Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range of bioethical (...) and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

This book explores Kant's views on the concept of God and on the attempt to demonstrate God's existence as a means of understanding Kant's work as a whole and of achieving a proper appreciation of the contents of Kant's moral faith.

This masterful work on Kant's Religion within the Boundaries of Mere Reason explores Kant's treatment of the Idea of God, his views concerning evil, and the moral grounds for faith in God. Kant and Religion works to deepen our understanding of religion's place and meaning within the history of human culture, touching on Kant's philosophical stance regarding theoretical, moral, political, and religious matters. Wood's breadth of knowledge of Kant's corpus, philosophical sharpness, and depth of reflection sheds light not only on (...) Kant, but also on the fate of religion and its relation to philosophy in the modern world. (shrink)

In today’s evolving understanding of gender, questions arise about the future of the feminist movement. Using Simone de Beauvoir’s The Second Sex, Hugh Ryan's “Who's Afraid of Social Contagion,” and Ben Kesslen’s “How the Idea of a 'Transgender Contagion' Went Viral—and Caused Untold Harm,” this paper explores the concept of the Other to analyze social contagion and gender-based oppression. It argues that while feminism must adapt, its future lies in embracing the experiences of all classified as the Other. Through de (...) Beauvoir's work, historical definitions of gender, and social constructivism, this paper proposes a new idea for the future of feminism. (shrink)

In this original work of cultural criticism, Allen S. Weiss explores the meaning of radio to the modern imagination.

This article explores chemical skin bleaching practices in urban Ghana to demonstrate the ways that particular racialized understandings of meaning are deployed in a contemporary postcolonial African society. I argue that the processes of racialization indexed by skin bleaching in Ghana must be contextualized within global racial formations; specifically, they can only be understood by examining the interlinked local and global ideologies and practices of race. In elaborating this argument, the essay also engages with contemporary African diaspora theorization that tends (...) to foreground diasporic identity and experience at the expense of contemporary continental processes. By bringing a postcolonial African society into a dialogue about race, processes of racialization, and the interlinked transnational construction of black identities, this essay offers one way out of the ambivalent relationship that I believe diaspora theorization has with Africa. (shrink)

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times (...) and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted. (shrink)

The latest volume in the Cambridge Histories of Philosophy series, The Cambridge History of Philosophy in the Nineteenth Century brings together twenty-nine leading experts in the field and covers the years 1790-1870. Their twenty-seven chapters provide a comprehensive survey of the period, organizing the material topically. After a brief editor's introduction, it begins with three chapters surveying the background of nineteenth century philosophy: followed by two on logic and mathematics, two on nature and natural science, five on mind and language, (...) including psychology, the human sciences and aesthetics, four on ethics, three on religion, seven on society, including chapters on the French Revolution, the decline of natural right, political economy, and social discontent, and three on history, dealing with historical method, speculative theories of history and the history of philosophy. The essays are framed by an editor's introduction and a bibliography. (shrink)

Within barely a year, two school shootings shook Finland. The school shootings shocked Finnish society, forcing media, academics and experts, police and politicians alike to search for reasons behind the violent incidents. Focusing their analysis on the two main Finnish newspapers, Helsingin Sanomat and Hufvudstadsbladet, authoritative sources of information for Finland’s two language communities, the authors maintain that the Finnish case contributes to research on school shootings by evidencing the intimate linkages between the state, gender and violence. The authors argue (...) that violence is to be understood through different discourses about the Finnish state. In particular, they discern three discourses about the state that produce gendered discourses of violence: the welfare state, the realist state and the neoliberal state. The authors conclude that these discourses produce different notions of rational and irrational violence thereby providing different legitimizations for male-embodied/masculine violence. (shrink)

In this book, Newell makes the case for unified theories by setting forth a candidate.

This book articulates a systematic vision of an international legal system grounded in the commitment to justice for all persons. It provides a probing exploration of the moral issues involved in disputes about secession, ethno-national conflict, "the right of self-determination of peoples," human rights, and the legitimacy of the international legal system itself. Buchanan advances vigorous criticisms of the central dogmas of international relations and international law, arguing that the international legal system should make justice, not simply peace among states, (...) a primary goal, and rejecting the view that it is permissible for a state to conduct its foreign policies exclusively according to what is in the "national interest." He also shows that the only alternatives are not rigid adherence to existing international law or lawless chaos in which the world's one superpower pursues its own interests without constraints. This book not only criticizes the existing international legal order, but also offers morally defensible and practicable principles for reforming it. Justice, Legitimacy, and Self-Determination will find a broad readership in political science, international law, and political philosophy. (shrink)

Thesis: Those affected by mental disorders whose actions are episodically influenced by their disorder are often overlooked by philosophers of moral and ethical responsibility. Allen gives us reasons for thinking it is inappropriate to either: a) “summarily exclude people with mental problems out of the universe of moral agents, reducing them to the status of rocks, trees, animals, and infants” b) “include the group on the false assumption that their moral lives are precisely like the paradigmatic moral lives of (...) the epistemically-sound and well-regulated people never personally touched by a mental condition” We must explore a revised approach to moral and ethical responsibility and obligation for this group. (shrink)

On the occasion of a first conference on Cognitive Science, it seems appropriate to review the basis of common understanding between the various disciplines. In my estimate, the most fundamental contribution so far of artificial intelligence and computer science to the joint enterprise of cognitive science has been the notion of a physical symbol system, i.e., the concept of a broad class of systems capable of having and manipulating symbols, yet realizable in the physical universe. The notion of symbol so (...) defined is internal to this concept, so it becomes a hypothesis that this notion of symbols includes the symbols that we humans use every day of our lives. In this paper we attempt systematically, but plainly, to lay out the nature of physical symbol systems. Such a review is in ways familiar, but not thereby useless. Restatement of fundamentals is an important exercise. (shrink)

First published in 1877, this book analyses the laws that govern human relations with society and with the natural world.

