Moral Discourse Research Articles

Power and Play: Investigating "License to Critique" in Teams' AI Ethics Discussions

Past work has sought to design AI ethics interventions--such as checklists or toolkits--to help practitioners design more ethical AI systems. However, other work demonstrates how these interventions may instead serve to limit critique to that addressed within the intervention, while rendering broader concerns illegitimate. In this paper, drawing on work examining how standards enact discursive closure and how power relations affect whether and how people raise critique, we recruit three corporate teams, and one activist team, each with prior context working with one another, to play a game designed to trigger broad discussion around AI ethics. We use this as a point of contrast to trigger reflection on their teams' past discussions, examining factors which may affect their ''license to critique'' in AI ethics discussions. We then report on how particular affordances of this game may influence discussion, and find that the hypothetical context created in the game is unlikely to be a viable mechanism for real world change. We discuss how power dynamics within a group and notions of ''scope'' affect whether people may be willing to raise critique in AI ethics discussions, and discuss our finding that games are unlikely to enable direct changes to products or practice, but may be more likely to allow members to find critically-aligned allies for future collective action.

Abortion is healthcare: In what sense?

In the wake of Dobbs versus Jackson Women's Health Organization, many nursing organizations asserted that “abortion is health care” and access to it must be protected. Such a phrase makes clear claims about the meanings of “health” and “care.” How one defines these terms gives decisive direction to how a nurse must practice regarding not just elective abortion but also myriad interventions that divide bioethicists, including gender affirmative care, cosmetic surgery, and euthanasia. We consider the issue of elective abortion to illustrate the nature of disputes about the scope and limits of professional nursing. We describe two competing intuitions about the nature of health care namely that health care is either for 1) health, objectively defined or 2) well-being, patient defined. We discuss how these intuitions lead to different understandings of the intelligibility of the phrase “abortion is health care” and the implications for ethical discourse within professional nursing.

Exploring teachers’ social-emotional competencies to navigate ethical dilemma discussions

ABSTRACT This study aimed to evaluate how teachers employed social-emotional competencies when discussing ethical dilemmas in various school contexts. In the first phase, the authors examined 20 scenarios arising from the day-to-day activities of the teachers and role-playing exercises they participated in during an annual course. During the second phase, we observed how social-emotional competencies were used during role-playing activities to resolve ethical dilemmas. There is evidence of individualistic and interpersonal aspects of emotional and social behaviour in this qualitative study, which indicates the application of social-emotional competencies. It can be argued that social-emotional competencies are theoretically justified when used by teachers to navigate ethical dilemma discussions. In practical terms, these findings can help to restructure social-emotional learning processes with simulations. Research limitations and future directions are also discussed.

AI-driven ethical issues in the development of personalised therapy for pediatric SIRS patients

Abstract Background Systemic Inflammatory Response Syndrome (SIRS) is a rare disease often presenting emergency. While the aetiology varies, current diagnostic criteria do not allow differentiation. Hopes are placed on OMICs research and development of Artificial intelligence (AI) algorithms for personalised disease management. Our report aims at identification and analysis of AI-driven ethical issues within the bigger ERA PerMed funded project of development of tailored immunotherapy for paediatric SIRS patients (TIPS) coordinated by Prof. Catharina Schütz from Technic University Dresden. Methods Systematic literature review followed by qualitative research methodology. Ten experts with different backgrounds were interviewed. Subsequent thematic analysis was performed by two independent researchers. Results Experts were on the opinion that AI can lead to a depart from individual approach in the medicine, as the physician may be induced to only act based on algorithms that are more or less representative (N = 2). Interviewees were aware that AI can lead to changes in the assessment of reality, as it is dependent on data quality (N = 4). AI-aided decision-making might be useful for special therapeutic situations, although it may not always capture the subtleties of individual situations (N = 2). Positive implications of AI were significantly more emphasised, though current frameworks were perceived as more limiting than enabling. Conclusions Personalised therapy is making its first steps while the ethical apprehensions has already been there with a strong emphasis on precautionary principle and resulting limitations on the application of AI-algorithms. The multifaceted nature of the AI-driven ethical issues in personalised medicine research requires an interdisciplinary discourse, strengthened ethics training of all professionals involved in the technology development and more active involvement of physicians in the shaping of AI. Key messages • AI algorithms promise therapeutic benefits, not achievable by other means, for specific categories of vulnerable pediatrics patients. • The multifaceted nature of the AI-driven ethical issues in personalised medicine research requires an interdisciplinary discourse and further ethics training of all stakeholders.

