In this paper, I examine the ethics of e - trust and e - trustworthiness in the context of health care, looking at direct computer-patient interfaces (DCPIs), information systems that provide medical information, diagnosis, advice, consenting and/or treatment directly to patients without clinicians as intermediaries. Designers, manufacturers and deployers of such systems have an ethical obligation to provide evidence of their trustworthiness to users. My argument for this claim is based on evidentialism about trust and trustworthiness: the idea that trust (...) should be based on sound evidence of trustworthiness. Evidence of trustworthiness is a broader notion than one might suppose, including not just information about the risks and performance of the system, but also interactional and context-based information. I suggest some sources of evidence in this broader sense that make it plausible that designers, manufacturers and deployers of DCPIs can provide evidence to users that is cognitively simple, easy to communicate, yet rationally connected with actual trustworthiness. (shrink)

This chapter presents an overview of the life, work, and philosophical contributions of Śāntarakṣita (c. 725–788), who is known for his synthesis of Nāgārjuna’s Madhyamaka with elements of the Dignāga-Dharmakīrti tradition of logic and epistemology. His two most important independent treatises, the Compendium of True Principles (Tattvasaṃgraha) and the Ornament of the Middle Way (Madhyamakālaṃkāra), are characterized by an emphasis on the indispensable role of rational analysis on the Buddhist path as well as serious and systematic engagement with competing Buddhist (...) and non-Buddhist schools of thought. Śāntarakṣita employs a pedagogical-rhetorical device of provisionally adopting what he deems to be successively more rational views to reject less rational ones. Using this approach, in the Ornament of the Middle Way, he recommends a gradual path to arrive at an understanding of the Madhyamaka ultimate truth by incorporating Yogācāra idealist ontology into his presentation of conventional truth. In this same text, he presents an influential iteration of the neither-one-nor-many argument for the Madhyamaka ultimate truth, the emptiness of intrinsic nature—i.e., the universal negation of ontologically independent being—leaving a lasting and significant impact on both Indian and Tibetan Madhyamaka Buddhist philosophy. (shrink)

Some recent accounts of testimonial warrant base it on trust, and claim that doing so helps explain asymmetries between the intended recipient of testimony and other non-intended hearers, e.g. differences in their entitlement to challenge the speaker or to rebuke the speaker for lying. In this explanation ‘dependence-responsiveness’ is invoked as an essential feature of trust: the trustor believes the trustee to be motivationally responsive to the fact that the trustor is relying on the trustee. I argue that dependence-responsiveness is (...) not essential to trust and that the asymmetries, where genuine, can be better explained without reference to trust. (shrink)

Trong bài viết này chúng tôi trình bày thông tin đại cương về vai trò của nickel trong công nghiệp chế tạo giữa bối cảnh yêu cầu bảo vệ môi sinh trong đại nghị sự mục tiêu phát triển bền vững (SDG) của Liên Hợp Quốc ngày một cấp bách, đối diện với nguy cơ không thể hoàn thành. Các thông tin tóm lược ở đây được dẫn chiếu tới một số nhỏ các tài liệu tham khảo chính và (...) không thể đảm bảo tính trọn vẹn trong khuôn khổ một bài báo nhỏ. Những vấn đề đặt ra có tính tổng quát cho quan hệ môi sinh với việc khai khoáng, tách và tinh chế nickel nói chung trên thế giới. Vì thế, có thể thông tin trong bài không hoàn toàn trùng khớp với tình hình cụ thể của một địa phương trên trái đất, do đặc điểm địa lý, địa chất và kinh tế-công nghệ khác biệt. Bài viết tập trung xoay quanh nguyên lý quan hệ kinh tế-môi trường và ý nghĩa thực tiễn của cụm từ “bền vững” trong bối cảnh cụ thể của công nghiệp nickel. (shrink)

Trong bài viết này chúng tôi trình bày thông tin đại cương về vai trò của nickel trong công nghiệp chế tạo giữa bối cảnh yêu cầu bảo vệ môi sinh trong đại nghị sự mục tiêu phát triển bền vững (SDG) của Liên Hợp Quốc ngày một cấp bách, đối diện với nguy cơ không thể hoàn thành. Các thông tin tóm lược ở đây được dẫn chiếu tới một số nhỏ các tài liệu tham khảo chính và (...) không thể đảm bảo tính trọn vẹn trong khuôn khổ một bài báo nhỏ. Những vấn đề đặt ra có tính tổng quát cho quan hệ môi sinh với việc khai khoáng, tách và tinh chế nickel nói chung trên thế giới. Vì thế, có thể thông tin trong bài không hoàn toàn trùng khớp với tình hình cụ thể của một địa phương trên trái đất, do đặc điểm địa lý, địa chất và kinh tế-công nghệ khác biệt. Bài viết tập trung xoay quanh nguyên lý quan hệ kinh tế-môi trường và ý nghĩa thực tiễn của cụm từ “bền vững” trong bối cảnh cụ thể của công nghiệp nickel. (shrink)

It is difficult to overstate the importance of freedom in Kant's critical philosophy, and there are few scholars whose expertise on this subject could rival Henry E. Allison's. In this magisterial commentary, Allison meticulously chronicles the development of Kant's theory of freedom from his earliest pre-critical works all the way through the Metaphysics of Morals. Great care is taken to explain how and why Kant's views changed over time, and Allison provides compelling, sympathetic interpretations at every turn. (...) The first four chapters deal with Kant's pre-critical writings and his lectures on metaphysics and ethics from the 1760s. The general narrative here is likely to be a familiar one for the target audience... (shrink)