Epistemic akrasia arises when one holds a belief even though one judges it to be irrational or unjustified. While there is some debate about whether epistemic akrasia is possible, this paper will assume for the sake of argument that it is in order to consider whether it can be rational. The paper will show that it can. More precisely, cases can arise in which both the belief one judges to be irrational and one’s judgment of it are epistemically rational in (...) the sense that both are supported by sufficient evidence. (shrink)

Allison begins this book by observing that although the eighteenth century is often called the “age of reason,” it has also been called the “century of taste.” There is a clear enough connection, however, between the two names, for anyone with eyes open enough to see it. For the phenomenon of taste—of likings and dislikings conforming to sharable standards, and invited or sought from others precisely for the sake of sharing them universally—was recognized by eighteenth-century rationalists, and certainly by Kant, (...) as a necessary adjunct or perhaps even a precondition for universally valid judgments based on reason, about science or morality or politics. Taste was also seen by them as overcoming the division between reason and sensation, and thus of making human beings whole; it is a way for reason to gain access to people’s feelings and motives, hence a precondition for it to shape their conduct. For Kant, a critique of aesthetic judgment is the inquiry in which the “great gulf” between knowledge and practice, theoretical understanding and moral reason is to be overcome and philosophy itself is to be made whole. (shrink)

Computers are already approving financial transactions, controlling electrical supplies, and driving trains. Soon, service robots will be taking care of the elderly in their homes, and military robots will have their own targeting and firing protocols. Colin Allen and Wendell Wallach argue that as robots take on more and more responsibility, they must be programmed with moral decision-making abilities, for our own safety. Taking a fast paced tour through the latest thinking about philosophical ethics and artificial intelligence, the authors (...) argue that even if full moral agency for machines is a long way off, it is already necessary to start building a kind of functional morality, in which artificial moral agents have some basic ethical sensitivity. But the standard ethical theories don't seem adequate, and more socially engaged and engaging robots will be needed. As the authors show, the quest to build machines that are capable of telling right from wrong has begun. -/- Moral Machines is the first book to examine the challenge of building artificial moral agents, probing deeply into the nature of human decision making and ethics. (shrink)

The aim of this article is to discuss the role that victim groups and organizations may have in framing and supporting an accountability agenda, as well as their potential for endorsing a distributive justice agenda. The article explores two empirical cases where victims' rights have been introduced and applied by victim organizations to promote accountability—Colombia and Peru. It will be argued that if transitional justice in general and victim reparations in particular are to embark in a quest for distributive justice, (...) it cannot do so without considering victims as political actors, and putting forward demands in terms of victims’ rights. (shrink)

This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance (...) directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement.

This paper addresses the role of integrity in global leadership. It reviews the philosophy of ethics and suggests that both contractarianism and pluralism are particularly helpful in understanding ethics from a global leadership perspective. It also reviews the challenges to integrity that come through interactions that are both external and internal to the company. Finally, the paper provides helpful suggestions on how global leaders can define appropriate ethical standards for themselves and their organizations.

Wittgenstein famously ended his Tractatus Logico-Philosophicus (Wittgenstein 1922) by writing: "Whereof one cannot speak, one must pass over in silence." (Wovon man nicht sprechen kann, darüber muss man schweigen.) In that earliest work, Wittgenstein gives no clue about whether this aphorism applied to animal minds, or whether he would have included philosophical discussions about animal minds as among those displaying "the most fundamental confusions (of which the whole of philosophy is full)" (1922, TLP 3.324), but given his later writings on (...) language and thought, it seems a plausible hypothesis. Years later he wrote in the Philosophical Investigations (1968, p. 223) another aphoristic statement: "If a lion could speak, we would not understand him." (Wenn der Löwe sprechen könnte, wir könnten ihn nicht verstehen.) Decades of philosophical discussion about what Wittgenstein meant by these remarks illustrate another point: when philosophers speak, we do not fully understand them. (shrink)

Which nonhuman animals experience conscious pain?1 This question is central to the debate about animal welfare, as well as being of basic interest to scientists and philosophers of mind. Nociception—the capacity to sense noxious stimuli—is one of the most primitive sensory capacities. Neurons functionally specialized for nociception have been described in invertebrates such as the leech Hirudo medicinalis and the marine snail Aplysia californica (Walters 1996). Is all nociception accompanied by conscious pain, even in relatively primitive animals such as Aplysia, (...) or is it the case, as some philosophers continue to maintain, that conscious experiences are the exclu- sive province of human beings? What philosophical and scientific resources are presently available for assessing claims lying between these extremes? (shrink)

A systematic introduction suitable for readers who have little familiarity with logic. Provides numerous examples and complete proofs.