The implementation of moral decision making abilities in artificial intelligence (AI) is a natural and necessary extension to the social mechanisms of autonomous software agents and robots. Engineers exploring design strategies for systems sensitive to moral considerations in their choices and actions will need to determine what role ethical theory should play in defining control architectures for such systems. The architectures for morally intelligent agents fall within two broad approaches: the top-down imposition of ethical theories, and the bottom-up building of (...) systems that aim at goals or standards which may or may not be specified in explicitly theoretical terms. In this paper we wish to provide some direction for continued research by outlining the value and limitations inherent in each of these approaches. (shrink)

Many industry leaders and academics from the field of machine ethics would have us believe that the inevitability of robots coming to have a larger role in our lives demands that robots be endowed with moral reasoning capabilities. Robots endowed in this way may be referred to as artificial moral agents. Reasons often given for developing AMAs are: the prevention of harm, the necessity for public trust, the prevention of immoral use, such machines are better moral reasoners than humans, and (...) building these machines would lead to a better understanding of human morality. Although some scholars have challenged the very initiative to develop AMAs, what is currently missing from the debate is a closer examination of the reasons offered by machine ethicists to justify the development of AMAs. This closer examination is especially needed because of the amount of funding currently being allocated to the development of AMAs coupled with the amount of attention researchers and industry leaders receive in the media for their efforts in this direction. The stakes in this debate are high because moral robots would make demands on society; answers to a host of pending questions about what counts as an AMA and whether they are morally responsible for their behavior or not. This paper shifts the burden of proof back to the machine ethicists demanding that they give good reasons to build AMAs. The paper argues that until this is done, the development of commercially available AMAs should not proceed further. (shrink)

Many industry leaders and academics from the field of machine ethics would have us believe that the inevitability of robots coming to have a larger role in our lives demands that robots be endowed with moral reasoning capabilities. Robots endowed in this way may be referred to as artificial moral agents. Reasons often given for developing AMAs are: the prevention of harm, the necessity for public trust, the prevention of immoral use, such machines are better moral reasoners than humans, and (...) building these machines would lead to a better understanding of human morality. Although some scholars have challenged the very initiative to develop AMAs, what is currently missing from the debate is a closer examination of the reasons offered by machine ethicists to justify the development of AMAs. This closer examination is especially needed because of the amount of funding currently being allocated to the development of AMAs coupled with the amount of attention researchers and industry leaders receive in the media for their efforts in this direction. The stakes in this debate are high because moral robots would make demands on society; answers to a host of pending questions about what counts as an AMA and whether they are morally responsible for their behavior or not. This paper shifts the burden of proof back to the machine ethicists demanding that they give good reasons to build AMAs. The paper argues that until this is done, the development of commercially available AMAs should not proceed further. (shrink)

In this article I try to define more precisely what scientism is and how it is related to a traditional religion such as Christianity. By first examining the writing of a number of contemporary natural scientists (Francis Crick, Richard Dawkins, Stephen Hawking, Carl Sagan and Edward O. Wilson), I show that the concept can be given numerous different meanings. I propose and defend a distinction between epistemic, rationalistic, ontological, axiological and redemptive scientism and it is also explained why we should (...) not directly identify scientism with scientific materialism or scientific naturalism. (shrink)

Breaches of electronic medical records constitute a type of healthcare error, but should be considered separately from other types of errors because the national focus on the security of electronic data justifies special treatment of medical information breaches. Guidelines for protecting electronic medical records should be applied equally to paper medical records.

When facing a choice between saving one person and saving many, some people have argued that fairness requires us to decide without aggregating numbers; rather we should decide by coin toss or some form of lottery, or alternatively we should straightforwardly save the greater number but justify this in a non-aggregating contractualist way. This paper expands the debate beyond well-known number cases to previously under-considered probability cases, in which not (only) the numbers of people, but (also) the probabilities of success (...) for saving people vary. It is shown that, in these latter cases, both the coin toss and the lottery lead to what is called an awkward conclusion, which makes probabilities count in a problematic way. Attempts to avoid this conclusion are shown to lead into difficulties as well. Finally, it is shown that while the greater number method cannot be justified on contractualist grounds for probability cases, it may be replaced by another decision method which is so justified. This decision method is extensionally equivalent to maximising expected value and seems to be the least problematic way of dealing with probability cases in a non-aggregating manner. (shrink)

