A novel advantage of the use of machine learning (ML) systems in medicine is their potential to continue learning from new data after implementation in clinical practice. To date, considerations of the ethical questions raised by the design and use of adaptive machine learning systems in medicine have, for the most part, been confined to discussion of the so-called “update problem,” which concerns how regulators should approach systems whose performance and parameters continue to change even after they have received regulatory (...) approval. In this paper, we draw attention to a prior ethical question: whether the continuous learning that will occur in such systems after their initial deployment should be classified, and regulated, as medical research? We argue that there is a strong prima facie case that the use of continuous learning in medical ML systems should be categorized, and regulated, as research and that individuals whose treatment involves such systems should be treated as research subjects. (shrink)

A number of philosophers working in applied ethics and bioethics are now earnestly debating the ethics of what they term “moral bioenhancement.” I argue that the society-wide program of biological manipulations required to achieve the purported goals of moral bioenhancement would necessarily implicate the state in a controversial moral perfectionism. Moreover, the prospect of being able to reliably identify some people as, by biological constitution, significantly and consistently more moral than others would seem to pose a profound challenge to egalitarian (...) social and political ideals. Even if moral bioenhancement should ultimately prove to be impossible, there is a chance that a bogus science of bioenhancement would lead to arbitrary inequalities in access to political power or facilitate the unjust rule of authoritarians; in the meantime, the debate about the ethics of moral bioenhancement risks reinvigorating dangerous ideas about the extent of natural inequality in the possession of the moral faculties. (shrink)

The cochlear implant controversy involves questions about the nature of disability and the definition of “normal” bodies; it also raises arguments about the nature and significance of culture and the rights of minority cultures. I defend the claim that there might be such a thing as “Deaf culture” and then examine how two different understandings of the role of culture in the lives of individuals can lead to different conclusions about the rights of Deaf parents in relation to their children, (...) and about the ethics of public funding for research on cochlear implants. An argument asserting the rights of minority cultures to equal respect and consideration within a multicultural society, informed by communitarian political philosophy, offers the best prospect for the defence of the unique culture(s) of the Deaf. (shrink)

In, “The Turing Triage Test”, published in Ethics and Information Technology, I described a hypothetical scenario, modelled on the famous Turing Test for machine intelligence, which might serve as means of testing whether or not machines had achieved the moral standing of people. In this paper, I: (1) explain why the Turing Triage Test is of vital interest in the context of contemporary debates about the ethics of AI; (2) address some issues that complexify the application of this test; and, (...) (3) in doing so, defend a way of thinking about the question of the moral standing of intelligent machines, which takes the idea of “seriousness” seriously. This last objective is, in fact, my primary one and is motivated by the sense that, to date, much of the “philosophy” of AI has suffered from a profound failure to properly distinguish between things that we can say and things that we can really mean. (shrink)

The argument of Julian Savulescu’s 2001 paper, “Procreative Beneficence: Why We Should Select the Best Children” is flawed in a number of respects. Savulescu confuses reasons with obligations and equivocates between the claim that parents have some reason to want the best for their children and the more radical claim that they are morally obligated to attempt to produce the best child possible. Savulescu offers a prima facie implausible account of parental obligation, as even the best parents typically fail to (...) do everything they think would be best for their children let alone everything that is in fact best for their children. The profound philosophical difficulties which beset the attempt to formulate a plausible account of the best human life constitute a further independent reason to resile from Savulescu’s conclusion. Savulescu’s argument also requires parents to become complicit with racist and homophobic oppression, which is yet another reason to reject it. Removing the equivocation from Savulescu’s argument allows us to see that the assertion of an obligation to choose the “best child” has much more in common with the “old” eugenics than Savulescu acknowledges. (shrink)

Most people who have considered the matter have concluded that machines cannot be moral agents. Responsibility for acting on the outputs of machines must always rest with a human being. A key problem for the ethical use of AI, then, is to ensure that it does not block the attribution of responsibility to humans or lead to individuals being unfairly held responsible for things over which they had no control. This is the “responsibility gap”. In this paper, we argue that (...) the claim that machines cannot be held responsible for their actions has unacknowledged implications for the conditions under which the outputs of AI can serve as reasons for belief. Following Robert Brandom, we argue that, because the assertion of a claim is an action, moral agency is a necessary condition for the giving and evaluating of reasons in discourse. Thus, the same considerations that suggest that machines cannot be held responsible for their actions suggest that they cannot be held to account for the epistemic value — or lack of value — of their outputs. If there is a responsibility gap, there is also a “testimony gap.” An under-recognised problem with the use of AI, then, is to ensure that it does not block the attribution of testimony to human beings or lead to individuals being held responsible for claims that they have not asserted. More generally, the “assertions” of machines are only capable of serving as justifications for belief or action where one or more people accept responsibility for them. (shrink)

