Recent publications on digital health technologies highlight the importance of ‘responsible’ use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping (...) review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher’s Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing ‘role responsibilities’ among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a ‘responsibility gap’ where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients’ accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Positive changes or transformations have been the subject of study within spiritual traditions as well as humanistic and transpersonal psychology. The aim of the current study is to understand the process of transformation among Moslems in Indonesia, who follow spiritual practices, to achieve the nafs al-muṭma ínnah [tranquil self]. Ten participants in Yogyakarta province were involved in this study. They were recruited using nafs al-muṭmaʾinnah scale developed by the authors. In-depth interviews of both the participants and their significant others were (...) conducted. To analyse the data, an interpretative phenomenological analysis was employed. Five themes emerged from the data, including deviation from the basis of religious environment, spiritual discipline, transformative experiences, new characters and a continuous process. We conclude that participants experience spiritual-religious transformation and achieve the state of nafs al-muṭma ínnah [tranquil self]. The process of transformation occurs gradually after a sudden experience, and it continuously happens throughout the course of life. Three factors contribute to the transformation, including the role of predisposition, the role of a spiritual guide and the role of spiritual experiences.Contribution: As the study of spiritual-religious transformation is mainly conducted within a Judea-Christian tradition, this study significantly contributes to the literature by providing spiritual-religious transformation from an Islamic-Sufi perspective. (shrink)

Recognized in his day as a man of letters equaling Rousseau and Voltaire in France and rivaling Samuel Johnson, David Hume passed from favor in the Victorian age--his work, it seemed, did not pursue Truth but rather indulged in popularization. Although Hume is once more considered as one of the greatest British philosophers, scholars now tend to focus on his thought rather than his writing. To round out our understanding of Hume, M. A. Box in this book charts the interrelated (...) development of Hume's literary ambitions, theories of style, and compositional practice from his Treatise in 1739 through the Enquiries. In so doing, Box makes the case for Hume's career-long concern with the presentational modes of reaching an audience for his philosophical writings. Hume reacted to the popular failure of his masterpiece, A Treatise of Human Nature, Box suggests, by self-consciously exploring strategies in his subsequent works for agreeably bringing his readership to participate in the act of philosophizing. Combining a sensitive grasp of the ways Restoration period and eighteenth-century writers conceived the relations between rhetoric and philosophy with sound readings of particular texts, Box shows how Hume's literary concerns went beyond matters of style to involve persona, structure, and doctrine. While this book helps explain long-standing ambiguities surrounding Hume, especially by pointing out the tension between his created persona and his own voice, it also serves as an excellent introduction to his philosophy. (shrink)

Jan Narveson has articulated a deeply held, widely shared intuition regarding what moral law has to say about bringing additional people into existence: while we are “in favour of making people happy,” we are “neutral about making happy people.” Various formulations of the Narvesonian intuition (closely related to the person-affecting intuition or restriction) have been widely criticized. This present paper outlines an off-the-beaten-path alternate construction of the intuition—the existence condition—and argues that that particular construction has the resources to avoid some (...) of those criticisms. But still other considerably more widely recognized alternate constructions have been offered as well. Thus John Broome outlines what he calls the neutrality intuition. While Broome finds the underlying intuition “strongly attractive,” he nonetheless argues that the neutrality intuition itself leads us quickly into inconsistency. Wlodek Rabinowicz disagrees. On his view, Broome’s inconsistency argument shows, not that the neutrality intuition is false, but rather that it doesn’t follow, from the fact that the outcome, or possible future or world, that includes the additional person is neither better nor worse than the (otherwise similar) world that excludes that person, that the one world is exactly as good as the other. The better view, according to Rabinowicz, is that, on occasion, and specifically when the coming into existence of additional people is at stake, the one world is incommensurate with the other. What is called the principle of trichotomy is, in other words, false. Difficulties arise, however, when we try to reject that seemingly compelling conceptual principle. This present paper concludes with the argument that the availability of the existence condition—which, together with certain other uncontroversial moral principles and a handful of conceptual principles, forms the existential approach—shows that we can maintain the most intuitive parts of neutrality intuition while avoiding both Broome’s inconsistency worry and Rabinowicz’s commitment to incommensurability. Incommensurability may be correct on other grounds—but not, this present paper argues, on the grounds provided by Broome’s inconsistency argument. (shrink)

Problems concerning future populations help us better understand what it is for one possible future, or world, to be morally better than another. The repugnant conclusion challenges traditional forms of consequentialism, including utilitarianism. A key issue is whether, per the traditional view, we make things morally better by creating additional people whose lives are worth living and by creating nonidentical better-off people in place of less well-off but distinct people. Or can we, instead, make things morally better only by making (...) things better for some particular person or another? Is the structure of morality aggregative in nature or instead person-affecting in nature? While the latter, non-traditional view may tempt us, it also seems to give rise to the nonidentity problem and various inconsistency objections. Can those problems be resolved? Questions raised by Parfit and others decades ago remain unsettled today but as critical as ever. (shrink)

