We present the details of a methodology for quality assurance in large medical terminologies and describe three algorithms that can help terminology developers and users to identify potential mistakes. The methodology is based in part on linguistic criteria and in part on logical and ontological principles governing sound classifications. We conclude by outlining the results of applying the methodology in the form of a taxonomy different types of errors and potential errors detected in SNOMED-CT.

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within (...) healthcare organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

-/- Policy regulations of ethically controversial genetic technologies should, on the one hand, be based on ethical principles. On the other hand, they should be socially acceptable to ensure implementation. In addition, they should align with ethical theory. Yet to date we lack a reliable and valid scale to measure the relevant ethical judgements in laypeople. We target this lacuna. -/- We developed a scale based on ethical principles to elicit lay judgments: the Genetic Technologies Questionnaire (GTQ). In two pilot (...) studies and a pre-registered main study, we validated the scale in a representative sample of the US population. -/- The final version of the scale contains 20 items but remains highly reliable even when reduced to five. It also predicts behaviour; for example, ethical judgments as measured by the GTQ predicted hypothetical donations and grocery shopping. In addition, the GTQ may be of interest to policymakers and ethicists because it reveals coherent and ethically justified judgments in laypeople. For instance, the GTQ indicates that ethical judgments are sensitive to possible benefits and harms (in line with utilitarian ethics), but also to ethical principles such as the value of consent-autonomy. -/- In conclusion, the GTQ can be recommended for research in both experimental psychology and applied ethics, as well as a tool for ethically and empirically informed policymaking. (shrink)

The advance of scientific approaches to life has recorded a plethora of successes as well as failures. Man being at the center of its experiment is tossed toe and fro by the result of its inquiry. Predictions are that in the nearest time, humanity might be living absolutely under the directives of Technology based on Artificial intelligence. At present, Technology based on Artificial Intelligence is quickly finding its way into various areas of life including health and social services. (...) This spread and or interplay connotes the relinquishing of health responsibilities from man to sensor technology as well as dependency on the data and result of this technology. This effort questions this unethical dependency as well as raises moral issues associated with the use of Technology base on artificial intelligence on psychiatric patient. It dabbles into medical values such as; autonomy of the patient cum consent, Kantian universal principle and its implication to implementing the universal usage of technology in mental health care services, and so on. The work of Patricia A. Arean (2016) titled Mobile Technology for Mental Health Assessment gave an in-depth analysis of the available approaches, doting advantages of sensor technology on psychiatric patient. The paper applied the analytic, descriptive and prescriptive method of philosophy to achieve its objective. To this end, it is in the view of this work imperative for the mental-medical community to consider reflectively these issues and the philosophic recommendations provided herein. (shrink)

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: -/- The main aim of this review will be to assess the effects of changing practitioner empathy or patient expectations for all conditions. The main objective is to conduct a systematic review of randomised trials where the intervention involves manipulating either (a) practitioner empathy or (b) patient expectations, or (c) both.

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and (...) assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies. (shrink)

PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes (...) sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma. (shrink)

It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including race, (...) gender, class, and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems. (shrink)

According to virtue epistemology, the main aim of education is the development of the cognitive character of students (Pritchard, 2014, 2016). Given the proliferation of technological tools such as ChatGPT and other LLMs for solving cognitive tasks, how should educational practices incorporate the use of such tools without undermining the cognitive character of students? Pritchard (2014, 2016) argues that it is possible to properly solve this ‘technology-education tension’ (TET) by combining the virtue epistemology framework with the theory of extended (...) cognition (EXT) (Clark and Chalmers, 1998). He argues that EXT enables us to consider tools as constitutive parts of the students’ cognitive system, thus preserving their cognitive character from technologically induced cognitive diminishment. The first aim of this paper is to show that this solution is not sufficient to solve the TET. Second, I aim to offer a complementary and more encompassing framework of tool-use to address the TET. Then, I apply it to the educational uses of ChatGPT as the most notable example of LLM, although my arguments can be extended to other generative AI systems. To do so, in Sect. 1.1, I present Pritchard’s framework of cognitive character and virtue epistemology applied in education, to which I am committed in this treatment. In Sects. 2 and 3, I respectively illustrate Pritchard’s (2014) solution to the TET, and I highlight the general limitations of his proposal. Thus, in Sect. 4.1 I characterize ChatGPT as a computational cognitive artifact using Fasoli’s (2017, 2018) taxonomy of cognitive artifacts. In Sect. 4.2, I introduce my proposal, which combines Pritchard’s account of virtue epistemology with Fasoli’s (2017, 2018) taxonomy of cognitive artifacts to address the TET. Finally, in Sect. 5.1, I present some epistemically virtuous uses of ChatGPT in educational contexts. To conclude, I argue in favor of a multidisciplinary approach for analyzing educational activities involving AI technologies such as ChatGPT. (shrink)

PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes (...) sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma. (shrink)

The thesis that technology is applied science is called by Niiniluoto (1997) the standard view. That is surprising because the identification between technology and applied science has been widely rejected by both historians and philosophers of technology, including Rapp (1974), Bugliarello and Doner (1976), Derry and Williams (1977), Feibleman (1983), Skolimowski (1966), Vermaas et al., (2011), Don Idhe (2013). The reasons of such rejection mainly stem from the fact that technology has historically progressed without (...) the benefit of science, i.e., it has been possible to design technological devices without the explicit and systematic development of the scientific theories and laws that would explain their functioning. Polish philosopher Henryk Skolimowski has attacked this identification based on historical evidence. He argues that in the development of technology, there are many cases wherein technological designs have supported pure scientific research, rather than the other way round if technology were applied science. According to Skolimowski, some cases that dispute the identification of technology as applied science are the design of the transistor, supersonic aircraft, and the Manhattan Project. However, this historical evidence should not persuade us for two reasons: 1) Rejecting the previous scientific research that served as the basis for the said technological designs commits Skolimowski to anachronism. 2) From a realistic perspective of science, technological devices are not only subject to the principles and laws of science, regardless of the extent of our knowledge of them, but incorporate insights on more articulated explanations that while not available at the time of designing, do inspire our practical and theoretical efforts and guide further work. In this paper, we posit that the cases offered by Skolimowski to motivate his rejection of the standard view are far from being conclusive. To this end, we not only critically assess each case but also identify other historical examples that might be even more promising to support Skolimowski's thesis. Finally, we critically deal with those more promising cases and argue for a deflationary interpretation of the standard view. -/- . (shrink)

Lately, more and more authors have asserted their belief that one of the criteria which, together with the medical ones, can and should be applied in the policy of selecting and/or prioritizing the patients in need for the allocation of medical resources with limited availability, is the principle of individual responsibility for illness. My intention in this study is to highlight some very serious obstacles looming against the attempt to apply this principle in the distribution of the (...) medical services with limited availability. Although there are numerous such obstacles, I shall only discuss five of them (the most important, in my opinion). These are: 1) the impossibility to establish with certainty whether a patient got ill due to his lifestyle; 2) the lack of a feasible and reliable method of establishing an individual’s responsibility for his lifestyle; 3) a patient’s right to privacy; 4) some moral requirements and principles and, last but not least, 5) the ethics of the medical profession. (shrink)

Introduction. The medical sphere is constantly evolving, requiring improved approaches to its organisation and functioning. Advances in medical technology, observable changes in patient needs and growing competition challenge medical institutions to improve their strategies and approaches. Marketing technologies are becoming one of the key tools for achieving strategic goals. Purpose. This article is aimed at studying the peculiarities of the use of marketing technologies in the medical field. The main purpose of the study is to (...) analyse the impact of marketing tools on the development and success of medical institutions. Method (methodology). The methodological approach involves the use of an analytical approach to studying current trends in marketing and their impact on the healthcare sector. The study uses methods of data analysis and comparative analysis of marketing practices in medical institutions. Results. The study found that the use of targeted marketing strategies allows healthcare facilities to attract more patients, increase customer satisfaction and ensure an excellent reputation. The results of the study show a positive impact of the use of marketing tools on changing the perception of medical services by patients. Conclusions. The scope of application of the results is the practical activities of medical institutions seeking to improve their strategy of promotion and interaction with customers. The findings of the study can be used by marketers and managers of healthcare organisations to develop and implement effective marketing strategies. In summary, this article reveals the importance of using marketing technologies in the healthcare sector and provides practical recommendations for their successful implementation. The study emphasises that marketing in the healthcare industry is necessary to increase competitiveness and ensure quality medical care. (shrink)