Uptake is typically understood as the hearer’s recognition of the speaker’s communicative intention. According to one theory of uptake, the hearer’s role is merely as a ratifier. The speaker, by expressing a particular communicative intention, predetermines what kind of illocutionary act she might perform. Her hearer can then render this act a success or a failure. Thus the hearer has no power over which act could be performed, but she does have some power over whether it is performed. Call this (...) the ratification theory of uptake. Several philosophers have recently endorsed an alternative theory of uptake, according to which the hearer can determine the nature of the act the speaker performs. According to this theory, if the hearer regards an utterance as illocutionary act y, then it is act y, even if the speaker intended to perform act x. Call this the constitution theory of uptake. The purported advantage of this theory is that it identifies a common but underanalysed way in which speakers can be silenced. I argue that despite its initial intuitive pull, the constitution theory of uptake should be rejected. It is incompatible with ordinary intuitions about speech, it entails a conceptual impossibility, and it has unsavoury political implications, entailing that marginalised speakers barely qualify as agents. (shrink)

In this paper, I explore the “expressivist critique” of the use of prenatal testing to select against the birth of persons with impairments. I begin by setting out the expressivist critique and then highlighting, through an investigation of an influential objection to this critique, the ways in which both critics and proponents of the use of technologies of genetic selection negotiate a difficult set of dilemmas surrounding the relationship between genes and identity. I suggest that we may be able to (...) advance the debate about these technologies by becoming more aware of the ways in which this debate is itself in part a political contestation over this relationship. Ultimately, I will argue, the real force of the expressivist objection lies in its capacity to draw our attention to political questions about the role of the state and about relationships between different social groups rather than between parents and prospective children. That is to say, crucial issues, when evaluating the force of this criticism, turn out to be: the nature of the institutions which determine how decisions about prenatal selection are made; and how we think of each other, that is, what we take to be the defining characteristics of human beings. Paradoxically, arguments about the ethics of the “sorting society”, both supportive and critical, are an important arena in which these institutions and these ideas about identity are contested and shaped. An increased awareness of the reflexive nature of the process of debating these issues may assist us in better negotiating them. (shrink)

This paper makes the case for arms control regimes to govern the development and deployment of autonomous weapon systems and long range uninhabited aerial vehicles.

This paper uses the fictional case of the ‘Babel fish’ to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf culture. I argue that the relationships between Deaf and hearing cultures that are revealed and constructed in debates about genetic testing are themselves deserving of ethical evaluation. Making (...) good policy about genetic testing for deafness will require addressing questions in political philosophy and anthropology about the value of culture and also thinking hard about what sorts of experiences and achievements make a human life worthwhile. (shrink)

A number of recent and influential accounts of military ethics have argued that there exists a distinctive “role morality” for members of the armed services—a “warrior code.” A “good warrior” is a person who cultivates and exercises the “martial” or “warrior” virtues. By transforming combat into a “desk job” that can be conducted from the safety of the home territory of advanced industrial powers without need for physical strength or martial valour, long-range robotic weapons, such as the “Predator” and “Reaper” (...) drones fielded by the United States, call the relevance of the “martial virtues” into question. This chapter investigates the implications of these developments for conceptions of military virtue and, consequently, for the future of war. (shrink)

In this paper I offer a philosophical analysis of the act of ‘liking’ a post on social media. First, I consider what it means to ‘like’ something. I argue that ‘liking’ is best understood as a phatic gesture; it signals uptake and anoints the poster’s positive face. Next, I consider how best to theorise the power that comes with amassing many ‘likes’. I suggest that ‘like’ tallies alongside posts institute and record a form of digital social capital. Finally, I consider (...) whether ‘likes’ have ultimately improved online discourse. I argue that while the ‘liking’ function itself is relatively innocuous, public ‘like’ tallies introduce a corrosive motivation to online communication. By making the prospect of increased social capital perpetually salient to us, they encourage us to prioritise high levels of engagement over meaningful engagement. (shrink)

