In lieu of an abstract, here is a brief excerpt of the content:Positive Change in Perception and Care for a Difficult PatientMelissa CavanaughIf you asked any healthcare professional if they had ever cared for a difficult patient, I am certain the answer would be a resounding "Yes!" I have encountered many over my forty-two years as an RN. The story of Ms. E. is one of exceptional challenge and, I hope, success.I met Ms. E. in 2012 when I took a (...) nursing position in an outpatient primary care Geriatric Clinic. The clinic was located within an inner city, Level 1 Trauma health system whose mission is to care for the underserved. This organization had cared for the most vulnerable in the area for decades. The clinic model is unique in that it provides a "one-stop shop" for the common medical needs of the older adult. Other specialties, including podiatry, rheumatology, dementia care, and stroke, held appointments in this clinic area. The supporting staff team members assisted in each of these clinics, leading them to interact with the same patients frequently.Most of my previous experiences had been in inpatient units with a quick turnover of patients. There was no time or need to develop a long-term relationship with the patients in these settings. However, the comprehensive services found in this clinic coupled with the low staff turnover, led to a stable group of seniors receiving care in this office. Many of these individuals had been attending this clinic for over twenty years.I heard about Ms. E. before I ever met her. She was well known to the clinic team as a "problem" patient. The general response when she was on the schedule was eye rolling and audible moans. I soon learned that in addition to her scheduled visits, she would randomly appear outside the full glass interior doors. She would hover in the area, tapping on the glass to get the attention of a staff member. She did not hesitate to interrupt staff and other patients to make her needs known when she was in the exam room hallway. Often team members would scatter and hide to avoid dealing with her. If she was not in the building, she was on the triage line with a question or physical complaint. To complicate matters even further, her husband was our patient as well, and they always attended appointments together.Ms. E. suffered from common geriatric chronic diseases such as hypertension, diabetes, and osteoarthritis. Her morbid obesity complicated her diagnoses. Though she was able to safely ambulate with an assistive device such as a cane or walker, she routinely used a motorized chair. She and her husband admitted visiting fast food restaurants often even though they had met with a dietician for counseling on several occasions. They often requested help obtaining medications, yet related stories about visiting the local casino. Ms. E. spoke with a small, weak voice that added to the countenance of helplessness and pity. Unfortunately, these behaviors of noncompliance, attention seeking, and dependency on others extended to her immediate community, and she is estranged from family and friends who may have been a source of support to her. [End Page E1]Ms. E.'s appointments were scheduled at the end of the day due to the expectation and pattern of the extended time they would take. No matter her expressed concerns or needs, our recommendations and interventions were never enough. She continually questioned the assessment information and did not want to accept the education and orders given as the correct response to her problems. As one can see, her appointments could be exhausting!Ms. E. certainly deserved the best and most comprehensive care available from our team. Developing a more therapeutic relationship for her within the clinic became a priority for me. However, it was a daunting task to provide this level of care and to convince her that she deserved and was receiving such care. She presented a laundry list of characteristics that could lead to biases from the staff. Overcoming such individual biases toward her may be a barrier as well. These included her obesity, her lack of initiative, her self-centered behaviors, and her constant need for attention.As healthcare professionals... (shrink)

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

Despite acknowledgment that performance failure among new salespeople is a prevalent issue for organizations, researchers do not fully understand the consequences of repetitive periods of failure on new salespeople’s unethical selling behaviors. Further, little is known about how a sales force’s reward structure and managerial attempts to intervene following failure affect new salespeople’s behavior. Combining an experiment with longitudinal growth models, we show that repetitive periods of failure increase unethical behaviors, and interventions intended to remind the salesperson to behave in (...) the customer’s best interests attenuate this effect under a non-contingent reward structure. However, counter to managerial assumptions, under a contingent reward structure these customer-oriented interventions actually backfire by amplifying the original relationship between repetitive failure and unethical behaviors. The results have potentially important managerial implications for those who manage new salespeople learning how to sell or during other failure-prone periods. (shrink)