Decision-making under pressure: ethical considerations in COVID-19 policy making in Switzerland

Abstract Background Policy making and science were deeply intertwined during the COVID-19 pandemic, particularly in justifying health policy measures with ethical considerations being at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. This study aims to explore the ethical challenges in COVID-19-related political decision-making as perceived by Swiss policy makers and scientists involved in policy making, the role of ethics advice, and what can be learned for future public health crises. Methods Thirteen qualitative expert interviews were conducted with policy makers and scientists involved in COVID-19 policy decisions in Switzerland at regional and national levels. We used inductive thematic content analysis to analyse the interviews. Results Key ethical challenges included making trade-offs between common vs. individual good and economic welfare vs. health of the population, proportionality of policy measures, and public capacity to handle uncertainty. Opinions varied on the sufficiency of ethical considerations on the policy level. Constraints included a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, its overlap with law, too much focus on few topics such as vaccination-related questions, and individual character traits, such as the dominance of medical professionals over ethicists. While ethics support was deemed adequately present in the decision-making process, there were calls for more ethics training, involvement of the public in the discourse, and for accompanying communication to build trust among the population for the future. Conclusions The study offers empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland, providing a basis to enhance ethics support for future crises also in other countries. Key messages • This study uncovers the key ethical considerations in Swiss COVID-19 policy making, emphasizing constraints to sufficient ethical discussions. • Enhanced ethics training and greater public engagement is needed in future health crises to build trust and improve decision-making in future health crises.

Clinicians' Perspectives and an Ethical Analysis of Safer Supply Opioid Prescribing.

In British Columbia, Canada, many physicians providing care to individuals with high-risk opioid use disorder adopted safer supply (SS) opioid prescribing in the spring of 2020 with the goal of facilitating public health measures for COVID-19. This prescribing practice continued after measures were lifted. This study aimed to explore prescribers' perspectives following several years of local experience in prescribing SS opioids, primarily in the form of hydromorphone tablets, and to apply ethical concepts to explore current challenges and ongoing sources of provider distress. Addiction medicine SS prescribers participated in individual or small group semi-structured interviews. Each interview was transcribed and analysed for recurrent themes. Themes were then integrated into a narrative ethics discussion. Eleven addiction medicine physicians practicing in various settings within Vancouver participated in this study. Six themes were identified: clinical assessment, clinician distress, gaps in care, models of safer supply, research, and special populations. Ethical dilemmas in prescribing SS are identified and explored through a discussion of biomedical ethics principles and the physician role.

Posthuman Ethics and Distributed Agency in Kazuo Ishiguro’s Klara and the Sun

This article discusses posthuman ethics in Kazuo Ishiguro’s Klara and the Sun by employing the concept of distributed agency. By examining the AI protagonist Klara, the study argues that Ishiguro redefines agency as a networked phenomenon involving both human and non-human actors, challenging traditional anthropocentric ethical frameworks. The novel suggests that ethical considerations in a posthuman world must account for this distributed agency, where human and AI entities co-create ethical dynamics. This study concludes that Ishiguro’s work not only critiques the limitations of human-centered ethics but also prompts a reevaluation of moral responsibility in a technologically mediated world. By positioning Klara and the Sun within the discourse of posthuman ethics, the article contributes to contemporary discussions on the ethical implications of AI and the evolving nature of agency.

