As COVID-19 spread, clinicians warned of mental illness epidemics within the coronavirus pandemic. Funding for digital mental health is surging and researchers are calling for widespread adoption to address the mental health sequalae of COVID-19. -/- We consider whether these technologies improve mental health outcomes and whether they exacerbate existing health inequalities laid bare by the pandemic. We argue the evidence for efficacy is weak and the likelihood of increasing inequalities is high. -/- First, we review recent trends in digital (...) mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities. (shrink)

This paper introduces a body of research on Organizational Behavior and Industrial/organizational Psychology that expands the range of empirical evidence relevant to the ongoing character-situation debate. This body of research, mostly neglected by moral philosophers, provides important insights to move the debate forward. First, the OB/io scholarship provides empirical evidence to show that social environments like organizations have significant power to shape the character traits of their members. This scholarship also describes some of the mechanisms through which this process of (...) reshaping character takes place. Second, the character-situation debate has narrowly focused on situational influences that affect behavior episodically and haphazardly. The OB/io research, however, highlights the importance of distinguishing such situational influences from influences that, like organizational influences, shape our character traits because they are continuous and coordinated. Third, the OB/io literature suggests that most individuals display character traits that, while local to the organization, can be consistent across situations. This puts pressure on the accounts of character proposed by traditional virtue ethics and situationism and provides empirical support to interactionist models based on cognitive-affective processing system theories of personality. Finally, the OB/io literature raises important challenges to the possibility of achieving virtue, provides valuable and untapped resources to cultivate character, and suggests new avenues of normative and empirical research. (shrink)

This paper brings together two erstwhile distinct strands of philosophical inquiry: the extended mind hypothesis and the situationist challenge to virtue theory. According to proponents of the extended mind hypothesis, the vehicles of at least some mental states (beliefs, desires, emotions) are not located solely within the confines of the nervous system (central or peripheral) or even the skin of the agent whose states they are. When external props, tools, and other systems are suitably integrated into the functional apparatus of (...) the agent, they are partial bearers of her cognitions, motivations, memories, and so on. According to proponents of the situationist challenge to virtue theory, dispositions located solely within the confines of the nervous system (central or peripheral) or even the skin of the agent to whom they are attributed typically do not meet the normative standards associated with either virtue or vice (moral, epistemic, or otherwise) because they are too susceptible to moderating external variables, such as mood modulators, ambient sensibilia, and social expectation signaling. We here draw on both of these literatures to formulate two novel views – the embedded and extended character hypotheses – according to which the vehicles of not just mental states but longer-lasting, wider-ranging, and normatively-evaluable agentic dispositions are sometimes located partially beyond the confines of the agent’s skin. (shrink)

Over the years, companies have adopted hiring algorithms because they promise wider job candidate pools, lower recruitment costs and less human bias. Despite these promises, they also bring perils. Using them can inflict unintentional harms on individual human rights. These include the five human rights to work, equality and nondiscrimination, privacy, free expression and free association. Despite the human rights harms of hiring algorithms, the AI ethics literature has predominantly focused on abstract ethical principles. This is problematic for two reasons. (...) First, AI principles have been criticized for being vague and not actionable. Second, the use of vague ethical principles to discuss algorithmic risks does not provide any accountability. This lack of accountability creates an algorithmic accountability gap. Closing this gap is crucial because, without accountability, the use of hiring algorithms can lead to discrimination and unequal access to employment opportunities. This paper makes two contributions to the AI ethics literature. First, it frames the ethical risks of hiring algorithms using international human rights law as a universal standard for determining algorithmic accountability. Second, it evaluates four types of algorithmic impact assessments in terms of how effectively they address the five human rights of job applicants implicated in hiring algorithms. It determines which of the assessments can help companies audit their hiring algorithms and close the algorithmic accountability gap. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after (...) becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

