Ethical Questions Research Articles

Sowing “seeds of trust”: How trust in normothermic regional perfusion is built in a continuum of care

Normothermic regional perfusion (NRP) is a promising technology to improve organ transplantation outcomes by reversing ischemic injury caused by controlled donation after circulatory determination of death. However, it has not yet been implemented in Canada due to ethical questions. These issues must be resolved to preserve public trust in organ donation and transplantation. This qualitative, constructivist grounded theory study sought to understand how those most impacted by NRP perceived the ethical implications. We interviewed 29 participants across stakeholder groups of donor families, organ recipients, donation and transplantation system leaders, and care providers. The interview protocol included a short presentation about the purpose of NRP and procedures in abdomen versus chest and abdomen NRP, followed by questions probing potential violations of the dead donor rule and concerns regarding brain reperfusion. The results present a grounded theory placing NRP within a trust-building continuum of care for the donor, their family, and organ recipients. Stakeholders consistently described both forms of NRP as an ethical intervention, but their rationales were predicated on assumptions that neurologic criteria for death had been met following circulatory death determination. Empirical validation of these assumptions will help ground the implementation of NRP in a trust-preserving way.

Melanoma in Pregnancy: A Shocking Report [ID 2683420

INTRODUCTION: This case describes the clinical course of a 25-year-old patient presenting for her 16-week obstetric check who was emergently diagnosed with stage 4 melanoma with metastasis to the oral cavity, liver, and skin. The young age of the patient and rapid advancement of the disease make this case worthy of attention. The study of this patient is designed to provide context and data for the actively growing body of literature on the potential relationship between pregnancy and melanoma, which is not currently understood. The goal of this case report is to contribute to the current literature, which is divided on whether there is a relationship between melanoma and pregnancy and whether a potential relationship is clinically relevant. METHODS: The hospital course of the patient was studied and written out in case report format. Patient consent was obtained to present her hospital course at conferences. RESULTS: Excisional biopsy of subcutaneous flank nodule was done, which confirmed diagnosis of stage 4 melanoma. The patient was started on chemotherapy, and treatment is ongoing. CONCLUSION: The case of a 25-year-old pregnant patient who was found to have stage 4 melanoma with metastasis has an important role in the ongoing investigation of the potential relationship between pregnancy and melanoma. This case is noteworthy because of the young age of the patient, the aggressive spread of the disease, and the ethical questions raised when treating cancer in a pregnant patient.

Reconstructing Paul Tillich's Ethics of Grace

This paper reconstructs Tillichian grace, analyzing its existential and ethical dimensions beyond traditional supernatural interpretations. It explores the historical lineage of Tillich's work, drawing parallels between ancient and medieval discourses on grace and Tillich's existential theology, with a particular emphasis on the theme of existential estrangement and its implications for moral development. In section one, I analyze Augustine's critique of Greek and Roman ethics, noting how his interpretations of sin and grace sought to address ethical, and not merely narrowly Christian theological, concerns. The paper then examines Martin Luther's shift towards a more personal apprehension of grace, setting the stage for Tillich's complex and nuanced understanding of justification. The strengths and ambiguities of Tillich's approach, along with its practical implications, are then critically evaluated. In conclusion, I advocate for the relevance of Tillich's conception of grace in modern secular ethical discourse, arguing that its emphasis on ethical intersubjectivity and the courage to embrace existential uncertainties provides a compassionate framework for addressing moral questions in our own time.

Well‐being in the context of Indigenous heritage management: A Hach Winik perspective from Metzabok, Chiapas, Mexico

AbstractIn this article, we examine what local well‐being means in the contexts of collaborative heritage management and national development in Mexico. Driven by the request of Lacandon Mayas (including the second author) who live in Puerto Bello Metzabok, Chiapas, Mexico, in 2018, we engaged in archeological consolidation and heritage management to promote local tourism and sustainable economic development. This collaboration raised a series of ethical and practical questions of how to engage with the Eurocentric project of development. Addressing these issues has become critical, as the Mexican president's signature infrastructure project, Tren Maya (Maya Train), is designed to promote nationwide development via increased cultural heritage tourism in Chiapas and southern Mexico. Through critical reflection on experiences with Metzabok community members, we address Eurocentrism and colonialism by enacting a Lacandon (i.e., Hach Winik) buen vivir. This form of well‐being is relational and communal and creates a common good that includes more‐than‐humans. Via this critical perspective, we argue that a decolonial project can use the tools of development as an initial step in creating Indigenous well‐being.