The brand behind the curtain: decoupling, recoupling and moral conflict in social media

Purpose Social media platforms have matured into significant arenas for moral conflict and often intense confrontation between brands and their consumers. This research aims to scrutinize the strategic development of a fresh brand entity deliberately detached from its morally compromised corporate parent, intended to reshape public perceptions and elude regulatory scrutiny. Design/methodology/approach Promoted as a center for transformative dialogue and innovation, Mission Winnow by Philip Morris is a novel example of a brand creating an entirely separate brand entity to provide sponsorship, and to associate itself with new brand values. This study employs a multisited netnography through which the posts and conversations on Mission Winnow’s platform and website hub are captured and interpreted, as well as the branded content and the free flows of consumers’ conversations generated around the brand on social media. Findings Findings reveal a broad interchange of moral controversy, acceptance and opposition discourses on social media. When consumers’ acceptance narratives gain traction, consumers extend their support toward the new brand entity, employing strategies that echo moral rationalization and decoupling. When resistance narratives dominate, consumers consciously draw connections between the decoupled brand and the parent brand’s immoral behavior. Originality/value This study expands upon prior research into brand activism and consumers’ moral reasoning toward controversial brands, linking the notion of brand decoupling to brand activism discourse and introducing key underexplored aspects like the power of imagery, linguistic creativity and nostalgia. Moreover, it presents significant implications for a more nuanced understanding of the important interrelationship of brand decoupling and recoupling on social media.

Antibiotic prescription, dispensing and use in humans and livestock in East Africa: does morality have a role to play?

Antimicrobial resistance (AMR) is a global threat to human and livestock health. Although AMR is driven by use of antimicrobials, it is often attributed to "misuse" and "overuse", particularly for antibiotics. To curb resistance, there has been a global call to embrace new forms of moral personhood that practice "proper" use, including prescription, dispensing and consumption of antimicrobials, especially antibiotics. This paper seeks to reflect on complex questions about how morality has become embedded /embodied in the AMR discourse as presented in the data collected on antimicrobial prescription, dispensing and use in human and livestock health in Tanzania, primarily focusing on antibiotics. This reflection is anchored on Jarrett Zigon's morality framework that is comprised of three dimensions of discourse; the institutional, public, and embodied dispositions. The data we use within this framework are derived from a qualitative study targeting human and animal health care service providers and community members in northern Tanzania. Data were collected through 28 in-depth interviews and ten focus group discussions and analysed through content analysis after translation and transcription. In addition, a review of the Tanzania's National Action Plans on antimicrobial resistance was conducted. Application of the framework demonstrates points of convergence and divergence in the institutional morality discourse articulated by the Tanzania National Action Plans, the public discourse and the embodied dispositions/ lived experiences of human and animal health care service providers and community members. We demonstrate that AMR is not just associated with "inappropriate" behaviour on the part of drug prescribers, dispensers, and users but also with shortcomings in health systems and service delivery. Antibiotic dispensing and use practices that may be associated with the development of AMR should not be viewed in isolation from the broader health context within which they occur.

The Impact of Generative Artificial Intelligence Technologies on Chinese Librarians' information Behavior and Ethical Discussion: An Empirical Study Based on a Small Sample

This study used a combination of questionnaires and interviews to survey 68 librarians in mainland China. The questionnaire was divided into three parts: (1) providing descriptive statistics of the interviewed librarians; (2) exploring the impact of generative technologies on librarians' information behaviour from work scenarios; (3) investigating librarians' concerns about ethics and strategies for coping with ethical challenges. The results show that generative AI technologies had a greater impact on information seeking, information encountering, and information using behaviours, and an insignificant impact on information sharing behaviours. In addition, the results of the study reflect that 67.65% of librarians showed a very high level of concern about privacy and security; 66.18% of them believed that the content generated by the tools needed further validation. The study also provided six recommendations from the perspective of libraries and librarians to address ethical challenges such as the spread of disinformation and bias.

