London shows that principled leadership and business diplomacy not only provide direction for management, but they also enhance development of leadership in ...

On the philosophy of religion and its effects on a society.

Recent claims that artificial intelligence (AI) systems demonstrate “emergent abilities” have fueled excitement but also fear grounded in the prospect that such systems may enable a wider range of parties to make unprecedented advances in areas that include the development of chemical or biological weapons. Ambiguity surrounding the term “emergent abilities” has added avoidable uncertainty to a topic that has the potential to destabilize the strategic landscape, including the perception of key parties about the viability of nonproliferation efforts. To avert (...) these problems in the future, scientists, developers, policymakers, and other parties should take cred- ible steps to strengthen the health of the scientific ecosystem around AI. (shrink)

The high rates of attrition that occur in drug development are widely regarded as problematic, but the failure of well-designed studies benefits both researchers and healthcare systems by, for example, generating evidence about disease theories and demonstrating the limits of proven drugs. A wider recognition of these benefits will help the biomedical research enterprise to take full advantage of all the information generated during the drug development process.

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Wars must be won if our country … is to be protected from unthinkable outcomes, as the events on September 11th most recently illustrated…. This best protection unequivocally requires armed forces having military physicians committed to doing what is required to secure victory…. As opposed to needing neutral physicians, we need military physicians who can and do identify as closely as possible with the military so that they, too, can carry out the vital part they play in meeting the needs (...) of the mission.Counterpoint:We believe the role of the “physician–soldier” to be an inherent moral impossibility because the military physician, in an environment of military control, is faced with the difficult problems of mixed agency that include obligations to the “fighting strength” and … “national security.”. (shrink)

Philosophical study of faith in God, nature, universe, etc., with special reference to Islam.

On indic philosophy; includes articles on Mahabharata epic.

To give substance to the rhetoric of ‘learning health systems’, a variety of novel trial designs are being explored to more seamlessly integrate research with medical practice, reduce study duration and reduce the number of participants allocated to ineffective interventions. Many of these designs rely on response adaptive randomisation. However, critics charge that RAR is unethical on the grounds that it violates the principle of equipoise. In this paper, I reconstruct critiques of RAR as holding that it is inconsistent with (...) five important ethical principles. I then argue that these criticisms rest on a faulty view of equipoise encouraged by the idea that a RAR study models the beliefs of a single rational agent about the relative merits of the interventions being studied. I outline a view in which RAR models an idealised health system in which diverse communities of fully informed experts shrink or grow as their constituent members update their expert opinions in light of reliable medical evidence. I show how a proper understanding of clinical equipoise can reconcile this conception of RAR with these five ethical principles. This analysis removes an in-principle objection to RAR and sheds important light on the relationship between clinical equipoise and transient diversity in the scientific community. (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)

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

To judge from the rash of recent law review articles, it is a miracle that research with human subjects in the U.S. continues to draw breath under the asphyxiating heel of the rent-seeking, creativity-stifling, jack-booted bureaucrethics that is the current system of research ethics oversight and review. Institutional Review Boards, sometimes called Research Ethics Committees, have been accused of perpetrating “probably the most widespread violation of the First Amendment in our nation's history,” resulting in a “disaster, not only for academics, (...) but for the whole nation.” One member of the President's Council on Bioethics went so far as to assert, “There has been no greater damage to academic freedom in the United States in my lifetime. And my lifetime encompasses McCarthy and it encompasses political correctness, both.” Locked in the bureaucratic “iron cage” of IRB oversight, critics charge that researchers have been transformed into a vulnerable, exposed population, subject to domination, that has been likened in one case to a kind of “Tuskegee in reverse.”. (shrink)

Statements of the core ethical and professional responsibilities of medical professionals are incomplete in ways that threaten fundamental goals of medicine. First, in the absence of explicit guida...

The foundations of research ethics are riven with fault lines emanating from a fear that if research is too closely connected to weighty social purposes an imperative to advance the common good through research will justify abrogating the rights and welfare of study participants. The result is an impoverished conception of the nature of research, an incomplete focus on actors who bear important moral responsibilities, and a system of ethics and oversight highly attuned to the dangers of research but largely (...) silent about threats of ineffective, inefficient, and inequitable medical practices and health systems. -/- In For the Common Good: Philosophical Foundations of Research Ethics, Alex John London defends a conception of the common good that grounds a moral imperative with two requirements. The first is to promote research that generates the information necessary to enable key social institutions to effectively, efficiently, and equitably safeguard the basic interests of individuals. The second is to ensure that research is organized as a voluntary scheme of social cooperation that respects its various contributors' moral claims to be treated as free and equal. Connecting research to the goals of a just social order grounds a framework for assessing and managing research risk that reconciles these requirements and justifies key oversight practices in non-paternalistic terms. Reconceiving research ethics as resolving coordination problems and providing credible assurance that these requirements are being met expands the issues and actors that fall within the purview of the field and provides the foundation for a more unified and coherent approach to domestic and international research. -/- This is an open access title available under the terms of a CC BY-NC-ND 4.0 license. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. (shrink)