As governments fail us on climate change, courts are forced to consider ethical questions

As governments fail us on climate change, courts are forced to consider ethical questions

Ethical Considerations in Artificial Intelligence: Addressing Bias and Fairness in Algorithmic Decision-Making

The expanding use of artificial intelligence (AI) in decision-making across a range of industries has given rise to serious ethical questions about prejudice and justice. This study looks at the moral ramifications of using AI algorithms in decision-making and looks at methods to combat prejudice and advance justice. The study investigates the underlying causes of prejudice in AI systems, the effects of biased algorithms on people and society, and the moral obligations of stakeholders in reducing bias, drawing on prior research and real-world examples. The study also addresses new frameworks and strategies for advancing justice in algorithmic decision-making, emphasizing the value of openness, responsibility, and diversity in dataset gathering and algorithm development. The study concludes with suggestions for further investigation and legislative actions to guarantee that AI systems respect moral standards and advance justice and equity in the processes of making decisions. Keywords Ethical considerations, Artificial intelligence, Bias, Fairness, Algorithmic decision-making, Ethical implications, Ethical responsibilities, Stakeholders, Bias in AI systems, Impact of biased algorithms, Strategies for addressing bias, Promoting fairness, Algorithmic transparency.

Chatbot for Mental Health Treatment using Face Detection

The advent of chatbots may influence many treatment procedures in the medical and psychological fields. In particular, chatbots may be useful in many situations before and after medical procedures when patients are back at home. For example, while being in the preparation phase of a colonoscopy, a chatbot might answer patient questions more quickly than a doctor. Moreover, it is more and more discussed whether chatbots may be the first entry point for (urgent) medical questions instead of the consultation of a medical expert, as there exist already well-established algorithms for some of these situations. For example, if a new medical symptom occurs, a chatbot might serve as the first “expert” to relieve a patient’s condition. Note that the latter situation to use chatbots is mainly driven by the trend that patients often have to wait too long for appointments with a proper medical expert due to capacity problems of many healthcare systems. While the usage of supporting “at home actions” of patients with chatbot technologies is typically welcomed by medical experts, the use of this technology to “replace” them in their core competence, namely diagnosis and therapy, is generally seen highly critical. Apart from the domain side, it must be carefully considered what currently available chatbot technologies can do or cannot do. Moreover, it has also to be considered, how existing technologies can be established in highly critical medical and interdisciplinary fields with possible emergency situations (e.g., if a chatbot gets the message of a patient that indicates to commit suicide), involving ethical questions as well as questions of responsibility and accountability. Therefore, this work raises aspects that might be the basis for medical as well as technical experts to better work together for proper chatbot solutions. Thereby, the work at hand proposes an architecture that should serve as a reference for various medical and psychological scenarios. When using suitable technical solutions, we argue that chances emerge, which mitigate upcoming challenges significantly.

All too real metacapitalism: towards a non-dualist political ontology of metaverse

Current techno-utopian visions of metaverse raise ontological, ethical, and political questions. Drawing on existing literature on virtual worlds but also philosophically moving beyond that body of work and responding to political contexts concerning identity, capitalism, and climate, this paper begins to address these questions by offering a conceptual framework to think about the ontology of metaverse(s) in ways that see metaverse as real, experienced and shaping our experience, technologically constituted, and political. It shows how this non-dualist political-ontological approach helps to better identify, understand, predict, and evaluate some real and potentially dangerous ethically and politically relevant phenomena, including what I call ‘metacapitalism’’s environmentally problematic dream.

Should the Use of Adaptive Machine Learning Systems in Medicine be Classified as Research?

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

The survey of through-wall radar system

In contemporary times, optical cameras have garnered extensive usage, particularly in the realm of surveillance applications. Nevertheless, optical cameras possess certain limitations that hinder their ability to capture images efficiently in certain scenarios. For instance, they struggle to produce clear photographs in environments characterized by excessive brightness, darkness, or the use of flash. Additionally, the acquisition of high-definition portraits using optical cameras may raise ethical questions regarding potential violations of personal privacy. The detection of occluded objects by optical cameras poses a significant difficulty in the context of security applications. The topic of through-wall radar has gained significant interest due to its notable camouflage, as well as its advantageous features such as through-wall detection and resilience to optical causes. Researchers have successfully devised and developed several efficient through-wall radar systems that have shown to be helpful in several domains such as search and rescue operations, counter-terrorism efforts, medical applications, and urban warfare scenarios. This study provides an overview of prevalent through-wall radar technologies, conducts comparative evaluations, and explores the potential advancements and issues associated with this technology.

When Should Popular Views be Included in a Reflective Equilibrium?