At the beginning of the COVID-19 pandemic, high hopes were placed on digital contact tracing. Digital contact tracing apps can now be downloaded in many countries, but as further waves of COVID-19 tear through much of the northern hemisphere, these apps are playing a less important role in interrupting chains of infection than anticipated. We argue that one of the reasons for this is that most countries have opted for decentralised apps, which cannot provide a means of rapidly informing users (...) of likely infections while avoiding too many false positive reports. Centralised apps, in contrast, have the potential to do this. But policy making was influenced by public debates about the right app configuration, which have tended to focus heavily on privacy, and are driven by the assumption that decentralised apps are “privacy preserving by design”. We show that both types of apps are in fact vulnerable to privacy breaches, and, drawing on principles from safety engineering and risk analysis, compare the risks of centralised and decentralised systems along two dimensions, namely the probability of possible breaches and their severity. We conclude that a centralised app may in fact minimise overall ethical risk, and contend that we must reassess our approach to digital contact tracing, and should, more generally, be cautious about a myopic focus on privacy when conducting ethical assessments of data technologies. (shrink)

Should parents try to give their children the best lives possible? Yes. Do parents have an obligation to give their children the widest possible set of opportunities in the future? No. Understanding how both of these things can be true will allow us to go a long way towards understanding why a Deaf couple might wish their child to be born Deaf and why we might have reason to respect this desire.

How could the initial, drastic decisions to implement “lockdowns” to control the spread of COVID-19 infections be justifiable, when they were made on the basis of such uncertain evidence? We defend the imposition of lockdowns in some countries by first, and focusing on the UK, looking at the evidence that undergirded the decision, second, arguing that this provided us with sufficient grounds to restrict liberty given the circumstances, and third, defending the use of poorly-empirically-constrained epidemiological models as tools that can (...) legitimately guide public policy. (shrink)

In a recent article, Ethan Bradley and Mark Navin (2021) argue that vaccine refusal is not akin to free riding. Here, I defend one connection between vaccine refusal and free riding and suggest that, when viewed in conjunction with their other arguments, this might constitute a reason to mandate Covid-19 vaccination.

Despite its long history of investigating sociality, phenomenology has, to date, said little about online sociality. The phenomenological tradition typically claims that empathy is the fundamental way in which we experience others and their experiences. While empathy is discussed almost exclusively in the context of face-to-face interaction, I claim that we can empathetically perceive others and their experiences in certain online situations. Drawing upon the phenomenological distinction between the physical, objective body and the expressive, lived body, I: (i) highlight that (...) empathy involves perceiving the other’s expressive, lived body, (ii) show that the lived body is not tied to the physical body and that empathy can take place outside of face-to-face interactions, and (iii) argue that the lived body can enter online space and is empathetically available to others there. I explore two ways in which the other’s lived body enters online space and can be empathetically perceived: first, in cases where our face-to-face encounter is technologically-mediated over video link and, second, by showing how the other’s texts, as speech, can form part of the other’s lived body. Investigating empathy online not only furthers our understanding of online encounters but also leads to a refined conception of empathy more generally. (shrink)

The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of “authenticity”, the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical (...) ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity—as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are 'black boxes'. The initial response in the literature was a demand for 'explainable AI'. However, recently, several authors have suggested that making AI more explainable or 'interpretable' is likely to be at the cost of the accuracy of these systems and that prioritising interpretability in medical AI may constitute a 'lethal prejudice'. In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realised. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems , may itself constitute a form of lethal prejudice that may diminish the benefits of AI to - and perhaps even harm - patients. (shrink)

At the beginning of the COVID-19 pandemic, high hopes were put on digital contact tracing, using mobile phone apps to record and immediately notify contacts when a user reports as infected. Such apps can now be downloaded in many countries, but as second waves of COVID-19 are raging, these apps are playing a less important role than anticipated. We argue that this is because most countries have opted for app configurations that cannot provide a means of rapidly informing users of (...) likely infections while avoiding too many false positive reports. Mathematical modelling suggests that differently configured apps have the potential to do this. These require, however, that some pseudonymised data be stored on a central server, which privacy advocates have cautioned against. We contend that their influential arguments are subject to two fallacies. First, they have tended to one-sidedly focus on the risks that centralised data storage entails for privacy, while paying insufficient attention to the fact that inefficient contact tracing involves ethical risks too. Second, while the envisioned system does entail risks of breaches, such risks are also present in decentralised systems, which have been falsely presented as ‘privacy preserving by design’. When these points are understood, it becomes clear that we must rethink our approach to digital contact tracing in our fight against COVID-19. There are no data in this work. (shrink)