In light of grand societal challenges, most recently the global Covid-19 pandemic, there is a call for research on responsible leadership. While significant advances have been made in recent years towards a better understanding of the concept, a gap exists in the understanding of responsible leadership in emerging countries, specifically how leaders resolve prevalent moral dilemmas. Following Werhane, we use moral imagination as an analytical approach to analyze a dilemmatic stakeholder conflict through the lense of different responsible leadership mindsets and (...) in light of different ethical principles and moral background theories. Based on this analysis, we arrive at a tentative moral judgement, concluding that the instrumental approach is morally inferior and recommending the integrative approach as the morally superior choice. In the subsequent discussion—focussed on what “could” be done, we apply the integrative script and use moral imagination as a pathway for generating morally justifiable solutions. Through this analysis, we provide novel insights on how to apply an integrative responsible leadership approach to a stakeholder conflict situation, using the single case study to expand the responsible leadership discussion to emerging markets. (shrink)

Empirical data show that members of underrepresented and historically marginalized groups in academia undertake many forms of undervalued or unnoticed labor. While the data help to identify that this labor exists, they do not provide a thick description of what the experience is like, nor do they offer a framework for understanding the different kinds of invisible labor that are being undertaken. We identify and analyze a distinct, undervalued, and invisible labor that the data have left unnamed and unmeasured: ontological (...) labor, the work required to manage one’s identity and body if either or both do not fit into academic structures, norms, and demands. We argue that ontological labor efforts should be understood as a form of labor. We then provide a characterization of ontological labor, detailing the labor as navigating one’s obligations to give and managing entitlements to take. We also highlight the ontological labor that takes place through instances of resistance, such as through complaint or refusals. (shrink)

We extend Tomasello's discussion of children's developing sense of obligation to testimonial learning. First, we review a battery of behaviors in testimonial exchanges that parallel those described by Tomasello. Second, we explore the variable ways in which children hold others accountable, suggestive that children's evaluations of moral and epistemic responsibilities in joint collaborative activities are distinct.

This article establishes an analysis of the first contributions and the importance of the Critical and Positivist theories of accounting in Latin America over the years, through the study of scientific articles by recognized accounting experts from different countries on the theories.. Also, carry out a bibliographic examination of criticism and positivism applied to accounting, resulting in the correlation of concepts focused on accounting in Latin America. The type of research is descriptive with a qualitative approach with the purpose of (...) developing a discussion of the Critical and Positivist theories of accounting in Latin America. Obtaining a greater scope to understand that this social science is immersed in two currents that are based on the fact that knowledge is obtained through practice and can be verified through scientific methods, establishing the importance of understanding the contributions that the critical and positivist theory in the field of accounting science. (shrink)

Despite attention to the concerns of labor migration by public policy makers and scholars, the effects of international recruitment policies in developed nations on the economies of the developing world have been largely unaddressed by management literature. This work addresses that lacuna by combining hitherto separate streams of management scholarship with the fledgling fields of nation and employer branding to consider their synthesis in an international context. This combination introduces the possibility for evaluating the effects of recruitment practices on developing (...) economies and creates space for future research regarding ethical international recruitment policies. We explore and discuss these issues from the perspective of potential employees in developing economies and offer suggestions to guide future research in this area. (shrink)

Meditation refers to a family of self-regulation practices that focuses on training attention and awareness to foster psycho-emotional well-being and to develop specific capacities such as calmness, clarity, and concentration. We report a prospective convenience-controlled study in which we analyzed the effect of two components of Preksha Dhyāna – buzzing bee sound meditation and color meditation on healthy college students. Mahapran and leśya dhyāna are two Preksha Dhyāna practices that are based on sound and green color, respectively. The study population (...) represents a suitable target as college students experience different stress factors during the school year. This study measures the individual and combined effects of two techniques, on short-term memory, attention, and affect, in novice meditators. We used a battery of cognitive, performance, and compared results with baseline and control values. We found improved cognition, especially attention, short-term memory, and affect in terms of positivity and reduced negativity. Overall, the two techniques produced variable benefits and subjects showed improved scores over baseline for short-term memory, cognitive function, and overall wellbeing. Further studies are required to understand underlying mechanisms for the observed differences between the two techniques and to elucidate mechanisms underlying the more pronounced and global benefits observed with the combined techniques. These results underscore a need to examine individual components of meditation practices in order to individualize treatment approaches for attention disorders in young adults.Clinical Trail Registration:ClinicalTrials.gov Identifier: NCT03779269. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

