Through this contribution I aim to explore the horizons and limits of digital medicine in light of an embodied approach to the issue of care. I will sketch the historical background of digital medicine and show the contemporary status of this interdisciplinary field, as well as its applications and outcomes. Then, I will address a critique of the computational theory of mind (CTM) upon which many contemporary mental health apps are designed. This approach to the mind (...) is inscribed into the modern trend of neuromania, which conceives the embodied, living human being as a mere series of data analyses and algorithms, with the brain as the seat of the person. Drawing on continental philosophy and classical phenomenology I will develop a notion of health conceived as a moral enterprise, showing how wellbeing and vitality are not reducible to a product made by technologies or doctors, but rather they are the results of an embodied encounter. As such, empathy and person-centered care cannot be achieved by digital medicine. They are the result of a journey into the regions of recognition, embodied presence and the aliveness constituting the person. Finally, I will show how the issue of care cannot be separated from an embodied encounter between people, especially in case of dementia. (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment (...) preferences, which can be instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

Background: The concept of digital twins has great potential for transforming the existing health care system by making it more personalized. As a convergence of health care, artificial intelligence, and information and communication technologies, personalized health care services that are developed under the concept of digital twins raise a myriad of ethical issues. Although some of the ethical issues are known to researchers working on digital health and personalized medicine, currently, there is no comprehensive review that (...) maps the major ethical risks of digital twins for personalized health care services. Objective: This study aims to fill the research gap by identifying the major ethical risks of digital twins for personalized health care services. We first propose a working definition for digital twins for personalized health care services to facilitate future discussions on the ethical issues related to these emerging digital health services. We then develop a process-oriented ethical map to identify the major ethical risks in each of the different data processing phases. Methods: We resorted to the literature on eHealth, personalized medicine, precision medicine, and information engineering to identify potential issues and developed a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. Developers of a digital twin for personalized health care service may use this map to identify ethical risks during the development stage in a more systematic way and can proactively address them. Results: This paper provides a working definition of digital twins for personalized health care services by identifying 3 features that distinguish the new application from other eHealth services. On the basis of the working definition, this paper further layouts 10 major operational problems and the corresponding ethical risks. Conclusions: It is challenging to address all the major ethical risks that a digital twin for a personalized health care service might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist the developers of digital twins for personalized health care services in analyzing ethical risks in a more systematic manner. (shrink)

Throughout the 20th century, philosophers have criticized the scientific understanding of the human body. Instead of presenting the body as a meaningful unity or Gestalt, it is regarded as a complex mechanism and described in quasi-mechanistic terms. In a phenomenological approach, a more intimate experience of the body is presented. This approach, however, is questioned by Jacques Lacan. According to Lacan, three basic possibilities of experiencing the body are to be distinguished: the symbolical (or scientific) body, the imaginary (or ideal) (...) body and the real body. Whereas the symbolical body is increasingly objectified (and even digitalized) by medical science, the phenomenological perception amounts to an idealization of the body. The real body cannot be perceived immediately. Rather, it emerges in the folds and margins of our efforts to symbolize or idealize the body, which are bound to remain incomplete and fragile. In the first part of the article (1-3), Lacan's conceptual distinction between the symbolical, the imaginary and the real body will be explained. In the second part (4-5), this distinction will be further clarified by relying on crucial chapters in the history of anatomy (notably Mundinus, Vesalius, Da Vinci and Descartes). (shrink)

This paper aims to outline the foundations for an ethics of digital touch. Digital touch refers to hardware and software technologies, often collectively referred to as ‘haptics’, that provide somatic sensations including touch and kinaesthesis, either as a stand-alone interface to users, or as part of a wider immersive experience. Digital touch has particular promise in application areas such as communication, affective computing, medicine, and education. However, as with all emerging technologies, potential value needs to be (...) considered against potential risk. We therefore identify some areas where digital touch raises ethical concerns, and we identify why these concerns arise, based on the distinctive physiological and functional properties of the human somatosensory system. Most scientific research in digital touch has focused on user interaction with external objects (active touch). However, the most pressing ethical concerns with digital touch technologies arise when users are being passively touched. Our analysis identifies several important questions about control, transparency, and epistemic procedure in digital touch scenarios. First, human somatosensation is “always on”, and many digital touch technologies take advantage of this (e.g., alerting systems). As a result, digital touch technologies can undermine individuals’ sensory autonomy (i.e., the right to choose what sensations one experiences). Second, users may reasonably want to know who or what is touching them, and for what purpose. Consent for digital touch will therefore need to be carefully and transparently transacted. Third, because touch gives us a special, direct experience of interacting with our physical environment, digital touch technologies that manipulate this interaction could potentially provide a major epistemic challenge, by changing a user’s basic understanding of reality and their relation to it. Informed by this discussion, we conclude by suggesting a basis for an ethical design framework for digital touch systems. (shrink)

