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Autonomy

Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Should we pay people to quit smoking or lose weight? Would paying them amount to coercion?  Is there a risk that if we start paying for healthy behaviour, its value will be corrupted? Is paying unhealthy people unfair to those who already lead healthy life styles? In this video interview (with Katrien Devolder),  Dr Rebecca… Read More »Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Cross Post: Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery

Guest Post by Nathan Hodson 

* Please note that this article is being cross-posted from the Journal of Medical Ethics Blog 

Research in robotics promises to revolutionize surgery. The Da Vinci system has already brought the first fruits of the revolution into the operating theater through remote controlled laparoscopic (or “keyhole”) surgery. New developments are going further, augmenting the human surgeon and moving toward a future with fully autonomous robotic surgeons. Through machine learning, these robotic surgeons will likely one day supersede their makers and ultimately squeeze human surgical trainees out of operating room.

This possibility raises new questions for those building and programming healthcare robots. In their recent essay entitled “Robot Autonomy for Surgery,” Michael Yip and Nikhil Das echoed a common assumption in health robotics research: “human surgeons [will] still play a large role in ensuring the safety of the patient.” If human surgical training is impaired by robotic surgery, however—as I argue it likely will be—then this safety net would not necessarily hold.

Imagine an operating theater. The autonomous robot surgeon makes an unorthodox move. The human surgeon observer is alarmed. As the surgeon reaches to take control, the robot issues an instruction: “Step away. Based on data from every single operation performed this year, by all automated robots around the world, the approach I am taking is the best.”

Should we trust the robot? Should we doubt the human expert? Shouldn’t we play it safe—but what would that mean in this scenario? Could such a future really materialize?

Read More »Cross Post: Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

By Brian D. Earp (@briandavidearp)

 

Four members of the Dawoodi Bohra sect of Islam living in Detroit, Michigan have recently been indicted on charges of female genital mutilation (FGM). This is the first time the US government has prosecuted an “FGM” case since a federal law was passed in 1996. The world is watching to see how the case turns out.

A lot is at stake here. Multiculturalism, religious freedom, the limits of tolerance; the scope of children’s—and minority group—rights; the credibility of scientific research; even the very concept of “harm.”

To see how these pieces fit together, I need to describe the alleged crime.

Read More »Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Video Series: Tom Douglas on Using Neurointerventions in Crime Prevention

Should neurointerventions be used to prevent crime? For example, should we use chemical castration as part of efforts to prevent re-offending in sex offenders? What about methadone treatment for heroin-dependent offenders? Would offering such interventions to incarcerated individuals involve coercion? Would it violate their right to freedom from mental interference? Is there such a right?… Read More »Video Series: Tom Douglas on Using Neurointerventions in Crime Prevention

Cross Post: Why you might want to think twice about surrendering online privacy for the sake of convenience

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Written by Carissa Veliz

DPhil Candidate in Philosophy, Uehiro Centre for Practical Ethics, University of Oxford

This article was originally published in The Conversation

Just a click away once you tick this too-long-to-read privacy agreement. Shutterstock

It is inconvenient to guard one’s privacy, and the better one protects it, the more inconvenience one must endure. Enjoying privacy, at a minimum, demands installing software to block tracking online, using long and different passwords for online services, remembering to turn off the WiFi and Bluetooth signals on your mobile phone when leaving the house, using cash, and so on.Read More »Cross Post: Why you might want to think twice about surrendering online privacy for the sake of convenience

Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

Guest Post by Philipp Kellmeyer

Imagine you had epilepsy and, despite taking a daily cocktail of several anti-epileptic drugs, still suffered several seizures per week, some minor, some resulting in bruises and other injuries. The source of your epileptic seizures lies in a brain region that is important for language. Therefore, your neurologist told you, epilepsy surgery – removing brain tissue that has been identified as the source of seizures in continuous monitoring with intracranial electroencephalography (iEEG) – is not viable in your case because it would lead to permanent damage to your language ability.

There is however, says your neurologist, an innovative clinical trial under way that might reduce the frequency and severity of your seizures. In this trial, a new device is implanted in your head that contains an electrode array for recording your brain activity directly from the brain surface and for applying small electric shocks to interrupt an impending seizure.

The electrode array connects wirelessly to a small computer that analyses the information from the electrodes to assess your seizure risk at any given moment in order to decide when to administer an electric shock. The neurologist informs you that trials with similar devices have achieved a reduction in the frequency of severe seizures in 50% of patients so that there would be a good chance that you benefit from taking part in the trial.

Now, imagine you decided to participate in the trial and it turns out that the device comes with two options: In one setting, you get no feedback on your current seizure risk by the device and the decision when to administer an electric shock to prevent an impending seizure is taken solely by the device.

This keeps you completely out of the loop in terms of being able to modify your behaviour according to your seizure risk and – in a sense – relegates some autonomy of decision-making to the intelligent medical device inside your head.

In the other setting, the system comes with a “traffic light” that signals your current risk level for a seizure, with green indicating a low, yellow a medium, and red a high probability of a seizure. In case of an evolving seizure, the device may additionally warn you with an alarm tone. In this scenario, you are kept in the loop and you retain your capacity to modify your behavior accordingly, for example to step from a ladder or stop riding a bike when you are “in the red.”

Read More »Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

In Praise of Ambivalence—“Young” Feminism, Gender Identity, and Free Speech

By Brian D. Earp (@briandavidearp)

Introduction

Alice Dreger, the historian of science, sex researcher, activist, and author of a much-discussed book of last year, has recently called attention to the loss of ambivalence as an acceptable attitude in contemporary politics and beyond. “Once upon a time,” she writes, “we were allowed to feel ambivalent about people. We were allowed to say, ‘I like what they did here, but that bit over there doesn’t thrill me so much.’ Those days are gone. Today the rule is that if someone—a scientist, a writer, a broadcaster, a politician—does one thing we don’t like, they’re dead to us.”

I’m going to suggest that this development leads to another kind of loss: the loss of our ability to work together, or better, learn from each other, despite intense disagreement over certain issues. Whether it’s because our opponent hails from a different political party, or voted differently on a key referendum, or thinks about economics or gun control or immigration or social values—or whatever—in a way we struggle to comprehend, our collective habit of shouting at each other with fingers stuffed in our ears has reached a breaking point.

It’s time to bring ambivalence back.Read More »In Praise of Ambivalence—“Young” Feminism, Gender Identity, and Free Speech

Why is chemical castration being used on offenders in some countries?

Written by Dr Jonathan Pugh
This article was originally published on The Conversation
The answer for some. Shutterstock

Following a horrific act of sexual violence against a 14-year-old girl, the president of Indonesia, Joko Widodo, recently signed a decree into law, which, among other things, authorised the death penalty for convicted child sex offenders, and also the use of chemical castration of such offenders.

The main justification cited by Widodo was that castration would act as a deterrent. But how do such interventions fit in the criminal justice system? Are they likely to be successful?Read More »Why is chemical castration being used on offenders in some countries?