Repetitive thinking predicts and maintains depression and anxiety, yet the role of RT in the perinatal context has been under-researched. Further, the content and themes that emerge during RT in the perinatal period have been minimally investigated. We recruited an online community sample of women who had their first baby within the past 12 months. Participants completed a battery of self-report questionnaires which included four open-ended questions about the content of their RT. Responses to the latter were analyzed using an (...) inductive thematic analysis approach. Participants reported RT about a range of unexpected emotional responses to becoming a new mother, impact on their sleep and cognitive functioning, as well as the impact on their identity, sense of self, lifestyle, achievements, and ability to function. RT was commonly experienced in first-time mothers, and the themes that emerged conveyed an overall sense of discrepancy between expectations and reality, as well as adjustment to profound change. By providing insight into the content of RT in new mothers, the findings of our study have scope to inform the content of interventions that seek to prevent and treat postnatal mental health problems, particularly those which target key psychological processes such as RT. (shrink)

Earp, Lewis, and Hart write about the racism entrenched in policies criminalizing drug use and possession and describe the disparate impact that these policies have on certain racialized com...

In this study, the researchers investigated the relationships between character strengths and ethical engagement in online faculty. One of the ethical duties for higher education faculty is to engage in effective teaching practices. As online higher education becomes increasingly popular, online faculty also bear this duty. Numerous studies have shown that character strengths cultivate ethical behavior. Hence, we sought to determine the relationship between character strengths and ethical engagement in online faculty. Specifically, we focused on intellectual character strengths, interpersonal character (...) strengths, and emotional character strengths because of their relevance to online faculty’s teaching practices. Through correlational analyses, we learned that interpersonal and emotional character strengths were positively and moderately related to ethical engagement, whereas intellectual character strengths were weakly related to ethical engagement. The findings of this study provide insight into online faculty’s character strengths and ethical engagement. However, further research is needed to understand the role of character strengths and ethical engagement in promoting effective teaching practices in online higher education classrooms. (shrink)

A crucial feature of Kant's critical-period writing on the sublime is its grounding in moral psychology. Whereas in the pre-critical writings, the sublime is viewed as an inherently exhausting state of mind, in the critical-period writings it is presented as one that gains strength the more it is sustained. I account for this in terms of Kantian moral psychology, and explain that, for Kant, sound moral disposition is conceived as a sublime state of mind.

Double-effect reasoning (DER) is attributed to Aquinas "tout court". Aquinas's account, however, differs from contemporary DER insofar as Thomas considers the ethical status of "risking" an assailant's life while contemporary accounts focus on actions causing harm inevitably. Since one cannot claim to risk the inevitable, and since there is a significant difference between risking harm and causing harm inevitably. Thomas's account does not extend to cases of inevitable harm. Thus, the received understanding of Aquinas's account is flawed and leads to (...) untenable attributions of the direction of intention to Aquinas and to misunderstandings of contemporary DER. (shrink)

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, (...) applied ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and (...) argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

This article articulates the Hippocratic medical ethic found in the Oath and the Christian medical ethic as exemplified in the parable of the Good Samaritan. It proposes that the Oath has a natural-law-based deontological character (as understood by Aquinas) that governs friendships of utility (as understood by Aristotle) between student and teacher and physician and patient. The article elaborates on the Samaritan’s conduct as exemplifying Christian agapeic-love. It contrasts agapeic-love with friendship-love, while noting that the Samaritan relies on friendship-love (as (...) found between the Samaritan and the innkeeper) to realize agapeic-love towards the robbers’ victim. It concludes with noting that the grace-based Christian medical ethic perfects the nature-based Hippocratic ethic not by destroying it, but, rather, by employing it. (shrink)

Since ancient Athens, democrats have taken pride in their power and inclination to change their laws, yet they have also sought to counter this capacity by creating immutable laws. In Democracy and Legal Change, Melissa Schwartzberg argues that modifying law is a fundamental and attractive democratic activity. Against those who would defend the use of 'entrenchment clauses' to protect key constitutional provisions from revision, Schwartzberg seeks to demonstrate historically the strategic and even unjust purposes unamendable laws have typically served, (...) and to highlight the regrettable consequences that entrenchment may have for democracies today. Drawing on historical evidence, classical political theory, and contemporary constitutional and democratic theory, Democracy and Legal Change reexamines the relationship between democracy and the rule of law from a new, and often surprising, set of vantage points. (shrink)

