Decision Making

Abortion in Wonderland

By Charles Foster

 

 

Image: Heidi Crowter: Copyright Don’t Screen Us Out

Scene: A pub in central London

John: They did something worthwhile there today, for once, didn’t they? [He motions towards the Houses of Parliament]

Jane: What was that?

John: Didn’t you hear? They’ve passed a law saying that a woman can abort a child up to term if the child turns out to have red hair.

Jane: But I’ve got red hair!

John: So what? The law is about the fetus. It has nothing whatever to do with people who are actually born.

Jane: Eh?

That’s the gist of the Court of Appeal’s recent decision in the case of Aidan Lea-Wilson and Heidi Crowter (now married and known as Heidi Carter).  Continue reading

Fracking and the Precautionary Principle

By Charles Foster

Image> Leolynn11, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

The UK Government has lifted the prohibition on fracking.

The risks associated with fracking have been much discussed. There is widespread agreement that earthquakes cannot be excluded.

The precautionary principle springs immediately to mind. There are many iterations of this principle. The gist of the principle, and the gist of the objections to it, are helpfully summarised as follows:

In the regulation of environmental, health and safety risks, “precautionary principles” state, in their most stringent form, that new technologies and policies should be rejected unless and until they can be shown to be safe. Such principles come in many shapes and sizes, and with varying degrees of strength, but the common theme is to place the burden of uncertainty on proponents of potentially unsafe technologies and policies. Critics of precautionary principles urge that the status quo itself carries risks, either on the very same margins that concern the advocates of such principles or else on different margins; more generally, the costs of such principles may outweigh the benefits. 

Whichever version of the principle one adopts, it seems that the UK Government’s decision falls foul of it. Even if one accepts (controversially) that the increased flow of gas from fracking will not in itself cause harm (by way of climate disruption), it seems impossible to say that any identifiable benefit from the additional gas (which could only be by way of reduced fuel prices) clearly outweighs the potential non-excludable risk from earthquakes (even if that risk is very small).

If that’s right, can the law do anything about it? Continue reading

The Homeric Power of Advance Directives

By Charles Foster

[Image: Ulysses and the Sirens: John William Waterhouse, 1891: National Gallery of Victoria, Melbourne]

We shouldn’t underestimate Homer’s hold on us. Whether or not we’ve ever read him, he created many of our ruling memes.

I don’t think it’s fanciful (though it might be ambitious) to suggest that he, and the whole heroic ethos, are partly responsible for our uncritical adoption of a model of autonomy which doesn’t do justice to the sort of creatures we really are. That’s a big claim. I can’t justify it here. But one manifestation of that adoption is our exaggerated respect for advance directives – declarations made when one is capacitous about how one would like to be treated if incapacitous, and which are binding if incapacity supervenes if (in English law) the declaration is ‘valid and applicable.’ 1.

I suspect that some of this respect comes from the earliest and most colourful advance directive story ever: Odysseus and the Sirens. Continue reading

Peter Railton’s Uehiro Lectures 2022

Written by Maximilian Kiener

Professor Peter Railton, from the University of Michigan, delivered the 2022 Uehiro Lectures in Practical Ethics. In a series of three consecutive presentations entitled ‘Ethics and Artificial Intelligence’ Railton focused on what has become one the major areas in contemporary philosophy: the challenge of how to understand, interact with, and regulate AI.

Railton’s primary concern is not the ‘superintelligence’ that could vastly outperform humans and, as some have suggested, threaten human existence as a whole. Rather, Railton focuses on what we are already confronted with today, namely partially intelligent systems that increasingly execute a variety of tasks, from powering autonomous cars to assisting medical diagnostics, algorithmic decision-making, and more. Continue reading

Hang Onto Your Soul

By Charles Foster

Image: https://the-conscious-mind.com

I can’t avoid Steven Pinker at the moment. He seems to be on every page I read. I hear him all the time, insisting that I’m cosmically insignificant; that my delusional thoughts, my loves, my aspirations, and the B Minor Mass’s effect on me are merely chemical events. I used to have stuck up above my desk (on the principle that you should know your enemy), his declaration (as stridently irrational as the sermon of a Kentucky Young Earth Creationist): ‘A major breakthrough of the Scientific Revolution – perhaps its greatest breakthrough – was to refute the intuition that the Universe is saturated with purpose.’ 1

He tells me that everything is getting better. Has been getting better since the first eruption of humans into the world.2 That there’s demonstrable progress (towards what, one might ask, if the universe has no purpose? – but I’ll leave that for the moment). That there’s less violence; there are fewer mutilated bodies per capita. He celebrates his enlightenment by mocking my atavism: he notes that the Enlightenment came after the Upper Palaeolithic, and (for the law of progress admits no exceptions) concludes that that means that our Enlightenment age is better than what went before. Continue reading

New Publication: ‘Overriding Adolescent Refusals of Treatment’

Written by Anthony Skelton, Lisa Forsberg, and Isra Black

Consider the following two cases:

Cynthia’s blood transfusion. Cynthia is 16 years of age. She is hit by a car on her way to school. She is rushed to hospital. She sustains serious, life-threatening injuries and loses a lot of blood. Her physicians conclude that she needs a blood transfusion in order to survive. Physicians ask for her consent to this course of treatment. Cynthia is intelligent and thoughtful. She considers, understands and appreciates her medical options. She is deemed to possess the capacity to decide on her medical treatment. She consents to the blood transfusion.