In this paper, we introduce the Japanese philosopher Tetsurō Watsuji’s phenomenology of aidagara (“betweenness”) and use his analysis in the contemporary context of online space. We argue that Watsuji develops a prescient analysis anticipating modern technologically-mediated forms of expression and engagement. More precisely, we show that instead of adopting a traditional phenomenological focus on face-to-face interaction, Watsuji argues that communication technologies — which now include Internet-enabled technologies and spaces — are expressive vehicles enabling new forms of emotional expression, shared experiences, (...) and modes of betweenness that would be otherwise inaccessible. Using Watsuji’s phenomenological analysis, we argue that the Internet is not simply a sophisticated form of communication technology that expresses our subjective spatiality (although it is), but that it actually gives rise to new forms of subjective spatiality itself. We conclude with an exploration of how certain aspects of our online interconnections are hidden from lay users in ways that have significant political and ethical implications. (shrink)

During the Covid-19 pandemic we increasingly turned to technology to stay in touch with our family, friends, and colleagues. Even as lockdowns and restrictions ease many are encouraging us to embrace the replacement of face-to-face encounters with technologically mediated ones. Yet, as philosophers of technology have highlighted, technology can transform the situations we find ourselves in. Drawing insights from the phenomenology of sociality, we consider how digitally-enabled forms of communication and sociality impact our experience of one another. In particular, we (...) draw attention to the way in which our embodied experience of one another is altered when we meet in digital spaces, taking as our focus the themes of perceptual access, intercorporeality, shared space, transitional spaces, and self-presentation. In light of the way in which technological mediation alters various dimensions of our social encounters, we argue that digital encounters constitute their own forms of sociality requiring their own phenomenological analysis. We conclude our paper by raising some broader concerns about the very framework of thinking about digitally and non-digitally mediated social encounters simply in terms of replacement. (shrink)

The internet provides us with a multitude of ways of interacting with one another. In discussions about how technological innovations impact and shape our interpersonal interactions, there is a tendency to assume that encountering people online is essentially different to encountering people offline. Yet, individuals report feeling a sense of togetherness with one another online that echoes offline descriptions. I consider how we can understand people’s experiences of being together with others online, at least in certain instances, as arising out (...) of their feeling together as a we. Using Walther’s phenomenological framework of communality, I explore whether the following might take place online: habitual communal experiences and actual we-experiences. While neither of these sketches amount to a full account of how we find ourselves with others online, I suggest that they reveal how insights from the phenomenology of sociality can be used to deepen our understanding of online communality. What is more, I suggest that the strength of this approach is that in some cases it allows us to circumvent tricky questions about embodiment online and, in others, prompts us to ask to what extent a fully-embodied interaction is really required for we-experiences. (shrink)

This chapter critically analyses the ethical and political dimensions of supposedly subtle and non-coercive interventions that aim to ‘prevent crime’ through environmental designs making certain public spaces less attractive for specific groups. Examples include benches designed to discourage sleeping (targeted at homeless people), high-pitched noises or classical music played to deter lingering (targeted at youngsters), and specific lighting to prevent aggression (targeted at nightlife). While these interventions may appear less problematic than more traditional exclusionary measures, they raise ethical and political (...) worries that come into view clearly when we analyse them as instances of nudging, on the one hand, and niche construction and affective scaffolding, on the other. Employing this approach reveals how these exclusionary environmental designs not only risk reinforcing problematic stereotypes and social inequalities and discipline rather than prevent crime, they also can alienate specific groups, constitute affective injustices, and inflexibly reduce the diverse purposes public spaces potentially have. The chapter argues that environments are never neutral as they inevitably support and encourage some bodies, behaviours, moods, and emotions while suppressing and discouraging others. (shrink)

In this paper I identify a distinctive kind of gaslighting: communicative gaslighting. Communicative gaslighters intentionally misrepresent the communicative properties of an utterance—their own or their target’s—in a way which functions to undermine the target’s confidence in her abilities as a communicator. I argue that we can gaslight people as both speakers and hearers, and about (among other properties) the locutionary, perlocutionary, and illocutionary dimensions of utterances. Communicative gaslighting is concerning because not only does it undermine targets’ communicative agency, but also (...) it can contribute to a general decay of communicative conventions. (shrink)

Anorexia Nervosa (AN) is an eating disorder characterised by self-starvation. Accounts of AN typically frame the disorder in individualistic terms: e.g., genetic predisposition, perceptual disturbances of body size and shape, experiential bodily disturbances. Without disputing the role these factors may play in developing AN, we instead draw attention to the way disordered eating practices in AN are actively supported by others. Specifically, we consider how Pro-Anorexia (ProAna) websites—which provide support and solidarity, tips, motivational content, a sense of community, and understanding (...) to individuals with AN—help drive and maintain AN practices. We use C. Thi Nguyen’s work on epistemic “echo chambers”, along with Maria Lugones’ work on “worlds” and “ease”, to explore the dynamics of these processes. Adopting this broader temporal and intersubjective perspective, we argue, not only helps to further illuminate the experiential character of AN but also has important clinical and therapeutic significance. (shrink)