The accumulation of potentially toxic elements (PTEs) has raised public awareness due to harmful contamination to both human and marine creatures. This study was designed to determine the concentration of copper (Cu), zinc (Zn), cadmium (Cd), and nickel (Ni) in the intestine, kidney, muscle, gill, and liver tissues of local commercial edible fish, fourfinger threadfin (Eleutheronema tetradactylum), and black pomfret (Parastromateus niger) collected from Morib (M) and Kuala Selangor (KS). Among the studied PTEs, Cu and Zn were essential elements (...) to regulate body metabolism with certain dosages required while Cd and Ni were considered as non-essential elements that posed chronic and carcinogenic risk. The concentration of PTEs in fish tissue samples was analyzed using flame atomic absorption spectrometry (F-AAS). By comparing the concentration of PTEs in fish tissues as a bioindicator, the environmental risk of Morib was more serious than Kuala Selangor because both fish species collected from Morib resulted in a higher PTEs concentration. For an average 62 kg adult with a fish ingestion rate (FIR) of 0.16 kg/person/day in Malaysia, the estimated weekly intake (EWI) of Cd from the consumption of E. tetradactylum (M: 0.0135 mg/kg; KS: 0.0134 mg/kg) and P. niger (M: 0.0140 mg/kg; KS: 0.0132 mg/kg) had exceeded the provisional tolerable weekly intake (Cd: 0.007 mg/kg) established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference dose (ORD) values of Cd (0.001 mg/kg/day) as provided by the United States Environmental Protection Agency (USEPA) regional screening level, thus it posed chronic risks for daily basis consumption. Besides, the value of the carcinogenic risk of Cd (0.7−3 to 0.8−3) and Ni (0.5−3 to 0.6−3) were in between the acceptable range (10−6 to 10−4) of the health index that indicates a relatively low possibility cancer occurrence to the consumers in both Morib and Kuala Selangor. This study recommended FIR to be 0.80 kg/person/day to reduce the possibility of posing chronic and carcinogenic risks while at the same time obtaining the essential nutrients from the fish. (shrink)

Spinoza’s conatus doctrine, the main proposition of which claims, “[e]ach thing, to the extent it is in itself, strives [conatur] to persevere in its being” (E3p6), has been the subject of growing interest. This is understandable, for Spinoza’s psychology and ethics are based on this doctrine. In my paper I shall examine the way Spinoza argues for E3p6 in its demonstration which runs as follows: "For singular things are modes by which God’s attributes are expressed in a certain and determinate (...) way (by 1p25c), i.e. (by 1p34), things that express, in a certain and determinate way, God’s power, by which God is and acts. And no thing has anything in itself by which it can be destroyed, or which takes its existence away (by p4). On the contrary, it is opposed to everything which can take its existence away (by p5). Therefore, to the extent it can, and is in itself, it strives to persevere in its being." This argument has been severely criticized for being defective in many ways. E3p6d contains four items, E1p25c, 1p34, 3p4, and 3p5. Most often, only the two last mentioned are regarded as doing any real work in the demonstration. However, I shall argue that having a proper grasp of Spinoza’s concept of power enables us see that the demonstration’s beginning, built on E1p25c and 1p34, brings forth a certain dynamic framework in which finite things are centers of causal power, capable of producing effects in virtue of their essences. My examination of this framework shows the beginning of the demonstration to be irreplaceable: in the end, conatus is one form of power, and E1p25c and 1p34 not only bring the notion of power into play, but also inform us on how finite things’ power should be understood in the monistic system. So, I disagree with such commentators as Jonathan Bennett, Edwin Curley, Daniel Garber, Michael Della Rocca, and Richard Manning, who see Spinoza as trying to derive the conatus doctrine from E3p4 and 3p5 alone; and I agree with Alexandre Matheron, Henry Allison, and Martin Lin, who stress the importance of E1p25c and 1p34. -/- However, this still leaves us the task of reconstructing the whole derivation and showing how its various ingredients fit together. If E1p25c and 1p34 are so important, could E3p6 not be derived from them alone, as Martin Lin has argued? In other words, why are E3p4 and 3p5 needed at all? To answer these questions I shall provide an interpretation of E3p6d that explains how the argument is supposed to work. E1p25c and 1p34 say that finite things are, in essence, dynamic causers, which, in case of opposition, truly resist opposing factors with their power and do not simply cease their causal activities whenever facing obstacles; in other words, they strive against any opposition. However, this is not enough to guarantee that they could not act self-destructively or restrain their own power, which would make them incapable of self-preservation. But this would go against E3p4, “No thing can be destroyed except through an external cause,” and Spinoza uses it to claim, “no thing has anything in itself by which it can be destroyed, or which takes its existence away.” So all this allows Spinoza to hold that finite things are consistent causers, that is, entities endowed with power and, insofar they cause effects solely in virtue of their essence, they never use their power self-destructively. The significance and role of the final item in the demonstration, E3p5 (“Things are of a contrary nature, i.e., cannot be in the same subject, insofar as one can destroy the other”), still needs to be determined. Indeed, considering its content and the way it is used in the demonstration, it seems to be a surprisingly decisive ingredient in the argument. Namely, what “each thing, to the extent it is in itself,” that is, insofar as any thing is considered disregarding everything external to it, strives to preserve, is its being (esse), not simply its present state. This together with E3p5’s view of subjecthood – which I shall explicate in my paper – suggests that we should rethink what kind of “being” or “existence” is meant in E3p6. Indeed, for Spinoza, each subject has a definable essence from which, as far as the subject in question is in itself, certain properties or effects necessarily follow; consequently a subject’s full being involves not only instantiating a certain essence, but also those properties inferable from the essence-expressing definition. Thus, E3p5 is meant to bring forward that things are not merely non-self-destroyers but subjects from whose definitions properties follow; and as Spinoza thinks to have shown (by E1p25c and 1p34) that finite modifications are entities endowed with power, any subject has true power to produce the properties or effects derivable from its definition, which, Spinoza claims, implies opposing everything harmful. In other words, things exercise power as their definition states, i.e. according to their definitions, and thus bringing in the idea of things as expressers of power enables Spinoza to convert logical oppositions (of E3p5) into real ones (of E3p6). To summarize, Spinoza reasons that each true finite thing is, in itself, an expresser of power (E1p25c, 1p34) that never acts self-destructively (E3p4) but instead strives to drive itself through opponents to produce effects as they follow from the definition of the thing in question (E1p25c, 1p34, and 3p5). Therefore, “each thing, to the extent it is in itself, strives to persevere in its being.” The demonstration of E3p6 has its roots deep in Spinoza’s ontology, and since its concept of power is supposed to provide the metaphysical grounding for real opposition, the importance of E1p25c and 1p34 should not be underestimated just because Spinoza – as often happens – puts his point exceedingly briefly. Moreover, the derivation is basically valid and contains no superfluous elements. Finally, all this tells us something decisive about the meaning of Spinoza’s doctrine: according to it, things are active causers whose “power to exist and act” has conatus character in temporality, amounting not only to striving to prolong the duration of one’s actualization but also to striving to be as active or autonomous as possible, that is, to attain a state determined by the striving subject’s essence alone. (shrink)

