Formal tools are attributed central roles in organizing work within many modern workplaces. How should one comprehend the power of these tools? Taking the medical record as an example, this article builds on recent calls to overcome the dichotomy between the formal and the informal and proposes an understanding of the generative power of such tools that does not attribute mythical capacities to either tool or human work. To do so, it is important to look both at the history offormal (...) tools and to their real-time use in concrete work practices. These steps toward a sociology of the formal are crucial for a more comprehensive understanding and evaluation offormal systems in practice. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This program enables (...) students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

BackgroundUse of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical (...) policy.MethodsEighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns.ResultsJurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing.ConclusionsInformed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data. (shrink)

We know a lot more about the epistemology of the net at the time the present summary is being written than we did two years ago when the topic of this collaboration was decided upon. In part, this increase in knowledge is a consequence of the tremendous development of the net itself; in part, however, it is a consequence of our own series of exchanges. I would like, therefore, to say that the project had a positive outcome; but to say (...) this would be misleading. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This program enables (...) students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

We have investigated attitudes towards the use of health data among the Swedish population by analyzing data from a survey answered by 1645 persons. Health data are potentially useful for a variety of purposes. Yet information about health remains sensitive. A balance therefore has to be struck between these opposing considerations in a number of contexts. The attitudes among those whose data is concerned will influence the perceived legitimacy of policies regulating health data use. We aimed to investigate what views (...) are held by the general public, and what aspects matter for the willingness to let one’s data be used not only for one’s own care but also for other purposes. We found that while there is a broad willingness to let one’s data be used, the possibility to influence that use is considered important. The study also indicated that when respondents are required to balance different interests, priority is typically given to compulsory schemes ensuring that data are available where needed, rather than voluntary participation and data protection. The policy implications to be drawn from this are not self-evident, however, since the fact that a majority has a certain attitude does not by itself determine the most adequate policy. (shrink)

Discussions about biotechnology tend to assume that it is something to do with genetics or manipulating biological processes in some way. However, the field of biometrics––the measurement of physical characteristics––is also biotechnology and is likely to affect the lives of more people more quickly than any other form. The possibility of social exclusion resulting from the use of biometrics data for such uses as identity cards has not yet been fully explored. Social exclusion is unethical, as it unfairly discriminates against (...) individuals or classes of people. Social exclusion is unethical, as it unfairly discriminates against individuals or classes of people. This article looks at some of the ways in which social exclusion might arise from the use of biometric data, and introduces a model of balancing individual interests with which to analyse whether it is justified to run the risk of excluding some members of society for the benefit of others. (shrink)

The unsustainable growth in U.S. health care costs is in large part attributable to the rising costs of pharmaceuticals and medical devices and to unnecessary medical procedures. This fact has led health reform advocates and policymakers to place considerable hope in the idea that increased government support for research on the comparative effectiveness of medical treatments will eventually help to reduce health care expenses by informing patients, health care providers, and payers about which treatments for common conditions are effective and (...) which are not. Comparative effectiveness research has shown in some cases that expensive but commonly used treatments are significantly less effective than relatively inexpensive alternatives. Critics warn, however, that CER will homogenize patient care, limit patient choices, and lead to improper health care rationing and even to the denial of lifesaving treatments. (shrink)

*The views expressed are the author's own and should not be construed as representing the policies and opinions of the American Medical Association.

Human cognition is not an island unto itself. As a species, we are not Leibnizian Monads independently engaging in clear, Cartesian thinking. Our minds interact. That's surely why our species has language. And that interactivity probably constrains both what and how we think.

Cet article présente les solutions utilisées pour le Corpus électronique des textes polonais des 17e et 18e siècles afin d’adapter son jeu de balises grammaticales à l’évolution du système morphologique qui a eu lieu au cours de la période. Les 17e et 18e siècles ont été marqués en effet par la formation d’une nouvelle catégorie grammaticale, appelée « masculine-personality » (Pl. *męskoosobowość*). Cette époque marque une transition de l’état ancien à l’état moderne et se caractérise par une variation significative des (...) terminaisons des formes plurielles N, A et V des noms masculins animés à cette époque. Par conséquent, le jeu de balises utilisé pour annoter le corpus, qui a été créé à l’origine pour le polonais moderne, a dû être légèrement modifié à cet égard. La deuxième partie de l’article décrit les recherches menées à l’aide de ce système d’annotation, qui ont montré que la différenciation des terminaisons flexionnelles des noms masculins personnels et impersonnels en polonais était déjà avancée au 17e siècle et presque achevée à la fin du 18e siècle. (shrink)