We argue that the interaction of biased media coverage and widespread employment of the recognition heuristic can produce epistemic injustices. First, we explain the recognition heuristic as studied by Gerd Gigerenzer and colleagues, highlighting how some of its components are largely external to, and outside the control of, the cognitive agent. We then connect the recognition heuristic with recent work on the hypotheses of embedded, extended, and scaffolded cognition, arguing that the recognition heuristic is best understood as an instance of (...) scaffolded cognition. In section three, we consider the double-edged sword of cognitive scaffolding. On the one hand, scaffolds can reduce the internal processing demands on cognitive agents while increasing their access to information. On the other hand, the use of scaffolding leaves cognitive agents increasingly vulnerable to forming false beliefs or failing to form beliefs at all about particular topics. With respect to the recognition heuristic, agents rely on third parties (such as the media) to report not just what’s true but also what’s important or valuable. This makes cognitive agents relying on these third parties vulnerable to two erroneous influences: 1) because they don’t recognize something, it isn’t important or valuable, and 2) because they do recognize something, it is important or valuable. Call the latter the Kardashian Inference and the former the Darfur Inference. In section four, we use Fricker’s (2007) concept of epistemic injustice to characterize the nature and harm of these false inferences, with special emphasis on the Darfur Inference. In section five, we use data-mining and an empirical study to show how Gigerenzer’s population estimation task is liable to produce Darfur Inferences. We conclude with some speculative remarks on more important Darfur Inferences, and how to avoid them by scaffolding better. One primary way to accomplish this it to shift the burden of embodying the virtue of epistemic justice from the hearer or consumer of media to the media themselves. (shrink)

This paper argues that the question, ‘where are virtues?’ demands a response from virtue theorists. Despite the polarizing nature of debates about the relevance of empirical work in psychology for virtue theory, I first show that there is widespread agreement about the underlying structure of virtue. Namely, that virtues are comprised of cognitive and affective processes. Next, I show that there are well-developed arguments that cognitive processes can extend beyond the agent. Then, I show that there are similarly well-developed arguments (...) that affective processes can extend beyond the agent. I then introduce three cases to establish that these cognitive and affective processes are relevantly similar to the cognitive and affective processes countenanced by plausible theories of virtue. Finally, I conclude that virtue theorists must abandon default internalism, the view that the cognitive and affective processes comprising virtues are internal to the agent. (shrink)

Cohen (2023) takes a fair and measured approach to the question of what ChatGPT means for bioethics. The hype cycles around AI often obscure the fact that ethicists have developed robust frameworks...

Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology (Ickes...

Well before the COVID-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental healthcare. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental healthcare for the foreseeable future. We argue that bioethicists are uniquely positioned to cut through the hype surrounding digital mental health, which can (...) obscure crucial ethical and epistemic gaps that ought to be considered by policymakers before committing to a digital psychiatric future. Here, we describe four such gaps: The evidence gap, the inequality gap, the prediction-intervention gap, and the safety gap. (shrink)

This paper aims to expand the range of empirical work relevant to the extended cognition debates. First, I trace the historical development of the person-situation debate in social and personality psychology and the extended cognition debate in the philosophy of mind. Next, I highlight some instructive similarities between the two and consider possible objections to my comparison. I then argue that the resolution of the person-situation debate in terms of interactionism lends support for an analogously interactionist conception of extended cognition. (...) I argue that this interactionism might necessitate a shift away from the dominant agent-artifact paradigm toward an agent–agent paradigm. If this is right, then social and personality psychology—the discipline(s) that developed from the person-situation debate—opens a whole new range of empirical considerations for extended cognition theorists which align with Clark & Chalmers original vision of agents themselves as spread into the world. (shrink)

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about how (...) to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond. (shrink)

Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by (...) Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity. (shrink)

Traditional medical Artificial Intelligence models, approved for clinical use, restrict themselves to single-modal data e.g. images only, limiting their applicability in the complex, multimodal environment of medical diagnosis and treatment. Multimodal Transformer Models in healthcare can effectively process and interpret diverse data forms such as text, images, and structured data. They have demonstrated impressive performance on standard benchmarks like USLME question banks and continue to improve with scale. However, the adoption of these advanced AI models is not without challenges. While (...) multimodal deep learning models like Transformers offer promising advancements in healthcare, their integration requires careful consideration of the accompanying ethical and environmental challenges. (shrink)

