Background Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users’ experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in (...) the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use? Methods A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis. Results Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others. Conclusions The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA. Trial registration German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020. (shrink)

Symptom Checker Applications (SCA) are mobile applications often designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology. The aim of this scoping review is to identify the ELSA of SCA in the scientific literature. A scoping review was conducted to identify the ELSA (...) of SCA. Ten databases (e.g., Web of Science and PubMed) were used. Studies on SCA that address ELSA, written in English or German, were included in the review. The ELSA of SCA were extracted and synthesized using qualitative content analysis. A total of 25,061 references were identified, of which 39 were included in the analysis. The identified aspects were allotted to three main categories: (1) Technology; (2) Individual Level; and (3) Healthcare system. The results show that there are controversial debates in the literature on the ethical and social challenges of SCA usage. Furthermore, the debates are characterised by a lack of a specific legal perspective and empirical data. The review provides an overview on the spectrum of ELSA regarding SCA. It offers guidance to stakeholders in the healthcare system, for example, patients, healthcare professionals, and insurance providers and could be used in future empirical research to investigate the perspectives of those affected, such as users. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Spiritual Experience and Psychopathology”Roland Littlewood (bio)Keywordsreligion, innovation, psychosis, culture, diagnosisThis is an ambiguous though clinically valuable paper. Jackson and Fulford suggest that the distinction between their two categories, spiritual experience and mental illness, is conventional, yet their emphasis on issues of correct practice from the medical perspective threatens to return both into distinct ontological categories, albeit with a shared phenomenology. I do not understand why any (...) single instance must either be pathological or spiritual, except through clinical and clerical demands for clarity and order.Mental illness and spirituality are not two distinct natural phenomena “out there,” existing independently of human volition. They are both social—cultural if one prefers—ascriptions. Neither has some substantive core whose elucidation through psychophysiological, phenomenological or ultrahuman procedures could enable us to define its essence and thus differentiate it from the other. Neither experience is a self-evident datum. Both are easily susceptible to critiques, either that they do not exist as natural categories, or else that they should more properly be described as something else—as the workings out of social exclusion in the case of mental illness, as cosmological understanding or mass hysteria in the case of spirituality. Neither, I would suggest, can be specified by physiology or ultrahuman interventions respectively, but rather through shared cultural meanings which in turn are experientially validated by the biosocial phenomena themselves. It is not that we need to exclude the possibility of concurrences in brain states, but rather that these cannot specify the meaning and experience of the phenomena.Note that I emphasize “experienced through cultural meanings,” not “influenced by” culture: I do not accept that psychophysiology can have any existence independent of the social world through which it occurs. The psychiatrists’ form/content distinction, an optimistic proxy for nature/culture (Birnbaum 1923; Schneider 1928) may remain a convenient heuristic device, but it has a curious, perhaps doubtful, intellectual history (see the Endnote following).Cross-cultural comparisons argue that local idioms which we might approximate to current Western notions of mental illness and religion are quite varied. And the validity of particular instances of both “spiritual experience” and “psychopathology” may be contested in any society. While the social consequences of a pattern may determine the approbation accorded to a pattern such that patterns recalling chronic schizophrenia [End Page 67] are regarded as a deficit (and here I agree with James [1902] and the two authors), they are not necessarily aligned to categories of physical illness, but may be seen as a spiritual failure or obstruction. Unsuccessful or inappropriate shamanic practice among Amerindian and circumpolar societies is the classic instance (Eliade 1964). Within Western societies, demonic possession may be read by doctors as mental illness. (It is just as much a “spiritual experience”: why introduce the religionist’s distinctions between different types of ultrahuman agency? Compare Maslow on “peak” experiences. The terms “spiritual” and “religious world view” are naturalized idioms of late Christianity rather than cross-culturally valid terms [Tambiah 1990].) But also the converse (Koch 1972). And this depends on our professional interests. Clearly, psychiatrists prefer to perceive the world in a psychopathological idiom, while religious enthusiasts and clergy may favor divine intercession or demonic possession; and a Christian psychiatry not surprisingly may claim to act as arbiter (Sims 1991). Any specific instance may be perceived differently by individuals in accordance with their interests and affiliations.The paper’s terminology—“spiritual psychotic experience,” “genuine spiritual experience”—is confusing in that it does imply realist, not conventional claims (cf. Endnote 1, Jackson and Fulford). It is not necessary. A less laden idiom—such as “statistically or normatively unusual brain states and their experiential correlates” (Littlewood 1993, 257)—may be just too unwieldy for repetition, but I would propose that at this level of detail we need rather four categories depending or not on concordance with (i) something close to psychiatry’s recognition of a major mental illness, and (ii) something like an anthropological notion of religious or spiritual experience (cf. Littlewood 1991):[Table 1]PsychosisReligious ExperiencePresentAbsentPresentABAbsentCDSo Jackson and Fulford’s three cases fall into group “A” if the PSE was scored... (shrink)