Nathan’s blood transfusion. Nathan is 16 years of age. He has Crohn’s disease. He is admitted to hospital with lower gastrointestinal bleeding. According to the physicians in charge of his care, the bleeding poses a significant threat to his health and to his life. His physicians conclude that a blood transfusion is his best medical option. Nathan is intelligent and thoughtful. He considers, understands and appreciates his medical options. He is deemed to possess the capacity to decide on his medical treatment. He refuses the blood transfusion.

Under English Law, Cynthia’s consent has the power to permit the blood transfusion offered by her physicians. Her consent is considered to be normatively (and legally) determinative. However, Nathan’s refusal is not normatively (or legally) determinative. Nathan’s refusal can be overridden by consent to the blood transfusion of either a parent or court. These parties share (with Nathan) the power to consent to his treatment and thereby make it lawful for his physicians to provide it.

Continue reading

Exercise, Population Health and Paternalism

Written by Rebecca Brown

 

The NHS is emphatic in its confidence that exercise is highly beneficial for health. From their page on the “Benefits of exercise” come statements like:

“Step right up! It’s the miracle cure we’ve all been waiting for”

“This is no snake oil. Whatever your age, there’s strong scientific evidence that being physically active can help you lead a healthier and happier life”

“Given the overwhelming evidence, it seems obvious that we should all be physically active. It’s essential if you want to live a healthy and fulfilling life into old age”.

Setting aside any queries about the causal direction of the relationship between exercise and good health, or the precise effect size of the benefits exercise offers, it at least seems that the NHS is convinced that it is a remarkably potent health promotion tool. Continue reading

The Aliens Are Coming

By Charles Foster

It’s said that 2022 is going to be a bumper year for UFO revelations. Secret archives are going to be opened and the skies are going to be probed as never before for signs of extraterrestrial life.

This afternoon we might be presented with irrefutable evidence not just of life beyond the Earth, but of intelligences comparable in power and subtlety to our own. What then? Would it change our view of ourselves and the universe we inhabit? If so, how? Would it change our behaviour? If so how?

Much would depend, no doubt, on what we knew or supposed about the nature and intentions of the alien intelligences. If they seemed hostile, intent on colonising Planet Earth and enslaving us, our reactions would be fairly predictable. But what if the reports simply disclosed the existence of other intelligences, together with the fact that those intelligences knew about and were interested in us? Continue reading

Three Observations about Justifying AI

Written by:  Anantharaman Muralidharan, G Owen Schaefer, Julian Savulescu
Cross-posted with the Journal of Medical Ethics blog

Consider the following kind of medical AI. It consists of 2 parts. The first part consists of a core deep machine learning algorithm. These blackbox algorithms may be more accurate than human judgment or interpretable algorithms, but are notoriously opaque in terms of telling us on what basis the decision was made. The second part consists of an algorithm that generates a post-hoc medical justification for the core algorithm. Algorithms like this are already available for visual classification. When the primary algorithm identifies a given bird as a Western Grebe, the secondary algorithm provides a justification for this decision: “because the bird has a long white neck, pointy yellow beak and red eyes”. The justification goes beyond just a description of the provided image or a definition of the bird in question, and is able to provide a justification that links the information provided in the image to the features that distinguish the bird. The justification is also sufficiently fine grained as to account for why the bird in the picture is not a similar bird like the Laysan Albatross. It is not hard to imagine that such an algorithm would soon be available for medical decisions if not already so. Let us call this type of AI “justifying AI” to distinguish it from algorithms which try, to some degree or other, to wear their inner workings on their sleeves.

Possibly, it might turn out that the medical justification given by the justifying AI sounds like pure nonsense. Rich Caruana et al present a  case whereby asthmatics were deemed less at risk of dying by pneumonia. As a result, it prescribed less aggressive treatments for asthmatics who contracted pneumonia. The key mistake the primary algorithm made was that it failed to account for the fact that asthmatics who contracted pneumonia had better outcomes only because they tended to receive more aggressive treatment in the first place. Even though the algorithm was more accurate on average, it was systematically mistaken about one subgroup. When incidents like these occur, one option here is to disregard the primary AI’s recommendation. The rationale here is that we could hope to do better than by relying on the blackbox alone by intervening in cases where the blackbox gives an implausible recommendation/prediction. The aim of having justifying AI is to make it easier to identify when the primary AI is misfiring. After all, we can expect trained physicians to recognise a good medical justification when they see one and likewise recognise bad justifications. The thought here is that the secondary algorithm generating a bad justification is good evidence that the primary AI has misfired.

The worry here is that our existing medical knowledge is notoriously incomplete in places. It is to be expected that there will be cases where the optimal decision vis a vis patient welfare does not have a plausible medical justification at least based on our current medical knowledge. For instance, Lithium is used as a mood stabilizer but the reason why this works is poorly understood. This means that ignoring the blackbox whenever a plausible justification in terms of our current medical knowledge is unavailable will tend to lead to less optimal decisions. Below are three observations that we might make about this type of justifying AI.

Continue reading

Impersonality and Non-identity: A Response to Bramble

by Roger Crisp

Consider the following case, from David Boonin:

Wilma. Wilma has decided to have a baby. She goes to her doctor for a checkup and the doctor tells her that…as things now stand, if she conceives, her child will have a disability. . . that clearly has a substantially negative impact on a person’s quality of life. . . [but is not] so serious as to render the child’s life worse than no life at all. . . .[But] Wilma can prevent this from happening. If she takes a tiny pill once a day for two months before conceiving, her child will be perfectly healthy. The pill is easy to take, has no side effects, and will be paid for by her health insurance. . . .Wilma decides that having to take a pill once a day for two months before conceiving is a bit too inconvenient and so chooses to throw the pills away and conceive at once. As a result of this choice, her child is born [with the disability].

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