This paper concerns the role of the transcendental distinction between agents qua phenomena and qua noumena in Kant's theory of free will. It argues (1) that Kant's incompatibilism can be accommodated if one accepts the "ontological" interpretation of this distinction (i.e. the view that agents qua noumena are ontologically prior to agents qua phenomena), and (2) that Kant's incompatibilism cannot be accommodated by the "two-aspect" interpretation, whose defining feature is the rejection of the ontological priority of agents qua noumena. The (...) ontological interpretation allows Kant to be an incompatibilist because the ontological priority of agents qua noumena "ontologically undermines" the significance of phenomenal determinism for agents' free will. That is, since agents qua noumena are ontologically prior to agents qua phenomena, the fact that agents qua noumena are not subject to determinism is more fundamental than the fact that agents qua phenomena are subject to determinism, and it is the more fundamental fact that we should be concerned with in the metaphysical foundations of moral responsibility. Recent (independent) work by myself, Eric Watkins, and Robert Hanna is drawn on to demonstrate that the ontological interpretation can mount a better defense against some traditional objections than has often been thought. -/- According to the two-aspect interpretation, the transcendental distinction between agents qua noumena and qua phenomena is a semantic and epistemological distinction. Since it rejects the ontological priority of noumena, it has no way to assert that the non-determinism of agents qua noumena is more metaphysically fundamental than the determinism of agents qua phenomena. For the two-aspect interpretation, the truth of determinism must remain just as fundamental as the truth of any other characterization of agents. This means that, on the two-aspect interpretation, there is no better reason to call Kant an incompatibilist than there is to call him a compatibilist. Since Henry Allison has presented the most detailed two-aspect interpretation of the agential transcendental distinction, the arguments against the two-aspect distinction address his interpretation. Part of Allison's strategy is to argue that phenomenal determinism poses less of a problem for free will if we accept his accounts of the Second Analogy and empirical psychology. I point our problems in these accounts and argue that this strategy cannot be accepted. -/- . (shrink)

Wall, G. Locke's attack on innate knowledge.--Harris, J. Leibniz and Locke on innate ideas.--Greenlee, D. Locke's idea of idea.--Aspelin, G. Idea and perception in Locke's essay.--Greenlee, D. Idea and object in the essay.--Mathews, H. E. Locke, Malebranche and the representative theory.--Alexander, P. Boyle and Locke on primary and secondary qualities.--Ayers, M. R. The ideas of power and substance in Locke's philosophy.--Allison, H. E. Locke's theory of personal identity.--Kretzmann, N. The main thesis of Locke's semantic theory.--Woozley, A. D. Some remarks (...) on Locke's account of knowledge.--Laudan, L. The nature and sources of Locke's views on hypotheses. (shrink)

