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

It is easier to talk frankly to a person whom one trusts. It is also easier to agree with a scientist whom one trusts. Even though in both cases the psychological state that underlies the behavior is called ‘trust’, it is controversial whether it is a token of the same psychological type. Trust can serve an affective, epistemic, or other social function, and comes to interact with other psychological states in a variety of ways. The way that the (...) functional role of trust changes across contexts and objects is further complicated when communities and individuals mediate it through technologies, and even more so when that mediation involves artificial intelligence (AI) and machine learning (ML). In this chapter I look at the ways in which trust in institutions, and specifically the medical profession, is affected by the use of AI and ML. There are two key elements of this analysis. The first is a disanalogy between institutional trust in medicine and institutional trust in science (Irzik and Kurtulmus 2021, 2019; Kitcher 2001). I note that as AI and ML become a more prominent part of medicine, trust in a medical institution becomes more like trust in a scientific institution. This is problematic for institutional trust in medicine and the practice of medicine, since institutional trust in science has been undermined by, among other things, the spread of misinformation online and the replication crisis (Romero 2019). There is also a strong analogy between the psychological state of the person who trusts a scientific report or testimony and the psychological state of a patient who trusts individual recommendations made by a medical professional in a clinical setting. In both cases, institutional trust makes it less likely that a mistake or malfeasance will result in reactive attitudes, such as blame or anger, directed at other individual members of that institution. However, it also renders people vulnerable enough to blame the institution itself. This, with time, can erode trust in the institution and naturally leads to policy recommendations that aim to preserve institutional trust. I survey two ways in which that can be done with institutional trust in medicine in the age of AI and ML. (shrink)

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

Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public (...) on healthcare matters, and by the system’s credibility. I apply my proposed analysis of public trust in health care systems to the phenomenon of vaccine hesitancy, a tendency to question vaccine policies, and to seek alternative vaccine schedules or to refuse vaccination. Understanding the role of trust and its components can be key to understanding the phenomenon. (shrink)

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

Trust is a core feature of the physician-patient relationship, and risk is central to trust. Patients take risks when they trust their providers to care for them effectively and appropriately. Not all patients take these risks: some medical relationships are marked by mistrust and suspicion. Empirical evidence suggests that some patients and families of color in the United States may be more likely to mistrust their providers and to be suspicious of specific medical practices and institutions. Given (...) both historical and ongoing oppression and injustice in American medical institutions, such mistrust can be apt. Yet it can also frustrate patient care, leading to family and provider distress. In this paper, I propose one way that providers might work to reestablish trust by taking risks in signaling their own trustworthiness. This interpersonal step is not meant to replace efforts to remedy systemic injustice, but is an immediate measure for addressing mistrust in occurrent cases. (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)

The rise of personalised medicine can be seen as an extension of individualism and as a threat to the common good.

As a result of the world-wide COVID-19 epidemic, an internal tension in the goals of medicine has come to the forefront of public debate. Medical professionals are continuously faced with a tug of...

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)

I discuss an influential argument put forward by Hatherley in theJournal of Medical Ethics. Drawing on influential philosophical accounts of interpersonal trust, Hatherley claims that medical artificial intelligence is capable of being reliable, but not trustworthy. Furthermore, Hatherley argues that trust generates moral obligations on behalf of the trustee. For instance, when a patient trusts a clinician, it generates certain moral obligations on behalf of the clinician for her to do what she is entrusted to do. I make (...) three objections to Hatherley’s claims: (1) At least one philosophical account of interagent trust implies that medical AI is capable of being trustworthy. (2) Even if this account should ultimately be rejected, it does not matter much because what we care mostly about is that medical AI is reliable. (3) It is false that trust in itself generates moral obligations on behalf of the trustee. (shrink)

This commentary offers a coherent reading of the papers presented in the special issue ‘Exclusion, Engagement, and Empathy: Reflections on Public Participation in Medicine and Technology’. Focusing on intellectual self-trust it adds a further perspective on the harmful epistemic consequences of social exclusion for individual agents in healthcare contexts. In addition to some clarifications regarding the concepts of ‘intellectual self-trust’ and ‘social exclusion’ the commentary also examines in what ways empathy, engagement and participatory sense-making could help to (...) avoid threats to intellectual self-trust that arise form being excluded from participation in communicative practices in the context of healthcare. (shrink)