Body feedback is the proprioceptive feedback that denominates the afferent information from position and movement of the body to the central nervous system. It is crucial in experiencing emotions, in forming attitudes and in regulating emotions and behavior. This paper investigates effects of dynamic body feedback on affect and attitudes, focusing on the impact of movement rhythms with smooth vs. sharp reversals as one basic category of movement qualities. It relates those qualities to already explored effects of approach vs. avoidance (...) motor behavior as one basic category of movement shape. Studies 1 and 2 tested the effects of one of two basic movement qualities (smooth vs. sharp rhythms) on affect and cognition. The third study tested those movement qualities in combination with movement shape (approach vs. avoidance motor behavior) and the effects of those combinations on affect and attitudes toward initially valence-free stimuli. Results suggest that movement rhythms influence affect (studies 1 and 2), and attitudes (study 3), and moderate the impact of approach and avoidance motor behavior on attitudes (study 3). Extending static body feedback research with a dynamic account, findings indicate that movement qualities – next to movement shape – play an important role, when movement of the lived body is an independent variable. (shrink)

This volume describes the current "main contenders," including neo-Piagetian, neo-connectionist, neo-innatist and sociocultural models.

Drawing on mostly ignored texts, this book thoroughly reassesses Marx and Engels's engagement with theology.

Introduction to Engineering Ethics provides the background for discussion of the basic issues in engineering ethics. Emphasis is given to the moral problems engineers face in the corporate setting. It places those issues within a philosophical framework, and it seems to exhibit both their social importance and their intellectual challenge. The primary goal is to stimulate critical and responsible reflection on moral issues surrounding engineering practice and to provide the conceptual tools necessary for pursuing those issues. As per new ABET (...) 2000 guidelines, more and more introductory engineering courses cover engineering ethics as part of their instruction. Students preparing to function within the engineering profession need to be introduced to the basic issues in engineering ethics. This book places those issues within a wider philosophical framework than has been customary in the past and aims to stimulate critical and responsible reflection on the moral issues surrounding engineering practice and to provide the conceptual tools necessary for pursuing those issues. (shrink)

For courses in European Intellectual History. An exploration of the major issues in thought -- from the French Revolution to Structuralism and beyond.

There has been no informed or honest debate in North America over the issue of liberalized euthanasia. Despite thousands of newspaper stories, scores of learned academic articles, a handful of closely analyzed legal decisions, and hours of broadcast news and talk show imagery, a full discussion is yet to begin.

The world of disability theory is currently divided between those who insist it reflects a physical fact affecting life quality and those who believe disability is defined by social prejudice. Despite a dialogue spanning bioethical, medical and social scientific literatures the differences between opposing views remains persistent. The result is similar to a figure-ground paradox in which one can see only part of a picture at any moment. This paper attempts to find areas of commonality between the opposing camps, and (...) thus to rearrange the figures of the paradox at a fundamental level. The purpose is first to identify areas in which common ground can be achieved, and secondarily, to clarify the areas in which disagreement continues. While a general and unified theory of physical difference/disability is beyond the scope of this paper the result may advance that general goal. (shrink)

Une approche philosophique de la prière à des fins politiques est possible dans le cas où les deux substantifs sont mis en relais inconditionnel. Le premier élément responsable de cette filature des liens c’est la présence de l’autre. Prier et faire de la politique sont deux activités humaines trop humaines qui exigent l’ouverture à l’autre, pour l’autre comme pour l’édification de sa propre identité individuelle et collective. Comme les rites et les cultes, la liturgie, notamment la prière collective, a un (...) effet thérapeutique, et pédagogique, disons didactique et sociopolitique. Elle calme les esprits, la volonté, apaise l’angoisse et solidifie les liens sociaux. L'Eglise, par exemple, est née du rassemblement du peuple de Dieu en prière et c'est dans son sein que toute célébration liturgique trouve perpétuellement son accomplissement aussi bien que sa régénération dans l’invocation du nom du Christ-Vérité, Rédempteur, Fondateur, Roi et Prêtre. La présente étude sur « Vérité et Royauté » focalise l’attention sur l’essence même du politique qui se nourrit du religieux tout en lui fournissant gloire, pouvoir et moyens d’existence. (shrink)

