This paper takes under consideration a piece by Roger Crisp in which he questions what the problem of moral luck can teach us about COVID-19 lockdown rule-breakers. Taking the position that although such rule-breakers might seem to be new examples of moral luck, Crisp ends up denying the existence of moral luck and argues that moral luck is an outdated notion in so far as it relies on other questionable aspects of morality, that is, retributivist punishment and blame. Although the (...) author agrees with Crisp that pandemic rule-breaker cases are putative examples of resultant moral luck, he proposes that Crisp has misconstrued what moral luck is and the paper examines in detail what he sees as the numerous problems with Crisp’s claims. The author concludes that Crisp’s analysis of pandemic rule-breaking does not shed any new light on the moral luck debate, and the difficult questions of luck, moral responsibility, and desert are not so easily resolved. -/- . (shrink)

In a landmark essay, Andreas Matthias claimed that current developments in autonomous, artificially intelligent (AI) systems are creating a so-called responsibility gap, which is allegedly ever-widening and stands to undermine both the moral and legal frameworks of our society. But how severe is the threat posed by emerging technologies? In fact, a great number of authors have indicated that the fear is thoroughly instilled. The most pessimistic are calling for a drastic scaling-back or complete moratorium on AI systems, while the (...) optimists aim to show that the gap can be bridged nonetheless. Contrary to both camps, I argue against the prevailing assumption that there is a technology-based responsibility gap. I show how moral responsibility is a dynamic and flexible process, one that can effectively encompass emerging technological entities. (shrink)

Background Big data and AI applications now play a major role in many health contexts. Much research has already been conducted on ethical and social challenges associated with these technologies. Likewise, there are already some studies that investigate empirically which values and attitudes play a role in connection with their design and implementation. What is still in its infancy, however, is the comparative investigation of the perspectives of different stakeholders. Methods To explore this issue in a multi-faceted manner, we conducted (...) semi-structured interviews as well as focus group discussions with patients and clinicians. These empirical methods were used to gather interviewee’s views on the opportunities and challenges of medical AI and other data-intensive applications. Results Different clinician and patient groups are exposed to medical AI to differing degrees. Interviewees expect and demand that the purposes of data processing accord with patient preferences, and that data are put to effective use to generate social value. One central result is the shared tendency of clinicians and patients to maintain individualistic ascriptions of responsibility for clinical outcomes. Conclusions Medical AI and the proliferation of data with import for health-related inferences shape and partially reconfigure stakeholder expectations of how these technologies relate to the decision-making of human agents. Intuitions about individual responsibility for clinical outcomes could eventually be disrupted by the increasing sophistication of data-intensive and AI-driven clinical tools. Besides individual responsibility, systemic governance will be key to promote alignment with stakeholder expectations in AI-driven and data-intensive health settings. (shrink)

We see cases of moral luck arising in recent times, as we face the uncertainties of provisional rules for navigating the coronavirus pandemic. How should we respond to rule-breakers, and how should they view themselves, when they cause harm inadvertently? Although some argue that guilt is unnecessary for any harm that may result from luck, this paper takes moral luck seriously and encourages consideration of the benefits to be achieved by expressions of self-blame amidst troubling circumstances, from pure accidents to (...) how we live during pandemics. It argues that rule-breakers in public health crises show us the importance of taking responsibility for our actions. (shrink)

BackgroundCritical Incident Reporting Systems (CIRS) provide a well-proven method to identify clinical risks in hospitals. All professions can report critical incidents anonymously, low-threshold, and without sanctions. Reported cases are processed to preventive measures that improve patient and staff safety. Clinical ethics consultations offer support for ethical conflicts but are dependent on the interaction with staff and management to be effective. The aim of this study was to investigate the rationale of integrating an ethical focus into CIRS.MethodsA six-step approach combined the (...) analysis of CIRS databases, potential cases, literature on clinical and organizational ethics, cases from ethics consultations, and experts’ experience to construct a framework for CIRS cases with ethical relevance and map the categories with principles of biomedical ethics.ResultsFour main categories of critical incidents with ethical relevance were derived: (1) patient-related communication; (2) consent, autonomy, and patient interest; (3) conflicting economic and medical interests; (4) staff communication and corporate culture. Each category was refined with different subcategories and mapped with case examples and exemplary related ethical principles to demonstrate ethical relevance.ConclusionThe developed framework for CIRS cases with its ethical dimensions demonstrates the relevance of integrating ethics into the concept of risk-, quality-, and organizational management. It may also support clinical ethics consultations’ presence and effectiveness. The proposed enhancement could contribute to hospitals’ ethical infrastructure and may increase ethical behavior, patient safety, and employee satisfaction. (shrink)

Tigard (2019) suggests that the medical community would benefit from continuing to promote notions of individual responsibility and blame in healthcare settings. In particular, he contends that blame will promote systematic improvement, both on the individual and institutional levels, by increasing the likelihood that the blameworthy party will ‘own up’ to his or her mistake and apologise. While we agree that communicating regret and offering a genuine apology are critical steps to take when addressing patient harm, the idea that medical (...) professionals should continue to ‘take the blame’ for medical errors flies in the face of existing science and threatens to do more harm than good. We contrast Dr Tigard’s approach with the current literature on blame to promote an alternative strategy that may help to create lasting change in the face of unfortunate error. (shrink)

Artificial intelligence and robotic technologies have become nearly ubiquitous. In some ways, the developments have likely helped us, but in other ways sophisticated technologies set back our interests. Among the latter sort is what has been dubbed the ‘severance problem’—the idea that technologies sever our connection to the world, a connection which is necessary for us to flourish and live meaningful lives. I grant that the severance problem is a threat we should mitigate and I ask: how can we stave (...) it off? In particular, the fact that some technologies exhibit behavior that is unclear to us seems to constitute a kind of severance. Building upon contemporary work on moral responsibility, I argue for a mechanism I refer to as ‘technological answerability’, namely the capacity to recognize human demands for answers and to respond accordingly. By designing select devices—such as robotic assistants and personal AI programs—for increased answerability, we see at least one way of satisfying our demands for answers and thereby retaining our connection to a world increasingly occupied by technology. (shrink)

In a critique of my work on ‘taking the blame’ as a response to medical errors, my position on the potential goods of individual responsibility and blame is challenged. It is suggested that medicine is a ‘team sport’ and several rich examples are provided to support the possible harms of practitioner self-blame. Yet, it appears that my critics have misunderstood my demands and to whom they are directed. With this response, I offer several clarifications of my account, as well as (...) a reiteration on the role of self-blame after medical error. (shrink)