The adoption of web-based telecare services has raised multifarious ethical concerns, but a traditional principle-based approach provides limited insight into how these concerns might be addressed and what, if anything, makes them problematic. We take an alternative approach, diagnosing some of the main concerns as arising from a core phenomenon of shifting trust relations that come about when the physician plays a less central role in the delivery of care, and new actors and entities are introduced. Correspondingly, we propose (...) an applied ethics of trust based on the idea that patients should be provided with good reasons to trust telecare services, which we call sound trust. On the basis of this approach, we propose several concrete strategies for safeguarding sound trust in telecare. (shrink)

Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older (...) persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusion The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543. (shrink)

This paper uses the figure of the nomad from the work of Rosi Braidoti to critically examine rhetoric about vaccine and masking mandates, and the science of covid more broadly. I draw out the tensions and ambivalence felt as we navigate this on-going crisis in ways epitomized by the phrase “I have a healthy mistrust of authority, and I am still vaccinated.” Though ambivalent, the nomadic subject finds an affirmative ethics, navigating the “right” response to incite positive change and expose (...) our current states of subjectivity. Recognizing the ambivalence of this state may be useful for feminists who critique medicine for its historical sexist and racist “objectivism,” while also supporting medical science and trust in the case of vaccine mandates. (shrink)

To clarify the proper role of values in science, focusing on controversial expert responses to Covid-19, this article examines the status of (in)convenient hypotheses. Polarizing cases like health experts downplaying mask efficacy to save resources for healthcare workers, or scientists dismissing “accidental lab leak” hypotheses in view of potential xenophobia, plausibly involve modifying evidential standards for (in)convenient claims. Societies could accept that scientists handle (in)convenient claims just like nonscientists, and give experts less political power. Or societies could hold scientists to (...) a higher bar, by expecting them not to modify evidential standards to avoid costs only incidentally tied to error. (shrink)

Kunstmatige intelligentie (AI) en systemen die met machine learning (ML) werken, kunnen veel onderdelen van het medische besluitvormingsproces ondersteunen of vervangen. Ook zouden ze artsen kunnen helpen bij het omgaan met klinische, morele dilemma’s. AI/ML-beslissingen kunnen zo in de plaats komen van professionele beslissingen. We betogen dat dit belangrijke gevolgen heeft voor de relatie tussen een patiënt en de medische professie als instelling, en dat dit onvermijdelijk zal leiden tot uitholling van het institutionele vertrouwen in de geneeskunde.

Fears of black-box algorithms are multiplying. Black-box algorithms are said to prevent accountability, make it harder to detect bias and so on. Some fears concern the epistemology of black-box algorithms in medicine and the ethical implications of that epistemology. In ‘Who is afraid of black box algorithms? On the epistemological and ethical basis of trust in medical AI,' Durán and Jongsma seek to allay such fears. While some of their arguments are compelling, we still see reasons for fear.

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

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue (...) that draws both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other. (shrink)

With the highest profile seller of $99 genetic tests under fire, will public trust in personalised medicine suffer?

A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor’s entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background (...) of full-body transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct. Certainly, this examination can only be preliminary, indicating what should be a wide and vigorous discussion among practitioners and ethicists. It concludes with practical suggestions for how the medical and bioethics community may proceed with ethical assessment. (shrink)

