesian account, rather than being used to constrain priors and likelihoods. I provide a detailed discussion of the case of how the Copernican and Ptolemaic theories explain retrograde motion, and suggest that one of the key explanatory considerations is the extent to which the explanation a theory provides depends on its core elements rather than on auxiliary hypotheses. I then suggest that this type of consideration is reflected in the Bayesian likelihood, given priors that a Bayesian might be inclined to adopt even without explicit guidance by IBE. The aim is to show that IBE and Bayesianism may be compatible, not because they can be amalgamated, but rather because they capture substantially similar epistemic considerations. 1 Introduction2 Preliminaries3 Inference to the Best Explanation4 Bayesianism5 The Incompatibilist View : Inference to the Best Explanation Contradicts Bayesianism5. 1 Criticism of the incompatibilist view6 Constraint - Based Compatibilism6. 1 Criticism of constraint - based compatibilism7 Emergent Compatibilism7. 1 Analysis of inference to the best explanation7. 1. 1 Inference to the best explanation on specific hypotheses7. 1. 2 Inference to the best explanation on general theories7. 1. 3 Copernicus versus Ptolemy7. 1. 4 Explanatory virtues7. 1. 5 Summary7. 2 Bayesian account8 Conclusion. (shrink)

The term “uncanny valley” goes back to an article of the Japanese roboticist Masahiro Mori. He put forward the hypothesis that humanlike objects like certain kinds of robots elicit emotional responses similar to real humans proportionate to their degree of human likeness. Yet, if a certain degree of similarity is reached emotional responses become all of a sudden very repulsive. The corresponding recess in the supposed function is called the uncanny valley. The present paper wants to propose a philosophical explanation (...) why we feel empathy with inanimate objects in the first place, and why the uncanny valley occurs when these objects become very humanlike. The core of this explanation—which is informed by the recently developing empirical research on the matter—will be a form of empathy involving a kind of imaginative perception. However, as will be shown, imaginative perception fails in cases of very humanlike objects. (shrink)

The authors respond to a letter by Mitchell Berger in the March‐April 2024 issue of the Hastings Center Report concerning their essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines.”.

Novel varieties of interplay between humans, robots and software agents are on the rise. Computer-based artefacts are no longer mere tools but have become interaction partners. Distributed problem solving and social agency may be modelled by social computing systems based on multi-agent systems. MAS and agent-based modelling approaches focus on the simulation of complex interactions and relationships of human and/or non-human agents. MAS may be deployed both in virtual environments and cyber-physical systems. With regard to their impact on the physical (...) environment, such systems possess a virtual actuality in a testbed. They have a real actuality when they are employed in real time in order to govern processes in the natural world. Constellations of inter-agency and distributed agency materialize. This paper presents a multidimensional, gradual classification framework for individual and joint agency. Activity level, adaptivity, interaction and personification of others are essential dimensions. The framework allows constellations of distributed and collective agency in socio-technical systems to be analysed in detail. Scenarios where solely humans act can be compared to testbed simulations based on this classification scheme. (shrink)

Bioethicists influence practices and policies in medicine, science, and public health. However, little is known about bioethicists’ views. We recently surveyed 824 U.S. bioethicists on a wide range of ethical issues, including topics related to abortion, medical aid in dying, and resource allocation, among others. We also asked bioethicists about their demographic, religious, academic, and professional backgrounds. We find that bioethicists’ normative commitments predict their views on bioethical issues. We also find that, in important ways, bioethicists’ views do not align (...) with those of the U.S. public: for instance, bioethicists are more likely than members of the public to think abortion is ethically permissible but are less likely to believe compensating organ donors is. Our demographic results indicate the field of bioethics is far less diverse than the U.S. population—less diverse even than other academic disciplines—suggesting far more work needs to be done to build an inclusive field. (shrink)

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘paradigms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher‐level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea that (...) higher‐level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. *Received July 2009; revised October 2009. †To contact the authors, please write to: Leah Henderson, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 32D‐808, Cambridge, MA 02139; e‐mail: [email protected]. (shrink)

_K. al-Manām_ by Ibn Abī al-Dunyā is a compendium of 350 Muslim dream narratives in Arabic. The English introduction examines the function of dreams in classical Arabic literature with a focus on dreams as a means of edification.