This paper critically assesses the possibility of moral enhancement with ambient intelligence technologies and artificial intelligence presented in Savulescu and Maslen (2015). The main problem with their proposal is that it is not robust enough to play a normative role in users’ behavior. A more promising approach, and the one presented in the paper, relies on an artifi-cial moral reasoning engine, which is designed to present its users with moral arguments grounded in first-order normative theories, such as Kantianism or utilitarianism, (...) that reason-responsive people can be persuaded by. This proposal can play a normative role and it is also a more promising avenue towards moral enhancement. It is more promising because such a system can be designed to take advantage of the sometimes undue trust that people put in automated technologies. We could therefore expect a well-designed moral reasoner system to be able to persuade people that may not be persuaded by similar arguments from other people. So, all things considered, there is hope in artificial intelli-gence for moral enhancement, but not in artificial intelligence that relies solely on ambient intelligence technologies. (shrink)

Autonomous vehicles must be programmed with procedures for dealing with trolley-style dilemmas where actions result in harm to either pedestrians or passengers. This paper outlines a Rawlsian algorithm as an alternative to the Utilitarian solution. The algorithm will gather the vehicle’s estimation of probability of survival for each person in each action, then calculate which action a self-interested person would agree to if he or she were in an original bargaining position of fairness. I will employ Rawls’ assumption that the (...) Maximin procedure is what self-interested agents would use from an original position, and then show how the Maximin procedure can be operationalized to produce unique outputs over probabilities of survival. (shrink)

Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...) the objection that AI could develop this capacity, I use Hubert Dreyfus’s analysis of AI to argue that attention to the needs of each patient requires the physician to attune his or her perception to the patient’s history and physical exam, an ability that seems uniquely human. Human physician judgment will remain better suited to the practice of primary care despite anticipated advances in AI technology. (shrink)

In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing diseases (e.g., high blood pressure or genetic tests that reveal risks of falling ill in the (...) future). Third, the technology can affect and change an already present illness experience (e.g., the way blood sugar measurement affects the perceived symptoms of diabetes). Fourth, therapeutic technologies may redefine our experiences of a certain condition as diseased rather than unfortunate (e.g. assisted reproductive technologies or symptom based diagnoses in psychiatry). Fifth, technology influences illness experiences through altering social-cultural norms and values regarding various diagnoses. Sixth, technology influences and changes our experiences of being healthy in contrast and relation to being diseased and ill. This typology of how technology forms illness and related conditions calls for reflection regarding the phenomenology of technology and health. How are medical technologies and their outcomes perceived and understood by patients? The phenomenological way of approaching illness as a lived, bodily being-in-the-world is an important approach for better understanding and evaluating the effects that medical technologies may have on our health, not only in defining, diagnosing, or treating diseases, but also in making us feel more vulnerable and less healthy in different regards. (shrink)

This paper puts forward a theoretical framework for the analysis of expertise and experts in contemporary societies. It argues that while prevailing approaches have come to see expertise in various forms and functions, they tend to neglect the broader historical and societal context, and importantly the relational aspect of expertise. This will be discussed with regard to influential theoretical frameworks, such as laboratory studies, regulatory science, lay expertise, post-normal science, and honest brokers. An alternative framework of expertise is introduced, showing (...) the limitations of existing frameworks and emphasizing one crucial element of all expertise, which is their role in guiding action. (shrink)

In recent years, a plethora of high-profile scientific publications has been reporting about machine learning algorithms outperforming clinicians in medical diagnosis or treatment recommendations. This has spiked interest in deploying relevant algorithms with the aim of enhancing decision-making in healthcare. In this paper, we argue that instead of straightforwardly enhancing the decision-making capabilities of clinicians and healthcare institutions, deploying machines learning algorithms entails trade-offs at the epistemic and the normative level. Whereas involving machine learning might improve the accuracy of medical (...) diagnosis, it comes at the expense of opacity when trying to assess the reliability of given diagnosis. Drawing on literature in social epistemology and moral responsibility, we argue that the uncertainty in question potentially undermines the epistemic authority of clinicians. Furthermore, we elucidate potential pitfalls of involving machine learning in healthcare with respect to paternalism, moral responsibility and fairness. At last, we discuss how the deployment of machine learning algorithms might shift the evidentiary norms of medical diagnosis. In this regard, we hope to lay the grounds for further ethical reflection of the opportunities and pitfalls of machine learning for enhancing decision-making in healthcare. (shrink)