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

Since 2004, it has been mandated by law that all Danish undergraduate university programmes have to include a compulsory course on the philosophy of science for that particular program. At the Faculty of Science and Technology, Aarhus University, the responsibility for designing and running such courses were given to the Centre for Science Studies, where a series of courses were developed aiming at the various bachelor educations of the Faculty. Since 2005, the Centre has been running a dozen different courses (...) ranging from mathematics, computer science, physics, chemistry over medical chemistry, biology, molecular biology to sports science, geology, molecular medicine, nano science, and engineering. -/- We have adopted a teaching philosophy of using historical and contemporary case studies to anchor broader philosophical discussions in the particular subject discipline under consideration. Thus, the courses are tailored to the interests of the students of the particular programme whilst aiming for broader and important philosophical themes as well as addressing the specific mandated requirements to integrate philosophy, some introductory ethics, and some institutional history. These are multiple and diverse purposes which cannot be met except by compromise. -/- In this short presentation, we discuss our ambitions for using case studies to discuss philosophical issues and the relation between the specific philosophical discussions in the disciplines and the broader themes of philosophy of science. We give examples of the cases chosen to discuss various issues of scientific knowledge, the role of experiments, the relations between mathematics and science, and the issues of responsibility and trust in scientific results. Finally, we address the issue of how and why science students can be interested in and benefit from mandatory courses in the philosophy of their subject. (shrink)

Until recently, psychologists have conceptualised and studied trust in God (TIG) largely in isolation from contemporary work in theology, philosophy, history, and biblical studies that has examined the topic with increasing clarity. In this article, we first review the primary ways that psychologists have conceptualised and measured TIG. Then, we draw on conceptualizations of TIG outside the psychology of religion to provide a conceptual map for how TIG might be related to theorised predictors and outcomes. Finally, we provide a (...) research agenda for future empirical work in this area, as well as practical applications for counsellors and religious leaders. (shrink)

We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.

Purpose The purpose of this paper is to defend the notion of “trust in technology” against the philosophical view that this concept is misled and unsuitable for ethical evaluation. In contrast, it is shown that “trustworthy technology” addresses a critical societal need in the digital age as it is inclusive of IT-security risks not only from a technical but also from a public layperson perspective. Design/methodology/approach From an interdisciplinary perspective between philosophy andIT-security, the authors discuss a potential instantiation of (...) a “trustworthy information and communication technology ”: a solution for privacy respecting video surveillance. Here, strong data protection measures address grave concerns such as the threat of bulk biometric tracking of citizens. In a logical argument, however, the authors show that this technical notion of “trust” needs to be complemented by interlocking trust relations to justify public trust. Findings Based on this argument, the authors demonstrate that the philosophical position considering “trust in technology” to denote either “reliability” or “interpersonal trust” is too limited as it fails to address critical aspects of IT-security. In a broader, socio-technical sense, however, it is shown that several distinct accounts of trust – technical, interpersonal and institutional – should meaningfully interlock, to address concerns with ICTs. Originality/value This conceptual study demonstrates the potential of “trust in technology” for a more comprehensive evaluation of ICTs within the context of operation. Furthermore, it adds to the discussion of trust in IT-security by highlighting the layperson’s challenge of judging a technology’s trustworthiness. Vice versa, it contributes to Ethics of Technology by highlighting crucial IT-security needs. (shrink)

Most traditional epistemologists see trust and knowledge as deeply antithetical: we cannot know by trusting in the opinions of others; knowledge must be based on evidence, not mere trust. I argue that this is badly mistaken. Modern knowers cannot be independent and self-reliant. In most disciplines, those who do not trust cannot know. Trust is thus often more epistemically basic than empirical evidence or logical argument, for the evidence and the argument are available only through (...) class='Hi'>trust. Finally, since the reliability of testimonial evidence depends on the trustworthiness of the testifier, this implies that knowledge often rests on a foundation of ethics. The rationality of many of our beliefs depends not only on our own character, but on the character of others. (shrink)

Collaborative filtering is being used within organizations and in community contexts for knowledge management and decision support as well as the facilitation of interactions among individuals. This article analyzes rhetorical and technical efforts to establish trust in the constructions of individual opinions, reputations, and tastes provided by these systems. These initiatives have some important parallels with early efforts to support quantitative opinion polling and construct the notion of “public opinion.” The article explores specific ways to increase trust in (...) these systems, albeit a “guarded trust” in which individuals actively seek information about system foibles and analyze the reputations of participants. (shrink)

