The prelims comprise: The Distinctiveness of the Ethics of Medicine The Distinctive Ethics of Medicine The Priority of Professional Ethics over Personal Morality Conclusion Notes References.

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

This article identifies ‘the tragedy of the commons’ as an essentially aggregative harm and considers what agents in such a scenario owe to one another. It proposes that the duty to take reasonable precautions requires that agents make efforts to establish collective solutions to any essentially aggregative harm to which they would otherwise contribute. Baylor Johnson has argued that the general obligation to promote the common good requires that agents make efforts to establish a collective agreement to avert a potential (...) tragedy of the commons. This article agrees with Johnson's analysis but argues that there are also negative duties, which give commons users additional moral reason to take collective action to prevent the destruction of the utility of the commons. These duties link commons users to resolving this particular problem and provide grounds to demand that they make greater efforts to prevent the destruction of the commons compared to bystanders. The article suggests that fulfilling negative duties can require establishing collective institutions with the power to regulate human action and interaction. This analysis could be applied to a range of social problems which result from the aggregation of actions and practices. (shrink)