The development of empirical research methods in both the social and the natural sciences has had a deep impact on the self-conception of philosophy. Jürgen Habermas aims to strike a balance between two ways of understanding the relationship between philosophy and the sciences: between a conception of philosophy as an Archimedean point from which to view the human condition and a conception of philosophy as a mere artefact of Western culturally embedded assumptions. Against the first, Habermas aims to integrate the (...) resources and methods of the social sciences into philosophy and to deny that philosophy can proceed outside of historical and social contexts. On his view, philosophical knowledge is produced communicatively, through socially embedded dialogue. Against the second, Habermas claims fundamental questions about the human condition cannot be answered by purely social or natural scientific approaches. His “postmetaphysical” methodology aims to integrate empirical resources into philosophy without losing sight of what is unique to philosophy: namely, its ability to step back from the empirical data in order to reconstruct in a systematic way underlying universal truths about us, our societies and our place in the world. (shrink)

If viable, DER justifies certain individual acts that—by definition—have two effects. Presumably, it would in some fashion justify policies concerning the very same acts. By contrast, acts that sometimes have a good effect and sometimes have a bad effect do not have the requisite two effects such that DER can justify them immediately. Yet, a policy concerning numerous such acts would have the requisite good and bad effects. For while any one such act would lack the relevant two effects, a (...) series of such acts and a policy governing such a series would have them. This paper addresses DER’s justification of policies that apply to such acts. It shows that there are certain acts which DER mediately justifies by justifying policies concerning them. Thus, it recommends the larger topic of DER’s bearing on policy. (shrink)

Can corporations remain socially responsible in today's fiercely competitive global economy? For several decades after World War II, companies like IBM, which exemplified what journalist Robert J. Samuelson called the 'good corporation,' poured forth material comforts and technological ideas while guaranteeing full employment and adequate retirement. In the 1980s all of that changed, as corporations moved to 'downsize' and become lean, mean global competitors. In this collection, thirteen prominent scholars in business ethics, finance, management, and religion and six corporate leaders (...) respond to a new essay by Samuelson that sounds the death knell of the 'good corporation.' They propose new approaches to corporate integrity and social responsibility in the global economy. The book will be useful in corporate workshops and will make an excellent business ethics text in philosophy departments and business schools. (shrink)

In what follows, I reply to critical appraisals of my book entitled Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession. Professors Tollefsen, McPherson, and Potts separately offer these thoughtful critiques. Professor Tollefsen approaches the work from the standpoint of the physician-patient relationship. Professors McPherson and Potts both address it in terms of virtues. Potts treats the theme of virtue generally while McPherson focuses on the virtue of piety. Since virtues attend relationships, in what follows, I discuss, first, (...) the physician-patient relationship ; second, virtue generally ; and third, and finally, the virtue of piety specifically. (shrink)

This paper explores Kant's account of force, a topic that was of central philosophical concern in his day, but which he does not explicitly address in any of his Critiques. Just as with the nature of space and time and the nature of the human will, the nature of force was under dispute by the philosophers and natural scientists to whose legacy Kant was responding. Yet, Kant does not make force an explicit topic of his Critiques, and thus provides no (...) explicit transcendental account of force. Nevertheless, I will argue that one can indeed find in Kant a transcendental account of force, one that is a synthesis of empiricist and rationalist accounts, but in an unexpected place; the third Critique, in the discussion of the principle of purposiveness. (shrink)

For the millions of people who struggle with food and body issues, yoga and its practice of mindfulness can offer a surprisingly effective path to well-being. For Melissa Grabau, a psychotherapist who has battled her own eating disorders since she was a child, yoga contains the key ingredients to transforming our connection to food and to our bodies. The Yoga of Food invites you to explore contemplation prompts and meditations that will help you create a deeper appreciation of the (...) body's health and vitality. Sharing lessons and stories she's cultivated from years of clinical practice, Melissa provides a roadmap toward a healthier approach to nutrition and the human spirit. (shrink)