What makes science trustworthy to the public? This chapter examines one proposed answer: the trustworthiness of science is based at least in part on its independence from the idiosyncratic values, interests, and ideas of individual scientists. That is, science is trustworthy to the extent that following the scientific process would result in the same conclusions, regardless of the particular scientists involved. We analyze this "idiosyncrasy-free ideal" for science by looking at philosophical debates about inductive risk, focusing on two recent proposals (...) which offer different methods of avoiding idiosyncrasy: the high epistemic standards proposal and the democratic values proposal. (shrink)

In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, (...) I argue that the RWT is historically workable, given a small number of modifications. I then expand Russo and Williamson’s account. I first develop their suggestion that causal relationships in medicine require some kind of evidence of mechanism. I begin with a number of accounts of mechanisms and produce a range of consensus features of them. I then develop this consensus position by reference to the two historical case studies with an eye to their operational competence. In particular, I suggest that it is mechanistic models and their representations which we are concerned with in medicine, rather than the mechanism as it exists in the world. -/- I then employ these mechanistic models to give an account of the sorts of evidence used in formulating and evaluating causal claims. Again, I use the two human viral oncogenesis cases to give this account. I characterise and distinguish evidence of mechanism from evidence of difference-making, and relate this to mechanistic models. I then suggest the relationship between types of evidence presents us with a means of tackling the reference-class problem. This sets the scene for the final chapter. Here, I suggest the manner in which these two different classes of evidence become integrated is also reflected in the way that developing research programmes change as their associated causal claims develop. (shrink)

We provide an analysis of the public's having warranted epistemic trust in science, that is, the conditions under which the public may be said to have well-placed trust in the scientists as providers of information. We distinguish between basic and enhanced epistemic trust in science and provide necessary conditions for both. We then present the controversy regarding the connection between autism and measles–mumps–rubella vaccination as a case study to illustrate our analysis. The realization of warranted epistemic public (...) trust in science requires various societal conditions, which we briefly introduce in the concluding section. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a (...) biomedical understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

Data from the World Values Survey shows that generalized trust in Mainland China—trust in out-group members—is very low, but generalized trust in Taiwan is much higher. The present article argues that positive interactions with out-group members in the context of Taiwan’s export-oriented economy fostered generalized trust—and so explains this difference. This line of argument provides evidence for Albert O. Hirschman’s doux commerce thesis, that market interaction can improve persons and even stabilize the social order. The present (...) article defends this point by separating two theses that Hirschman combines under that label, a countervailing forces thesis and a doux commerce thesis narrowly understood. These theses offer different explanations (or mechanisms) for how commerce could have those positive effects. The data about Taiwanese trust practices provides evidence for the latter. (shrink)

The demise of the value-free ideal constitutes a threat to public trust in science. One proposal is that whenever making value judgments, scientists rely only on democratic values. Since the influence of democratic values on scientific claims and recommendations is legitimate, public trust in science is warranted. I challenge this proposal. Appealing to democratic values will not suffice to secure trust because of at least two obstacles: polarization and marginalization.

In this paper, I distinguish three general approaches to public trust in science, which I call the individual approach, the semi-social approach, and the social approach, and critically examine their proposed solutions to what I call the problem of harmful distrust. I argue that, despite their differences, the individual and the semi-social approaches see the solution to the problem of harmful distrust as consisting primarily in trying to persuade individual citizens to trust science and that both approaches face (...) two general problems, which I call the problem of overidealizing science and the problem of overburdening citizens. I then argue that in order to avoid these problems we need to embrace a (thoroughly) social approach to public trust in science, which emphasizes the social dimensions of the reception, transmission, and uptake of scientific knowledge in society and the ways in which social forces influence both positively and negatively the trustworthiness of science. (shrink)

There is a growing consensus among philosophers of science that core parts of the scientific process involve non-epistemic values. This undermines the traditional foundation for public trust in science. In this article I consider two proposals for justifying public trust in value-laden science. According to the first, scientists can promote trust by being transparent about their value choices. On the second, trust requires that the values of a scientist align with the values of an individual member (...) of the public. I argue that neither of these proposals work and suggest an alternative that does better. When scientists must appeal to values in the course of their research, they should appeal to democratic values: the values of the public or its representatives. (shrink)