This article identifies and examines a tension in mental health researchers’ growing enthusiasm for the use of computational tools powered by advances in artificial intelligence and machine learning (AI/ML). Although there is increasing recognition of the value of participatory methods in science generally and in mental health research specifically, many AI/ML approaches, fueled by an ever-growing number of sensors collecting multimodal data, risk further distancing participants from research processes and rendering them as mere vectors or collections of data points. The (...) imperatives of the “participatory turn” in mental health research may be at odds with the (often unquestioned) assumptions and data collection methods of AI/ML approaches. This article aims to show why this is a problem and how it might be addressed. (shrink)

Case reports about patients undergoing Deep Brain Stimulation (DBS) for various motor and psychiatric disorders - including Parkinson’s Disease, Obsessive Compulsive Disorder, and Treatment Resistant Depression - have sparked a vast literature in neuroethics. Questions about whether and how DBS changes the self have been at the fore. The present chapter brings these neuroethical debates into conversation with recent research in moral psychology. We begin in Section 1 by reviewing the recent clinical literature on DBS. In Section 2, we consider (...) whether DBS poses a threat to personal identity. In Section 3 we argue for engagement with recent empirical work examining judgements of when identity changes. We conclude in Section 4 by highlighting a range of ethical issues raised by DBS, including various cross-cultural considerations. (shrink)

A recent systematic review of Machine Learning (ML) approaches to health data, containing over 100 studies, found that the most investigated problem was mental health (Yin et al., 2019). Relatedly, recent estimates suggest that between 165,000 and 325,000 health and wellness apps are now commercially available, with over 10,000 of those designed specifically for mental health (Carlo et al., 2019). In light of these trends, the present chapter has three aims: (1) provide an informative overview of some of the recent (...) work taking place at the intersection of text mining and mental health so that we can (2) highlight and analyze several pressing ethical issues that are arising in this rapidly growing field and (3) suggest productive directions for how these issues might be better addressed within future interdisciplinary work to ensure the responsible development of text mining approaches in psychology generally, and in mental health fields, specifically. In Section 1, we review some of the recent literature on text-mining and mental health in the contexts of traditional experimental settings, social media, and research involving electronic health records. Then, in Section 2, we introduce and discuss ethical concerns that arise before, during, and after research is conducted. Finally, in Section 3, we offer several suggestions about how ethical oversight of text-mining research might be improved to be more responsive to the concerns mapped out in Section 2. (shrink)

Peer commentary on: Blumenthal-Barby, J. S. (2016). Biases and heuristics in decision making and their impact on autonomy. The American Journal of Bioethics, 16(5), 5-15.

Peer commentary on: Goering, S., Klein, E., Dougherty, D. D., & Widge, A. S. (2017). Staying in the loop: Relational agency and identity in next-generation DBS for psychiatry. AJOB Neuroscience, 8(2), 59-70.

Peer commentary on Char, Abràmoff & Feudtner (2020) target article: "Identifying Ethical Considerations for Machine Learning Healthcare Applications" .

By introducing the concept of “mental data,” Palermos (2023) highlights an underappreciated aspect of data ethics that policymakers would do well to heed. Sweeping artificial intelligence (AI) legi...

Commentary about the role of AI in bioethics for the 10th anniversary issue of AJOB: Empirical Bioethics.

This paper argues that the activist, feminist and pragmatist Jane Addams was an experimental philosopher. To defend this claim, I argue for capacious notions of both philosophical pragmatism and experimental philosophy. I begin in Section 2 with a new defence of Rose and Danks’ [‘In Defense of a Broad Conception of Experimental Philosophy’. Metaphilosophy 44, no. 4 : 512–32] argument in favour of a broad conception of experimental philosophy. Koopman [‘Pragmatist Resources for Experimental Philosophy: Inquiry in Place of Intuition’. Journal (...) of Speculative Philosophy 26, no. 1 : 1–24] argues that many twentieth-century American pragmatists can make important contributions to contemporary experimental philosophy. In Section 3, I argue that while this may be true, it is also true that under the broad conception, many of the pragmatists just were experimental philosophers. In Section 4, I argue that as a pragmatist philosopher in her own right, Jane... (shrink)

