What are the ethics of child genital cutting? In a recent issue of the journal, Duivenbode and Padela (2019) called for a renewed discussion of this question. Noting that modern health care systems...

When is it ethically permissible for clinicians to surgically intervene into the genitals of a legal minor? We distinguish between voluntary and nonvoluntary procedures and focus on nonvoluntary procedures, specifically in prepubescent minors (“children”). We do not address procedures in adolescence or adulthood. With respect to children categorized as female at birth who have no apparent differences of sex development (i.e., non-intersex or “endosex” females) there is a near-universal ethical consensus in the Global North. This consensus holds that clinicians may (...) not perform any nonvoluntary genital cutting or surgery, from “cosmetic” labiaplasty to medicalized ritual “pricking” of the vulva, insofar as the procedure is not strictly necessary to protect the child’s physical health. All other motivations, including possible psychosocial, cultural, subjective-aesthetic, or prophylactic benefits as judged by doctors or parents, are seen as categorically inappropriate grounds for a clinician to proceed with a nonvoluntary genital procedure in this population. We argue that the main ethical reasons capable of supporting this consensus turn not on empirically contestable benefit–risk calculations, but on a fundamental concern to respect the child’s privacy, bodily integrity, developing sexual boundaries, and (future) genital autonomy. We show that these ethical reasons are sound. However, as we argue, they do not only apply to endosex female children, but rather to all children regardless of sex characteristics, including those with intersex traits and endosex males. We conclude, therefore, that as a matter of justice, inclusivity, and gender equality in medical-ethical policy (we do not take a position as to criminal law), clinicians should not be permitted to perform any nonvoluntary genital cutting or surgery in prepubescent minors, irrespective of the latter’s sex traits or gender assignment, unless urgently necessary to protect their physical health. By contrast, we suggest that voluntary surgeries in older individuals might, under certain conditions, permissibly be performed for a wider range of reasons, including reasons of self-identity or psychosocial well-being, in keeping with the circumstances, values, and explicit needs and preferences of the persons so concerned. Note: Because our position is tied to clinicians’ widely accepted role-specific duties as medical practitioners within regulated healthcare systems, we do not consider genital procedures performed outside of a healthcare context (e.g., for religious reasons) or by persons other than licensed healthcare providers working in their professional capacity. (shrink)

In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

In this article, I explain why stabilizing constructs is important to the success of the Research Domain Criteria Project and identify one measure for facilitating such stability.

Much of the literature on values in science is limited in its perspective because it focuses on the role of values in individual scientists’ decision making, thereby ignoring the context of scientific collaboration. I examine the epistemic structure of scientific collaboration and argue that it gives rise to two arguments showing that moral and social values can legitimately play a role in scientists’ decision to accept something as scientific knowledge. In the case of scientific collaboration some moral (...) and social values are properly understood to be extrinsic epistemic values, that is, values that promote the attainment of scientific knowledge. (shrink)

BackgroundThe methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts.DiscussionA considered reference to normative research questions can be expected from good quality empirical research in medical (...) ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics.SummaryHigh quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. (shrink)

We examine the framing mechanisms used to maintain a cross-sector partnership that was created to address a complex long-term social issue. We study the first 8 years of existence of an XSP that aims to create a market for recycled phosphorus, a nutrient that is critical to crop growth but whose natural reserves have dwindled significantly. Drawing on 27 interviews and over 3000 internal documents, we study the evolution of different frames used by diverse actors in an XSP. We demonstrate (...) the role of framing in helping actors to avoid some of the common pitfalls for an XSP, such as debilitating conflict, and in creating sufficient common ground to sustain collaboration. As opposed to a commonly held assumption in the XSP literature, we find that collaboration in a partnership does not have to result in a unanimous agreement around a single or convergent frame regarding a contentious issue. Rather, successful collaboration between diverse partners can also be achieved by maintaining a productive tension between different frames through “optimal” frame plurality—not excessive frame variety that may prevent agreements from emerging, but the retention of a select few frames and the deletion of others toward achieving a narrowing frame bandwidth. One managerial implication is that resources need not be focussed on reaching a unanimous agreement among all partners on a single mega-frame vis-à-vis a contentious issue, but can instead be used to kindle a sense of unity in diversity that allows sufficient common ground to emerge, despite the variety of actors and their positions. (shrink)