If Annette Baier is right that ‘some degree of trust is … the very basis of morality” (Baier 2004, 180) , it is surprising that a philosopher so interested in moral psychology and interpersonal relationships such as Iris Murdoch does not explicitly discuss trust in her work. However, on closer inspection, Murdoch’s proposal of an ethics focused on realism, unselfing and attention crucially depends upon the possibility of trust – trust in reality, and in one’s own (...) capacity for moral vision. Connecting Murdoch's project with feminist philosophy and especially feminist epistemology, and drawing on the philosophy of trust developed by C. Thi Nguyen and Karen Jones, this chapter argues for a vision of 'trust in the world' implicit in Murdoch's work, where trust emerges not in the domain of personal relationships, but in our attitude towards reality, including moral reality, that is not perceived by us as merely something inert. (shrink)

Trust is important in the food sector. This is primarily because households entrust some of the tasks related to food preparation to food processors. The public is concerned about pesticides, food additives, preservatives, and processed foods that may harbor unwanted chemicals or additives. After numerous food scandals, consumers expect food processing industries and retailers to take responsibility for food safety. Meanwhile, the food industry focuses on profit growth and costs reduction to achieve higher production efficiency and competitiveness. It means (...) that they introduce innovations, such as new production methods, processing techniques, and additives. Consumers have to delegate the responsibility for ensuring food safety to food producers, retailers, and regulatory authorities who ensure that the foods are safe, healthy, and pose no risks. For consumers, trusting these actors can reduce feelings of uncertainty. It is helpful for companies to be responsible for their activities through transparency and traceability. In turn, the food industry tries to gain consumers’ trust by providing objective information, such as ranked brands or labels on food packages. (shrink)

In this paper, I offer one example of conceptual change. Specifically, I contend that the discovery that viruses could cause cancer represents an excellent example of branch jumping, one of Thagard’s nine forms of conceptual change. Prior to about 1960, cancer was generally regarded as a degenerative, chronic, non-infectious disease. Cancer causation was therefore usually held to be a gradual process of accumulating cellular damage, caused by relatively non-specific component causes, acting over long periods of time. Viral infections, on the (...) other hand, were generally understood to be acute processes, whereby single, specific and necessary causal agents acted alone to produce disease. However, during the 1960s and 1970s, a number of cancers were discovered to have an infectious aetiology. Of particular note were two—Burkitt’s lymphoma and cervical cancer—which I will discuss in detail later in this piece. Together, these discoveries led, in the short term, to a tentative aetiological reclassification of some types of cancer as infectious diseases and, in the longer term, to a full-blown reclassification of cancer as an aetiological disease branch in its own right. This process of reclassification forms the empirical basis for my concluding remarks on the influence of classification upon causation in medicine. Through this, I aim to demonstrate that conceptual change, far from being a purely abstract concern of the philosopher of science, is of substantial import to scientific practitioners. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, (...) which, by bringing medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

Expert knowledge regularly informs personal and civic-decision making. To decide which experts to trust, lay publics —including policymakers and experts from other domains—use different epistemic and non-epistemic cues. Epistemic cues such as honesty, like when experts are forthcoming about conflicts of interest, are a popular way of understanding how people evaluate and decide which experts to trust. However, many other epistemic cues, like the evidence supporting information from experts, are inaccessible to lay publics. Therefore, lay publics simultaneously use (...) second-order social cues in their environment to inform decisions to trust. These second-order social cues, or ‘social indicators of trust’, prevent lay publics from having to trust blindly. Social indicators of trust therefore inform lay publics’ epistemic vigilance, or constant low level-monitoring of testimony from experts. This special issue examines the nature, acquisition and application of social indicators of trust for scientific experts and institutions. It also raises questions about the types of trust asked of lay publics and challenges traditional normative assumptions about the relationship between science and lay publics through study of attitudes, values, and experiences. The issue descriptively re-examines the structure of institutions, their role and methods for ferrying information, as well as how social indicators operate in times of crisis. In this collection of works, we bridge history, science, philosophy of science, science and technology studies, science communication and social epistemology, to broaden the discourse on trust in experts and more accurately reflect the imperfect yet indispensable endeavour that trusting is. (shrink)