AbstractIt has become increasingly common to conduct research on popular views on ethical questions. In this paper, we discuss when and to what extent popular views should be included in a reflective equilibrium process, thereby influencing normative theory. We argue that popular views are suitable for inclusion in a reflective equilibrium if they approximate considered judgments and examine some factors that plausibly contribute to the consideredness of popular views. We conclude that deliberation and familiarity contribute to the consideredness of popular views, whereas prevalence does not. Furthermore, we raise the “fair trial” objection: that expert deliberation on popular views might fail to respect the consideredness of these views. Eliciting views approximating considered judgments directly from participants is therefore preferable to refining popular views or treating them as “bare” intuitions in the reflective process. These conclusions have important implications for which research methods will likely elicit popular views suitable for a reflective equilibrium process. Research focusing on the prevalence of views is unlikely to yield popular views suitable for a reflective equilibrium, whereas deliberative and in-depth work is more promising.

Stewardship according to context: Justifications for coercive antimicrobial stewardship policies in agriculture and their limitations.

Antimicrobial resistance (AMR) is an urgent, global threat to public health. The development and implementation of effective measures to address AMR is vitally important but presents important ethical questions. This is a policy area requiring further sustained attention to ensure that policies proposed in National Action Plans on AMR are ethically acceptableand preferable to alternatives that might be fairer or more effective, for instance. By ethically analysing case studies of coercive actions to address AMR across countries, we can better inform policy in a context-specific manner. In this article, I consider an example of coercive antimicrobial stewardship policy in Canada, namely restrictions on livestock farmers' access to certain antibiotics for animal use without a vet's prescription. I introduce and analyse two ethical arguments that might plausibly justify coercive action in this case: the harm principle and a duty of collective easy rescue. In addition, I consider the factors that might generally limit the application of those ethical concepts, such as challenges in establishing causation or evidencing the scale of the harm to be averted. I also consider specifics of the Canadian context in contrast to the UK and Botswana as example settings, to demonstrate how context-specific factors might mean a coercive policy that is ethically justified in one country is not so in another.

Cross-border surrogacy and the European Convention on Human Rights: The Strasbourg Court caught between “fait accompli”, “ordre public”, and the best interest of the child

Surrogacy is a form of family creation that raises many medical, ethical, and legal questions. This article examines how the European Court of Human Rights (ECtHR) deals with the issue of cross-border surrogacy and its legal consequences in its recent case law. It will demonstrated that the Strasbourg Court has developed a nuanced case law that leaves it in the first place to the national authorities to deal with the complex issue of surrogacy, whereby it is nevertheless clear that further to the Strasbourg case law even if legislators rule out the possibility of surrogacy on their territory, they will have to find solutions to “‘regularise”’ the de facto situation of the child, taking into account its best interests.

Automation, agencies and aesthetics: the politics of data visualizations in configuring teachers’ expertise

ABSTRACT It is well-known that digital learning materials influence the classroom curriculum and didactics. At the same time, few studies examine the role of the data visualizations offered by digital learning materials. Data visualizations signpost the emergence of students as data subjects who can be observed and compared on a computer screen. They thus shape teachers’ socio-technical ways of seeing student learning and are likely to influence student assessments. Drawing inspiration from Science and Technology Studies (STS), this paper advances an analytical framework for eliciting the politics of data visualizations, focusing on automation, agencies, and aesthetics. The framework is exemplified through a case study of a popular Danish digital mathematics platform. In a concluding discussion, the paper considers the importance of addressing unsettled and ethical questions about the role of automated digital systems in teachers’ knowledge practices.

Barcode lipids for absolute quantitation of liposomes in ocular tissues

Lipid-based drug formulations are promising systems for improving delivery of drugs to ocular tissues, such as retina. To develop lipid-based systems further, an improved understanding of their pharmacokinetics is required, but high-quality in vivo experiments require a large number of animals, raising ethical and economic questions. In order to expedite in vivo kinetic testing of lipid-based systems, we propose a barcode approach that is based on barcoding liposomes with non-endogenous lipids. We developed and evaluated a liquid-chromatography-mass spectrometry method to quantify many liposomes simultaneously in aqueous humor, vitreous, and neural retina at higher than ±20% precision and accuracy. Furthermore, we showed in vivo suitability of the method in pharmacokinetic evaluation of six different liposomes after their simultaneous injection into the rat vitreal cavity. We calculated pharmacokinetic parameters in vitreous and aqueous humor, quantified liposome concentrations in the retina, and quantitated retinal distribution of the liposomes in the rats. Compared to individual injections of the liposome formulations, the barcode-based study design enabled reduction of animal numbers from 72 to 12. We believe that the proposed approach is reliable and will reduce and refine ocular pharmacokinetic experiments with liposomes and other lipid-based systems.