We provide a detailed history of the concepts of atomic number and isotopy before the discovery of protons and neutrons that draws attention to the role of evolving interplays of multiple aims and criteria in chemical and physical research. Focusing on research by Frederick Soddy and Ernest Rutherford, we show that, in the context of differentiating disciplinary projects, the adoption of a complex and shifting concept of elemental identity and the ordering role of the periodic table led to a relatively (...) coherent notion of atomic number. Subsequent attention to valency, still neglected in the secondary literature, and to nuclear charge led to a decoupling of the concepts of elemental identity and weight and allowed for a coherent concept of isotopy. This concept received motivation from empirical investigations on the decomposition series of radioelements and their unstable chemical identity. A new model of chemical order was the result of an ongoing collaboration between chemical and physical research projects with evolving aims and standards. After key concepts were considered resolved and their territories were clarified, chemistry and physics resumed autonomous projects, yet remained bound by newly accepted explanatory relations. It is an episode of scientific collaboration and partial integration without simple, wholesale gestalt switches or chemical revolutions. (shrink)

Due to the ongoing advancements in technology, socio-technical collaboration has become increasingly prevalent. This poses challenges in terms of governance and accountability, as well as issues in various other fields. Therefore, it is crucial to familiarize decision-makers and researchers with the core of human–machine collaboration. This study introduces a taxonomy that enables identification of the very nature of human–machine interaction. A literature review has revealed that automation and technical autonomy are main parameters for describing and understanding such interaction. (...) Both aspects must be carefully evaluated, as their increase has potentially far-reaching consequences. Hence, these two concepts comprise the taxonomy’s axes. Five levels of automation and five levels of technical autonomy are introduced below, based on the assumption that both automation and autonomy are gradual. The levels of automation were developed from existing approaches; those of autonomy were carefully derived from a review of the literature. The taxonomy’s use is also explained, as are its limitations and avenues for further research. (shrink)

The scientific relationship between neuroscience and artificial intelligence is generally acknowledged, and the role that their long history of collaboration has played in advancing both fields is often emphasized. Beyond the important scientific insights provided by their collaborative development, both neuroscience and AI raise a number of ethical issues that are generally explored by neuroethics and AI ethics. Neuroethics and AI ethics have been gaining prominence in the last few decades, and they are typically carried out by different research (...) communities. However, considering the evolving landscape of AI-assisted neurotechnologies and the various conceptual and practical intersections between AI and neuroscience—such as the increasing application of AI in neuroscientific research, the healthcare of neurological and mental diseases, and the use of neuroscientific knowledge as inspiration for AI—some scholars are now calling for a collaborative relationship between these two domains. This article seeks to explore how a collaborative relationship between neuroethics and AI ethics can stimulate theoretical and, ideally, governance efforts. First, we offer some reasons for calling for the collaboration of the ethical reflection on neuroscientific innovations and AI. Next, we explore some dimensions that we think could be enhanced by the cross-fertilization between these two subfields of ethics. We believe that considering the pace and increasing fusion of neuroscience and AI in the development of innovations, broad and underspecified calls for responsibility that do not consider insights from different ethics subfields will only be partially successful in promoting meaningful changes in both research and applications. (shrink)