The prevailing discourse around AI ethics lacks the language and formalism necessary to capture the diverse ethical concerns that emerge when AI systems interact with individuals. Drawing on Sen and Nussbaum’s capability approach, we present a framework formalizing a network of ethical concepts and entitlements necessary for AI systems to confer meaningful benefit or assistance to stakeholders. Such systems enhance stakeholders’ ability to advance their life plans and well-being while upholding their fundamental rights. We characterize two necessary conditions for morally (...) permissible interactions between AI systems and those impacted by their functioning, and two sufficient conditions for realizing the ideal of meaningful benefit. We then contrast this ideal with several salient failure modes, namely, forms of social interactions that constitute unjustified paternalism, coercion, deception, exploitation and domination. The proliferation of incidents involving AI in high-stakes domains underscores the gravity of these issues and the imperative to take an ethics-led approach to AI systems from their inception. (shrink)

First-in-human clinical trials represent a critical juncture in the translation of laboratory discoveries. However, because they involve the greatest degree of uncertainty at any point in the drug development process, their initiation is beset by a series of nettlesome ethical questions [1]: has clinical promise been sufficiently demonstrated in animals? Should trial access be restricted to patients with refractory disease? Should trials be viewed as therapeutic? Have researchers adequately minimized risks? The resolution of such ethical questions inevitably turns on claims (...) about future events like harms, therapeutic response, and clinical translation. Recurrent failures in clinical translation, like Eli Lilly's Alzheimer candidate semagacestat, highlight the severe limitations of current methods of prediction. In this case, patients in the active arm of the placebo-controlled trial had earlier onset of dementia and elevated rates of skin cancer [2]. Various authoritative accounts of human research ethics state that decision-making about risk and benefit should be careful, systematic, and non-arbitrary [3]–[5]. Yet, these sources provide little guidance about what kinds of evidence stakeholders should use to ensure their estimates of such events ground responsible ethical decisions. In this article, we suggest that investigators, oversight bodies, and sponsors often base their predictions on a flawed and inappropriately narrow preclinical evidence base. (shrink)

This paper examines the concept of a 'standard of care' as it has been used in recent arguments over the ethics of international human-subjects research. It argues that this concept is ambiguous along two different axes, with the result that there are at least four possible standard of care arguments that have not always been clearly distinguished. As a result, it has been difficult to assess the implications of opposing standard of care arguments, to recognize important differences in their supporting (...) rationales, and even to locate the crux of the disagreement in some instances. The goal of the present discussion, therefore, is to disambiguate the concept of a 'standard of care' and to highlight the areas of genuine disagreement among different standards. In the end it is argued that one standard of care argument in particular is more complex than either its proponents or its critics may have recognized and that understanding this possibility opens up a potentially promising avenue of inquiry that remains to be carefully explored. (shrink)

Contributed articles on the life, works and philosophy of S. Radhakrishnan, 1888-1975, Indian philosopher.

This study examines urban agriculture (UA) in Sacramento, California (USA), the nation's self-branded “Farm-to-Fork Capital,” in order to highlight UA’s distinct yet entangled roots. The study is based on 24 interviews with a diverse array of UA leaders, conducted as part of a five-year transdisciplinary study of UA in Sacramento. In it, we unearth three primary “taproots” of UA projects, each with its own historical legacies, normative visions, and racial dynamics. In particular, we examine UA projects with “justice taproots,” “health (...) taproots,” and “market taproots.” We use this analysis to understand how different kinds of UA projects are embedded in racial capitalism in ways that transform relationships between people, the city, and food systems. Unearthing these entangled roots helps illuminate UA’s underlying politics, showing how these roots grow in both competitive and symbiotic ways within the soil matrix of racial capitalism. We argue that these roots interact differently with racial capitalism, creating disparities in their growth trajectories. In particular, UA projects associated with the justice taproot are historically underrepresented and undervalued. However, we argue that there are some prospects for building alliances between the UA movement’s three roots, and that these are both promising and problematic. (shrink)