In The Future of Human Nature, Jürgen Habermas raises the question of whether the embryonic genetic diagnosis and genetic modification threatens the foundations of the species ethics that underlies current understandings of morality. While morality, in the normative sense, is based on moral interactions enabling communicative action, justification, and reciprocal respect, the reification involved in the new technologies may preclude individuals to uphold a sense of the undisposability of human life and the inviolability of human beings that is necessary for (...) their own identity as well as for reciprocal relations. Engaging with liberal bioethics and Catholic approaches to bioethics, the article clarifies how Habermas’ position offers a radical critique of liberal autonomy while maintaining its postmetaphysical stance. The essay argues that Habermas’ approach may guide the question of rights of future generations regarding germline gene editing. But it calls for a different turn in the conversation between philosophy and theology, namely one that emphasizes the necessary attention to rights violations and injustices as a common, postmetaphysical starting point for critical theory and critical theology alike. In 2001, Jürgen Habermas published a short book on questions of biomedicine that took many by surprise.[1] To some of his students, the turn to a substantive position invoking the need to comment on a species ethics rather than outlining a public moral framework was seen as the departure from the “path of deontological virtue,”[2] and at the same time a departure from postmetaphysical reason. Habermas’ motivation to address the developments in biomedicine had certainly been sparked by the intense debate in Germany, the European Union, and internationally on human cloning, pre-implantation genetic diagnosis, embryonic stem cell research, and human enhancement. He turned to a strand of critical theory that had been pushed to the background by the younger Frankfurt School in favor of cultural theory and social critique, even though it had been an important element of its initial working programs. The relationship of instrumental reason and critical theory, examined, among others, by Max Horkheimer, Theodor W. Adorno, and Herbert Marcuse and taken up in Habermas’ own Knowledge and Interest and Theory of Communicative Action became ever-more actual with the development of the life sciences, human genome analysis, and genetic engineering of human offspring. Today, some of the fictional scenarios discussed at the end of the last century as “science fiction” have become reality: in 2018, the first “germline gene-edited” children were born in China.[3] Furthermore, the UK’s permission to create so-called “three-parent” children may create a legal and political pathway to hereditary germline interventions summarized under the name of “gene editing.”In this article, I want to explore Habermas’ “substantial” argument in the hope that philosophy and theology become allies in their struggle against an ever-more reifying lifeworld, which may create a “moral void” that would, at least from today’s perspective, be “unbearable”, and for upholding the conditions of human dignity, freedom, and justice. I will contextualize Habermas’ concerns in the broader discourse of bioethics, because only by doing this, his concerns are rescued from some misinterpretations.[1] Jürgen Habermas, The Future of Human Nature.[2] Ibid., 125, fn. 58. 8[3] Up to the present, no scientific publication of the exact procedure exists, but it is known that the scientist, Jiankui He, circumvented the existing national regulatory framework and may have misled the prospective parents about existing alternatives and the unprecedented nature of his conduct. Yuanwu Ma, Lianfeng Zhang, and Chuan Qin, "The First Genetically Gene‐Edited Babies: It's “Irresponsible and Too Early”," Animal Models and Experimental Medicine ; Matthias Braun, Meacham, Darian, "The Trust Game: Crispr for Human Germline Editing Unsettles Scientists and Society," EMBO reports 20, no. 2. (shrink)

A recent report revealed a staggering 61% drop in the market value of carbon offsets, attributed to adverse findings from both the scientific community and the media. These findings have raised concerns about the effectiveness of carbon credit projects, leading investors to reduce their involvement or withdraw completely, thereby substantially decreasing the market’s overall value [1,2]. This reluctance among buyers is fueled by escalating skepticism about the actual environmental impact of these projects and concerns over potential “greenwashing,” where companies misleadingly (...) present their environmental practices as more eco-friendly than they are. (shrink)

The paper examines the ways trust can be re-build for the future of free trade.