Wearable devices are increasingly present in the health context, as tools for biomedical research and clinical care. In this context, wearables are considered key tools for a more digital, personalised, preventive medicine. At the same time, wearables have also been associated with issues and risks, such as those connected to privacy and data sharing. Yet, discussions in the literature have mostly focused on either technical or ethical considerations, framing these as largely separate areas of discussion, and the contribution (...) of wearables to the collection, development, application of biomedical knowledge has only partially been discussed. To fill in these gaps, in this article we provide an epistemic (knowledgerelated) overview of the main functions of wearable technology for health: monitoring, screening, detection, and prediction. On this basis, we identify 4 areas of concern in the application of wearables for these functions: data quality, balanced estimations, health equity, and fairness. To move the field forward in an effective and beneficial direction, we present recommendations for the 4 areas: local standards of quality, interoperability, access, and representativity. (shrink)

The right to privacy extends only to information through which the persons concerned are identifiable. This assumption is widely shared in law and in philosophical debate; it also guides the handling of personal data, for example, in medicine. However, this essay argues that the dissemination of anonymous information can also constitute a violation of privacy. This conclusion arises from two theses: (1) From the perspective of the affected person, judgments by others about anonymous information refer to its originator, even (...) if outsiders do not know who it is; (2) Our self-understanding is co-constituted by the judgment of others about us. This is a consequence of our social nature. There are certain areas of our lives that we do not want to expose to the gaze of others for our own sake. Therefore, the unauthorized dissemination of information concerning these areas can violate our privacy even if they are anonymous. While the question of the extent of privacy poses a general problem, there are reasons to discuss it in the context of digital medicine. (shrink)

In recent decades, Information and Communication Technology (ICT) has been advanced and widely spread around the globe in addition to ICT revolution and technological advances are considered the major role in the evolution of modern age, which is called "Digital Transformation Age". Therefore, Electronic Technology (E-Technology) has become one of the most prominent approaches such as Electronic Learning (E-Learning), Electronic Training (E-Training), Mobile Learning (M-Learning), Virtual Lab (V-Lab), Virtual University, etc. E-Technology includes some features, for instance anyone, anywhere, anytime (...) and reducing of geographical barriers. ETechnology is a great trend and influences many fields and sectors such as Learning, Training, Military, Navy, Aviation, Medicine, and Digital space. According to nature of usage, E-Technology can be used in positive or negative trends. E-Technology is considered as a valuable tool in providing several opportunities for learning and training processes for individuals and organizations, especially in critical issues. Finally, we give a quick overview of neutrosophic data and some recent applications. (shrink)

Health data processing fields face ethical and legal problems regarding fundamental rights. As we know, patients can benefit in the Digital Era from having health or medical information available, and medical decisions can be more effective with a better understanding of clinical histories, medical and health data thanks to the development of Artificial Intelligence, Internet of Things and other Digital technologies. However, at the same time, we need to guarantee fundamental rights, including privacy ones. The complaint about ethical (...) and legal requirements – including constitutional ones – is particularly relevant in the processing of health data. This paper is focused on the problem of the consent required to the processing of health data and the exceptions established in the new European Union General Data Regulation, which cover the processing of this special data -within other aims- for scientific, historical and statistical research as legitimate purposes, which include biomedical research. The conclusion is that these open concepts are problematic both for the protection of privacy rights and for the legal security/certainty of research. On one hand there are several interpretation problems, regarding the processing of health data and the protection of information privacy. On the other hand, professionals must follow the Multilevel legal framework and to guarantee fundamental rights in the processing of health data, so there are also problems of interpretation for researchers. Therefore, we need a clearer legal framework for biomedical research. (shrink)

Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions and changing (...) behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

Braun explores the use of digital twin technology in medicine with a particular emphasis on the question of how such simulations can represent a person.1 In defining some first conditions for ethically justifiable forms of representation of digital twins, he argues that digital twins do not threaten an embodied person, as long as that person retains control over their simulated representation via dynamic consent, and ideally with the option to choose both form and usage of the (...) simulation. His thoughtful elaboration provides insight into the challenges inherent in interactions between a person and their digital twin, emphasising the modes of control required to respect personal modes of freedom. This individual-centric approach to the question of representation leaves out the important ethical consideration of ensuring that all, not merely some, can be represented. Braun describes dynamic consent as a necessary mode of control, arguing that where a person is unable to give consent, ‘such simulations threaten to become illegitimate representations. They would then shift the kind of interaction from representation to illegitimate forms of prediction or surveillance and thereby could lead to infringements to individual modes of freedom.’ Consequently, the implementation of digital twin technology in healthcare would seem to exclude the most vulnerable members of society from participation in and benefiting from medical innovation, …. (shrink)

Starting from texts and data collected during the installation of the online database DArIL (Digital Archive of Inaugural Lectures at Renaissance and Early Modern Universities), the paper presents some results of this work. It is divided in two sections: in the first one, Marco Forlivesi describes DArIL, its structure, content, aims, and potential. In the second part, Iolanda Ventura attempts to distinguish the various types of lectiones inaugurales by focusing on specific texts dealing with medicine produced at the (...) Universities of Padua, Jena, and Helmstedt during the Eighteenth Century. -/- . (shrink)