The Presentation of Brain-computer Interfaces As Autonomy-enhancing Therapy Products

This paper explores the societal and individual acceptance of technologies for the human body, focusing on brain-computer interfaces (BCIs), particularly Elon Musk's Neuralink. BCIs promise a direct connection between the brain and computers. Their acceptance depends on general aspects such as feasibility and usefulness. In the case of brain implants, they should also not jeopardize the user's autonomy or have a dehumanizing effect. In the case of innovative technologies that are still in development, such as BCIs, acceptance depends largely on their public relation presentation. The article uses the case of Neuralink to analyze how new technologies for human bodies, and specifically BCIs, are presented as acceptable technologies. Analyzing Neuralink's public relations communication, the study reveals how the company constructs a vision of a plausible and desirable future, countering skepticism often associated with science fiction tropes. The article emphasizes the relevance of the categorization of BCIs and shows how the presentation of BCI as an autonomy-enhancing therapy product can positively influence the acceptability of the technology. By addressing key topics of ethical discourse, such as autonomy and identity, Neuralink attempts to create social acceptance for its innovative but controversial BCI technology. The results contribute to the understanding of the complicated dynamics between technological development, public relations, and societal values.

The Rise of Tech Ethics: Approaches, Critique, and Future Pathways

In this editorial to the Topical Collection “Innovation under Fire: The Rise of Ethics in Tech”, we provide an overview of the papers gathered in the collection, reflect on similarities and differences in their analytical angles and methodological approaches, and carve out some of the cross-cutting themes that emerge from research on the production of ‘Tech Ethics’. We identify two recurring ways through which ‘Tech Ethics’ are studied and forms of critique towards them developed, which we argue diverge primarily in their a priori commitments towards what ethical tech is and how it should best be pursued. Beyond these differences, we observe how current research on ‘Tech Ethics’ evidences a close relationship between public controversies about technological innovation and the rise of ethics discourses and instruments for their settlement, producing legitimacy crises for ‘Tech Ethics’ in and of itself. ‘Tech Ethics’ is not only instrumental for governing technoscientific projects in the present but is equally instrumental for the construction of socio-technical imaginaries and the essentialization of technological futures. We suggest that efforts to reach beyond single case-studies are needed and call for collective reflection on joint issues and challenges to advance the critical project of ‘Tech Ethics’.

Integrating ethics and democratic principles in chemistry education: a case study

Abstract This study presents a novel approach to integrating ethics and core values into chemistry education through the module “Culture of Democracy Through the Didactics of Chemistry.” Developed as part of a broader initiative aimed at educating future teachers for democracy and human rights, this module explores the ethical dimensions of chemical knowledge and its social and environmental impact. Utilizing the Council of Europe’s Reference Framework of Competences for Democratic Culture, it introduces pre-service teachers to concepts such as responsibility, human dignity, and the rule of law. The module involved six pre-service teachers and two schoolteacher-mentors. Key activities included student-led discussions, such as exploring personal responsibility and moral dilemmas in chemistry, exemplified by the Heinz dilemma, and engaging in discourse on the possibility of breaking a law for morally justifiable reasons to comprehend the delicate balance between legal duties and moral responsibilities. Through reflective exercises and collaborative learning, pre-service teachers engage critically with the ethical implications of their future profession. Initial feedback highlights the value of integrating ethical discussions into chemistry education, fostering deeper reflection and a sense of responsibility among pre-service teachers. The study provides a valuable framework for educators integrating ethics into science curricula, fostering responsible chemistry practice aligned with social values.

Anxiety among Medical Students Regarding Generative Artificial Intelligence Models: A Pilot Descriptive Study