When product design teams gather at the whiteboard in big-tech office parks and startup garages around the world, they ask themselves: How will customers use our technology? Is it better than our competitors’? How much money can we make? But one question that’s rarely asked: does our technology advance human flourishing? -/- In a new white paper by Harvard professor Danielle Allen and her colleagues Eli Frankel, Woojin Lim, Divya Siddarth, Josh Simons, and Glen Weyl entitled “The Ethics (...) of Decentralized Social Technologies: Lessons from Web3, the Fediverse, and Beyond,” the authors not only ask this question but offer a powerful framework for answering it. Drawing on the accumulated wisdom of democratic societies, the authors show that the values of democratic governance that have promoted human flourishing can be translated into a rubric for judging new technologies. -/- In this short research brief, we unpack and comment on the four-step logic at the core of their case. Ultimately, their argument demonstrates the power and the challenge – and above all, the urgency – of placing human flourishing at the center of technology governance. (shrink)

That technologies may raise ethical issues is now widely recognised. The ‘responsible innovation’ literature – as well as, to a lesser extent, the applied ethics and bioethics literature – has responded to the need for ethical reflection on technologies by developing a number of tools and approaches to facilitate such reflection. Some of these instruments consist of lists of questions that people are encouraged to ask about technologies – a methodology known as the ‘Socratic approach’. However, to date, these (...) instruments have often not adequately acknowledged various political impacts of technologies, which are, I suggest, essential to a proper account of the ethical issues they raise. New technologies can make some people richer and some people poorer, empower some and disempower others, have dramatic implications for relationships between different social groups and impact on social understandings and experiences that are central to the lives, and narratives, of denizens of technological societies. The distinctive contribution of this paper, then, is to offer a revised and updated version of the Socratic approach that highlights the political, as well as the more traditionally ethical, issues raised by the development of new technologies. (shrink)

Medicine is often thought of as a science of the body, but it is also a science of data. In some contexts, it can even be asserted that data drive health. This article focuses on a key piece of data technology central to contemporary practices of medicine: the medical record. By situating the medical record in the perspective of its history, we inquire into how the kinds of data that are kept at sites of clinical encounter often (...) depend on informational requirements that originate well outside of the clinic, in particular in health insurance records systems. Although this dependency of today's electronic medical records on billing requirements is widely lamented by clinical providers, its history remains little studied. Following the archaeology of medicine developed by Michel Foucault in The Birth of the Clinic and expanding his methodology in light of more recent contributions to the field of media archaeology, this article excavates some of the underexplored technological conditions that help constitute today's electronic medical record. If in some contexts, it is true that data drive health, then an archaeology of medical records helps reveal how health insurance records often impact clinical care and, by extension, health and disease. (shrink)

According to a chorus of authors, the human life-world is currently invaded by an avalanche of high-tech devices referred to as “emerging,” ”intimate,” or ”NBIC” technologies: a new type of contrivances or gadgets designed to optimize cognitive or sensory performance and / or to enable mood management. Rather than manipulating objects in the outside world, they are designed to influence human bodies and brains more directly, and on a molecular scale. In this paper, these devices will be framed as ‘extimate’ (...) technologies (both intimate and external; both embedded and foreign; both life-enhancing and intrusive), a concept borrowed from Jacques Lacan. Although Lacan is not commonly regarded as a philosopher of technology, the dialectical relationship between human desire and technological artefacts runs as an important thread through his work. Moreover, he was remarkably prescient concerning the blending of life science and computer science, which is such a distinctive feature of the current techno-scientific turn. Building on a series of Lacanian concepts, my aim is to develop a psychoanalytical diagnostic of the technological present. Finally, I will indicate how such an analysis may inform our understanding of human life and embodiment as such. (shrink)

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow (...) a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

That a standard of medical care must outline services that benefit the patient is relatively uncontroversial. However, one must determine how the practices outlined in a medical standard of care should benefit the patient. I will argue that practices outlined in a standard of medical care must not detract from the patient’s well-functioning and that clinicians can refuse to provide services that do. This paper, therefore, will advance the following two claims: (1) a standard of medical (...) care must not cause dysfunction, and (2) if a physician is medically rational to not provide some service which fails to meet the above condition (i.e. fails to be a standard of medical care), then she may refuse to do so. I then apply my thesis to the prescription of puberty blockers to children with gender dysphoria. (shrink)

