Spinal muscular atrophy (SMA) is the most common genetic disease that causes infant mortality. Its treatment and prevention represent the paradigmatic example of the ethical dilemmas of 21st‐century medicine. New therapies (nusinersen and AVXS‐101) hold the promise of being able to treat, but not cure, the condition. Alternatively, genomic analysis could identify carriers, and carriers could be offered in vitro fertilization and preimplantation genetic diagnosis. In the future, gene editing could prevent the condition at the embryonic stage. How should these (...) different options be evaluated and compared within a health system? In this paper, we discuss the ethical considerations that bear on the question of how to prioritize the different treatments and preventive options for SMA, at a policy level. We argue that despite the tremendous value of what we call ‘ex‐post’ approaches to treating SMA (such as using pharmacological agents or gene therapy), there is a moral imperative to pursue ‘ex‐ante’ interventions (such as carrier screening in combination with prenatal testing and preimplantation genetic diagnosis, or gene editing) to reduce the incidence of SMA. There are moral reasons relating to autonomy, beneficence and justice to prioritize ex‐ante methods over ex‐post methods. (shrink)

Nowadays, the concepts of soldier and war have changed due to terrorism and the war on terrorism. According to the literature, to prevent terrorism, it is possible to use more violence, but how can we grant the safety of many versus the dignity of a few? In Israel, in order to protect civilians against possible terrorist attacks, Palestinian ambulances that would reach the Israeli hospitals (or the Palestinian hospitals in East Jerusalem) must be quickly controlled. However, many times, at the (...) checkpoint, patients have to wait for an Israeli vehicle that will take them to Israel. This procedure causes many delays in medical emergency. How to avoid that terrorists may receive better care than Palestinian civilians may just because they are already on the Israeli side of the Separation Wall? How is it possible to ensure the life and safety of many, without denying the right to healthcare to somebody? How to decide when the State requirements conflict with traditional medical duties? Is it acceptable to provide health care to a terrorist? What should be done when it is uncertain whether the ambulance transports weapons besides patients? These questions call upon the core role of the doctor and of the medical profession: taking care of all sick persons. The care is the starting point of ethics. If we do not care about other human beings we do not have a real moral comprehension of any human ideal or action. For this reason we can say that the care is the premise of morality. The rights of all citizens, including the claim to public security, grounds on the care for each individual who needs help. (shrink)

We describe the application of fundamental moral principles, with particular emphasis on prima facie duties, to formal codes of ethics that regulate the conduct of forensic psychologists who act as expert witnesses. Then we discuss the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct" and the Committee on Ethical Guidelines for Forensic Psychologists's "Specialty Guidelines for Forensic Psychologists" and critically appraise how these documents translate basic moral principles. We conclude that, in many ways, the documents exemplify ethical (...) obligations such as nonmaleficence, beneficence, and justice, but they fall short in many other ways, particularly with regard to autonomy and fidelity. (shrink)

Reasoners compare problems to prior cases to draw conclusions about a problem and guide decision making. All Case-Based Reasoning (CBR) employs some methods for generalizing from cases to support indexing and relevance assessment and evidences two basic inference methods: constraining search by tracing a solution from a past case or evaluating a case by comparing it to past cases. Across domains and tasks, however, humans reason with cases in subtly different ways evidencing different mixes of and mechanisms for these components.In (...) recent CBR research in Artificial Intelligence (AI), five paradigmatic approaches have emerged: statistically-oriented, model-based, planning/design-oriented, exemplar-based, and adversarial or precedent-based. The paradigms differ in the assumptions they make about domain models, the extent to which they support symbolic case comparison, and the kinds of inferences for which they employ cases. (shrink)

This article describes recent jurisprudential accountsof analogical legal reasoning andcompares them in detail to the computational modelof case-based legal argument inCATO. The jurisprudential models provide a theoryof relevance based on low-levellegal principles generated in a process ofcase-comparing reflective adjustment. Thejurisprudential critique focuses on the problemsof assigning weights to competingprinciples and dealing with erroneously decidedprecedents. CATO, a computerizedinstructional environment, employs ArtificialIntelligence techniques to teach lawstudents how to make basic legal argumentswith cases. The computational modelhelps students test legal hypotheses againsta database of (...) legal cases, draws analogiesto problem scenarios from the database, andcomposes arguments by analogy with a setof argument moves. The CATO model accountsfor a number of the important featuresof the jurisprudential accounts, includingimplementing a kind of reflective adjustment.It also avoids some of the problems identifiedin the critique; for instance, it deals withweights in a non-numeric, context-sensitivemanner. The article concludes by describingthe contributions AI research can make tojurisprudential investigations of complexcognitive phenomena of legal reasoning. Forinstance, unlike the jurisprudential models,CATO provides a detailed account of how togenerate multiple interpretations of a citedcase, downplaying or emphasizing the legalsignificance of distinctions in terms of thepurposes of the law as the argument contextdemands. (shrink)