Résumé Les affinités paradoxales que la recherche a pu pointer entre la « secte » philosophique épicurienne et la secte chrétienne dans les premiers siècles de notre ère sont rappelées puis examinées dans le détail du premier document attestant une rencontre précise entre les deux sectes, le récit des Actes des Apôtres qui montre Paul discutant avec les Épicuriens et les Stoïciens d’Athènes, puis nous restitue le discours de Paul devant l’Aréopage d’Athènes. Il apparaît que Paul se pose en philosophe (...) pour exposer sa doctrine en des termes jusqu’à un certain point compatibles avec une doctrine matérialiste voire polythéiste. (shrink)

The experimental philosophy movement advocates the use of empirical methods in philosophy. The methods most often discussed and in fact employed in experimental philosophy are appropriated from the experimental paradigm in psychology. But there is a variety of other (at least partly) empirical methods from various disciplines that are and others that could be used in philosophy. The paper explores the application of corpus analysis to philosophical issues. Although the method is well established in linguistics, there are only a few (...) tentative attempts of philosophers to utilise it. Examples are introduced and the merit of corpus analysis is compared to that of using general internet search engines and questionnaires for similar purposes. (shrink)

It seems natural to think that Carnapian explication and experimental philosophy can go hand in hand. But what exactly explicators can gain from the data provided by experimental philosophers remains controversial. According to an influential proposal by Shepherd and Justus, explicators should use experimental data in the process of ‘explication preparation’. Against this proposal, Mark Pinder has recently suggested that experimental data can directly assist an explicator’s search for fruitful replacements of the explicandum. In developing his argument, he also proposes (...) a novel aspect of what makes a concept fruitful, namely, that it is taken up by the relevant community. In this paper, I defend explication preparation against Pinder’s objections and argue that his uptake proposal conflates theoretical and practical success conditions of explications. Furthermore, I argue that Pinder’s suggested experimental procedure needs substantial revision. I end by distinguishing two kinds of explication projects, and showing how experimental philosophy can contribute to each of them. (shrink)

In this paper, we first briefly survey the main responses to the challenge that experimental philosophy poses to the method of cases, given the common assumption that the latter is crucially based on intuitive judgments about cases. Second, we discuss two of the most popular responses in more detail: the expertise defense and the mischaracterization objection. Our take on the expertise defense is that the available empirical data do not support the claim that professional philosophers enjoy relevant expertise in their (...) intuitive judgments about cases. In contrast, the mischaracterization objection seems considerably more promising than its largely negative reception has suggested. We argue that the burden of proof is thus on philosophers who still hold that the method of cases crucially relies on intuitive judgments about cases. Finally, we discuss whether conceptual engineering provides an alternative to the method of cases in light of the challenge from experimental philosophy. We argue that this is not clearly the case, because conceptual engineering also requires descriptive information about the concepts it aims to improve. However, its primarily normative perspective on our concepts makes it largely orthogonal to the challenge from experimental philosophy, and it can also benefit from the empirical methods of the latter. (shrink)

To those defining euthanasia as a battle for the principle of self-determination, persons seeking physician assisted death (PAD) are soldiers in the fight for patient autonomy. The reasons they seek it, or the potential of other, non-life-threatening interventions is less important than this principle: individuals have the right not only to choose death (suicide), but to be assisted in dying. They should not be second guessed or denied on the basis of another's distaste for that decision. This paper offers a (...) general review of deaths attributed to Dr. Jack Kevorkian's PAD practice in an attempt to answer two questions: Why do persons seek physician assisted death, and, to what extent does induced death seem, in retrospect, a reasonable and perhaps necessary medical response to specific patient complaints? (shrink)