Self-tracking-technologies can serve as a prominent example of how digital technologies put to test established practices, institutions, and structures of medicine and healthcare. While proponents emphasize the potentials, e.g., for individualized healthcare and new research data, opponents stress the risk that these technologies will reinforce gender-related inequalities. -/- While this has been made clear from—often intersectional—feminist perspectives since the introduction of such technologies, we aim to provide a queer-feminist perspective on self-tracking applications in healthcare by analyzing three concrete (...) cases. In this way, we want to show why such a perspective is helpful in assessing self-tracking technologies and how such a perspective might contribute to a queering of healthcare. -/- After a short introduction to self-tracking in healthcare and the corresponding risks of reproducing gender-related inequalities, we introduce queer bioethics as a methodology to examine structural discrimination and marginalization in bioethical research. We apply this framework in the analysis of three exemplary self-tracking applications from the areas of nutrition/fitness, reproductive health, and mental health. In the subsequent discussion of these results against the backdrop of already existing queer-sensitive technologies, we identify an equal access, a subversive design, an inclusive database, and a diversity-sensitive and discriminatory-critical definition of purposes as well as individualized usage possibilities as first possible starting points for a queering of self-tracking applications. Finally, we draw conclusions, how such a critical perspective on self-tracking applications might also contribute to a queering of the healthcare system at a structural level. (shrink)

Our technological lifeworld has become an info-computational media populated by data and algorithms, an artificial environment for life and shared experiences. In this chapter, I tried to sketch three new assumptions for bioethics – it is hardly possible to substantiate ethical guidelines or an idea of normativity in an aprioristic manner; moral status is a function of data entities, not something solely human; agency is plural and thus is shared or sometimes delegated – in order to chart a proposal for (...) a posthuman bioethics. Posthuman is perhaps not the best expression available, but it covers the idea of a shift from a world centered on self-contained and exclusively human agency to a more comprehensive and relational way of thinking. The “posthuman” label should be understood as a rebuttal of biocentrism and anthropocentrism by moving closer to conceptions we encounter in population ethics or in discourse about biosocial and technical systems. Posthuman bioethics is “environmentalist” without losing the humanistic stance. The question regarding how suitable an infocentric bioethics is in practice remains to be settled. The moral principles in bioethics could be reconceived as relying on these new assumptions, in a postindividualistic manner that accepts formal primacy of causal digital artifacts in affording actions in a world of ambient algorithmic intelligence. (shrink)

This paper focuses on Precision Public Health (PPH), described in the scientific literature as an effort to broaden the scope of precision medicine by extrap- olating it towards public health. By means of the “All of Us” (AoU) research pro- gram, launched by the National Institutes of Health in the U.S., PPH is being devel- oped based on health data shared through a broad range of digital tools. PPH is an emerging idea to harness the data collected for (...) precision medicine to be able to tai- lor preventive interventions for at-risk groups. The character of these data concern genetic identity, lifestyle and overall health and therefore affect the ‘intimacy’ of personhood. Through the concept of biological citizenship, we elucidate how AoU and its recruitment tactics, by resonating ‘diversity’, at the same time appeal to and constitute identity, defining individuals as ‘data sharing subjects’. Although PPH is called for; the type of bio-citizenship that is enacted here, has a particular definition, where participant recruitment focuses on ‘citizenship’ in terms of empowerment (front), it is the ‘bio’ prefix that has become the main focus in terms of research. i.e. biosubjectivities vs biocapital. This raises the question whether the societal chal- lenges that often underlie public health issues can be sufficiently dealt with based on the way ‘diversity’ is accounted for in the program. We suggest that the AoU still risks of harming underrepresented groups based on the preconditions and the design of the program. (shrink)

Background. The COVID-19 pandemic necessitated drastic changes to undergraduate medical training at the University of Botswana (UB). To save the academic year when campus was locked down, the Department of Medical Education conducted a needs assessment to determine the readiness for emergency remote teaching (ERT) of the Faculty of Medicine, UB. Objectives. To report on the findings of needs assessment surveys to assess learner and teaching staff preparedness for fair and just ERT, as defined by philosopher John Rawls. Methods. (...) Needs assessment surveys were conducted using Office 365 Forms distributed via WhatsApp, targeting medical students and teaching staff during the 5 undergraduate years. Data were analysed quantitatively and qualitatively. Results. Ninety-two percent (266/289) of students and 73.5% (62/84) of teaching staff responded. Surveys revealed a high penetration of smartphones among students, but poor internet accessibility and affordability in homes. Some teaching staff also reported internet and device insufficiencies. Only WhatsApp was accessible to students and teaching staff. Conclusions. For equitable access to ERT in the future, the surveys revealed infrastructural improvement needs, including wider, stronger, affordable WiFi coverage within Botswana and enhanced digital infrastructures in educational institutions, with increased support for students. (shrink)

Information, Communication, Technology and Services (ICTS) is increasingly being used in various fields that include agriculture, education, medicine, tourism and business. However, due to challenges caused by the digital divide and other factors, the use of ICTS and its contribution to socio-economic development is generally more intense in developed countries than in developing countries, and also more in urban areas than in rural areas. This article gives an overview of ICTS, the extent of its adoption in different fields, (...) factors that hinder ICTS driven socio-economic development in developing countries and rural areas, and various possible ways of maximizing potential benefits that marginalised communities can derive from the limited ICTS that is accessible to them. (shrink)

Based on the Ontology for General Medical Science, we propose definitions for biomarkers of various types of. These definitions provide not only a complete formal representation of what biomarkers are according to the Institute of Medicine (IOM), but also remove the ambiguities and inconsistencies encountered in the documentation provided by the IOM.