The presence of intelligence and rationality in Artificial Intelligence and the Internet requires a new context of analysis in which Herbert Simon’s approach to the sciences of the artificial is surpassed in order to grasp the role of information in our contemporary setting. This new framework requires taking into account some relevant aspects. In the historical endeavor of building up AI and the Internet, minds and machines have interacted over the years and in many ways through the interrelation between scientific (...) creativity and technological innovation. Philosophically, minds and machines can have epistemological, methodological and ontological differences, which are based on the distinct configuration of human intelligence and artificial intelligence. Their comparison with rationality and its various forms is particularly relevant. Scientifically, AI and the Internet belong to the sciences of the artificial, because they work on designs that search for specific aims, following selected processes in order to achieve expected results. Technologically, AI and the Internet require the support of information and communication technologies. These have an instrumental role regarding the existence of AI and the Internet. Also ICT shape their diverse forms of configuration over the years.Within this framework, this paper offers a new context of analysis that goes beyond Simon’s and follows four main steps: the interaction between scientific creativity and technological innovation as the philosophico-methodological setting for Artificial Intelligence and the Internet; artificial intelligence and human intelligence as epistemological basis for machines and minds, where the differences between artificial intelligence and human intelligence are made explicit and the analysis of minds and machines is made from the perspective of rationality ; intention and its difference with design of machine learning are considered to distinguish human intelligence from artificial intelligence; and the internal and external aspects of artificial designs in contemporary society are considered through the perspective of rationality, which leads to the transition from intelligence to rationality in the Internet as well as to the historicity of information. (shrink)

Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...) the objection that AI could develop this capacity, I use Hubert Dreyfus’s analysis of AI to argue that attention to the needs of each patient requires the physician to attune his or her perception to the patient’s history and physical exam, an ability that seems uniquely human. Human physician judgment will remain better suited to the practice of primary care despite anticipated advances in AI technology. (shrink)

John Broome; V*—Fairness, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, Pages 87–102, https://doi.org/10.1093/aristotelian/91.1.87.

Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and healthcare (...) continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

Robots are becoming an increasingly pervasive feature of our personal lives. As a result, there is growing importance placed on examining what constitutes appropriate behavior when they interact with human beings. In this paper, we discuss whether companion robots should be permitted to “nudge” their human users in the direction of being “more ethical”. More specifically, we use Rawlsian principles of justice to illustrate how robots might nurture “socially just” tendencies in their human counterparts. Designing technological artifacts in such a (...) way to influence human behavior is already well-established but merely because the practice is commonplace does not necessarily resolve the ethical issues associated with its implementation. (shrink)

The COVID-19 pandemic has, of necessity, demanded the rapid incorporation of virtual technologies which, suddenly, have superseded the physical medical encounter. These imperatives have been implemented in advance of evaluation, with unclear risks to patient care and the nature of medical practice that might be justifiable in the context of a pandemic but cannot be extrapolated as a new standard of care. Models of care fit for purpose in a pandemic should not be generalized to reconfigure medical care as virtual (...) by default, and personal by exception at the conclusion of the emergency. (shrink)

In "Rethinking Research Ethics," Rosamond Rhodes argues that everyone has a responsibility to participate in research ethics programs (Rhodes 2005). After discussing the moral underpinnings upon which such a claim might rest, this article brings up two concerns in response to Rhodes' claim. The first worry is pragmatic: Rhodes argues that the focus in research ethics should be on the hypothetical consent of idealized moral agents, an approach that is constrained by practical considerations. The second objection is that, in most (...) research studies, participants are paid, which undermines the accusation of free-riding for non-participants. (shrink)