It is often claimed that the development of nanotechnology will constitute a “technological revolution” with profound social, economic, and political consequences. The full implications of this claim can best be understood by imagining a scenario in which a political revolutionary made all the same claims that are commonly made by enthusiasts for nanotechnology. I argue that most people would be outraged to learn that the members of an unelected group were planning to radically reshape society in this fashion. I survey (...) a number of arguments that might be used to block this analogy and argue that none of them justify drawing a sharp distinction between social change due to technology and change due to other political causes. Two things follow for discussions of the social impacts of nanotechnology. First, we need to reconsider the appropriateness of the language of technological revolution when talking about nanotechnology. The likely impacts of nanotechnology may be less dramatic than is often claimed. Second, if we do decide that the language of revolution is the appropriate one to use when talking about nanotechnology then we should acknowledge that any such revolution should be delayed until the public has had a chance to make a democratic decision about whether they wish their lives to be transformed in this way. (shrink)

Anorexia Nervosa (AN) is a complex disorder characterised by self-starvation, an act of self-destruction. It is often described as a disorder marked by paradoxes and, despite extensive research attention, is still not well understood. Much AN research focuses upon the distorted body image that individuals with AN supposedly experience. However, based upon reports from individuals describing their own experience of AN, I argue that their bodily experience is much more complex than this focus might lead us to believe. Such research (...) often presents an overly cognitive understanding of bodily experience in AN, underplaying the affective, felt experience of individuals with AN, as well as descriptions of empowerment, strength and control reported in the early stages of AN. This paper seeks to enrich our understanding of bodily experience in AN as it progresses throughout the various stages of the disorder. I show how the classical phenomenological distinction between the body-as-subject and the body-as-object, as well as Leder’s conception of the visceral body, can inform our understanding of bodily experience in AN. I suggest that the project of self-starvation is an attempt to overcome the noisy demands of the visceral body, which are experienced as threatening the body-as-subject, through a process of objectifying the body-as-object. By cashing out AN as a project of radical bodily control that, tragically, comes to control the individual, we can capture important aspects of the bodily experience of AN and the temporal progression of the disorder. -/- . (shrink)

In this paper I make a number of points about “political correctness”. Although individually these arguments seem straightforward - and will hopefully be uncontroversial - put together in context they reveal the idea of a “politically correct”, left-wing dominated, media or intelligentsia in Western political culture to be a conservative bogeyman. The rhetoric of “political correctness” is in fact overwhelmingly a right-wing conservative one which itself is used mainly to silence dissenting political viewpoints. However, the same investigation also suggests that (...) a “politics of speech” is an inevitable fact of social life and that some sorts of censorship are likewise inevitable. The question of censorship is therefore revealed as not “Whether we should tolerate all sorts of speech?” but “Which sorts of speech should we tolerate?”. (shrink)

Speech act theorists tend to hold that the illocutionary force of an utterance is determined by one interlocutor alone: either the speaker or the hearer. Yet experience tells us that the force of our utterances is not determined unilaterally. Rather, communication often feels collaborative. In this paper, I develop and defend a collaborative theory of illocutionary force, according to which the illocutionary force of an utterance is determined by an agreement reached by the speaker and the hearer. This theory, which (...) builds upon linguistic and sociological work on adjacency pairs and conversational interaction, can accommodate the complexity of speaker intentions (which may be disjunctive, indeterminate, and/or inconsistent over time), and renders speech act theory more compatible with theories of common ground. (shrink)

At this stage of the COVID-19 pandemic, two policy aims are imperative: avoiding the need for a general lockdown of the population, with all its economic, social and health costs, and preventing the healthcare system from being overwhelmed by the unchecked spread of infection. Achieving these two aims requires the consideration of unpalatable measures. Julian Savulescu and James Cameron argue that mandatory isolation of the elderly is justified under these circumstances, as they are at increased risk of becoming severely ill (...) from COVID-19, and are thus likely to put disproportionate strain on limited healthcare resources. However, their arguments for this strategy are contingent on the lack of viable alternatives. We suggest that there is a possible alternative: a mandatory, centralised contact-tracing app. We argue that this strategy is ethically preferable to the selective isolation of the elderly, because it does not target members of a certain group, relying instead on the movements of each individual, and because it avoids the extended isolation of certain members of the society. Although this type of contact-tracing app has its drawbacks, we contend that this measure warrants serious consideration. (shrink)