Prescription Drug Monitoring Programs (PDMPs) contain detailed information about which controlled medications physicians prescribe individuals, including where, when, how much, by whom, and more. The programs allow physicians to glimpse into the life of each patient that visits them — sometimes before a single word is exchanged between them. Every state has a PDMP, and almost all states share the data they collect through it. In this paper, I argue that informed consent should be required for recording of prescriptions related (...) to addiction management into the PDMP. (shrink)

The paper argues that digital ontology (the ultimate nature of reality is digital, and the universe is a computational system equivalent to a Turing Machine) should be carefully distinguished from informational ontology (the ultimate nature of reality is structural), in order to abandon the former and retain only the latter as a promising line of research. Digital vs. analogue is a Boolean dichotomy typical of our computational paradigm, but digital and analogue are only “modes of presentation” (...) of Being (to paraphrase Kant), that is, ways in which reality is experienced or conceptualised by an epistemic agent at a given level of abstraction. A preferable alternative is provided by an informational approach to structural realism, according to which knowledge of the world is knowledge of its structures. The most reasonable ontological commitment turns out to be in favour of an interpretation of reality as the totality of structures dynamically interacting with each other. The paper is the first part (the pars destruens) of a two-part piece of research. The pars construens, entitled “A Defence of Informational Structural Realism”, is developed in a separate article, also published in this journal. (shrink)

The purpose of the article is to reveal the scientific approach that substantiates the impact of the creation of strategic alliances (SA) on the digital transformation of business and the development of their innovative power based on identified success factors. The aim was achieved using the following methods: abstract logic and typification (for classification of SA's success factors), generalization (to determine the peculiarities of SA's influence on their innovation development), analytical and ranking method (to determine the relationship between the (...) dynamics creating of SA and the degree of acceleration of digital transformation), expert evaluation (to determine the degree of influence of SA success factors by business areas). Implementing a business-integrated approach to understanding digital transformation will accelerate implementation of innovation and organizational change, identifies future prospects for market, customer and business relationships, highlighting the importance of researching the factors that ensure their success. An alternative vision of SA’s success factors is suggested, which are determined by the possibilities the organization of partnerships and organizational culture, integration of business sectors, compatibility of management goals, external relevance, obtaining synergies. Innovation is considered by the authors as an integration factor that reconciles all groups of SA success factors, giving them the necessary focus to solve business problems. The results of the study show that the creation of SA has a significant impact on accelerating and changes priority of digital transformation of business areas involved in strategic partnerships, and the impact of SA on the development of their innovation power is crucial. (shrink)

Throughout Iran and various countries, the recent calls of the “Zan, Zendegi, Azadi” (in Persian), “Jin, Jiyan, Azadi” (in Kurdish), or “Woman, Life, Freedom” (in English) movement call for change to acknowledge the importance of women. While these feminist protests and demonstrations have been met with brutality, systematic oppression, and internet blackouts within Iran, they have captured significant social media attention and coverage outside the country, especially among the Iranian diaspora and various international organizations. This article, grounded in feminist urban (...) theories of the Global South, analyzes the digital feminist placemaking movement in Iran. As the first counter‐revolution led by women, the movement utilizes digital art, graffiti, and protest movements to embody women’s solidarity groups and sympathy rallies. Our analysis employs various digital research methods, including social media scrutiny and the study of protest illustrations. Analyzing the digital feminist placemaking in Iran will enable us to compare the commonalities, differences, challenges, and opportunities between the minorities and majorities in the world’s countries. The outcomes of this research can help international organizations such as Amnesty International and the United Nations Agency for Gender Equality and Women’s Empowerment (UN Women), as well as policymakers, institutions, academics, and NGOs, to highlight the various ways in which broader public participation could be encouraged in the process of digital feminist insurgent placemaking. (shrink)

The technological revolution and appropriation of internet tools began to reshape the material basis of society and the urban space in collaborative, grassroots, leaderless, and participatory actions. The protest squares’ representation on Television screens and mainstream media has been broad. Various health, governmental, societal, and urban challenges have marked the advent of the Covid-19 virus. Inequalities have become more salient as poor people and minorities are more affected by the virus. Social distancing makes the typical forms of protest impossible to (...) carry out. Under social distancing, some state-led policies took advantage of social media to focus on the Covid-19 pandemic to silence social and political activities, censor criticism, and control the press. However, during the pandemic era, the movements for social justice have been particularly active, focusing on defending workers’ rights, mutual aid and solidarity, monitoring policymakers, and popular education. These progressive movements combined concrete practices and experiences to confront the reactionary, capitalist, and governmental actors that sought to shape and envision the world. Through different case studies of protest movements during the pandemic in Europe, the UK, and Asia, this paper argues that at the time of rising racial, social, and economic inequalities, the social activities adapted to the circumstances determined by the social distancing and the impossibility of people gathering in physical spaces. Subsequently, the people in different countries had various individual and collective responses to the support of health workers, systemic inequalities, loss of jobs, and other societal and financial challenges imposed by the governments. It means that, rather than disappearing, the social movements have adapted to the unexpected situations during the pandemic outbreak. The pandemic broke the new digital global wave of protests in this sense. (shrink)