In this paper I present an interpretation of Immanuel Kant’s transcendental deduction of the categories (a dangerous interpretation it turns out), based primarily on the “two-step” argument of the B deduction of the Critique of Pure Reason. I undertake to show that Kant’s distinction between the “pure forms of intuition” and “pure formal intuition” is successful in its attempt to prove that all sensible intuitions presuppose the a priori categories, in a way which is compatible, I claim, with Kant’s statements (...) (in the Aesthetic and elsewhere) that sensible intuition is prior to all concepts; and therefore that the Transcendental Aesthetic presupposes the Transcendental Analytic. Thus my Interpretation is a "conceptualist" reading of the deduction, in holding that perception, as receptivity, presupposes an underlying spontaneity of the pure understanding and categories. The categories are held to be not just compatible with all possible sensible intuitions, but through their "transcendental content" constitutive of the relation of sensible intuitions to objects - and this explains how our thought can represent objects a priori. It is one of the claims of my interpretation that the logical forms of judgment of general logic derive from the pure categories of transcendental logic, rather than vice-versa. I.e. that the logical forms through which we make empirical judgments by combining analytical concepts in inner sense in time, are originally grounded in an atemporal categorial synthesis in pure intuition (i.e. in the form of time but not the dimension of time), referring an outer intuition in general to the transcendental object of intuition (as “something in general” outside sensibility or receptivity), thereby providing the synthetic unity of the manifold which “..all analysis presupposes.” My conceptualist reading of the deduction, I claim, avoids the problems associated with other conceptualist readings, for example inconsistency with the text (“Intuitions are prior to all concepts.” etc.) and blurring of the distinction between receptivity and spontaneity. In my paper I prove that the categories can correctly be held to provide the a priori unity of intuitions, notwithstanding the fact that the latter are “prior to all concepts,” because this unity is not provided by the categories as fully-fledged concepts in the empirical subject, but as the transcendental logical form of these concepts, as a unity in the pure understanding - and the categories therefore require their empirical content or application for their objective reality as concepts. I.e. the categories, as logical functions of judgment for transcendental apperception, in the pure forms of intuition, are prior to all "concepts", correctly speaking, as well as prior to all intuitions, and provide the necessary unity of both. Likewise, at the empirical level my version of conceptualism cannot be accused of blurring the distinction between receptivity and spontaneity, or sensibility and understanding, because although the transcendental content of the categories, as a logical function of judgment in the pure forms of intuition, in transcendental apperception, is in necessary relation to sensibility (in combining the manifold in the pure or formal representation of the transcendental object) their empirical content is not. - At the empirical level the divide between spontaneity (as judgment in the empirical subject) and receptivity (as the effect of transcendental synthesis and the transcendental object on outer and inner sense) remains intact. Conceptualist readings of the deduction also have to avoid infringing Kant’s requirement that the sensible manifold originally be given prior to and independently of all acts of the understanding, or otherwise to qualify the requirement in some way - e.g. by taking a Hegelian direction, such as that taken by John McDowell.1 On my reading of the deduction the sensible manifold given indeterminately in the pure forms of space and time must be given prior to the categorial synthesis of the manifold in the pure representation of the transcendental object, i.e. in the pure 'concept' of an object in general affecting sensibility. Therefore Kant’s requirement for an undetermined manifold given prior to, and independently of, all acts of the understanding (“..the manifold to be intuited must be given prior to the synthesis of understanding, and independently of it. How this takes place, remains here undetermined” [cf.B145/146]) is not infringed. In a later section of the paper, however, I will argue that the transcendental object (of intuition) does have pure theoretical reason as one of its two interacting immanent aspects, but is distinct from pure theoretical reason in the other of its (the transcendental object of intuition's) two interacting immanent aspects, i.e. pure will, which adds a Schopenhauerian element to my interpretation (which will be argued for in a way which supports Kantian optimism over Schopenhauerian pessimism however, in regard to the freedom of the will). Another perceived inconsistency in the deduction, which my interpretation can explain, is Kant’s description (in the B deduction) of the principle of the necessary synthetic unity of apperception as analytic, while in the A deduction it is described as synthetic. I explain this as a difference in the reference of terms such as “my representations” in the two versions - a transcendental reference in the B version but an empirical and transcendental reference in the A version of the principle. I also show that the first part of the two-step B deduction can correctly be characterised by Kant as analytic and the second, concluding part, synthetic (a point of dispute amongst Kant scholars) because transcendental logic (which refers to both the analytic and synthetic aspects of the principle of apperception) “does not abstract from the pure content of knowledge.” While being a “double aspect” rather than “two world” view of transcendental Idealism (because objects of intuition are comprised of both the empirical and transcendental object, i.e. transcendental referent, of intuition, my view differs significantly from the “double aspect” interpretation of Henry Allison (which distinguishes empirical reality from the “God’s eye” view). The view of transcendental idealism resulting from my reading of the deduction, I claim, allows a full empirical realism, because empirical intuitions, as objects of cognition, are the appearance of both the transcendental subject and the transcendental object (i.e. transcendental referent ) of transcendental synthesis (both as “something in general” outside sensibility or receptivity, or rather outside sensibility as receptivity). I conclude that Kant succeeds (although only with the addition of what I have called my 'Schopenhauerian element') in his attempt to prove that we have a transcendental unity of apperception which both constitutes, and is constituted by, the relation of sensible representations to objects, and that since transcendental apperception is the a priori underlying ground of empirical apperception, the categories (as the logical functions of judgment by which transcendental apperception relates sensible representations to objects) are the a priori underlying ground of all experience, and are therefore valid synthetically a priori for all objects of experience. 1 E.g. in “On Pippin’s Postscript.” European Journal of Philosophy 15:3 pp. 395-410. (shrink)

This paper sets out an account of trust in AI as a relationship between clinicians, AI applications, and AI practitioners in which AI is given discretionary authority over medical questions by clinicians. Compared to other accounts in recent literature, this account more adequately explains the normative commitments created by practitioners when inviting clinicians’ trust in AI. To avoid committing to an account of trust in AI applications themselves, I sketch a reductive view on which discretionary authority is exercised by AI (...) practitioners through the vehicle of an AI application. I conclude with four critical questions based on the discretionary account to determine if trust in particular AI applications is sound, and a brief discussion of the possibility that the main roles of the physician could be replaced by AI. (shrink)

The burden of research ethics review falls not just on researchers, but on those who serve on research ethics committees (RECs). With the advent of automated text analysis and generative artificial intelligence, it has recently become possible to teach models to support human judgment, for example by highlighting relevant parts of a text and suggesting actionable precedents and explanations. It is time to consider how such tools might be used to support ethics review and oversight. This commentary argues that with (...) a suitable strategy of engagement, artificial intelligence can be used in a variety of ways that can genuinely support RECs and manage their workload and improve the quality of review. It would be wiser to take an active role in the development of AI tools for ethics review, rather than to adopt ad hoc tools after the fact. (shrink)

Some philosophers argue that we should be suspicious about shame. For example, Nussbaum endorses the view that shame is a largely irrational or unreasonable emotion rooted in infantile narcissism. This claim has also been used to support the view that we should largely abandon shaming as a social activity. If we are worried about the emotion of shame, so the thought goes, we should also worry about acts which encourage shame. I argue that this line of reasoning does not license (...) the leap from the critique of shame to the critique of shaming. This is because shaming does not always aim to inflict shame on its targets. Many acts of shaming (which I label ‘performative shaming’) should simply be understood as aiming to serve their characteristic function of shoring up social norms and standards. (shrink)

This paper develops a philosophical account of moral disruption. According to Robert Baker (2013), moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the Harm Account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the Qualified Harm Account, there is (...) no harm in cases where moral uncertainty is related to innovation that is “for the best” in historical perspective, or where uncertainty is the expression of a deliberative virtue. The two accounts are compared by applying them to Baker’s historical case of the introduction of mechanical ventilation and organ transplantation technologies, as well as the present-day case of mass data practices in the health domain. (shrink)

Engineers are traditionally regarded as trustworthy professionals who meet exacting standards. In this chapter I begin by explicating our trust relationship towards engineers, arguing that it is a linear but indirect relationship in which engineers “stand behind” the artifacts and technological systems that we rely on directly. The chapter goes on to explain how this relationship has become more complex as engineers have taken on two additional aims: the aim of social engineering to create and steer trust between people, and (...) the aim of creating automated systems that take over human tasks and are meant to invite the trust of those who rely on and interact with them. (shrink)

