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Review of Walter Glannon’s The Neuroethics of Memory: From Total Recall to Oblivion, Cambridge University Press, 2019 沃尔特·格兰农《记忆的神经伦理学:从全面回忆到遗忘》,剑桥大学出版社,2019
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-05-13 DOI: 10.1007/s12152-022-09495-x
E. Racine
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引用次数: 0
Deep Brain Stimulation for Parkinson’s Disease: Why Earlier Use Makes Shared Decision Making Important 帕金森病的脑深部刺激:为什么早期使用使共同决策变得重要
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-04-24 DOI: 10.1007/s12152-022-09496-w
Jaime Montemayor, H. Sarva, Karen Kelly-Blake, L. Cabrera
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引用次数: 1
The Illusion of Agency in Human–Computer Interaction 人机交互中的代理幻觉
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-04-05 DOI: 10.1007/s12152-022-09491-1
Michael Madary

This article makes the case that our digital devices create illusions of agency. There are times when users feel as if they are in control when in fact they are merely responding to stimuli on the screen in predictable ways. After the introduction, the second section of the article offers examples of illusions of agency that do not involve human–computer interaction in order to show that such illusions are possible and not terribly uncommon. The third and fourth sections of the article cover relevant work from empirical psychology, including the cues that are known to generate the sense of agency. The fifth section of the article shows that our devices are designed to deliver precisely those cues. In the sixth section, the argument is completed with evidence that users frequently use their smartphones without the sort of intentional supervision involved in genuine agency. This sixth section includes the introduction of Digital Environmental Dependency Syndrome (DEDS) as a possible way of characterizing extended use of the smartphone without genuine agency. In the final section of the article, there is a discussion of questions raised by the main claim, including suggestions for reducing occurrences of illusions of agency through software design.

这篇文章说明,我们的数字设备制造了代理幻觉。有时用户会觉得他们在控制,而实际上他们只是以可预测的方式对屏幕上的刺激做出反应。在介绍之后,文章的第二部分提供了一些不涉及人机交互的代理幻觉的例子,以表明这种幻觉是可能的,而且并不罕见。文章的第三和第四部分涵盖了经验心理学的相关工作,包括已知的产生代理感的线索。本文的第五部分表明,我们的设备被设计为精确地传递这些线索。在第六部分,论证以证据来完成,即用户经常在没有真正代理所涉及的那种有意监督的情况下使用智能手机。第六部分包括数字环境依赖综合症(DEDS)的介绍,作为一种可能的方式来描述在没有真正代理的情况下长时间使用智能手机。在文章的最后一部分,讨论了主要主张提出的问题,包括通过软件设计减少代理幻觉的出现的建议。
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引用次数: 1
Moral Neuroenhancement for Prisoners of War 战俘的道德神经增强
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-03-18 DOI: 10.1007/s12152-022-09482-2
Blake Hereth
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引用次数: 1
The Case of Hannah Capes: How Much Does Consciousness Matter? 汉娜·卡普斯案:意识有多重要?
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-03-15 DOI: 10.1007/s12152-022-09480-4
Lois Shepherd, C. William Pike, Jesse B. Persily, Mary Faith Marshall

A recent legal case involving an ambiguous diagnosis in a woman with a severe disorder of consciousness raises pressing questions about treatment withdrawal in a time when much of what experts know about disorders of consciousness is undergoing revision and refinement. How much should diagnostic certainty about consciousness matter? For the judge who refused to allow withdrawal of artificial nutrition and hydration, it was dispositive. Rather than relying on substituted judgment or best interests to determine treatment decisions, he ruled that withdrawal was categorically prohibited, even as he concluded that Hannah Capes was more likely than not in a permanent vegetative state. In many jurisdictions, his decision would likely be consistent with existing law. Evolving technological advances have demonstrated that biologically distinct diagnoses incorporated into state laws may be difficult to establish even under ideal conditions. We offer the Capes case for purposes of examining the consequences of enshrined legal distinctions between permanent vegetative state and other severe disorders of consciousness. Insistence on proof of the permanent absence of consciousness before treatment withdrawal is allowed fails to respect the rights of persons with disorders of consciousness. Even the well-established rights to treatment withdrawal for those in a permanent vegetative state may be in jeopardy if reform is not undertaken.