Nelson Goodman's distinction between autographic and allographic arts is appealing, we suggest, because it promises to resolve several prima facie puzzles. We consider and rebut a recent argument that alleges that digital images explode the autographic/allographic distinction. Regardless, there is another familiar problem with the distinction, especially as Goodman formulates it: it seems to entirely ignore an important sense in which all artworks are historical. We note in reply that some artworks can be considered both as historical products and (...) as formal structures. Talk about such works is ambiguous between the two conceptions. This allows us to recover Goodman's distinction: art forms that are ambiguous in this way are allographic. With that formulation settled, we argue that digital images are allographic. We conclude by considering the objection that digital photographs, unlike other digital images, would count as autographic by our criterion; we reply that this points to the vexed nature of photography rather than any problem with the distinction. (shrink)

As ever more advanced digital systems are created, it becomes increasingly likely that some of these systems will be digital minds, i.e. digital subjects of experience. With digital minds comes the risk of digital suffering. The problem of digital suffering is that of mitigating this risk. We argue that the problem of digital suffering is a high stakes moral problem and that formidable epistemic obstacles stand in the way of solving it. We then (...) propose a strategy for solving it: Access Monitor Prevent (AMP). AMP uses a ‘dancing qualia’ argument to link the functional states of certain digital systems to their experiences—this yields epistemic access to digital minds. With that access, we can prevent digital suffering by only creating advanced digital systems that we have such access to, monitoring their functional profiles, and preventing them from entering states with functional markers of suffering. After introducing and motivating AMP, we confront limitations it faces and identify some options for overcoming them. We argue that AMP fits especially well with—and so provides a moral reason to prioritize—one approach to creating such systems: whole brain emulation. We also contend that taking other paths to digital minds would be morally risky. (shrink)

To date, technology has become so integral to our lives that it is almost impossible to imagine a day without using it. The digitization of society is gaining speed every day, affecting all areas of life: communication with people and the management of entire governments. To one degree or another, the use of digital technologies can be observed in every social institution on which society is built. The process includes social changes associated with introducing modern technologies into society and (...) social control. Since the second half of the XX century, the introduction of digital technologies has been seen as a means of overcoming temporal and spatial restrictions, the negatives of subjectivity that hinder the development of modern society. In the XXI century, the influence of digital technologies has grown significantly, which calls into question the sovereignty of the person himself as a social object. Undoubtedly, technology makes our lives much more accessible, with benefits such as saving time, accessing new information, and simplifying everyday life. However, the more social space is captured by objective digitalization, the more this space undergoes subjective influence. Digital technologies do not liberate the person from subjective control but, on the contrary, contribute to it. In the article, we consider how this happens in the field of the major social institutions of society, and possible vital consequences of this impact. (shrink)

The digital is deeply transforming reality. Through discussion of concepts such as identity, location, presence, law and territoriality, this article explores why and how these transformations are occurring, and highlights the importance of having a design and a plan for our new digital world.

Digital privacy scholars tend to bemoan ordinary people’s limited knowledge of and lukewarm interest in what happens to their digital data. This general lack of interest and knowledge is often taken as a consideration in favor of legislation aiming to force internet companies into adopting more responsible data practices. While we remain silent on whether any new laws are called for, in this paper we wish to underline a neglected consequence of people’s ignorance of and apathy for (...) class='Hi'>digital privacy: their potential to encourage capture by industry interests. In particular, we argue that such laws may be at increased risk of capture because they are unlikely to be democratically responsive. We make this claim on a twofold basis: first, well-known theoretical mechanisms explaining how the absence of responsiveness leads to capture, identified in prior political science and political philosophy literature, yield the prediction that digital privacy legislation is likely to be unresponsive and thus captured; second, empirical data concerning the European Union’s digital privacy laws, with a special focus on the General Data Protection Regulation, appears to confirm these predictions: the bloc’s (world’s?) flagship privacy protection law seems more responsive to corporate than citizen interests. (shrink)