In 1916 John Dewey expressed a worry that American philosophy would be relegated to “chewing a historic cud long since reduced to a woody fibre, or an apologetics for lost causes (lost to natural science).”1 In this paper, I will attempt to contribute to a growing body of literature within the classical American philosophical tradition that seeks to avoid this fate by engaging Dewey’s thought with debates in contemporary philosophy of mind.2 To date, the vast majority of this work has (...) centered around Dewey’s notion of embodiment and its relation to the thesis of the embodied mind. In this paper I will evaluate the degree to which the embodied mind thesis (henceforth “EMT”) provides the proper framework for .. (shrink)

This chapter aims to expand the body of empirical literature considered relevant to virtue theory beyond the burned-over districts that are the situationist challenges to virtue ethics and epistemology. We thus raise a rather simple-sounding question: why doesn’t virtue epistemology have an account of intelligence? In the first section, we sketch the history and present state of the person-situation debate to argue for the importance of an interactionist framework in bringing psychological research in general, and intelligence research in particular, to (...) bear on questions of virtue. In Section 2, we discuss the history and present state of intelligence research to argue for its relevance to virtue epistemology. In Section 3, we argue that intelligence sits uneasily in both responsibilist and reliabilist virtue frameworks, which suggests that a new approach to virtue epistemology is needed. We conclude by placing intelligence within a new interactionist framework. (shrink)

Debates about obesity in bioethics tend to unfold in predictable epicycles between individual choices and behaviours and the oppressive socio-economic structures constraining them. Here, we argue that recent work from two cutting-edge research programmes in microbiology and social psychology can advance this conceptual stalemate in the literature. We begin in section 1 by discussing two promising lines of obesity research involving the human microbiome and relationship partners. Then, in section 2, we show how this research has made viable novel strategies (...) for fighting obesity, including microbial therapies and dyad-level interventions. Finally, in section 3, we consider objections to our account and conclude by arguing that attention to the most immediate features of our biological and social environment offers a middle ground solution, while also raising important new issues for bioethicists. (shrink)

In this chapter, we outline the interdisciplinary contributions that philosophy, psychology, and neuroscience have provided in the understanding of the self and identity, focusing on one specific line of burgeoning research: the importance of morality to perceptions of self and identity. Of course, this rather limited focus will exclude much of what psychologists and neuroscientists take to be important to the study of self and identity (that plethora of self-hyphenated terms seen in psychology and neuroscience: self-regulation, self-esteem, self-knowledge, self-concept, self-perception, (...) and more). We will likewise not engage with many canonical philosophical treatments of self and identity. But we will lay out a body of research that brings together classic themes in philosophy, psychology, and neuroscience to raise empirically tractable philosophical questions, and philosophically rigorous empirical questions about self and identity. More specifically, in section 4.2, we will review some recent research that has treated traditional philosophical questions about self and identity as empirical questions. Within this body of work, we will be primarily concerned with the finding that morality (more so than memory) is perceived to be at the core of self and identity. Then, in section 4.3, we raise and respond to a variety of questions and criticisms: first, about the operationalization of identity concepts in the empirical literature; second, about the generalizability of the moral self effect; third, about the direction of change; fourth, about connections with recent work in neuroscience; and fifth, about the target of evaluation. Finally, in section 4.4, we consider a variety of implications and applications of this work on the moral self. Throughout, we aim to highlight connections between classical themes in philosophy, psychology, and neuroscience, while also suggesting new directions for interdisciplinary collaboration. (shrink)

Abstract: While pragmatism and the so-called 4E program may form a united front against methodological individualism, classical cognitivism, traditional internalism, and the like, the 4E approach is not without its own internal tensions. One such tension, between Embodied and Extended, is brought to light by Clark (2008), who argues in favor of the latter. Dempsey and Shani (2013) reply that Clark’s functionalism undercuts what should be a more fundamental commitment to Embodied. With respect to this tension, Gallagher (2014) claims that (...) “there may be resources in pragmatism that can help to adjudicate some of the current debate and to develop a more integrated perspective” (Gallagher 2014, 110). In this paper, I assess Gallagher’s strategy and offer a critical perspective on the use of Deweyan pragmatism to resolve these tensions in the 4E program. (shrink)

Review of: Abel, C. (2014). The extended self: Architecture, memes and minds. Manchester University Press.