最近的一起法律案件涉及一名患有严重意识障碍的妇女的模糊诊断,在专家们对意识障碍的了解正在进行修订和完善的时候,这引发了关于停药的紧迫问题。关于意识的诊断确定性有多重要?对于拒绝允许撤回人工营养和水合作用的法官来说,这是决定性的。他没有依靠替代判断或最佳利益来决定治疗决定,而是明确禁止停药,尽管他得出结论,汉娜·卡普斯更有可能处于永久植物人状态。在许多司法管辖区,他的决定可能与现行法律一致。不断发展的技术进步表明,即使在理想的条件下,也很难将生物学上不同的诊断纳入州法律。我们提供卡普斯案例的目的是为了检查永久植物人状态和其他严重意识障碍之间的法律区别的后果。坚持要求在允许停药前提供永久性意识丧失的证据,这没有尊重意识障碍患者的权利。如果不进行改革,即使是那些处于永久植物人状态的人已经确立的停止治疗的权利也可能处于危险之中。
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引用次数: 0
Do Different Kinds of Minds Need Different Kinds of Services? Qualitative Results from a Mixed-Method Survey of Service Preferences of Autistic Adults and Parents 不同的人需要不同的服务吗?孤独症成人和父母服务偏好的混合方法调查的定性结果
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-03-11 DOI: 10.1007/s12152-022-09487-x
M. Ariel Cascio, Eric Racine

Many services can assist autistic people, such as early intervention, vocational services, or support groups. Scholars and activists debate whether such services should be autism-specific or more general/inclusive/mainstream. This debate rests on not only clinical reasoning, but also ethical and social reasoning about values and practicalities of diversity and inclusion. This paper presents qualitative results from a mixed-methods study. An online survey asked autistic adults and parents of autistic people of any age in Canada, the United States, Italy, France, and Germany what types of services they prefer (autism-specific, mixed-disability, or general/inclusive/mainstream). This paper presents the advantages and disadvantages of different service types, identified through inductive thematic coding and organized into higher-level themes focusing on clinical, structural, societal, interpersonal, and personal aspects of services. Autism-specific services were praised for addressing autism needs, helping clinically, and providing interpersonal benefits of others understanding autism; general services were praised for inclusion, helping clinically, community obligations and awareness, and social skills development. Looking at the interaction of these different aspects in respondent narratives nuances debates about autism-specificity, with a complex interplay between clinical, interpersonal, and societal aspects. Clinical and social perspectives are not necessarily separate and opposed, but intertwined based on different understandings of inclusion. Compared to parents, adults focused more on harm/safety issues, enjoyment, and stereotyping among other themes, attending to personal themes. These findings do not identify one best service type, but suggest that determining the right service in a given context may be informed by definitions of and goals about inclusion.

许多服务可以帮助自闭症患者,如早期干预、职业服务或支持团体。学者和积极分子争论这些服务是应该针对自闭症,还是更普遍/更包容/更主流。这场辩论不仅依赖于临床推理,还依赖于关于多样性和包容性的价值和实用性的伦理和社会推理。本文介绍了一种混合方法研究的定性结果。一项在线调查询问了加拿大、美国、意大利、法国和德国的自闭症成年人和自闭症患者的父母,他们喜欢哪种类型的服务(自闭症专用、混合残疾、或一般/包容性/主流)。本文介绍了不同服务类型的优缺点,通过归纳主题编码识别,并组织成更高层次的主题,重点关注服务的临床、结构、社会、人际和个人方面。针对自闭症的服务因满足自闭症需求、提供临床帮助以及为他人理解自闭症提供人际利益而受到称赞;一般事务因包容、临床帮助、社区义务和意识以及社会技能发展而受到赞扬。观察受访者叙述中这些不同方面的相互作用,就会发现关于自闭症特异性的争论存在细微差别,在临床、人际关系和社会方面存在复杂的相互作用。临床和社会观点不一定是分开和对立的,而是基于对包容的不同理解而交织在一起的。与父母相比,成年人更关注伤害/安全问题、享受和刻板印象等主题,关注个人主题。这些发现并没有确定一种最佳的服务类型,但表明在给定的上下文中确定正确的服务可能是由包含的定义和目标提供的。
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引用次数: 3
Neuroenhancements in the Military: A Mixed-Method Pilot Study on Attitudes of Staff Officers to Ethics and Rules 军事中的神经增强:参谋人员对道德和规则态度的混合方法试点研究
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-02-28 DOI: 10.1007/s12152-022-09490-2
Sebastian Sattler, Edward Jacobs, Ilina Singh, David Whetham, Imre Bárd, Jonathan Moreno, Gian Galeazzi, Agnes Allansdottir