In contemporary healthcare, medical image categorization is essential for illness prediction, diagnosis, and therapy planning. The emergence of digital imaging technology has led to a significant increase in research into the use of machine learning (ML) techniques for the categorization of images in medical data. We provide a thorough summary of recent developments in this area in this review, using knowledge from the most recent research and cutting-edge methods.We begin by discussing the unique challenges and opportunities associated (...) with medical image classification, including the complexity of anatomical structures, variability in imaging modalities, and the need for interpretability and reliability in clinical settings. Subsequently, we survey a wide range of ML algorithms and techniques employed for medical image classification, including traditional methods such as support vector machines and k-nearest neighbors, as well as deep learning approaches like convolutional neural networks (CNNs) and recurrent neural networks (RNNs). Furthermore, we examine key considerations in dataset preparation, feature extraction, and model evaluation specific to medical image classification tasks. We highlight the importance of large, annotated datasets, transfer learning, and data augmentation techniques in enhancing model performance and generalization. (shrink)

In this chapter, we analyze the relationship between Kondratieff waves and major technological revolutions on the basis of the theory of production principles and production revolutions, and offer some forecasts about the features of the Sixth Kondratieff Wave/the Fourth Industrial Revolution. We show that the technological breakthrough of the Sixth Kondratieff Wave may be interpreted as both the Fourth Industrial Revolution and as the final phase of the Cybernetic Revolution. We assume that the sixth K-wave in the 2030s and 2040s (...) will merge with the final phase of the Cybernetic Revolution (which we call a phase of selfregulating systems). This period will be characterized by the breakthrough in medical technologies which will be capable of combining a number of other technologies into a single system of new and innovative technologies (we denote this system as a system of MANBRIC-technologies—i.e. medical, additive, nano-, bio-, robo-, info-, and cogno-technologies). (shrink)

Background: Liver cancer is one of the malignant tumors worldwide, while the prevention and control situation is grim at present, and the diffusion of its early screening technology still faces some challenges. This study aims to investigate the influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on hepatic early screening technologies use by physicians, so as to promote the wider use of corresponding technologies. -/- Methods: Under the theoretical guidance of technology-organization-environment framework (...) and mindsponge theory, this study took hepatic contrast-enhanced ultrasound as an example, and conducted a cross-sectional questionnaire by randomly selecting physicians from Fujian and Jiangxi provinces in China with a high and low incidence of liver cancer, respectively. Structural equation modeling was used to determine the correlation among perceived ease of use, organizational support mechanism, and industry competitive pressure, as well as their impact on the physicians’ behavior toward contrast-enhanced ultrasound use. -/- Results: The hypothesis model fits well with the data (χ2/df = 1.863, GFI = 0.937, AGFI = 0.908, RMSEA = 0.054, NFI = 0.959, IFI = 0.980, CFI = 0.980). Under technology-organization-environment framework, the perceived ease of use (β = 0.171, p < 0.05), organizational support mechanism (β = 0.423, p < 0.01), industry competitive pressure (β = 0.159, p < 0.05) significantly influenced physicians’ use of hepatic contrast-enhanced ultrasound. Besides, perceived ease of use and organizational support mechanism (β = 0.216, p < 0.01), perceived ease of use and industry competitive pressure (β = 0.671, p < 0.01), organizational support mechanism and industry competitive pressure (β = 0.330, p < 0.01) were all associated significantly. -/- Conclusion: From the lens of information processing (mindsponge theory) and technology-organization-environment framework, this study clarified the social and psychological influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians’ use of hepatic contrast-enhanced ultrasound. The results will directly propose recommendations for expanding hepatic contrast-enhanced ultrasound utilization and indirectly promoting other appropriate and effective health technologies diffusion within the integrated health system. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good (...) or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

Smart Farming Technologies raise ethical issues associated with the increased corporatization and industrialization of the agricultural sector. We explore the concept of biomimicry to conceptualize smart farming technologies as ecological innovations which are embedded in and in accordance with the natural environment. Such a biomimetic approach of smart farming technologies takes advantage of its potential to mitigate climate change, while at the same time avoiding the ethical issues related to the industrialization of the agricultural sector. We explore six principles of (...) a natural concept of biomimicry and apply these principles in the context of smart farming technologies. (shrink)