Recent debates over the use of sham surgery as a control for studies of fetal tissue transplantation for Parkinson’s disease have focused primarily on rival interpretations of the US federal regulations governing human-subjects research. Using the core ethical and methodological considerations that underwrite the equipoise requirement, we nd strong prima facie reasons against using sham surgery as a control in studies of cellular-based therapies for Parkinson’s disease and more broadly in clinical research. Additionally, we believe that these reasons can be (...) generalized to apply to the use of other placebo controls that carry signi cant risks of positive harms in and of themselves. As a result, our arguments are centrally relevant to the emerging drive to subject therapies with a surgical component to the same rigorous standards of evaluation as those governing the approval of new pharmaceuticals. (shrink)

IN BOTH THE EUDEMIAN ETHICS AND THE NICOMACHEAN ETHICS, Aristotle says that the aim of ethical inquiry is a practical one; we want to know what virtue is so that we may become good ourselves and thereby do well and be happy. By classifying ethical inquiry as a practical endeavor, Aristotle is rejecting a view that he attributes to Socrates according to which ethics is a kind of theoretical science. In theoretical sciences, such as geometry or astronomy, the knowledge of (...) a particular subject matter is sought as an end in itself, and the possession of such knowledge is sufficient to make one a geometer or an astronomer. In rejecting this model Aristotle argues that the knowledge of virtue is sought not solely for itself but in order to inform praxis and in order that we become virtuous and good, not by knowing what the virtues are but by cultivating them in practice. (shrink)

Recent claims that artificial intelligence (AI) systems demonstrate “emergent abilities” have fueled excitement but also fear grounded in the prospect that such systems may enable a wider range of parties to make unprecedented advances in areas that include the development of chemical or biological weapons. Ambiguity surrounding the term “emergent abilities” has added avoidable uncertainty to a topic that has the potential to destabilize the strategic landscape, including the perception of key parties about the viability of nonproliferation efforts. To avert (...) these problems in the future, scientists, developers, policymakers, and other parties should take credible steps to strengthen the health of the scientific ecosystem around AI. (shrink)

The debate over when medical research may be performed in developing countries has steered clear of the broad issues of social justice in favor of what seem more tractable, practical issues. A better approach will reframe the question of justice in international research in a way that makes explicit the links between medical research, the social determinants of health, and global justice.

In “The Real Problem With Equipoise,” Chiong (2006) raises two distinct, but interrelated issues concerning the concept of equipoise. The first deals with the role of equipoise in evaluating intern...

The threat of biological and chemical terrorism highlights a growing tension in research ethics between respecting the interests of individuals and safeguarding and protecting the common good. But what it actually means to protect the common good is rarely scrutinized. There are two conceptions of the common good that provide very different accounts of the limits of permissible medical research. Decisions about the limits of acceptable medical research in defense of the common good should be carried out only within the (...) latter framework. (shrink)

Innovation is disruptive and a deeply social phenomenon. As a result, discussions of innovation in the Anglo-American philosophical tradition are often tightly bound up with concerns about individual freedom and pluralism, including pluralism about ethical values. In response, stakeholders looking to evaluate and assess ethical aspects of the innovation ecosystem are often driven to pragmatic approaches that utilize a set of ethical values that can be regarded as “free-standing,” or “thin” in the sense that they are not tied to any (...) particular, substantive conception of the good. This set often includes values such as beneficence, nonmaleficence, respect for autonomy, fairness, and justice. Discussions focused on justice, however, are the least extensive and least well-developed. As a result, most approaches are well-suited to surfacing first-order or direct effects of the discrete activities of a relatively narrow set of stakeholders. Paradoxically, however, such analyses are often not well-suited to identifying and evaluating (a) quintessentially social or higher-order effects (such as network-level or institutional level effects), (b) the role of a larger number of stakeholders who shape the innovation ecosystem in more indirect ways, and (c) some of the positive ethical claims of individuals that are relevant to evaluating innovation. After articulating these shortcomings, I argue that they might be overcome by adopting a justice-led framework for evaluating innovation. (shrink)

The “fair benefits” approach to international research is designed to produce results that all can agree are fair without taking a stand on divisive questions of justice. But its appealing veneer of collaboration masks ambiguities at both a conceptual and an operational level. An attempt to put it into practice would look a lot like an auction, leaving little reason to think the outcomes will satisfy even minimal conditions of fairness.

: An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in his Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. An important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this (...) feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding. (shrink)