Complex technology has become an essential aspect of everyday life. We rely on technology as part of basic infrastructure and repeatedly for tasks throughout the day. Yet, in many cases the relation surpasses mere reliance and evolves to trust in technology. A new, disruptive technology is blockchain. It claims to introduce trustless relationships among its users, aiming to eliminate the need for trust altogether—even being described as “the trust machine”. This paper presents a proposal to adjust the (...) concept of trust in blockchain applications with the tools provided by conceptual engineering. Its goal is to propose a concept of trust, that offers more than a halo term, devoid of the normative depth that the original, philosophical term actually carries. To evaluate possible concepts of trust in blockchain applications, five criteria are proposed: These criteria ensure that the conceptual relation indeed embodies trust, thereby being richer than mere reliance, and that the chosen concept highlights the active role of the trustor. While the concepts of trust in engineers and trust in algorithms have to be discarded, institutional trust emerges as a viable candidate, given some refinements. Ultimately, the concept of trust by normative expectations and attribution is suggested to capture the essence of trust in blockchain applications. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.3 (2000) 453-471 [Access article in PDF] Liberty, Authority, and Trust in Burke's Idea of Empire Richard Bourke When Edmund Burke first embarked upon a parliamentary career, British political life was in the process of adapting to a series of critical reorientations in both the dynamics of party affiliation and the direction of imperial policy. During the period of the Seven Years' (...) War, a reconstituted militia became a focus for patriotic enthusiasm, uniting national sentiment against France and effectively eradicating the remnants of Jacobite rhetoric and aspiration. Traditional opposition between Tory and Whig became irrelevant, while Court and Country jointly came to the support of the Pitt-Newcastle ministry. However, in due course the Old Corps disintegrated as George III succeeded to the throne with the promise of an end to factional strife and the beginning of a patriotic alliance in government. But while competing ideologies and interests on the domestic political scene were undergoing comprehensive realignment, the pursuit of a blue-water policy in tandem with strategic continental campaigns brought Britain's struggle against France into North America, the Caribbean, and India. Trade continued to expand into Asia and West Africa, but the principles of commercial advantage were continually brought into open conflict with the exigencies of war. The division of power in Europe became embroiled in a substantial redivision of empire, and by 1763 British territorial expansion had reached its zenith.When Burke was appointed private secretary to the Marquis of Rockingham, with the national debt standing at an all time high and the demands of imperial defense unlikely to diminish, the politics of empire called for urgent attention from all sections of the political establishment. In particular the Rockinghamites, adopting a posture of aloofness from venality and petty interest, were obliged to advance policies for imperial government on the solid basis of political principle. 1 Coming into parliament as a member for Wendover in the wake of [End Page 453] Grenville's Stamp Act, at a time when the East India Company was assuming control of the revenue in Bengal, Burke set about formulating a doctrine of imperial sovereignty which would be serviceable to the party either in power or in opposition and which would be adequate to the complex reality of detached and extensive empire. The immediate reception of that inquiry, both in Britain and on the Continent, into the fraught world of post-Revolutionary political debate has had the long-term effect of distorting the order of emphasis in terms of which his career as a whole ought properly to be understood.The vigorous elaboration, in opposition to the Jacobin experiment in France, of the conditions under which moderate government could be exercised within the context of an absolute sovereignty was expressed in terms which had originally been invoked as part of a sustained attempt to reconcile civility with empire. As we shall see, that attempt involved a process of delicate coordination by means of which the interests of freedom would be brought into harmony with the demands of public power. In that sense the effort to make liberty and authority mutually responsible can be said to constitute the core ambition of Burke's political rhetoric. In this context responsibility defines the optimally beneficial relation between government and people on the one hand and national sovereignty and the extended empire on the other. This article outlines the practical and theoretical exploration of those relations within the frame of Burke's intervention in the world of eighteenth-century political discourse.Burke was of course well placed in 1765 to evolve a theory of imperial government that was at once ideologically compelling and politically viable. In his capacity as secretary to William Gerard Hamilton in the early 1760s he had already examined the corruption of legitimate empire as represented by the introduction of penal legislation into Ireland after 1694. The Tracts Relating to Popery Laws set out to convict the Irish Parliament in Dublin of flagrant misrule. A subordinate legislature within the empire is charged with having employed... (shrink)