While artificial intelligence (AI) is increasingly applied for decision-making processes, ethical decisions pose challenges for AI applications. Given that humans cannot always agree on the right thing to do, how would ethical decision-making by AI systems be perceived and how would responsibility be ascribed in human-AI collaboration? In this study, we investigate how the expert type (human vs. AI) and level of expert autonomy (adviser vs. decider) influence trust, perceived responsibility, and reliance. We find that participants consider humans to (...) be more morally trustworthy but less capable than their AI equivalent. This shows in participants’ reliance on AI: AI recommendations and decisions are accepted more often than the human expert’s. However, AI team experts are perceived to be less responsible than humans, while programmers and sellers of AI systems are deemed partially responsible instead. (shrink)

The applied discipline of agroecological design provides a useful case study for examining broader philosophical questions about the existence and importance of ecological generalizations or “laws.” Recent developments in the availability and use of formal meta-analyses have led to the discovery of many resilient generalizations in ecology (Linquist et al. 2016). However, these “laws” face numerous challenges when it comes to their practical application. Concerns about their reliability and scope might stem from unclear logical and epistemic connections to more foundational (...) or “unifying” generalizations (Lean in Philos Top 47(1), 2019) which, in ecology, tend to be derived from first principles and in association with highly abstract models. This raises questions about the nature of those foundational generalizations themselves. In particular, how resilient are they compared to the generalizations uncovered by empirically driven methods? Here we propose a procedure for evaluating the resilience of generalizations across five ecologically relevant dimensions. This procedure was applied to seven well known foundational generalizations in ecology. Surprisingly, it turned out to be impossible to estimate the resilience of these foundational generalizations based on the available literature. This points to the need for a more centralized repository of information about ecological generalizations, created with the explicit aim of evaluating such important dimensions as causal mechanism and predictive power. (shrink)

Ce livre repose sur un projet ambitieux : proposer une anthropologie historique de cette catégorie d’individus que le langage quotidien et les médias aussi bien qu’un large faisceau de sciences humaines et sociales nomment les « victimes ». En bref, les victimes sont à la mode, associées à toutes les commémorations, parce qu’elles offrent un regard renouvelé sur toutes les affaires du monde ; elles permettent de construire une histoire ou une sociologie « d’en bas », from below. Les grands (...) fl... (shrink)

Fruit d’un colloque organisé par la Société internationale pour l’étude des femmes de l’Ancien Régime (SIEFAR) en novembre 2008, ce volume, sous la direction d’É. Viennot, constitue le premier volet d’un triptyque consacré à l’étude d’une controverse centrale, mais méconnue de l’histoire de l’Europe moderne et du féminisme : la « Querelle des femmes ». En effet, de la fin du Moyen Âge aux premières décennies du xxe siècle, l’Europe a été « le théâtre d’une gigantesque polémique sur la place (...) e... (shrink)

In their paper ‘Responsibility, second opinions and peer-disagreement: ethical and epistemological challenges of using AI in clinical diagnostic contexts’, Kempt and Nagel discuss the use of medical AI systems and the resulting need for second opinions by human physicians, when physicians and AI disagree, which they call the rule of disagreement.1 The authors defend RoD based on three premises: First, they argue that in cases of disagreement in medical practice, there is an increased burden of proof for the physician in (...) charge, to defend why the opposing view is adopted or overridden. This burden for justification can be understood as an increased responsibility. In contrast, such burden does allegedly not arise, when physicians agree in their judgement. Second, in those medical contexts where humans collaborate with humans such justification can be provided, since human experts can discuss the evidence and reasons that have led them to their judgement, through which the sources of disagreement can be found and a justified decision can be made by the physician in charge. Third, unlike human-to-human collaboration, such communicative exchange is not possible with an AI system. Due to AI’s opacity, the physician in charge has no means of illuminating why the AI disagrees. Conclusively, the authors propose RoD as a solution. RoD suggests that a second human expert should be consulted for advise in cases of human–AI disagreement. Once AI systems become more widespread in clinical practice, it can be expected that such type of disagreement occurs more frequently. AI, after all, is being implemented, because it promises, among others, higher accuracy, which implies that some abnormalities will be detected that the physician would have missed.2 Hence, it is laudable to discuss the moral implications of …. (shrink)