Aufgrund des demografischen Wandels wird der Anteil pflegebedürftiger Menschen in den nächsten Jahrzehnten stark zunehmen. In Prognosen zur Bevölkerungsentwicklung wird unter dem Stichwort „Pflegenotstand“ davon ausgegangen, dass sich in den nächsten zehn Jahren der Anteil der sehr alten Menschen bei sinkenden Geburtenzahlen zumindest verdoppelt. In dieser Altersgruppe wird ein sehr hoher Anteil der Menschen pflegebedürftig sein. Laut einer Studie der Bertelsmann-Stiftung werden bis zum Jahr 2030 in Deutschland bis zu 500.000 Pflegekräfte fehlen.

Patient-reported outcomes are increasingly used as dependent variables in studies regarding the effectiveness of clinical interventions. But patient-reported outcome measures (PROMs) do not provide intuitively meaningful data. For instance, it is not clear what a five point increase or decrease on a particular scale signifies. Establishing ‘interpretability’ involves making changes in outcomes meaningful. Attempts to interpret PROMs have led to the development of methods for identifying a minimum important difference (MID). In this paper, however, I draw on Charles Taylor’s distinction (...) between weak and strong evaluations to suggest that identifying a MID, specifically, a MID that uses a patient-reported reference group, may not provide an adequate interpretation of these measures. Moreover, I argue that the difficulty with interpreting these measures is tied to a larger problem concerning their validity. If researchers wish to interpret PROMs, they may first need to know more about the constructs they attempt to measure, namely, quality of life. (shrink)

In his recent article “Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis,” Bart Engelen (2019) develops a useful framework for evaluating health-related nudges in an attempt to...

Twelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high‐end multi‐fetal pregnancies. This evidence has appeared to resolve the moral debate.In this (...) paper I look at the role of clinical evidence in medical ethics. In particular I examine the role of clinical evidence in determining what counts as a significant harm or risk. First, I challenge the extent to which these empirical claims are descriptive, suggesting instead that the evidence is to some degree normative in character. Second, I question whether such empirical claims should count as evidence for what are essentially difficult ethical decisions – a role they appear to play in the case of elective reductions. I will argue that they should not, primarily because the value‐laden nature of this evidence conceals much of what is ethically at stake. It is important to recognize that empirical evidence cannot be a substitute for ethical deliberation. (shrink)

These essays engage Jin Y. Park’s recent translation of the work of Kim Iryŏp, a Buddhist nun and public intellectual in early twentieth-century Korea. Park’s translation of Iryŏp’s Reflections of a Zen Buddhist Nun was the subject of two book panels at recent conferences: the first a plenary session at the annual meeting of the Society for Asian and Comparative Philosophy and the second at the Eastern Division of the American Philosophical Association on a group program session sponsored by the (...) International Society for Buddhist Philosophy. This exchange also includes a response from Park. (shrink)

The development of increasingly intelligent and autonomous technologies will eventually lead to these systems having to face morally problematic situations. This gave rise to the development of artificial morality, an emerging field in artificial intelligence which explores whether and how artificial systems can be furnished with moral capacities. This will have a deep impact on our lives. Yet, the methodological foundations of artificial morality are still sketchy and often far off from possible applications. One important area of application of artificial (...) systems with moral capacities is geriatric care. The goal of this article is to afford the methodological foundations for artificial morality, i.e., for implementing moral capacities in artificial systems in general, and to discuss them with respect to an assistive system in geriatric care which is capable of moral learning. (shrink)