This report aims to offer insights into cutting-edge research on digital well-being. Many of these insights come from a 2-day academic-impact event, The Future of Digital Well-Being, hosted by a team of researchers working with the Royal Netherlands Academy of Arts and Sciences (KNAW) in February 2024. Today, achieving and maintaining well-being in the face of online technologies is a multifaceted challenge that we believe requires using theoretical resources of different research disciplines. This report explores diverse perspectives on (...) how digital well-being can be actively cultivated, while also emphasising the importance of considering individual differences, societal contexts, and nuanced cultural factors. We aim to offer a holistic view of the future of digital well-being, one that will inspire the next generation of designers of online tools, as well as policymakers who will regulate these tools. We start by asking what digital well-being is – how we can best define a concept that is used by diverse stakeholders and researchers from many disciplines in various ways. To do this, we explore the classic ethical theories of well-being, showing how they can give us insights into how the term digital well-being is currently deployed. We then move to look at the existing strategies that have been proposed to actively cultivate digital well-being, exploring the business models that threaten digital well-being and the relative advantages of the digital and non-digital solutions that are currently proposed. On the one hand, digital tools – such as Apple’s Screen Time and app blockers such as Opal and Forest – integrate seamlessly with the digital lifestyles of users. They also create precise metrics for digital well-being, which facilitates their solutions to reduce screen time. On the other hand, non-digital solutions, including mindfulness practices, digital detoxes, and digital well-being coaching, offer a new set of tools to reconnect individuals to their natural rhythms and help to actively promote offline activities. We then move to discuss diversity and how various groups of users have strikingly different digital well-being needs. Embracing neurodiversity in digital well-being is crucial as it strongly impacts the users’ experience of online technologies. When designing for diversity, organisations and designers alike need to prioritise customization for people with physical disabilities, mitigate harmful content for users with mental well-being conditions, address gender stereotypes and online harassment, and be designed in ways that recognize the very real risks of online technologies. This report closes by examining cultural differences. We believe that non-Western conceptions of well-being offer rich sources for enhancing digital well-being insofar as these traditions can inform and inspire the designers of future online technologies. We focus on East-Asian and South-Asian traditions, although in further work we recognise it would be useful to investigate conceptions of well-being that are influential in the Gulf region, Africa, and South America. Each of these areas have ethical frameworks that discuss well-being in depth as well as a rich cultural heritage. In conclusion, this report’s insights underscore the imperative of recognizing diversity in digital well-being, both in terms of cultural contexts and disciplinary perspectives. It emphasises the need for culturally responsive design methodologies and the integration of non-Western philosophical perspectives into current digital well-being research. Embracing this diversity, we believe, offers the best chance to create digital environments that prioritise well-being for users and the societies they live in across the world. Ultimately, we believe that it is not only about designing better online products; it’s about shaping a digital landscape that promotes well-being and flourishing for everyone. (shrink)

Digital duplicates reduce the scarcity of individuals and thus may impact their instrumental and intrinsic value. I here expand upon this idea by introducing the notion of collective scarcity, which pertains to the limitations faced by social groups in maintaining their size, cohesion, and function.

Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, (...) and that clinics are ethically required to use their DBTready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. (shrink)

This chapter explores the influence of Artificial Intelligence (AI) on digital democracy, focusing on four main areas: citizenship, participation, representation, and the public sphere. It traces the evolution from electronic to virtual and network democracy, underscoring how each stage has broadened democratic engagement through technology. Focusing on digital citizenship, the chapter examines how AI can improve online engagement while posing privacy risks and fostering identity stereotyping. Regarding political participation, it highlights AI's dual role in mobilising civic actions and (...) spreading misinformation. Regarding representation, AI's involvement in electoral processes can enhance voter registration, e-voting, and the efficiency of result tabulation but raises concerns regarding privacy and public trust. Also, AI's predictive capabilities shift the dynamics of political competition, posing ethical questions about manipulation and the legitimacy of democracy. Finally, the chapter examines how integrating AI and digital technologies can facilitate democratic political advocacy and personalised communication. However, this also comes with higher risks of misinformation and targeted propaganda. (shrink)

As a generation of ‘digital natives,’ secondary students who were born from 2002 to 2010 have various approaches to acquiring digital knowledge. Digital literacy and resilience are crucial for them to navigate the digital world as much as the real world; however, these remain under-researched subjects, especially in developing countries. In Vietnam, the education system has put considerable effort into teaching students these skills to promote quality education as part of the United Nations-defined Sustainable Development Goal (...) 4 (SDG4). This issue has proven especially salient amid the COVID−19 pandemic lockdowns, which had obliged most schools to switch to online forms of teaching. This study, which utilizes a dataset of 1061 Vietnamese students taken from the United Nations Educational, Scientific, and Cultural Organization (UNESCO)’s “Digital Kids Asia Pacific (DKAP)” project, employs Bayesian statistics to explore the relationship between the students’ background and their digital abilities. Results show that economic status and parents’ level of education are positively correlated with digital literacy. Students from urban schools have only a slightly higher level of digital literacy than their rural counterparts, suggesting that school location may not be a defining explanatory element in the variation of digital literacy and resilience among Vietnamese students. Students’ digital literacy and, especially resilience, also have associations with their gender. Moreover, as students are digitally literate, they are more likely to be digitally resilient. Following SDG4, i.e., Quality Education, it is advisable for schools, and especially parents, to seriously invest in creating a safe, educational environment to enhance digital literacy among students. (shrink)

Common mental health disorders are rising globally, creating a strain on public healthcare systems. This has led to a renewed interest in the role that digital technologies may have for improving mental health outcomes. One result of this interest is the development and use of artificial intelligence for assessing, diagnosing, and treating mental health issues, which we refer to as ‘digital psychiatry’. This article focuses on the increasing use of digital psychiatry outside of clinical settings, in the (...) following sectors: education, employment, financial services, social media, and the digital well-being industry. We analyse the ethical risks of deploying digital psychiatry in these sectors, emphasising key problems and opportunities for public health, and offer recommendations for protecting and promoting public health and well-being in information societies. (shrink)