Despite the potential benefits of generative artificial intelligence (genAI), concerns about its psychological impact on medical students, especially about job displacement, are apparent. This pilot study, conducted in Jordan during July–August 2024, aimed to examine the specific fears, anxieties, mistrust, and ethical concerns medical students harbor towards genAI. Using a cross-sectional survey design, data were collected from 164 medical students studying in Jordan across various academic years, employing a structured self-administered questionnaire with an internally consistent FAME scale—representing Fear, Anxiety, Mistrust, and Ethics—comprising 12 items, with 3 items for each construct. Exploratory and confirmatory factors analyses were conducted to assess the construct validity of the FAME scale. The results indicated variable levels of anxiety towards genAI among the participating medical students: 34.1% reported no anxiety about genAI‘s role in their future careers (n = 56), while 41.5% were slightly anxious (n = 61), 22.0% were somewhat anxious (n = 36), and 2.4% were extremely anxious (n = 4). Among the FAME constructs, Mistrust was the most agreed upon (mean: 12.35 ± 2.78), followed by the Ethics construct (mean: 10.86 ± 2.90), Fear (mean: 9.49 ± 3.53), and Anxiety (mean: 8.91 ± 3.68). Their sex, academic level, and Grade Point Average (GPA) did not significantly affect the students’ perceptions of genAI. However, there was a notable direct association between the students’ general anxiety about genAI and elevated scores on the Fear, Anxiety, and Ethics constructs of the FAME scale. Prior exposure to genAI and its previous use did not significantly modify the scores on the FAME scale. These findings highlight the critical need for refined educational strategies to address the integration of genAI into medical training. The results demonstrate notable anxiety, fear, mistrust, and ethical concerns among medical students regarding the deployment of genAI in healthcare, indicating the necessity of curriculum modifications that focus specifically on these areas. Interventions should be tailored to increase familiarity and competency with genAI, which would alleviate apprehensions and equip future physicians to engage with this inevitable technology effectively. This study also highlights the importance of incorporating ethical discussions into medical courses to address mistrust and concerns about the human-centered aspects of genAI. In conclusion, this study calls for the proactive evolution of medical education to prepare students for new AI-driven healthcare practices to ensure that physicians are well prepared, confident, and ethically informed in their professional interactions with genAI technologies.

Ethics Discourse in a Recurring Journal Format: A Proposal to Increase Ethics Discussion and Supports for Ethical Decision-Making

Ethics Discourse in a Recurring Journal Format: A Proposal to Increase Ethics Discussion and Supports for Ethical Decision-Making

Moving Towards Ethical-Practical Recommendations for Alzheimer's Disease Prediction: Addressing Interindividual, Interprofessional, and Societal Aspects.

Biomarkers for predicting Alzheimer's disease (AD) are advancing and their implementation in various healthcare systems is imminent. There is a need for ethical standards addressing information needs, socio-ethical concerns, and expectations of healthy and at-risk persons. We present an ethical approach that integrates different existing ethical frameworks and discussion of our empirical, cross-cultural findings in a multi-layered perspective by addressing three levels. The micro-level focuses on the communication between counseling professionals, persons at risk or in an early stage of dementia, and family members. The meso-level addresses interprofessional cooperation and exchange as a key element for best person-centered care. The macro-level considers public health promotion, the media, and public-funded research. This approach allows to address key ethical concepts including beneficence, non-maleficence, autonomy, informational self-determination, empowerment, and justice. Our contribution specifically examines the ethical challenges associated with AD prediction by means of biomarkers, based on insights from a German-Israeli comparison, and promotes a transdisciplinary discussion across different healthcare contexts. We propose a reflection on three levels to go beyond the clinical counseling context and to consider the rapidly evolving field of biomarkers in the coming years. Our ethical-practical recommendations should not be considered final, but rather procedural and will require continuous adaptation regarding culturally varying practices, new algorithms, meta-analyses, and re-evaluation of established recommendations.

HINDERING POLICY CHANGE: Under What Conditions Have Marriage Equality Policies Been Hampered in Latin America?

Since 1993, over a hundred bills have been submitted to National Congresses in Latin America, proposing a shift from restrictive to permissive marriage equality or same sex partnerships regulations. Only five of 19 countries have approved legal changes, and five have done so in courts. Extant research has focused on the explanatory factors of the positive policy changes, but few studies have examined cases of hampered policies. This article aims to identify under what conditions marriage equality, as a moral policy, has stalled in Latin America. It contributes to our understanding of policy non-decisions by offering a cross-national analysis and overcoming the limitations of “mirror” strategies that explain negative cases solely by the absence of factors associated with positive change. It highlights the importance of studying conditions conjunctionally. High levels of religiosity can significantly influence political decisions and may obfuscate religious cleavages, as left-wing parties also engage in moral discourse.