In this article, I explore difficult and sensitive questions regarding the nature of transgender identity claims and the appropriate medical treatment for those suffering from gender dysphoria. I first analyze conceptions of transgender identity, highlighting the prominence of the wrong-body narrative and its dualist presuppositions. I then briefly argue that dualism is false because our bodily identity is essential and intrinsic to our overall personal identity and explain why a sound, nondualist anthropology implies that gender identity cannot be entirely divorced (...) from sexual identity. Finally, I make the case that arguments in favor of hormonal and surgical treatments for gender dysphoria rest on this mistaken dualist anthropology, and that these treatments therefore give false hope to those suffering from gender dysphoria, while causing irreversible bodily harm and diverting attention from underlying psychological problems that often need to be addressed. I also briefly discuss how these philosophical claims relate to empirical studies on the outcomes of hormonal and surgical treatments for gender dysphoria and to testimonies of transgender individuals who regret having undergone these treatments. (shrink)

This paper demonstrates that accounting for the moral harm of selecting for deafness is not as simple or obvious as the widespread negative response from the hearing community would suggest. The central questions addressed by the paper are whether our moral disquiet with regard to selecting for deafness can be adequately defended, and if so, what this might entail. The paper considers several different strategies for accounting for the supposed moral harm of selecting for deafness and concludes that the deaf (...) case cannot be treated in isolation. Accounting for the moral harm of selecting for deafness necessarily entails moral implications for other cases of procreation and procreative decision-making, including unassisted coital reproduction. The lesson to be learned from the deaf case is that we need norms that govern not just the use of reproductive technology, but procreation and procreative decision-making in all of its various forms. (shrink)

This paper presents experimental data relevant to understanding the modal free choice effect (Kamp, 1973) when there are more than two disjuncts under the relevant modal operator. The results suggest that speakers' willingness to draw free choice inferences is correlated with whether the embedded disjuncts are *modally separable*, in a sense brought into focus by considering cases within which the relevant propositions fail to be pairwise redundant but are redundant as a set.

Scholars have widely assumed that the aspects of Kant’s virtue theory that nod to ancient ethics must be cashed out with reference to Aristotle. Interpreters then worry that Kant's conception of virtue as a “moral strength of will” (Doctrine of Virtue, 6:405) must be tantamount to Aristotle’s notion of “continence” (enkrateia) — the state of a person who knows the good, and acts accordingly, but must overcome strong countervailing impulses in order to do so. The result plays into caricatures of (...) Kantian ethics as valorising a joyless standard of duty, which these Aristotelian-oriented commentators (rightly) wish to resist. However, the worry is misplaced. I show that Kant is not thinking about Aristotle here, but is instead engaged with a specifically Stoic approach to ethics as a dimension of natural teleology. I draw on this context to show that Kant’s virtue-as-strength idea is not marred in the ways it appears to be when read through an Aristotelian lens. (shrink)

In this thesis, I examine the metaphysical debate between the A-theory and the B-theory of time, first by elaborating upon its proper characterization, and then by examining the sorts of evidence that are often thought to be germane to it. This debate, as I see it, is about whether or not time passes in any objective sense: the A-theory holds that it does, while the B-theory holds that it does not. I identify two opposing conceptions of time—that of the “time (...) of ordinary experience” on one hand, and that of “scientific time” on the other—and argue that the tension between them is the driving force behind this debate. I then examine two aspects of “evidence” from the time of ordinary experience: the phenomenological experience of time and the linguistic experience of time. It is often supposed, by both A- and B-theorists alike, that these sorts of evidence lend credence to the A-theory of time, since ordinary experience suggests that time passes. I hope to discredit this presumption, and so challenge the very framework in which this debate is so often carried out. In particular, by closely examining both of these kinds of experience—phenomenological and linguistic—in turn, I hope to provide a partial argument to the effect that the ordinary experience of time as a whole does not favour the A-theory over the B-theory of time. In the case of the phenomenological evidence, this is because the A-theory is just as inconsistent with such evidence as is the B-theory of time; in the case of the linguistic evidence, this is because the B-theory is equally consistent with such evidence as is the A-theory of time, particularly once it is revealed that a certain key assumption is tacitly accepted by both sides of the debate. Because of the popularity of the claim that the ordinary experience of time favours the A-theory, I take this conclusion to be something of a modest defence for the B-theory of time. (shrink)

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)