Digital COVID certificates are a novel public health policy to tackle the COVID-19 pandemic. These immunity certificates aim to incentivize vaccination and to deny international travel or access to essential spaces to those who are unable to prove that they are not infectious. In this article, we start by describing immunity certificates and highlighting their differences from vaccination certificates. Then, we focus on the ethical, legal, and social issues involved in their use, namely autonomy and consent, data protection, equity, (...) and international mobility from a global fairness perspective. The main conclusion of our analysis is that digital COVID certificates are only acceptable if they meet certain conditions: that they should not process personal data beyond what is strictly necessary for the aimed goals, that equal access to them should be guaranteed, and that they should not restrict people’s autonomy to access places where contagion is unlikely. We conclude that, if such conditions are guaranteed, digital COVID certificates could contribute to mitigating some of the most severe socioeconomic consequences of the pandemic. (shrink)

In recent years discussions centered around digital inheritance have increased among social media users and across blockchain ecosystems. As a result digital assets such as social media content cryptocurrencies and non-fungible tokens have become increasingly valuable and widespread, leading to the need for clear and secure mechanisms for transferring these assets upon the testators death or incapacitation. This study proposes a framework for digital inheritance using soulbound tokens and the social recovery pallet as a use case in (...) the Polkadot and Kusama blockchain networks. The findings discussed within this study suggest that while soulbound tokens and the social recovery pallet offer a promising solution for creating a digital inheritance plan the findings also raise important considerations for testators digital executors and developers. While further research is needed to fully understand the potential impacts and risks of other technologies such as artificial intelligence and quantum computing this study provides a primer for users to begin planning a digital inheritance strategy and for developers to develop a more intuitive solution. (shrink)

Nietzsche promises to “translate man back into nature,” but it remains unclear what he meant by this and to what extent he succeeded at it. To help come to grips with Nietzsche’s conceptions of drive (Trieb), instinct (Instinkt) and virtue (Tugend and/or Keuschheit), I develop novel digital humanities methods to systematically track his use of these terms, constructing a near-comprehensive catalogue of what he takes these dispositions to be and how he thinks they are related. Nietzsche individuate drives and (...) instincts by the type of actions they motivate. One way in which the “translation” of man back into nature might succeed is through naturalistic explanation and reduction of moral notions such as virtue in terms of amoral, naturalistic notions, such as drives and instincts. I go on to show that this is indeed Nietzsche’s project: for him, a virtue is a well-calibrated drive. Such calibration relates both to the rest of the agent’s psychic economy (her other drives) and to her social context (what’s considered praiseworthy and blameworthy in her community). (shrink)

In this paper, I discuss some prominent features of our use of social media and what I think are its harms. My paper has three main parts. In the first part, I use a dialogical framework to argue that much of the discursive activity online is manifested as an ethically impoverished other-directedness and interactivity. In the second part, I identify and discuss several reasons that help explain why so much of the discursive activity on social media is ethically lacking. And (...) in the final part, I mention some of the effects these discursive practices have on us even when offline. Specifically, I suggest that the persistent use of digital communication technologies trains its users to adopt these problematic online discursive attitudes and activities into their experiences offline, making it more difficult for them to engage with themselves and others in more dialogically ethical ways. (shrink)

This research report presents findings about the extent and nature of digital self-harm among New Zealand teens. Digital self-harm is broadly defined here as the anonymous online posting or sharing of mean or negative online content about oneself. The report centres on the prevalence of digital self-harm (or self-cyberbullying) among New Zealand teens (aged 13-17), the motivations, and outcomes related to engaging in this behaviour. The findings described in this report are representative of the teenage population of (...) New Zealand by gender, ethnicity and age. Key findings are: Overall, 6% of New Zealand teens have anonymously posted mean or negative content online about themselves in the past year. Teenagers’ top reasons for this behaviour were: making a joke, wanting to show resilience, looking for friends’ sympathy, and seeking reassurance of friendship. By exploring the nature and extent of this behaviour, we are providing the online safety community, schools and parents with insights about a complex and, to some extent, hidden phenomenon involving New Zealand teens. (shrink)

In the popular and academic literature on the problems of the so-called attention economy, the cost of attention grabbing, sustaining, and immersing digital medias has been addressed as if it touched all people equally. In this paper I ask whether everyone has the same resources to respond to the recent changes in their stimulus environments caused by the attention economy. I argue that there are not only differences but disparities between people in their responses to the recent, significant increase (...) in the degree and persuasiveness of digital distraction. I point toward individual variance in an agent’s top-down and bottom-up attention regulation, and to further inequality-exacerbating variance in active participation on the internet and in regulating reward-seeking behaviors on the internet. Individual differences in these areas amount to disparities because they have been found to be connected to socioeconomic background factors. I argue that disparities in responding to digital distraction threaten fair equality of opportunity when it comes to digital distraction in the classroom and that they may lead to an unequal contribution of achievements that require complex cognition by people from lower socioeconomic backgrounds. (shrink)