A person presented with adequate but not conclusive evidence for a proposition is in a position voluntarily to acquire a belief in that proposition, or to suspend judgment about it. The availability of doxastic options in such cases grounds a moderate form of doxastic voluntarism not based on practical motives, and therefore distinct from pragmatism. In such cases, belief-acquisition or suspension of judgment meets standard conditions on willing: it can express stable character traits of the agent, it can be responsive (...) to reasons, and it is compatible with a subjective awareness of the available options. (shrink)

The proposition that digital innovations can put people in charge of their health has been accompanied by prolific talk of empowerment. In this paper we consider ethical challenges and opportunities of trying to achieve justice and empowerment using digital health initiatives. The language of empowerment can misleadingly suggest that by using technology, people can control their health and take responsibility for health outcomes to a greater degree than is realistic or fair. Also, digital health empowerment often primarily reaches people who (...) already have high technological and health literacy, leaving others behind. We critically investigate whether the concept of health empowerment could be re-engineered to mean something different, namely the process of improving the health literacy and access of those who least possess it, in line with recent proposals for conceptual engineering in the service of justice. We settle on the weaker conclusion that underlying ethical values including justice should be used to interpret the existing concept of empowerment. To conclude, we take a high-level view of various strategies for achieving the ethical value associated with digital health empowerment. (shrink)

Modern health data practices come with many practical uncertainties. In this paper, I argue that data subjects’ trust in the institutions and organizations that control their data, and their ability to know their own moral obligations in relation to their data, are undermined by significant uncertainties regarding the what, how, and who of mass data collection and analysis. I conclude by considering how proposals for managing situations of high uncertainty might be applied to this problem. These emphasize increasing organizational flexibility, (...) knowledge, and capacity, and reducing hazard. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Technology is a practically indispensible means for satisfying one’s basic interests in all central areas of human life including nutrition, habitation, health care, entertainment, transportation, and social interaction. It is impossible for any one person, even a well-trained scientist or engineer, to know enough about how technology works in these different areas to make a calculated choice about whether to rely on the vast majority of the technologies she/he in fact relies upon. Yet, there are substantial risks, uncertainties, and unforeseen (...) practical consequences associated with the use of technological artifacts and systems. The salience of technological failure (both catastrophic and mundane), as well as technology’s sometimes unforeseeable influence on our behavior, makes it relevant to wonder whether we are really justified as individuals in our practical reliance on technology. Of course, even if we are not justified, we might nonetheless continue in our technological reliance, since the alternatives might not be attractive or feasible. In this chapter I argue that a conception of trust in technological artifacts and systems is plausible and helps us understand what is at stake philosophically in our reliance on technology. Such an account also helps us understand the relationship between trust and technological risk and the ethical obligations of those who design, manufacture, and deploy technological artifacts. (shrink)

In this chapter, we consider ethical and philosophical aspects of trust in the practice of medicine. We focus on trust within the patient-physician relationship, trust and professionalism, and trust in Western (allopathic) institutions of medicine and medical research. Philosophical approaches to trust contain important insights into medicine as an ethical and social practice. In what follows we explain several philosophical approaches and discuss their strengths and weaknesses in this context. We also highlight some relevant empirical work in the section on (...) trust in the institutions of medicine. It is hoped that the approaches discussed here can be extended to nursing and other topics in the philosophy of medicine. (shrink)

According to a dominant view of stigma, a person is stigmatized within a community if sufficiently many people within that community hold a bad view of her. I call this the 'Bad View Model'. In this paper, I argue against the Bad View Model on the grounds that such beliefs are neither necessary nor sufficient for stigma, and that the account cannot explain the distinctive phenomenology of stigma, including certain vulnerabilities to shame. I then develop an alternative that explains these (...) features of stigma, which I call the 'Shaming Model'. On this view, a person is stigmatized within a community if she is shamed by members of that community, and this is explained by their belief that she has deviated from some social norm and/or standard. (shrink)

This chapter considers possible moral grounds for recognizing and realizing economic and social rights (ESRs) as human rights. It begins by suggesting that ESRs fall into three families: (1) welfareoriented ESRs, which protect adequate income, education, health, and safe and healthful working conditions; (2) freedom-oriented ESRs, which prohibit slavery, ensure free choice of employment, and protect workers’ freedoms to organize and strike: and (3) fairness-oriented ESRs, which require nondiscrimination and equal opportunity in the workplace along with fair remuneration for one’s (...) work. To accommodate the normative diversity found in these three families, the chapter suggests a pluralistic justicatory framework that appeals to three kinds of moral reasons: human welfare, freedom, and fairness. A final section considers the possibility of subsuming all three of these approaches to justication under the idea of human dignity or the associated idea of equal respect for persons. (shrink)

There’s a common line of reasoning which supposes that the phenomenal unity of conscious experience is grounded in a mind-like simple subject. To the contrary, Mādhyamika Buddhist philosophers like Śrīgupta (seventh–eighth century) argue that any kind of mental simple is incoherent and thus metaphysically impossible. Lacking any unifying principle, the phenomenal unity of conscious experience is instead an unfounded illusion. In this paper, I present an analysis of Śrīgupta’s "neither-one-nor-many argument" against mental simples and show how his line of reasoning (...) is driven by a set of implicit questions concerning the nature of and relation between consciousness and its intentional object. These questions not only set the agenda for centuries of intra-Buddhist debate on the topic, but they are also questions to which any defender of unified consciousness or a simple subject of experience arguably owes responses. (shrink)