Many contemporary logicians acknowledge a plurality of logical theories and accept that theory choice is in part motivated by logical evidence. However, just as there is no agreement on logical theories, there is also no consensus on what constitutes logical evidence. In this paper, I outline Jean Piaget’s psychological theory of reasoning and show how he used it to diagnose and solve one of the paradoxes of material implication. I assess Piaget’s use of psychology as a source of evidence for (...) logical theory in light of reservations raised by psychologism, and I highlight some ramifications for exceptionalism and anti-exceptionalism about logic by considering his use of psychology as logical evidence in the framework of genetic epistemology, Piaget’s research programme. I conclude that Piaget’s psychological theory of reasoning not only plausibly serves as a source of evidence for logical theory but also makes a strong case for anti-exceptionalism about logic. (shrink)

Quantum mechanical measurements on a physical system are represented by observables - Hermitian operators on the state space of the observed system. It is an important question whether all observables may be realized, in principle, as measurements on a physical system. Dirac’s influential text ( [1], page 37) makes the following assertion on the question: The question now presents itself – Can every observable be measured? The answer theoretically is yes. In practice it may be very awkward, or perhaps even (...) beyond the ingenuity of the experimenter, to devise an apparatus which could measure some particular observable, but the theory always allows one to imagine that the measurement can be made. This Letter re-examines the question of whether it is possible, even in principle, to measure every quantum mechanical observable. Unexpectedly, ideas from com-. (shrink)

We demonstrate that the key components of cognitive architectures (declarative and procedural memory) and their key capabilities (learning, memory retrieval, probability judgment, and utility estimation) can be implemented as algebraic operations on vectors and tensors in a high‐dimensional space using a distributional semantics model. High‐dimensional vector spaces underlie the success of modern machine learning techniques based on deep learning. However, while neural networks have an impressive ability to process data to find patterns, they do not typically model high‐level cognition, and (...) it is often unclear how they work. Symbolic cognitive architectures can capture the complexities of high‐level cognition and provide human‐readable, explainable models, but scale poorly to naturalistic, non‐symbolic, or big data. Vector‐symbolic architectures, where symbols are represented as vectors, bridge the gap between the two approaches. We posit that cognitive architectures, if implemented in a vector‐space model, represent a useful, explanatory model of the internal representations of otherwise opaque neural architectures. Our proposed model, Holographic Declarative Memory (HDM), is a vector‐space model based on distributional semantics. HDM accounts for primacy and recency effects in free recall, the fan effect in recognition, probability judgments, and human performance on an iterated decision task. HDM provides a flexible, scalable alternative to symbolic cognitive architectures at a level of description that bridges symbolic, quantum, and neural models of cognition. (shrink)

Objective: To assess the opinions and practice patterns of obstetrician-gynaecologists on acceptance and use of free drug samples and other incentive items from pharmaceutical representatives.Methods: A questionnaire was mailed in March 2003 to 397 members of the American College of Obstetricians and Gynecologists who participate in the Collaborative Ambulatory Research Network.Results: The response rate was 55%. Most respondents thought it proper to accept drug samples , an informational lunch , an anatomical model or a well-paid consultantship from pharmaceutical representatives. A (...) third of the respondents thought that their own decision to prescribe a drug would probably be influenced by accepting drug samples. Respondents were more likely to think the average doctor’s prescribing would be influenced by acceptance of the items than theirs would be . Respondents who distributed drug samples to patients indicated doing so because of patients’ financial need and for their convenience and less so as a result of knowledge of the efficacy of the sample product . A third of respondents agreed that interactions with industry should be more strictly regulated.Conclusion: Obstetrician-gynaecologists largely indicated that they would act in accordance with what they think is proper regarding accepting incentive items from pharmaceutical representatives. Although accepting free drug samples was considered to be appropriate more often than any other item, samples were most commonly judged to be influential on prescribing practices. The widely accepted practice of receiving and distributing free drug samples needs to be examined more carefully. (shrink)

This paper investigates four questions related to ethical issues associated with the involvement of engineers and scientists in 'military work', including the influence of ethical values and beliefs, the role of gendered perspectives and moves beyond the purely technical. It fits strongly into a human (and planet)-centred systems perspective and extends my previous AI and Society papers on othering and narrative ethics, and ethics and social responsibility. It has two main contributions. The first involves an analysis of the literature through (...) the application of different ethical theories and the application of gendered analysis to discussion of masculinities in engineering and the military. The second is a survey of scientists and engineers to investigate their opinions and experiences. The conclusions draw together the results of these two contributions to provide preliminary responses to the four questions and include a series of recommendations covering education and training, ethical approval of work not involving human participants or animals, the need for organisational support, approaches covering wider perspectives and the encouragement of individual ethical commitment. (shrink)

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

For 150 years after Galileo's condemnation in 1633, there were many references to the trial, but no sustained, heated or polarized discussions. Then came the thesis that Galileo was condemned not for being a good astronomer but for being a bad theologian (using Scripture to support astronomical hypotheses); it began in 1784-1785 with an apology of the Inquisition by Mallet du Pan in the Mercure de France and the printing in Tiraboschi's Storia della letteratura italiana of an apocryphal letter attributed (...) to Galileo but forged by Onorato Gaetani. This thesis is not only untenable and false but inverts and subverts the truth; it proved to be long-lasting and widely accepted; so it may be labeled a myth. It was held by such writers as . Afterwards, it was generally abandoned, its death knell being pope John Paul II's speeches in 1979-1992. The myth seems to have acted as a catalyst insofar as its creation encouraged the proliferation of pro-clerical accounts and the articulation of pro-Galilean ones, thus making the discussion of Galileo's trial the cause celebre it is today. (shrink)