The fact that real-world decisions made by artificial intelligences (AI) are often ethically loaded has led a number of authorities to advocate the development of “moral machines”. I argue that the project of building “ethics” “into” machines presupposes a flawed understanding of the nature of ethics. Drawing on the work of the Australian philosopher, Raimond Gaita, I argue that ethical dilemmas are problems for particular people and not (just) problems for everyone who faces a similar situation. Moreover, the force of (...) an ethical claim depends in part on the life history of the person who is making it. For both these reasons, machines could at best be engineered to provide a shallow simulacrum of ethics, which would have limited utility in confronting the ethical and policy dilemmas associated with AI. (shrink)

This paper argues that one part of the picture of thinking about decolonising the philosophy curriculum should include problematising the notion of Western philosophy. I argue that there are many problems with the idea of Western philosophy, and with the idea that decolonising the curriculum should involve rejecting so-called Western philosophy. Doing this could include granting the West a false narrative about its origins, influences and interactions, perpetuating exclusions within contemporary and recent North American and European philosophy, perpetuating exclusions and (...) failed acknowledgements within the history of so-called Western philosophy, while at the same time rejecting a tradition which has included in itself so many topics and methodologies that what is left after excluding it would leave other traditions with limited resources, at the same time as wrongly granting the West proprietary rights over any ideas it has happened to investigate, rather than seeing these as belonging to all of humanity. I therefore conclude that a central part of curriculum change should be problematising Western philosophy, including our learning more about, and teaching, more complex views of its history and interactions with other traditions. (shrink)

When I started reading Sara Protasi’s book, The Philosophy of Envy, I was excited to learn more about an emotion I thought I rarely experienced. In the opening pages, I found myself nodding along as Protasi quotes her mother saying: “I never feel envy, but I often feel jealousy!” (6). But envy, it turns out, is sneaky, often masking itself in the guise of other emotions, hiding just below the surface. What this meticulously argued book unveils is both a nuanced (...) taxonomy of different kinds of envy and the intimate relationship that envy has to all manner of other emotions, including jealousy, shame, resentment, despair, and love. I now recognize that not only am I more familiar with envy than I supposed, but I experience envy rather often. This got me thinking about other instances of envy that I experience which I have previously overlooked or perhaps mislabeled. Prompted by Protasi’s insightful handling of envy in its varied forms, one question kept coming back to me: can you envy yourself? (shrink)

Respect for autonomy and beneficence are frequently regarded as the two essential principles of medical ethics, and the potential for these two principles to come into conflict is often emphasised as a fundamental problem. On the one hand, we have the value of beneficence, the driving force of medicine, which demands that medical professionals act to protect or promote the wellbeing of patients or research subjects. On the other, we have a principle of respect for autonomy, which demands that we (...) respect the self-regarding decisions of individuals. As well as routinely coming into opposition with the demands of beneficence in medicine, the principle of respect for autonomy in medical ethics is often seen as providing protection against beneficial coercion (i.e. paternalism) in medicine. However, these two values are not as straightforwardly opposed as they may appear on the surface. In fact, the way that we understand autonomy can lead us to implicitly sanction a great deal of paternalistic action, or can smuggle in paternalistic elements under the guise of respect for autonomy. -/- This paper is dedicated to outlining three ways in which the principle of respect for autonomy, depending on how we understand the concept of autonomy, can sanction or smuggle in paternalistic elements. As the specific relationship between respect for autonomy and beneficence will depend on how we conceive of autonomy, I begin by outlining two dominant conceptions of autonomy, both of which have great influence in medical ethics. I then turn to the three ways in which how we understand or employ autonomy can increase or support paternalism: firstly, when we equate respect for autonomy with respect for persons; secondly, when our judgements about what qualifies as an autonomous action contain intersubjective elements; and thirdly, when we expect autonomy to play an instrumental role, that is, when we expect people, when they are acting autonomously, to act in a way that promotes or protects their own wellbeing. I then provide a proposal for how we might work to avoid this. I will suggest that it may be impossible to fully separate paternalistic elements out from judgements about autonomy. Instead, we are better off looking at why we are motivated to use judgements about autonomy as a means of restricting the actions of patients or research subjects. I will argue that this is a result of discomfort about speaking directly about our beneficent motivations in medical ethics. Perhaps we can reduce the incentive to smuggle in these beneficent motivations under the guise of autonomy by talking directly about beneficent motivations in medicine. This will also force us to recognise paternalistic motivations in medicine when they appear, and to justify paternalism where it occurs. (shrink)