"The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for physician, and genesis, meaning origin. Discussion of the disease of medical progress has moved up on the agendas of medical conferences, researchers concentrate on the sick-making powers of diagnosis and therapy, and reports on paradoxical damage caused by cures for sickness take (...) up increasing space in medical dope-sheets [...] The public has been alerted to the perplexity and uncertainty of the best among its hygienic caretakers [...] This book argues that panic is out of place. Thoughtful public discussion of the iatrogenic pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal."-- from Introduction. (shrink)

Information and communication technology is changing many aspects ofhuman endeavour and existence. This is beyond dispute for most. Whatare contested are the social and ethical implications of thesechanges. Possible sources of these disputes are the multiple ways inwhich one can conceptualize and interpret the informationtechnology/society interrelationship. Each of these ways ofconceptualization and interpretation enables one to see theinformation technology/society relationship differently and thereforeconstrue its social and ethical implications in a different manner. Atthe center of this technology/society interrelationship we find manycomplex (...) questions about the nature of the human, the technical,agency, autonomy, freedom and much more. This is indeed a vastintellectual landscape, which can obviously not be explored here inits fullness. This entry is about just one particular perspective onthis landscape. It is primarily concerned with the phenomenologicalapproach to interpreting information technology and its social andethical implications. It should be noted from the start that there isnot a unified phenomenological tradition or approach to informationtechnology in particular, or other phenomena more generally. Thephenomenological tradition consists of many different approaches thatshare certain characteristics but not all. We may however suggest, with Don Ihde,that they all accept that “phenomenology investigates theconditions of what makes things appear as such [as that which we takethem to be].” Differently stated, phenomenology suggests thatthere is a co-constitutive relationship between us and the phenomenawe encounter in our engagement with the world. In this sensephenomenologists would suggest that to understand thetechnology/society relationship we need to reveal how theyco-constitute each other—i.e. draw on each other for theirongoing meaning and sense. We will elaborate more precisely what thismeans in section 2 below. However, in order to understand the distinctiveness of thephenomenological approach other possible ways of interpreting thistechnology/society relationship will also be outlined brieflybelow., It can be said that information technology has become in a very realsense ubiquitous. Most everyday technologies such as elevators,automobiles, microwaves, watches, and so forth depend onmicroprocessors for their ongoing operation. Most organizations andinstitutions have become reliant on their information technologyinfrastructure to a lesser or greater degree. Indeed informationtechnology is seen by many as a cost-efficient way to solve amultitude of problems facing our complex contemporary society. One canalmost say that information technology has become construed as thedefault technology for solving a whole raft of technical and socialproblems such as health provision, security, governance, etc. Onecould also argue that it has become synonymous with society’sview of modernization and progress. For most it seems obvious thatinformation technology has made it possible for humans to continue toconstruct increasingly complex systems of coordination and socialordering—systems without which contemporary society would not beable to exist in its present form. To say the least, we, ascontemporary human beings, have our manner of being made possiblethrough a rather comprehensive entanglement with information andcommunication technology. Indeed, the economic, organizational andsocial benefit of information technology is not widely disputed. Thedispute is more often about the way information technology is changingor transforming the social domain, and in particular, the ethicaldomain. This dispute is largely centered around different ways ofconceptualizing and interpreting the nature of our entanglement withinformation technology. This debate is not merely an academic debateabout different and competing theoretical ‘models.’Rather, these different ways of conceptualizing it is central to ourunderstanding of how we go about managing our increasingly entangledrelationship with information technology. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

A significant proportion of elderly and psychiatric patients do not have the capacity to make health care decisions. We suggest that machine learning technologies could be harnessed to integrate data mined from electronic health records (EHRs) and social media in order to estimate the confidence of the prediction that a patient would consent to a given treatment. We call this process, which takes data about patients as input and derives a confidence estimate for a particular patient’s predicted health care-related decision (...) as an output, the autonomy algorithm. We suggest that the proposed algorithm would result in more accurate predictions than existing methods, which are resource intensive and consider only small patient cohorts. This algorithm could become a valuable tool in medical decision-making processes, augmenting the capacity of all people to make health care decisions in difficult situations. (shrink)