In this paper we raise the question whether technological artifacts can properly speaking be trusted or said to be trustworthy. First, we set out some prevalent accounts of trust and trustworthiness and explain how they compare with the engineer’s notion of reliability. We distinguish between pure rational-choice accounts of trust, which do not differ in principle from mere judgments of reliability, and what we call “motivation-attributing” accounts of trust, which attribute specific motivations to trustworthy entities. Then we consider some examples (...) of technological entities that are, at first glance, best suited to serve as the objects of trust: intelligent systems that interact with users, and complex socio-technical systems. We conclude that the motivation-attributing concept of trustworthiness cannot be straightforwardly applied to these entities. Any applicable notion of trustworthy technology would have to depart significantly from the full-blown notion of trustworthiness associated with interpersonal trust. (shrink)

Some of the systems used in natural language generation (NLG), a branch of applied computational linguistics, have the capacity to create or assemble somewhat original messages adapted to new contexts. In this paper, taking Bernard Williams’ account of assertion by machines as a starting point, I argue that NLG systems meet the criteria for being speech actants to a substantial degree. They are capable of authoring original messages, and can even simulate illocutionary force and speaker meaning. Background intelligence embedded in (...) their datasets enhances these speech capacities. Although there is an open question about who is ultimately responsible for their speech, if anybody, we can settle this question by using the notion of proxy speech, in which responsibility for artificial speech acts is assigned legally or conventionally to an entity separate from the speech actant. (shrink)

According to assurance views of testimonial justification, in virtue of the act of testifying a speaker provides an assurance of the truth of what she asserts to the addressee. This assurance provides a special justificatory force and a distinctive normative status to the addressee. It is thought to explain certain asymmetries between addressees and other unintended hearers (bystanders and eavesdroppers), such as the phenomenon that the addressee has a right to blame the speaker for conveying a falsehood but unintended hearers (...) do not, and the phenomenon that the addressee may deflect challenges to his testimonial belief to the speaker but unintended hearers may not. Here I argue that we can do a better job explaining the normative statuses associated with testimony by reference to epistemic norms of assertion and privacy norms. Following Sanford Goldberg, I argue that epistemic norms of assertion, according to which sincere assertion is appropriate only when the asserter possesses certain epistemic goods, can be ‘put to work’ to explain the normative statuses associated with testimony. When these norms are violated, they give hearers the right to blame the speaker, and they also explain why the speaker takes responsibility for the justification of the statement asserted. Norms of privacy, on the other hand, directly exclude eavesdroppers and bystanders from an informational exchange, implying that they have no standing to do many of the things, such as issue challenges or questions to the speaker, that would be normal for conversational participants. This explains asymmetries of normative status associated with testimony in a way logically independent of speaker assurance. (shrink)

Assurance theories of testimony attempt to explain what is distinctive about testimony as a form of epistemic warrant or justification. The most characteristic assurance theories hold that a distinctive subclass of assertion (acts of “telling”) involves a real commitment given by the speaker to the listener, somewhat like a promise to the effect that what is asserted is true. This chapter sympathetically explains what is attractive about such theories: instead of treating testimony as essentially similar to any other kind of (...) evidence, they instead make testimonial warrant depend on essential features of the speech act of testimony as a social practice. One such feature is “buck-passing,” the phenomenon that when I am challenged to defend a belief I acquired through testimony, I may respond by referring to the source of my testimony (and thereby “passing the buck”) rather than providing direct evidence for the truth of the content of the belief. The chapter concludes by posing a serious challenge to assurance theories, namely that the social practice of assurance insufficiently ensures the truth of beliefs formed on the basis of testimony, and thereby fails a crucial epistemological test as a legitimate source of beliefs. (shrink)

Making decisions with an, often significant, element of risk seems to be an integral part of many of the projects of the diverse profession of engineering. Whether it be decisions about the design of products, manufacturing processes, public works, or developing technological solutions to environmental, social and global problems, risk taking seems inherent to the profession. Despite this, little attention has been paid to the topic and specifically to how our understanding of engineering as a distinctive profession might affect how (...) we should make decisions under risk. This paper seeks to remedy this, firstly by offering a nuanced account of risk and then by considering how specific claims about our understanding of engineering as a social profession, with corresponding social values and obligations, should inform how we make decisions about risk in this context. (shrink)

According to Madhyamaka Buddhist philosophers, everything depends for its existence on something else. But what would a world devoid of fundamentalia look like? In this paper, I argue that the anti-foundationalist “neither-one-nor-many argument” of the Indian Mādhyamika Śrīgupta commits him to a position I call “metaphysical indefinitism.” I demonstrate how this view follows from Śrīgupta’s rejection of mereological simples and ontologically independent being, when understood in light of his account of conventional reality. Contra recent claims in the secondary literature, I (...) clarify how the Madhyamaka metaphysical dependence structure is not a straightforward infinitism since it does not honor strict asymmetry or transitivity. Instead, its dependence relations are irreflexive and extendable, admitting of dependence chains of indefinite (though not actually infinite) length and dependence loops of non-zero length. Yet, the flexible ontology of Śrīgupta's Madhyamaka can accommodate a contextualist account of asymmetry and support a revisable theory of conventional truth, delivering significant payoffs for the view, including the capacity to accommodate developments in scientific explanation. (shrink)

How should we interpret the popular objection that stigmatised subjects are not treated as individuals? The Eidelson View claims that stigma, because of its connection to stereotypes, violates an instance of the general requirement to respect autonomy. The Self-Presentation View claims that stigma inhibits the functioning of certain morally important capacities, notably the capacity for self-presentation. I argue that even if we are right to think that stigma violates a requirement to respect autonomy, this is insufficient to account for the (...) full weight of the charge that stigmatised subjects are not treated as individuals. We need the Self-Presentation View to explain a special threat to agency. I then address the worry that focusing on a concern with being treated as individuals opens the door to the suggestion that treating as superior can be just as morally troubling as stigma. This objection is fatal for the Eidelson View. But the Self-Presentation View has a number of resources for deflating the worry. We should not exclude the possibility of a moral symmetry between some cases of stigma and some cases of treating as superior. Rather, we should provide a nuanced account of the circumstances in which either phenomenon is detrimental for self-presentation. (shrink)