The acceptance of military directives violating medical ethics and international covenants encouraged by the demonisation of the enemy by the US president in 2002 has effectively removed the right of medical personnel to refuse participation in internationally proscribed actionsMedicine and its traditional ethic of care is today a victim of the current conflict in Iraq and Afghanistan, its uniquely humanising mission rejected by US President George W Bush and his advisors. In denying the applicability of international agreements guaranteeing medicine’s ecumenical (...) role in this conflict they have transformed medicine into just another weapon of tactical significance. The result, predictable in retrospect, has been to make military physicians and nurses complicit—actively or passively—in what Litton calls an “atrocity-producing situation”, resulting in detainee or prisoner abuse.1From the first revelations of detainee torture in US detention camps to recent allegations of continued abuse , the focus of international attention has shifted from the US prosecution of low ranking, non-commissioned military personnel to the context in which the atrocities they committed occurred. “No one up the chain of command has ever been held accountable for what is in these horrifying images,” Center for Constitutional Rights Director Bill Goodman said of recently published photographs of 2004 prisoner torture and abuse.2 “The situation in several areas violates international law and conventions on human rights and torture,” said the UN Special Rapporteur on Torture following a 2006 investigation.3The denial of international law and convention involved the overt disavowal of covenants and conventions that for almost 150 years required medical personnel in the US military to act within the guidelines of a Hippocratic vision of medicine. To understand how fundamental this change has been requires a brief review of the history of medicine’s previously protected status and then a description of …. (shrink)

The 2015 Disneyland outbreak of measles in the US unequivocally brought to light what had been brewing below the surface for a while: a slow but steady decline in vaccination rates resulting in a rising number of outbreaks. This can be traced back to an increasing public questioning of vaccines by an emerging anti-vaccination movement. This article argues that, in the face of diminishing vaccination rates, childhood vaccinations should not be seen as part of the domain of parental choice but, (...) instead, as a non-negotiable legal obligation. The first part of the article formulates and defends two arguments in favour of unqualified mandatory childhood vaccination laws. First, government should not permit parents to put their children at avoidable risk of death and suffering; second, government should guard the common good of herd immunity to protect vulnerable persons. The second part rejects legal and pragmatic objections against such mandatory vaccination laws. (shrink)

A question between John Harris and I is the degree to which lessons may be learned, and insights gained, from a life distinguished by physical differences. He argues it as the “aborting Beethoven fallacy”, I insist on the evidence that what we learn from physical differences may be critical and life enhancing.

The critical role of surrogates—commonly if erroneously called “Informal caregivers”—has been generally ignored by clinical and bioethical literatures. While assumed to provide no more than ancillary support, these patient representatives directly or indirectly affect patient care to the extent they inhibit or facilitate both home-based care and patient decisions regarding treatment alternatives. Members of this group include relatives and neighbors who may or may not act in consort as advisors, assistants, care providers, and surrogate decisionmakers acting on the patient's behalf (...) with members of the medical community. Not only do they often possess a critical voice strongly influencing both patient care decisions and, after discharge, home care and rehabilitation, this paper argues they do so from a perspective that is often radically different from one endorsed by medical professionals. (shrink)

Although space limitations do not permit including all the responses received after the passing of David Thomasma, some representative expressions are included below. As these remembrances attest, Edmund Pellegrino spoke for all of us when he said at David's memorial service, “It has been said that we die only when forgotten; if so, David will live a long time. He remains a presence for his family, friends, collaborators, and all who met him.”.

In a special issue of this journal, a range of authors addressed the critical problem of difference in bioethics. To what extent do class, culture, ethnicity, and race affect the ethical decisions that patients and professionals must make in a medical context? Those arguing for an understanding of cultural influences in bioethical decisionmakingtypically argue from the perspective of individual case studies to demonstrate the importance of these social constructs. Others, like Erika Blacksher, however, worry that this approach will obscure the (...) uniqueness of individual decisionmakng patterns, allowing all persons of a single group to be aggregated as if their class, cultural construct, or religious affiliation were the single motive element in their medicolegal decisionmaking. There is, she cautions, a risk of misuse if a professional care provider reflexively assumes individual patient or surrogate reactions on the basis of ethnicity or culture. (shrink)

A recent issue of CambridgeQuarterlyofHealthcareEthics provides a fascinating look into the uncertainties surrounding the subject of human cloning. As Nelkin and Lindee point out, for example, the popular assumption is that this technology will lead to individual immortality. life everlasting for the deserving.considers the use of cloning for the replication of human individuals to be ethically unacceptable.”.

Contrary to received opinion among philosophers, psychologists, and neuroscientists, conscious duality as a principle of brain organization is neither incoherent nor demonstrably false. The present paper begins by reviewing the history of the theory and its anatomical basis and defending it against the claim that it rests upon an arbitrary decision as to what constitutes the biological substratum of mind or person.

Roland Reichenbach; On Irritation and Transformation: A–teleological Bildung and its Significance for the Democratic Form of Living, Journal of Philosophy of Ed.