When medical assistance in dying (MAiD) was legalized in Canada in June 2016, the question of allowing decisionally capable persons to make advance requests in anticipation of later incapacity was reserved for further consideration during the mandatory parliamentary review originally scheduled to begin in June 2020 (but since delayed by COVID-19). In its current form the legislation does not permit such requests, since it stipulates that at the time at which the procedure is to be administered the patient must (...) give “express consent” to receiving it. Since express consent presupposes decisional capacity, this requirement rules out administering MAiD to a patient who has lost capacity. Amendments to the legislation passed by Parliament in March 2021 open the door slightly by allowing advance requests by patients after they have been approved for MAiD, if they fear losing capacity before the procedure can be administered. But this provision would apply only to patients whose natural death was deemed to be “reasonably foreseeable”, and would continue to exclude (a) requests made after diagnosis of a “grievous and irremediable medical condition” but in advance of approval for MAiD, and (b) requests made before such a diagnosis. My aim in this paper is twofold: to explore the ethical and legal issues concerning advance requests for MAiD, and to argue for expanding provision for such requests to include both of these further scenarios. (shrink)

In this article, we investigate how to explain the difference between traditional design, engineering, and technology—which have exploited nature and put increasing pressure on Earth’s carrying capacity since the industrial revolution—and biomimetic design—which claims to explore nature’s sustainable solutions and promises to be regenerative by design. We reflect on the concept of mimesis. Mimesis assumes a continuity between the natural environment as a regenerative model and measure for sustainable design that is imitated and reproduced in biomimetic design, engineering, and (...) technology. We conceptualize mimesis in terms of two interdependent boundary conditions: differentiation and participation. We subsequently develop four characteristics of biomimicry as regenerative design, engineering, and technology: technological mimesis is 1) a participative differentiation of nature; 2) supplemental to natural mimesis in biomimetic design; 3) the participative differentiation of technological mimesis is constitutive of nature; 4) the participative differentiation of technological mimesis is always limited. (shrink)

Throughout its brief history the philosophy of technology has been largely concerned with the debate over the nature of technology. Typically, technology has been viewed as being essentially another term for applied science, the practical application of scientific theory to the material world. In recent years philosophers and cultural critics have characterised technology in a far more problematic fashion, as an authoritarian power with the ability to bring about far-reaching cultural, political and ecological effects. Proponents (...) of the former view are often termed instrumentalists and those of the latter technological determinists. The debate between them revolves around the question of the fact/value distinction, namely whether technology can be deemed to be value-neutral. I argue that employing a phenomenological approach to technology grants us a fresh perspective on the instrumentalism-determinism debate. It enables us to recast the instrumentalist/determinist debate as a debate between technological idealism and materialism, and to ground the instrumentalist and determinist positions in different experiential relations to technology. It also gives us a better grasp of the function of the different critiques of technology, with idealists concerned primarily with the misapplication of technology as a form of knowledge, and materialists with the existential implications of concrete technological relations. (shrink)

There have recently been novel applications of medical systematic review guidelines to economic policy interventions which contain controversial methodological assumptions that require further scrutiny. A landmark 2017 Cochrane review of unconditional cash transfer (UCT) studies, based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE), exemplifies both the possibilities and limitations of applying medical systematic review guidelines to UCT and universal basic income (UBI) studies. Recognizing the need to upgrade GRADE to incorporate the differences between medical (...) and policy interventions, the GRADE Public Health Project Group (PHPG) was convened to enumerate and address these methodological challenges. However, in light of our analysis of additional methodological challenges that arise for UCT and UBI studies, we argue that the adaptation of medical systematic review guidelines to economic methodology is far from straightforward and is in fact more challenging than claimed by the PHPG. (shrink)

In the paper, the authors explore the relations between educational technology and educational ideology through the lens of philosophical inquiry. The optics of critical analysis is applied to review the instructional tools, services and systems which compose the complex picture of contemporary educational technology. The authors claim that even when initially established in the ideological domain of educational anarchism most educational technologies when being applied systemically can end up on the more oppressive side of the ideological (...) spectrum close to educational totalitarianism. They focus on the risks of technology that are growing with the social change brought by the lifelong learning paradigm in education. (shrink)

In the present paper, on the basis of the theory of production principles and production revolutions, we reveal the interrelation between K-waves and major technological breakthroughs in history and make some predictions about features of the sixth Kondratieff wave in the light of the Cybernetic Revolution which, we think, started in the 1950s. We assume that the sixth K-wave in the 2030s and 2040s will merge with the final phase of the Cybernetic Revolution (which we call the phase of self-regulating (...) systems). This period will be characterized by breakthroughs in medical technologies which will manage to combine many other technologies into a single complex of MBNRIC-technologies (med-bio-nano-robo-info-cognitive technologies). The article offers some predictions concerning the development of these technologies. (shrink)