Legitimacy Revisited: Moral Power and Civil Disobedience

Abstract In Legitimacy: The Right to Rule in a Wanton World, I offer both a conceptual analysis of legitimacy, the power-liability view, and a substantive moral theory, the free group agency view. Here, I defend my account against three challenges brought by Kjarsten Mikalsen. First, though I argue that conceptual analysis should not prematurely close open moral questions, it is not my view that conceptual analysis must have no substantive implications. Second, though I acknowledge that free group agency ordinarily supports a moral duty to obey, it is a feature, not a bug, that my conceptual analysis is consistent with moral theories that disagree with my preferred moral theory. Third, I argue that Mikalsen’s proposed explanation of justified civil disobedience, which sees law in such cases as creating a moral claim-right that entails a merely presumptive duty, is less perspicuous than the explanation given by the power-liability view. Along the way, I emphasize that the distinction between felicitous moral power and justified causal power is as important as the distinction between moral liability and moral duty.

Hugh Lacey and values in contemporary science: era of technology and crises

This article provides an understanding of Hugh Lacey's ideas regarding the influence of values in contemporary science. We explore the interaction between scientific activity and values, fostering critical awareness of scientific practice and its impact on society. The aim is to fill gaps in the comprehension of cognitive, social, and ethical values, considering how they have been shaped by technological transformations and sociocultural crises. A comprehensive literature review examines Lacey's key tenets presented in works such as "Values and Scientific Activity 1 and 2" and Oliveira's "From Cognitive Science to Dialectic", as well as articles in scientific databases and communications with the philosopher in 2023. According to him, values and science should be intrinsically linked, provided there is impartiality in scientific assessments. This relationship does not compromise the ongoing pursuit of a robust understanding of the phenomena in the world. The results highlight the relevance of Lacey's perspectives on values in contemporary science, as in contexts such as transgenic research, which raises crucial ethical questions. The applications of such research can have profound impacts, highlighting the importance of ethics.

Navigating the ‘grey zone’: academic collaboration and research on/in Russia during geopolitical crisis

Russia’s illegal annexation of Crimea in 2014 and attack on Ukraine in 2022 have led to widespread sanctions being placed on Russia by the European Union, including sanctions related to academic cooperation. National governments, supranational bodies, science academies and research institutions as well as publishers have likewise formed policies suspending and restricting collaboration regarding Russia-related research. These policies are, however, not straight forward and there are many practical and ethical questions that individual researchers must ask themselves. At Finnish Geography Days 2023 in Joensuu, a panel was dedicated to discussing some of these questions. This article summarizes main themes discussed during the panel and sheds light on the multiple ways researchers experience and navigate the ‘grey zone’ of academic collaboration and research on/in Russia in the current geopolitical context. The article emphasizes the necessity of further discussing the effectiveness and impact of the sanctions and restrictions: Are they reasonable? Who benefits from them, and who suffers?

The Future of the Philosophy of Work

ABSTRACTWork has always been a significant source of ethical questions, philosophical reflection, and political struggle. Although the future of work in a sense is always at stake, the issue is particularly relevant right now, in light of the advent of advanced AI systems and the collective experience of the COVID‐19 pandemic. This has reinvigorated philosophical discussion and interest in the study of the future of work. The purpose of this survey article is to provide an overview of the emerging philosophical field that engages with the future of work, with a special focus on equality and justice, and to outline a research agenda that can help the field to develop further. Section 2 provides some historical context for the current surge in interest in the topic. Then, we discuss what work is and whether there is a philosophy of work (Section 3). The four main sub‐debates we then turn to concern the value of work (Section 4), distributive justice and work (Section 5), productive justice (Section 6), and institutional reforms prompted by changes in how work is organized (Section 7). The final section discusses the importance of the distinction between ideal and non‐ideal theory in philosophical investigations into the future of work.

Digitale werktuigkist met ethische overlegmethoden in de zorg

Digital toolbox with methods of ethical case deliberation in care This era is characterized by pluralism of values. Therefore, caregivers cannot find the answer to the question “How do I have to act to be a good caregiver?” any longer in old certainties, but in dialogue between everybody involved in a given care situation. It is necessary to hold this dialogue systematically. Especially in complex situations, moral case deliberation is, therefore, the most proper method. The essential point in each ethical deliberation is posing the accurate moral question, which doesn’t probe only into theoretical or practical knowhow, but interrogates what the persons involved in the given situation are permitted to do, must do or have to refrain from. There are a lot of different methods of ethical deliberation, but in principle, they all have the same basic structure consisting of 7 parts. Moral deliberation must always start from the facts that occur in a specific situation, but one must look beyond the bare facts. Humans essentially give meaning to the facts that happen in their lives. Ethical deliberation should especially give attention to this sense-making. In practice, moral deliberation is not always practicable due to the lack of time. Therefore, more compact methods of ethical deliberation were developed. In order to place all these methods at everyone’s disposal, 2 websites with a digital toolbox were created: one in Dutch and one in French.