This chapter explores the nature of dehumanizing speech. It begins by considering the nature of dehumanization simpliciter, building on the work of David Livingstone Smith. It argues that dehumanization can take multiple forms; it can be demonizing, enfeebling, mechanizing, or objectifying. It then argues, contra Smith, that dehumanization is not always a way of conceiving of someone. Instead, dehumanization can also be a linguistic phenomenon, whereby one asserts, implicates, or presupposes dehumanizing propositions or attitudes. The chapter then explores how one (...) might assert dehumanizing propositions, and suggests that one can do this with both literal and figurative language. It also explains why some uses of animalistic figurative language are dehumanizing and some are not. The chapter concludes by identifying a uniquely linguistic version of the paradox of dehumanization: dehumanizing speakers who directly address their targets often assert that these targets are subhuman, while, through the mechanism of second-personal address, presupposing that they are human after all. (shrink)

In this chapter, I explore how experiences of social belonging might emerge and be sustained in online communities, drawing from the work on rituals by Randall Collins. I argue that rather than viewing mediated interactions in terms of whether they are suitable substitutes for face-to-face interactions, we should consider mediated encounters in their own right. This allows us to recognize the creative ways that people can create rituals in a mediated setting and thus support and create a sense of belonging (...) with others online. I also highlight how some online platforms not only support online rituals but that they are well-positioned to create and circulate collective symbols (or sacred objects) of groups and, thus, can continue to scaffold and sustain on-going feelings of belonging. (shrink)

There is growing interest in political phenomenology in the role that affectivity and emotions play in the political realm. Broadly speaking, it has been suggested that political emotions fall into two sub-categories: political emotions of allegiance and political emotions of antagonism. However, what makes an emotion one of allegiance or one of antagonism has yet to be explored. In this chapter, we show how work done on the phenomenology of emotions, the phenomenology of sociality, and critical phenomenology, can inform our (...) understanding of political emotions. Inspired by frameworks from each of these fields respectively, we introduce three ‘levels’ of phenomenological analysis with regards antagonistic political emotions: (i) the antagonistic character of the emotion, (ii) the antagonistic role in group dynamics, and (iii) a critical reflection on the very notion of antagonistic. Through this three-pronged phenomenological analysis we show how we can better understand, and critique, the conceptualisation of political emotions of antagonism and allegiance as well as show that whether an emotion is considered one of allegiance or antagonism depends on what level of analysis is employed. (shrink)

Objectives: Machine learning (ML) has the potential to facilitate “continual learning” in medicine, in which an ML system continues to evolve in response to exposure to new data over time, even after being deployed in a clinical setting. In this article, we provide a tutorial on the range of ethical issues raised by the use of such “adaptive” ML systems in medicine that have, thus far, been neglected in the literature. -/- Target audience: The target audiences for this tutorial are (...) the developers of ML AI systems, healthcare regulators, the broader medical informatics community, and practicing clinicians. -/- Scope: Discussions of adaptive ML systems to date have overlooked the distinction between 2 sorts of variance that such systems may exhibit—diachronic evolution (change over time) and synchronic variation (difference between cotemporaneous instantiations of the algorithm at different sites)—and underestimated the significance of the latter. We highlight the challenges that diachronic evolution and synchronic variation present for the quality of patient care, informed consent, and equity, and discuss the complex ethical trade-offs involved in the design of such systems. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are “black boxes.” The initial response in the literature was a demand for “explainable AI.” However, recently, several authors have suggested that making AI more explainable or “interpretable” is likely to be at the cost of the accuracy of these systems and that prioritizing interpretability in medical AI may constitute a “lethal prejudice.” In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realized. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems, may itself constitute a form of lethal prejudice that may diminish the benefits of AI to—and perhaps even harm—patients. (shrink)

Medical ethicists conventionally assume that the requirement to employ informed consent procedures is grounded in autonomy. It seems intuitively plausible that providing information to an agent promotes his autonomy by better allowing him to steer his life. However, James Taylor questions this view, arguing that any notion of autonomy that grounds a requirement to inform agents turns out to be unrealistic and self-defeating. Taylor thus contends that we are mistaken about the real theoretical grounds for informed consent procedures. Through analysing (...) Taylor's arguments and showing that they do not stand up to scrutiny, it is possible to defend the view that autonomy is a plausible theoretical basis for informed consent, and to enhance our understanding of the relationship between autonomy and informed consent. (shrink)