Public preferences regarding slow codes in critical care.

The term slow code refers to an intentional reduction in the pace or intensity of resuscitative efforts during a medical emergency. This can be understood as an intermediate level between full code (full resuscitation efforts) and no code (no resuscitation efforts) and serves as a symbolic gesture when intervention is considered medically futile. While some previous research acknowledges the slow code as an integral part of clinical practice, many ethicists have condemned the practice as dishonest and causing unnecessary pain for the patient. As the public's views on this issue have been largely absent from the discussion to date, two vignette experiments were performed to investigate their perceptions. The findings indicate that laypersons believe that slow codes are commonplace and often prefer them over a no code. While a full code was perceived as the standard approach and rated most ethical and least punishable, the present results do not support the widespread assumption that laypersons generally oppose slow codes, and this finding should inform ethical discussion and clinical practice.

THE PROBLEM OF VIOLENCE IN THE ANCIENT CULTURAL AND PHILOSOPHICAL TRADITION

The article attempts to trace the key points of view on the problem of violence in the philosophical views of the most famous thinkers of European antiquity. It is shown that in the system of social relations, violence in its pure form plays the role of the oldest and most primitive way of resolving the objectively existing conflict of interests of the participants of the social process. The nature of the conflict is rooted in the actual inequality of one subject to another, which finds its fullest expression in the inequality of the needs of individuals. It is substantiated that violence becomes a legal regulator of public interests when the extent of its use in society is recognized by the majority. It is shown that in the context of the development of ancient philosophy, the problem of violence was considered mainly in connection with the socio-political teachings of the classics of Greek philosophy, as well as within the framework of moral discourse. The phenomenon of violence was not tolerated by representatives of ancient philosophy as a separate problem worthy of consideration.

How Does Any One Film Explore Moral Problems Associated with Choice?

The Dark Knight (Christopher Nolan, 2008) focuses on Batman Bruce Wayne (Christian Bale): the dark knight, and Harvey Dent (Aaron Eckhart): the white knight as Gotham’s prosecutor, who work together to fight the criminal Joker (Heath Ledger). Harvey Dent was a prosecutor who defended the law, upheld justice, and put many criminal organizations in prison in Gotham. But in the process of confronting the Joker, Harvey Dent gradually became “Two-Face” who committed multiple murders. This ultimately left Batman with a difficult choice: whether to reveal the crimes committed by Harvey Dent and therefore release all the prisoners that led to Harvey’s arrest, or to take all the crimes upon Batman himself and disappear from Gotham, leaving the legal system established by Harvey Dent to continue to work in Gotham. Although Batman ultimately chose to take the blame for Harvey’s crimes, perpetuating the legal system established by Harvey Dent, and making Batman’s identity disappear as a result. However, Batman’s choice still raises many moral problems. Moral problems are related to the rights and wrongs of our actions, and how to distinguish morally right and morally wrong is “the primary question posed within ethics” (Karofsky & Litch, 1963, p. 145), in other words, moral philosophy is ethics. According to Downing and Saxton, “Ethics [ …] is a process of questioning” and “designates a way of responding to the encounter between the self and others” (Downing & Saxton, 2010, p. 3), this illustrates that a question about ethics is approached from different people or different perspectives. This also dictates that when it comes to an action as morally right or wrong, it must be approached from a different perspective. At the same time, “Film as a medium of “ethical experience: through which conflicting, clashing, or incompatible ideas, commitments, or beliefs can be revealed” (Sinnerbrink, 2016, p. 6). This explains that film, as a medium for the display of behaviour, can reveal the different characteristics present in the act, providing a space for the viewer to make a moral judgement. Therefore, this essay will base on Amy Karofsky and Mary M. Litch’s categorical discussion of ethics, specifically analysing the moral problems associated with Bruce Wayne’s choices at the end of The Dark Knight.