Bradford Hill (1965) highlighted nine aspects of the complex evidential situation a medical researcher faces when determining whether a causal relation exists between a disease and various conditions associated with it. These aspects are widely cited in the literature on epidemiological inference as justifying an inference to a causal claim, but the epistemological basis of the Hill aspects is not understood. We offer an explanatory coherentist interpretation, explicated by Thagard's ECHO model of explanatory coherence. The ECHO model captures the (...) complexity of epidemiological inference and provides a tractable model for inferring disease causation. We apply this model to three cases: the inference of a causal connection between the Zika virus and birth defects, the classic inference that smoking causes cancer, and John Snow’s inference about the cause of cholera. (shrink)

The claim is made in the book, Applied Ethics, published under the auspices of the Australian Association for Professional and Applied Ethics (AAPAE), that it can strengthen ethical behaviour. That claim, embodied in the subtitle, is based on more than a half dozen practices set out in the book. In total, they are drawn from an examination of ethical practices across fourteen different disciplines. The purpose of this paper is to outline and support that claim, drawing primarily on (...) chapters of the book, but also drawing on a small amount of additional information. The research on the ethical issues in each of these disciplines, and the writing of the chapters, were undertaken by members and associates of AAPAE. The fourteen disciplines were Marketing, Business, Accounting, Pharmacy, Nursing, Medicine, Veterinary & Animal Ethics, Engineering, Information and Communications Technology (ICT), Journalism, Policing, Politics, the Law and the Sciences. The findings have significance for the teaching of ethics by moral philosophers, for not all ethics classes follow the practices suggested by these findings. A few of the practices are even rejected by some moral philosophers. That the practices will improve ethical behaviour is the principal position taken by this paper. -/- . (shrink)

Can human life have value in a world in which humans are rendered obsolete by technological advances? This article answers this question by developing an extended analysis of the axiological impact of human obsolescence. In doing so, it makes four main arguments. First, it argues that human obsolescence is a complex phenomenon that can take on at least four distinct forms. Second, it argues that one of these forms of obsolescence is not a coherent concept and hence not a plausible (...) threat to human well-being. Third, it argues that existing fears of technologically-induced human obsolescence are less compelling than they first appear. Fourth, it argues that there are two reasons for embracing a world of widespread, technologically-induced human obsolescence. (shrink)

This paper proposes a specific approach to understanding the nature of technology that encompasses the entire field of technological praxis, from the making of primitive tools to using the Internet. In that approach, technology is a specific form of human agency that yields to (an imperfect) realization of human control over a technological situation—that is, a situation not governed to an end by natural constraints but by specific human aims. The components of such technological situations are a given (...) collection of natural or artificial beings, humans, human aims, and situation-bound tools. By performing technological situation analysis, the essential form of tool making, the complex system of relationships between science and technology, technological practices with and without machines, the finiteness or imperfectness of any technology, and engineering (i.e., the possibility of the creation of technological situations) can be considered. For a better characterization of the approach to technology, the paper also presents a comparison of other philosophies of technology. Following Feenberg’s comparative analysis, the so-called fundamental question of the philosophy of technology is formulated, its two sides are identified, and it is applied for clarification of our position within philosophy of technology. In our approach, all human praxis can be considered to be technological; more precisely, every human activity has a technological aspect or dimension. (shrink)

This essay examines narratives of fundamental change, which portray a break in the continuity between a pre-transition and post-transition transgender subject, in accounts of transgender transitions. Narratives of fundamental change highlight the various changes that occur during transition and its disruptive effects upon a trans subject’s continuous identity. First, this essay considers the historical appearance of fundamental change narratives in the social sciences, the media, and their use by families of trans people, partners of trans people, and trans people themselves. (...) After this is a consideration of Mark Johnson’s account of narrative as a meaning-making activity that occurs in the context of social norms. Johnson’s account is then applied to narratives of fundamental change to explain why these narratives occur, especially in relation to social norms and lived experience. The essay concludes by considering the trajectory of fundamental change narratives, looking at emerging transgender narratives, which stress a more integrated, complex account of transgender lives. (shrink)