Dharmakīrti’s (c. seventh century) Examination of Relations (Sambandhaparīkṣā) is unique in the Indian Buddhist canon for its being the only extant root text devoted entirely to the topic of the ontological status of relations. But the core thesis of this treatise—that relations are only nominally real—is in prima facie tension with another claim that is central to Dharmakīrti’s epistemology: that there exists some kind of “natural relation” (svabhāvapratibandha) that reliably underwrites inferences. Understanding how Dharmakīrti can consistently rely on natural relations (...) to prop up his presentation of inferential reasoning while at the same time advancing an anti-realist account of relations is critical for making sense of his system of logic and epistemology, which came to be nearly universally adopted in Tibetan Buddhism cutting across traditions. Chomden Rikpé Reldri (1227–1305), who was perhaps the most prolific commentator on logic and epistemology in the history of Tibetan philosophy, composed two texts commenting on the Examination of Relations, neither of which have received any scholarly attention to date. In this paper, I provide an introduction to Chomden Reldri’s two commentaries and consider how they may illuminate Dharmakīrti’s text and also what they reveal about the understanding of Dharmakīrti’s account of relations in early Tibetan scholasticism. I then present a translation of Dharmakīrti’s Examination of Relations together with Chomden Reldri’s commentary, Annotations and Topical Outline of the Examination of Relations (’Brel pa brtag pa’i mchan dang sa bcad gnyis). (shrink)

Trust should be able to explain cooperation, and its failure should help explain the emergence of cooperation-enabling institutions. This proposed methodological constraint on theorizing about trust, when satisfied, can then be used to differentiate theories of trust with some being able to explain cooperation more generally and effectively than others. Unrestricted views of trust, which take trust to be no more than the disposition to rely on others, fare well compared to restrictive views, which require the trusting person to have (...) some further attitude in addition to this disposition. The same methodological constraint also favours some restrictive views over others. (shrink)

This article is about relations of support and conflict within systems of fundamental legal rights—and the arguments for and against rights that those relations make possible. Justificatory linkage arguments defend controversial rights by claiming that they provide very useful support to the realisation of well-accepted rights. This article analyses such arguments in detail and discusses their structures, uses and pitfalls. It then shows that linkage arguments can be used not just to defend rights, but also to attack them. When rights (...) conflict—whether severely or weakly, logically or practically—negative linkage arguments attacking them can be based on the trouble they make for other rights. Many examples of conflicts of rights are provided. Negative linkage arguments provide reasons for rejecting, repealing or trimming the criticised right. Such arguments are already in regular use, but their c. (shrink)

Canonical defenders of the principle of sufficient reason (PSR), such as Leibniz and Spinoza, are metaphysical foundationalists of one stripe or another. This is curious since the PSR—which says that everything has a ground, cause, or explanation—in effect, denies fundamental entities. In this paper, I explore the apparent inconsistency between metaphysical foundationalism and approaches to metaphysical system building that are driven by a commitment to the PSR. I do so by analyzing how Indian Buddhist philosophers arrive at foundationalist and anti-foundationalist (...) positions motivated by implicit commitments to different versions of the PSR. I begin by introducing the Buddhist principle of dependent origination (pratītyasamutpāda) as a proto-PSR that is restricted to causal explanation. Next, I show how Vasubandhu’s Sautrāntika Abhidharma metaphysics is shaped by a qualified commitment to both causal and metaphysical grounding versions of the PSR. I then reveal how Nāgārjuna’s Madhyamaka metaphysics is driven by an unrestricted and exceptionless commitment to causal and metaphysical grounding versions of the PSR. Finally, I consider how Nāgārjuna’s account may put him in a unique position to respond to a common contemporary objection to the PSR from necessitarianism. I conclude by addressing a competing interpretation on which Nāgārjuna is best understood as an anti-rationalist rather than an uber-rationalist, as I characterize him. (shrink)

The contents of our conscious mind can seem unpredictable, whimsical, and free from external control. When instructed to attend to a stimulus in a work setting, for example, one might find oneself thinking about household chores. Conscious content thus appears different in nature from reflex action. Under the appropriate conditions, reflexes occur predictably, reliably, and via external control. Despite these intuitions, theorists have proposed that, under certain conditions, conscious content resembles reflexes and arises reliably via external control. We introduce the (...) Reflexive Imagery Task, a paradigm in which, as a function of external control, conscious content is triggered reliably and unintentionally: When instructed to not subvocalize the name of a stimulus object, participants reliably failed to suppress the set-related imagery. This stimulus-elicited content is considered ‘high-level’ content and, in terms of stages of processing, occurs late in the processing stream. We discuss the implications of this paradigm for consciousness research. (shrink)

Schopenhauer’s pessimistic philosophy is a depressing read. He writes many pages about how suffering is the norm, and any happiness we feel is merely a temporary alleviation of suffering. Even so, his account of suffering rings true to many readers. What are we to do with our lives if Schopenhauer is right, and we are doomed to suffer? In this paper, I use William James’ pragmatic method to find practical implications of Schopenhauer’s pessimism. I provide a model for how we (...) are to live our lives in a suffering world, a model that provides means to reduce suffering. (shrink)

The aim of this paper is to present a novel reading of Kantian idealism. In want of a better name, I call my interpretation “one-object-plus-epistemic phenomenalism”. I partially endorse Allison’s celebrated position, namely his rejection of metaphysical world-dualism. Yet, I reject Allison’s deflationary two-aspect view. I argue that Kantian idealism is also metaphysically committed to an ontological noumenalism (one-object), namely the claim that the ultimate nature of reality is made up of unknown things in themselves (substantia noumena). Natural (...) sciences can only reveal the relational/structural properties of things as they appear rather than the intrinsic properties of substantia noumena in the negative sense. My anti-deflationary reading is similar to Allais’s, and my agnostic monism to Hanna’s. However, against both, I hold that appearances are not the accusative objects of our sensible representations, but rather, as Kant repeatedly states: “mere representations”. The accusative objects of our senses are substantia noumena in the negative sense. Moreover, my view is also similar to Langton’s. Again, against Langton, I hold that appearances are not merely relational properties of substantia noumena but the way that such substantia noumena exist inside our mind as “mere representations”. In this regard, I also partially endorse Guyer’s and Van Cleve’s phenomenalist reading because these substantia noumena in the negative sense can only be cognized mind-dependently, namely as appearances. However, against Guyer and Van Cleve, I hold that the phenomenalist side of Kantian idealism is purely epistemological rather than ontological: what Kant calls the necessary unity of representations according to categories is not a logical construction of objects out of representations, that is, an ontological reduction of noumena to appearances, but rather the way we sense-independently cognize mind-independent noumena. (shrink)