Tombs of the kings of the Western Han dynasty often contain burial items that are related to the material culture of the Eastern Eurasian Steppe. These artifacts are usually interpreted in a general sense, for instance as a sign for the fascination of the Han elite with the exotic. A closer analysis of relevant finds, however, shows different strategies of dealing with foreign influences. While the exchange with the empire’s northern neighbors is evidenced through goods for which identical excavated parallels (...) from the steppe exist, the royal tombs of the Han also contained items that resemble and reference steppe motifs and objects but were clearly produced locally and for local consumers. Especially the latter type of artifacts can thus not simply be interpreted as the passive byproduct of exchange relations. Instead, we have to acknowledge that design, production, and usage of these objects were based on conscious decisions. Based on the insight that objects always have a social function, this article argues that the Han elite not only appropriated steppe influences and motifs but also strategically produced and integrated them into their world in order to redefine, enhance, and strengthen their position within their social framework. (shrink)

In this paper, we study discourses of emotion management on the reality television show Survivor. We analyze segments of the program that feature emotionally charged interactional moments and examine how these interactions are interwoven with contestants’ confessional interviews and framed by the narrator’s introductions of the segments. In a two part analysis, we first analyze the talk produced by the contestants and the host as individual texts, using a discourse analytic perspective that focuses on the details of the talk itself. (...) We then consider the ways the talk constitutes a series of layered texts and analyze these texts, using a discourse analytic approach that attends to macro-level and critical perspectives. We conclude that Survivor largely reinforces dominant cultural discourses of emotion management as strategic interactional practice that allow a person to be competitive. Furthermore, the analysis links performances of emotion management to representations of specific aspects of contestants’ social identities. (shrink)

Shenker has claimed that Von Neumann's argument for identifying the quantum mechanical entropy with the Von Neumann entropy, S() = – ktr( log ), is invalid. Her claim rests on a misunderstanding of the idea of a quantum mechanical pure state. I demonstrate this, and provide a further explanation of Von Neumann's argument.

The need for greater privacy protections in the United States has never been greater. In their work, “Ethical Responsibilities for Companies That Process Personal Data”, McCoy et al. (2023) correct...

Journal of Political Philosophy, EarlyView.

A short, concise book in favor of honoring doubt and admitting when the answer is: I don’t know. From the acclaimed author of No Book but the World and 2019's searing new novel Strangers and Cousins. In a tight, enlightening narrative, Leah Hager Cohen explores why, so often, we attempt to hide our ignorance, and why, in so many different areas, we would be better off coming clean. Weaving entertaining, anecdotal reporting with eye-opening research, she considers both the ramifications (...) of and alternatives to this ubiquitous habit in arenas as varied as education, finance, medicine, politics, warfare, trial courts, and climate change. But it’s more than just encouraging readers to confess their ignorance—Cohen proposes that we have much to gain by embracing uncertainty. Three little words can in fact liberate and empower, and increase the possibilities for true communication. So much becomes possible when we honor doubt. (shrink)

Patient-reported outcome measures (PROMs) are increasingly used to assess multiple facets of healthcare, including effectiveness, side effects of treatment, symptoms, health care needs, quality of care, and the evaluation of health care options. There are thousands of these measures and yet there is very little discussion of their theoretical underpinnings. In her 2008 Presidential address to the Society for Quality of Life Research (ISOQoL), Professor Donna Lamping challenged researchers to grapple with the theoretical issues that arise from these measures. In (...) this paper, I attempt to do so by arguing for an analogy between PROMs and Hans-Georg Gadamer’s logic of question and answer. While researchers readily admit that the constructs involved in PROMs are imperfectly understood and lack a gold standard, they often ignore the consequences of this fact. Gadamer’s work on questions and their importance to philosophical hermeneutics helps to show that the questions researchers ask about such constructs are also imperfectly understood. I argue that these questions should not be standardized, and I instead propose a theoretical framework that understands PROMs as posing genuine questions to respondents—questions that are open to reinterpretation. (shrink)