Both biosemiotics and evolutionary epistemology are concerned with how knowledge evolves. (Applied) Evolutionary Epistemology thereby focuses on identifying the units, levels, and mechanisms or processes that underlie the evolutionary development of knowing and knowledge, while biosemiotics places emphasis on the study of how signs underlie the development of meaning. We compare the two schools of thought and analyze how in delineating their research program, biosemiotics runs into several problems that are overcome by evolutionary epistemologists. For one, by emphasizing signs, (...) biosemiotics needs to delineate a semiotic threshold, which is a problem not encountered by evolutionary epistemologists. Instead, the latter recognizes that all organisms are knowers that evolve knowledge, which they recognize to extend toward phenomena produced by organisms such as behavior, cognition, language, culture, science, and technology. Secondly, biosemiotics attempts at continuing adaptationist notions on how organisms relate to their environment, while especially Applied Evolutionary Epistemology comes to redefine the nature of the organism–environment relationship in such a way that it recognizes the spatiotemporal boundedness of existence, which in turn makes adaptationist accounts obsolete. (shrink)

If medical complicity is understood as compliance with a directive to act against the professional's best medical judgment, the question arises whether it can ever be justified. This paper will trace the contours of what would legitimate a directive to act against a professional's best medical judgment (and in possible contravention of her oath) using Joseph Raz's service conception of authority. The service conception is useful for basing the legitimacy of authoritative directives on the ability of the (...) putative authority to enable subjects to comply better with reasons that already apply to them. Hence, the service conception bases the legitimacy of practical authority on a certain kind of greater knowledge or expertise. This helps to focus the conundrum regarding complicity on the clash of expertise between the medical expert and the governing body tasked with coordinating behaviour and otherwise devising rules for the social good. The ethical dilemma presented by a hypothetically legitimate directive to act against a professional's best medical judgment also serves to highlight the moral dimension of one's duty to obey a legitimate authority. (shrink)

Investigating an actual case that occurred in a New York state hospital where an Orthodox Jewish patient’s legal proxy demands that the clinicians and hospital administrators should provide aggressive treatment with all available technological resources for the seemingly brain-dead patient with a medically futile condition. The authors argue that a health care policy or regulation should be developed to limit patient’s access to technology in critical care. Otherwise, we will be allowing society to issue a carte blanche to religious (...) autonomy by technology abuse. It is argued that religious autonomy should be restricted when its demand exhibits apparent logical absurdity and/or goes against the common survival of the entire population. (shrink)

In 1968, Jürgen Habermas claimed that, in an advanced technological society, the emancipatory force of knowledge can only be regained by actively recovering the ‘forgotten experience of reflection’. In this article, we argue that, in the contemporary situation, critical reflection requires a deliberative ambiance, a process of mutual learning, a consciously organised process of deliberative and distributed reflection. And this especially applies, we argue, to critical reflection concerning a specific subset of technologies which are actually oriented towards optimising human cognition. (...) In order to create a deliberative ambiance, fostering critical upstream reflection on emerging technologies, we developed the concept of a mutual learning exercise. Building on a number of case studies, we analyse what an MLE involves, both practically and conceptually, focussing on key aspects such as ambiance and expertise, the role of ‘genres of the imagination’ and the profiles of various ‘subcultures of debate’. Ideally, an MLE becomes a contemporary version of the Socratic agora, providing a stage where multiple and sometimes unexpected voices and perspectives mutually challenge each other, in order to strength-en the societal robustness and responsiveness of emerg-ing technologies. (shrink)

Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they might (...) first appear. I explore how LOGRA applies more broadly to certain types of charitable giving in developed countries, with a focus on medical crowdfunding. I then highlight how LOGRA does not apply to charitable giving aimed at alleviating the suffering of the absolutely politically marginalized, or those especially vulnerable people to whom governments are never responsive. (shrink)

When agents insert technological systems into their decision-making processes, they can obscure moral responsibility for the results. This can give rise to a distinct moral wrong, which we call “agency laundering.” At root, agency laundering involves obfuscating one’s moral responsibility by enlisting a technology or process to take some action and letting it forestall others from demanding an account for bad outcomes that result. We argue that the concept of agency laundering helps in understanding important moral problems in a (...) number of recent cases involving automated, or algorithmic, decision-systems. We apply our conception of agency laundering to a series of examples, including Facebook’s automated advertising suggestions, Uber’s driver interfaces, algorithmic evaluation of K-12 teachers, and risk assessment in criminal sentencing. We distinguish agency laundering from several other critiques of information technology, including the so-called “responsibility gap,” “bias laundering,” and masking. (shrink)

This book examines the moral luck paradox, relating it to Kantian, consequentialist and virtue-based approaches to ethics. It also applies the paradox to areas in medical ethics, including allocation of scarce medical resources, informed consent to treatment, withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing and medical research. If risk and luck are taken seriously, it might seem to follow that we cannot develop any definite moral standards, that we are doomed to moral relativism. However, Dickenson offers (...) strong counter-arguments to this view that enable us to think in terms of universal standards. (shrink)