When doubts were first raised about the veracity of the dramatic advances in stem cell research announced by Professor Hwang Woo-Suk, a significant minority response was to question the qualifications of journalists to investigate the matter. In this paper I examine the contemporary relationships between science, scientists, the public, and the media. In the modern context the progress of science often relies on the media to mobilise public support for research and also for the purpose of communication within the scientific (...) community. As a result, attempts to counterpose "science" and "the media" should be treated with some caution. I argue that because of the essential role played by ethics in good science, journalists may in fact sometimes be well placed to investigate scientists. At the conclusion of my paper I draw out some of the implications of my analysis for the ethics of investigative journalism directed towards scientific research. (shrink)

Individuals suffering from depression consistently report experiencing a lack of connectedness with others. David Karp (2017, 73), in his memoir and study of depression, has gone so far to describe depression as “an illness of isolation, a disease of disconnectedness”. It has become common, in phenomenological circles, to attribute this social impairment to the depressed individual experiencing their body as corporealized, acting as a barrier between them and the world around them (Fuchs 2005, 2016). In this paper, I offer an (...) alternative view of the experience of social disconnectedness in depression, suggesting that rather than necessarily experiencing their body as object-like, the depressed individual’s bodily is saturated with experiences of lethargy, tiredness, heaviness, sadness, hopelessness and so on, to the exclusion of being able to bodily connect to others. I suggest that depression does not involve a complete social impairment but a specific impairment of affective forms of interpersonal experience. (shrink)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...) of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

In Deep Medicine, Eric Topol argues that the development of artificial intelligence (AI) for healthcare will lead to a dramatic shift in the culture and practice of medicine. Topol claims that, rather than replacing physicians, AI could function alongside of them in order to allow them to devote more of their time to face-to-face patient care. Unfortunately, these high hopes for AI-enhanced medicine fail to appreciate a number of factors that, we believe, suggest a radically different picture for the future (...) of healthcare. Far from facilitating a return to “the golden age of doctoring”, the role of economic and institutional considerations in determining how medical AI will be used mean that it is likely to further erode therapeutic relationships and threaten professional and patient satisfaction. (shrink)

In my article "Controlling the noise," I present a phenomenological investigation of bodily experience in anorexia nervosa. Turning to descriptions of those who have suffered from AN, which repeatedly detail the experience of finding their bodies threatening, out of control and noisy, I suggest that the phenomenological conceptions of body-as-object, body-as-subject and visceral body can help us unpack the complex bodily experience of AN throughout its various stages. My claim is that self-starvation is enacted by a bodily-subject who wishes to (...) quell or reassert authority over a visceral body whose demands and needs she finds threatening to her autonomy.The relationship between body-as-object and... (shrink)

In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but that there is another (...) autonomy-based objection to paid plasma donation that has not received sufficient attention. Namely, the stigma that surrounds exchanging plasma for payment makes it difficult to make an autonomous decision to engage in this activity. I suggest that this problem can be overcome in one of two ways; by banning payment for plasma, or by reducing the stigma surrounding this practice. I provide an indication of how we might work to achieve the latter, contending that this possibility should be taken seriously, due to the difficulties in achieving a sufficient supply of plasma without remuneration. (shrink)

This text presents a few preliminary results of research currently being conducted at the Université de Sherbrooke’s Research Institute on Educational Practices. The study seeks to understand how situations presented in teacher education can support the functioning and success of trainee teachers’ professional learning. The article’s aim is to identify the points of convergence between situations of professional activity, situations of professional learning, and training situations. The text will attempt to analyze the role that can be played by certain training (...) structures that seek to support a professionalization process that we define in terms of a general aim: the construction of professional knowledge. The originality of this research lies in that it draws on the work of Gaston Bachelard to develop a theoretical frame enabling a reading and interpretation of the results. Ce texte présente quelques résultats préliminaires d’une recherche menée présentement à l’Institut de recherche sur les pratiques éducatives de l’Université de Sherbrooke. Cette recherche vise à comprendre comment les situations présentes dans la formation à l’enseignement peuvent soutenir le fonctionnement et la réussite de l’apprentissage professionnel des enseignants en formation. Nous cherchons à identifier les points de rencontre entre les situations d’activité professionnelle, les situations d’apprentissage professionnel et les situations de formation. Nous tenterons d’analyser le rôle que peuvent jouer certains dispositifs visant à soutenir un processus de professionnalisation que nous définissons au regard d’une finalité : la construction de savoirs professionnels. L’originalité de cette recherche est la convocation des travaux de Gaston Bachelard pour élaborer le cadre théorique permettant la lecture et l’interprétation des résultats. (shrink)