It is a common view that artificial systems could play an important role in dealing with the shortage of caregivers due to demographic change. One argument to show that this is also in the interest of care-dependent persons is that artificial systems might significantly enhance user autonomy since they might stay longer in their homes. This argument presupposes that the artificial systems in question do not require permanent supervision and control by human caregivers. For this reason, they need the capacity (...) for some degree of moral decision-making and agency to cope with morally relevant situations (artificial morality). Machine ethics provides the theoretical and ethical framework for artificial morality. This article scrutinizes the question how artificial moral agents that enhance user autonomy could look like. It discusses, in particular, the suggestion that they should be designed as moral avatars of their users to enhance user autonomy in a substantial sense. (shrink)

ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked (...) to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field. (shrink)

This essay argues that recent reflexively oriented critiques of social studies of science, especially those of Steve Woolgar, present a problematic version of instrumental irony. Woolgar's own view is presented as instrumental and his antipathy to theorizing is opposed by arguing for the need to adopt a privileged position in order to carry out his recommended refusal of objectivist discourse.

One of philosophy’s oldest paradoxes is the apparent contradiction between the great triumphs and the dramatic failures of the human mind. The same organism that routinely solves inferential problems too subtle and complex for the mightiest computer often makes errors in the simplest of judgments about everyday events. (Nisbett and Ross 1980, p. xi).

Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)

The Covid‐19 pandemic highlighted the need to examine public trust in the U.S. Food and Drug Administration (FDA) vaccine approval process and the role of political influence in the FDA's decisions. Ensuring that the FDA is itself trustworthy is important for justifying public trust in its actions, like vaccine approvals, thereby promoting public health. We propose five conditions of trustworthiness that the FDA should meet when it reviews vaccines, even during emergencies: consistency with rules, proper expert or political decision‐makers, proper (...) decision‐making and noninterference, connection to public preference, and transparency of both reasons and procedures. The five conditions provide a road map of procedural and substantive requirements, which the FDA has variably implemented, focused on ensuring appropriate influence of political interests. While being a trustworthy agency cannot guarantee the public's trust, implementing these conditions builds a groundwork for public trust. (shrink)

In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

BackgroundThe main purpose of this study was to describe the latent structure of pregnancy perception by investigating the role of risks and medical examinations in pregnancy perception across the sexes and pregnancy status.MethodsStudy 1 developed a questionnaire based on the responses of 29 young adults on their perception of pregnancy. Study 2 consisted of distributing the questionnaire among 290 participants.ResultsThe statistical clustering analysis revealed three major clusters of pregnancy perceptions: “evaluative,” “physio-medical,” and “future considerations,” each of them encompassing several meaningful (...) sub-clusters. This structure of pregnancy perceptions supports Beck and Beck-Gernsheim’s modernization approach. Negative emotions toward pregnancy were related to social cognitions, whereas thoughts about risks were included in the medical sub-cluster. After reliability analyses, comparisons of scale scores revealed that women experienced more positive emotions, thought more about physical symptoms and about future issues compared to men.ConclusionPregnant participants felt less ambivalence toward pregnancy, thought more about risks and medical examinations and less about parents’ duties than non-pregnant participants. (shrink)

This paper proposes that Dickens’s Bleak House is symptomatic of a so-called social realm, in which neither oikos nor polis exists as a distinct, autonomous entity; therefore, neither can offer sanctuary or adequately discharge the historical role of the household – maintaining life. In this zone of indistinction, the symbolic structures of London’s law have become the city’s physical structures, leading to symptoms like Jo the outlaw, whose illness and death is attributed to the failure of both the polis and (...) the oikos – the city’s legal housekeeping and the law-as-house, respectively – to maintain life. London’s law has become so immanent that it takes on the role of religion, thus precluding God’s transcendence. Ultimately, the novel recoils from London’s threatening presence and attempts to inter the nineteenth-century anxieties associated with the city – anxieties centering around the law both as structure and religion – through redemptive repetition: Bleak House attempts to wrest the oikos from the clutches of the polis. But despite the novel’s efforts, as the divisions between oikos and polis collapse, it is ultimately impossible for either sphere to retain any semblance of itself. As a result, retreat from the polis to the oikos is impossible: there are no longer well-defined domains – of oikos or polis – into which to retreat in the growing indistinction of the social realm. (shrink)

Volume 19, Issue 7, July 2019, Page 64-65.