As we enter the 21st century, we do well to consider the values implicit in science fiction, the principal arena of future speculation in popular culture. This study explored whether consumption of science fiction (SF) is correlated with distinctive socio-ethical views. SF tends to advocate the extension of value and rights to all forms of intelligence, regardless of physical form; enthusiasm for technology; and social and economic libertarianism. This suggests that consumers with these socio-ethical views would be attracted to (...) the SF genre, and that amount of SF consumption would be correlated with adoption of these views. -/- Groups of respondents involved in medical ethical and environmental issues were surveyed in 1992 (N=278). SF consumption was found, at first-order correlation and controlling for covariates, to be associated with: greater support for extending rights to animal and machine intelligence; greater enthusiasm for technology, and rejection of limits to human endeavors; and greater social libertarianism. SF consumption was not associated with specific views on the cognitively and physically disabled; support for abortion rights; or economic libertarianism. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable (...) us to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

Biomedical science has been remarkably successful in explaining illness by categorizing diseases and then by identifying localizable lesions such as a virus and neoplasm in the body that cause those diseases. Not surprisingly, researchers have aspired to apply this powerful paradigm to addiction. So, for example, in a review of the neuroscience of addiction literature, Hyman and Malenka (2001, p. 695) acknowledge a general consensus among addiction researchers that “[a]ddiction can appropriately be considered as a chronic medical illness.” Like (...) other diseases, “Once addiction has taken hold, it tends to follow a chronic course.” (Koob and La Moal 2006, p. ?). Working from this perspective, much effort has gone into characterizing the symptomology of addiction and the brain changes that underlie them. Evidence for involvement of dopamine transmission changes in the ventral tegmental area (VTA) and nucleus accumbens (NAc) have received the greatest attention. Kauer and Malenka (2007, p. 844) put it well: “drugs of abuse can co-opt synaptic plasticity mechanisms in brain circuits involved in reinforcement and reward processing”. Our goal in this chapter to provide an explicit description of the assumptions of medical models, the different forms they may take, and the challenges they face in providing explanations with solid evidence of addiction. <br>. (shrink)

An adequate philosophy of technology will not stop with knowledge-claim considerations, like traditional philosophy of science, but will address public policy issues, as is done regarding science via science policy studies. Technology is not merely "applied science" but generates attention to normative issues engendered by technologies. Philosophers of technology can find support for such normative concerns in studies of the value impact of applying science, e.g., those of Radnitzky, Ravetz and Mumford, and such organizations as the (...) Club of Rome. (shrink)

The use of the term "applied ethics" to denote a particular field of moral inquiry (distinct from but related to both normative ethics and meta-ethics) is a relatively new phenomenon. The individuation of applied ethics as a special division of moral investigation gathered momentum in the 1970s and 1980s, largely as a response to early twentieth- century moral philosophy's overwhelming concentration on moral semantics and its apparent inattention to practical moral problems that arose in the wake of significant (...) social and technological transformations. The field of applied ethics is now a well established, professional domain sustained by institutional research centers, professional academic appointments, and devoted journals. As the field of applied ethics grew and developed, its contributors predominantly advocated consequentialist and deontological approaches to the problems they address; but lately a significant number of moral philosophers have begun to bring the resources of virtue ethics to bear upon the ever-evolving subject matters of applied ethics. (shrink)

Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since (...) AI systems can be relied on, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely on AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice. (shrink)

This paper argues that private property and rights assignment, especially as applied to communication infrastructure and information, should be informed by advances in both technology and our understanding of psychology. Current law in this area in the United States and many other jurisdictions is founded on assumptions about human behavior that have been shown not to hold empirically. A joint recognition of this fact, together with an understanding of what new technologies make possible, leads one to question basic (...) assumptions about how law is made and what laws we should have in a given area, if any. I begin by analyzing different aspects of U.S. law, from a high-level critique of law making to a critique of rights assignment for what I call 'simple nonrival goods.' I describe my understanding, as a non-lawyer with a background in psychology and computing, of the current conventions in U.S. law, consider the foundational assumptions that justify current conventions, describe advances in psychology and technology that call these conventions into question, and briefly note how the law might normatively change in this light. I then apply this general analysis to the question of domain name assignment by the Internet Corporation for Assigned Names and Numbers (ICANN). (shrink)