The practical problem of how to conduct oneself as a Christian and a Philosopher or Bioethicist in public debate an when asked to be engaged in government committees is difficult. One solution that has had some support has been to approach the issues on the grounds of our natural law tradition but understood anthropocentrically – the ultimate end is not communion with God by integral human development. This is often called New Natural Law (NNL). This separation of Philosophy and Theology (...) has had its critics and most notably the current Poe and his immediate predecessor. In their own writing addressed to people of goodwill, they took a different approach that was essentially Christocentric and involving s close partnership between Philosohy and Theology. In my own experience over thirty years of public involvement in Bioethics, I have discovered that the NNL approach has two overwhelming problems. What is offered to the secular dialogue, as an anthropocentric natural law, often sounds false to secular others because we propose something guided by our beliefs, but failing to acknowledge that contribution. However something that I have discovered latterly in that approach is in fact false by our own standards. By the strictures we impose on our contribution we in fact ignore the New Law instituted by Christ, the law of love. The New Natural Law (NNL) Project has proved to be a failure where it has been tried, and, I know realize, was doomed from the outset, because in being anthropocentric it was essentially lacking and the answers that it gave to problems were often unsatisfactory because lacking love and the particular demand of needing to be capable of being oriented towards God, the God of love. The NNL approach tended to produce a casuistry that was too liberal and too lacking in understanding of the essential role that affectivity plays in our lives, created as we are in the imago dei, in the image and likeness of the God of love. Such a morality demands much more than anthropocentricism can demand. In recognizing these difficulties I propose instead a more pragmatic approach that reflects a partnership between Philosophy and Theology as espoused by the Second Vatican Council, and by Pope’s Benedict XVI and Pope John Paul II, and which engages the work of Alasdair MacIntyre and Servais Pinckaers. An approach that I have tried with some success in chairing government committees. (shrink)

Shows how international biomedical researchers in Sri Lanka work across cultural, epistemic, economic, and power differences to accomplish clinical trials.

Background: Since presenteeism is related to numerous negative health and work-related effects, measures are required to reduce it. There are initial indications that how an organization deals with health has a decisive influence on employees’ presenteeism behavior.Aims: The concept of health-promoting collaboration was developed on the basis of these indications. As an extension of healthy leadership it includes not only the leader but also co-workers. In modern forms of collaboration, leaders cannot be assigned sole responsibility for employees’ health, (...) since the leader is often hardly visible or there is no longer a clear leader. The study examines the concept of health-promoting collaboration in relation to presenteeism. Relationships between health-promoting collaboration, well-being and work ability are also in focus, regarding presenteeism as a mediator.Methods: The data comprise the findings of a quantitative survey of 308 employees at a German university of applied sciences. Correlation and mediator analyses were conducted.Results: The results show a significant negative relationship between health-promoting collaboration and presenteeism. Significant positive relationships were found between health-promoting collaboration and both well-being and work ability. Presenteeism was identified as a mediator of these relationships.Conclusion: The relevance of health-promoting collaboration in reducing presenteeism was demonstrated and various starting points for practice were proposed. Future studies should investigate further this newly developed concept in relation to presenteeism. (shrink)

Most research on animal self-awareness focuses on the question of what self-awareness is, however, the present study addresses the question of what self-awareness is for. It is argued that different forms of self-awareness are needed for conspecific collaboration in different types of animal societies. In the order of the increasing level of fluidity in conspecific cooperation, animal societies are divided into three main types: caste society, individualized society, and alliance society. Accordingly, three forms of self-awareness are differentiated: awareness of (...) one’s kinship relations in the caste society, awareness of one’s ranking place in the individualized society, and awareness of one’s situational roles in the alliance society. Unlike the awareness of kinship and ranks, which is genetically or associatively determined, role awareness is a form of reflective self-awareness acquired by taking the perspectives of others for contingent collaboration with conspecifics in transient situations. (shrink)