Digital sovereignty, and the question of who ultimately controls AI seems, at first glance, to be an issue that concerns only specialists, politicians and corporate entities. And yet the fight for who will win digital sovereignty has far-reaching societal implications. Drawing on five case studies, the paper argues that digital sovereignty affects everyone, whether digital users or not, and makes the case for a hybrid system of control which has the potential to offer full democratic legitimacy (...) as well as innovative flexibility. (shrink)

This study aims to identify the digital reputation at the University of Palestine: an analytical perspective of the employees ’point of view, where the researchers used the descriptive and analytical approach, through a questionnaire distributed to a sample of employees at the University of Palestine, where the size of the study population is (234) employees, and the size of The sample is (117) employees, of whom (90) employees responded. The study provided a theoretical framework for what the writers and (...) researchers presented about the study variables, as well as a practical analytical framework for the opinions of employees at the University of Palestine. The digital reputation was expressed as an independent variable through its four indicators (feeling about the organization (satisfaction), admiration and respect, and trust, and social responsibility). The study found a set of results, the most important of which are: the existence of a high degree of digital reputation at the University of Palestine from the viewpoint of employees, and the absence of differences in the opinions of the study sample about digital reputation according to demographic variables. The study presented a set of recommendations, the most important of which are: The need for universities to enhance their digital reputation and raise its level. (shrink)

Objective: The study seeks to provide a thorough description of the teachers' digital literacy (DL) and digital competence (DC) and shine a light on the variables that influence the development of their digital literacies and competence. Method: Comprehensive data collection and analysis from 274 participants were completed. Descriptive and inferential statistics were conducted to accomplish the objectives of this study. Results: It came to light that teachers with less than ten years of experience have higher levels of (...) digital literacy. Pre-service education, having access to ICT resources, and a favorable attitude about using ICT were all strongly associated with DL and DC. The research's essential contribution is its findings affirming the value of DL and DC, which can be utilized to approach new technologies critically and use them as a part of digital pedagogy. Novelty: The critical contribution of the research is the result claiming the positive status of DL and DC, which can be used to approach new tools from a critical pedagogical perspective and apply them as part of digital pedagogy. -/- . (shrink)

The success of precision medicine depends on obtaining large amounts of information about at-risk populations. However, getting consent is often difficult. Why? In this commentary I point to the differentials in social status involved. These differentials are inevitable once personal information is surrendered, but are particularly intense when the studied populations are socioeconomically or socioculturally disadvantaged and/or ethnically stigmatized groups. I suggest how the deep distrust of the latter groups can be partially justified as a lack of confidence that (...) their core values or interests will sufficiently be taken into account. Hence, the ethical challenge here lies not in avoiding status differentials, but in dealing with them appropriately. Scientists should not assume trust from others but adopt a norm of “demonstrating trustworthiness”. (shrink)

Digital technology has prompted philosophers to rethink some of the fundamental categories we use to make sense of the world and ourselves. Particularly, the concept of ‘identity’ and its reconfiguration in the digital age has sparked much debate in this regard. While many studies have addressed the impact of the digital on personal and social identities, the concept of ‘collective identity’ has been remarkably absent in such inquiries. In this article, I take the context of social movements (...) as an entry point to discuss the reconfiguration of collective identity in social media environments. I do so by introducing a narrative approach to collective identity. I argue that Twitter’s affordances invite new ways of constructing collective identities and imply a shifting relationship between the individual and the collective. (shrink)

It is becoming increasingly common for authoritarian regimes to leverage digital technologies to surveil, repress and manipulate their citizens. Experts typically refer to this practice as digital authoritarianism (DA). Existing definitions of DA consistently presuppose a politically repressive agent intentionally exploiting digital technologies to pursue authoritarian ends. I refer to this as the intention-based definition. This paper argues that this definition is untenable as a general description of DA. I begin by illustrating the current predominance of the (...) intention-based definition (Section 2). Section 3 then presents four counterexamples to this definition: benign surveillance; digital sovereignty; attention-harvesting algorithms; and tech-induced loneliness. In each case, we witness authoritarianism being promoted by digital technologies without any evidence of this being intentionally caused by politically repressive agents. Based on these observations, I contend that the intention-based definition is underinclusive and is therefore unsustainable. Section 4 outlines an improved definition of DA – what I call the promotion-based definition. Since this more expansive definition does not posit intentional, politically repressive agency as a precondition of DA, it can accommodate the counterexamples discussed in Section 3. Moreover, it enables us to catch a broader spectrum of cases of DA, such as tech-induced loneliness, which those adhering to the intention-based definition are prone to overlook. After outlining further practical benefits of the promotion-based definition, I argue that we still need to distinguish between intentional and unintentional forms of DA since they call for distinct types of remedial action. -/- . (shrink)

The question this article addresses is how the WTO supports and deals with digital trade. The article then analyzes how existing WTO agreements have dealt with digital trade. The article also addresses recent trade agreements particularly the USMCA.