This paper aims to present a novel reading of Kantian idealism. In want of a better name, I call my interpretation “one-object-plus-epistemic phenomenalism.” I partially endorse Allison’s celebrated position, namely his rejection of metaphysical world-dualism. Yet, I reject Allison’s deflationary two-aspect view. I argue that Kantian idealism is also metaphysically committed to an ontological noumenalism (one-object), namely the claim that the ultimate nature of reality is made up of unknown things in themselves (substantia noumena). Natural sciences can only (...) reveal the relational/structural properties of things as they appear rather than the intrinsic properties of substantia noumena in the negative sense. My anti-deflationary reading is similar to Allais’s, and my agnostic monism to Hanna’s. However, against both, I hold that appearances are not the accusative objects of our sensible representations but rather, as Kant repeatedly states: “mere representations.” The accusative objects of our senses are substantia noumena in the negative sense. Moreover, my view is also similar to Langton’s. Again, against Langton, I hold that appearances are not merely relational properties of substantia noumena but the way that such substantia noumena exist inside our mind as “mere representations.” In this regard, I also partially endorse Guyer’s and Van Cleve’s phenomenalist reading because these substantia noumena in the negative sense can only be cognized mind-dependently, namely as appearances. However, against Guyer and Van Cleve, I hold that the phenomenalist side of Kantian idealism is purely epistemological rather than ontological: what Kant calls the necessary unity of representations according to categories is not a logical construction of objects out of representations, that is, an ontological reduction of noumena to appearances, but rather the way we sense-independently cognize mind-independent noumena. (shrink)

The so-called ”argument from religious experience’ plays a prominent role in today’s analytical philosophy of religion. It is also of considerable importance to richard Swinburne’s apologetic project. However, rather than joining the polyphonic debate around this argument, the present paper examines the fundamental concept of religious experience. The upshot is that Swinburne neither develops a convincing concept of experience nor explains what makes a religious experience religious. The first section examines some problems resulting mainly from terminology, specifically Swinburne’s use of (...) appear-words as success-verbs. While these problems might be resolved by a recurrence to the observer, the second and third part of our paper present problems not so easily resolved: namely, that Swinburne’s concept of experience as conscious mental events is too broad and inaccurate for its role in the argument given ; and that Swinburne does not even attempt to figure out which features of an experience, when present, turn an experience simpliciter into a distinctly religious experience. Section 4, in conclusion, outlines possible reasons for this unusual and remarkable inaccuracy in conceptualisation. (shrink)

The U.S. Supreme Court's majority opinion in Vacco v. Quill assumes that the principle of double effect explains the permissibility of hastening death in the context of ordinary palliative care and in extraordinary cases in which painkilling drugs have failed to relieve especially intractable suffering and terminal sedation has been adopted as a last resort. The traditional doctrine of double effect, understood as providing a prohibition on instrumental harming as opposed to incidental harming or harming asa side effect, must be (...) distinguished from other ways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care. (shrink)

Jan Westerhoff defends an account of thoroughgoing non-foundationalism that he calls “irrealism,” which is implicitly modeled on a Madhyamaka Buddhist view. In this paper, I begin by raising worries about the irrealist’s account of human cognition as taking place in a brain-based representational interface. Next, I pose first-order and higher-order challenges to how the irrealist—who defends a kind of global error theory—can sensibly accommodate an unlocalized appearance-reality distinction, both metaphysically and epistemologically. Finally, although Westerhoff insists that irrealism itself is not (...) an ontological theory and that the irrealist’s rejection of absolutely general quantification precludes his commitment to any ultimately true theories, I propose strategies inspired by the Svātantrika commentarial tradition of Madhyamaka for how the irrealist might develop a lightweight account of unrestricted quantification that could be used to advance a lightweight ultimately true theory. This, I suggest, may allow the irrealist to (i) preserve a commitment to an unlocalized appearance-reality distinction, (ii) underwrite a distinction between ordinary veridical states and metaphysically accurate epistemic states, and (iii) provide an explanation for the massive error that he claims characterizes ordinary cognition. (shrink)

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

The arrival of synthetic organs may mean we need to reconsider principles of ownership of such items. One possible ownership criterion is the boundary between the organ’s being outside or inside the body. What is outside of my body, even if it is a natural organ made of my cells, may belong to a company or research institution. Yet when it is placed in me, it belongs to me. In the future, we should also keep an eye on how the (...) availability of synthetic organs may change our attitudes toward our own bodies. (shrink)

Longchen Rabjampa (1308–64), scholar of the Tibetan Buddhist Nyingma tradition, presents a novel doxographical taxonomy of the so-called Svātantrika branch of Madhyamaka Buddhist philosophy, designating the Indian Mādhyamika Śrīgupta (c. 7th/8th century) as the exemplar of a Svātantrika sub-school which maintains that appearance and emptiness are metaphysically distinct. This paper compares Longchenpa’s characterization of this “distinct-appearance-and-emptiness” view with Śrīgupta’s own account of the two truths. I expose a significant disconnect between Longchenpa’s Śrīgupta and Śrīgupta himself and argue that the impetus (...) for Longchenpa’s doxographical innovation originates not in Buddhist India, but within his own Tibetan intellectual milieu, tracing back to his twelfth-century Sangpu Monastery predecessors, Gyamarwa and Chapa. (shrink)