Utilising science and technology to maximize human performance is often an essential feature of military activity. This can often be focused on mission success rather than just the welfare of the individuals involved. This tension has the potential to threaten the autonomy of soldiers and military physicians around the taking or administering of enhancement neurotechnologies (e.g., pills, neural implants, and neuroprostheses). The Hybrid Framework was proposed by academic researchers working in the U.S. context and comprises “rules” for military neuroenhancement (e.g., ensuring transparency and maintaining dignity of the warfighter). Integrating traditional bioethical perspectives with the unique requirements of the military environment, it has been referenced by military/government agencies tasked with writing official ethical frameworks. Our two-part investigation explored the ethical dimensions of military neuroenhancements with military officers – those most likely to be making decisions in this area in the future. In three workshops, structured around the Hybrid Framework, we explored what they thought about the ethical issues of enhancement neurotechnologies. From these findings, we conducted a survey (N = 332) to probe the extent of rule endorsement. Results show high levels of endorsement for a warfighter’s decision-making autonomy, but lower support for the view that enhanced warfighters would pose a danger to society after service. By examining the endorsement of concrete decision-making guidelines, we provide an overview of how military officers might, in practice, resolve tensions between competing values or higher-level principles. Our results suggest that the military context demands a recontextualisation of the relationship between military and civilian ethics.

利用科学技术最大限度地发挥人的效能往往是军事活动的一个基本特征。这通常关注于任务的成功,而不仅仅是参与其中的个人的福利。这种紧张关系有可能威胁到士兵和军医在服用或管理增强神经技术(如药片、神经植入物和神经假体)方面的自主权。混合框架是由在美国工作的学术研究人员提出的,包括军事神经增强的“规则”(例如,确保透明度和维护战士的尊严)。它将传统的生物伦理观点与军事环境的独特要求相结合,被负责编写官方伦理框架的军事/政府机构所引用。我们的调查分为两部分,探讨了军事神经增强的道德维度,其中包括军官——这些军官未来最有可能在这一领域做出决定。在围绕混合框架的三个研讨会中,我们探讨了他们对增强神经技术的伦理问题的看法。根据这些发现,我们进行了一项调查(N = 332),以探讨规则认可的程度。结果显示,对作战人员决策自主权的认可程度较高,但对增强作战人员服役后会对社会构成危险的观点的支持程度较低。通过审查对具体决策指导方针的认可,我们概述了军官如何在实践中解决相互竞争的价值观或更高层次原则之间的紧张关系。我们的研究结果表明,军事背景要求对军事和平民伦理之间的关系进行重新语境化。
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引用次数: 4
Correction to: Human Brain Organoids and Consciousness 更正:人脑类器官与意识
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-02-28 DOI: 10.1007/s12152-022-09493-z
T. Niikawa, Yoshiyuki Hayashi, J. Shepherd, Tsutomu Sawai
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引用次数: 1
Memory Modification and Authenticity: A Narrative Approach 记忆修饰与真实性:一种叙事方法
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-02-16 DOI: 10.1007/s12152-022-09489-9
Muriel Leuenberger
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引用次数: 7
Unlocking the Voices of Patients with Severe Brain Injury 解开严重脑损伤患者的声音
IF 1.4 4区 哲学 Q1 ETHICS Pub Date : 2022-02-11 DOI: 10.1007/s12152-022-09492-0
Andrew Peterson, Kevin Mintz, Adrian M. Owen

This paper critically examines whether patients with severe brain injury, who can only communicate through assistive neuroimaging technologies, may permissibly participate in medical decisions. We examine this issue in the context of a unique case study from the Brain and Mind Institute at the University of Western Ontario. First, we describe how the standard approach to medical decision making might problematically exclude patients with communication impairments secondary to severe brain injury. Second, we present a modified approach to medical decision making. We argue that this approach might warrant the inclusion of some patients with severe brain injury in low-stakes decisions, or to express preferences. Third, we present a model of supported decision making to address recalcitrant uncertainty. We conclude by suggesting that the modified approach to decision making and supported decision making might allow a patient with severe brain injury to participate in some medical decisions. Our analysis is provisional and has not yet been implemented in practice. Our discussion is intended to generate further debate on approaches to enhancing autonomy in patients with profound motor and cognitive impairments.

这篇论文批判性地研究了严重脑损伤患者,谁只能通过辅助神经成像技术进行交流,是否可以允许参与医疗决策。我们在西安大略大学大脑与心理研究所的一个独特案例研究的背景下研究这个问题。首先,我们描述了医疗决策的标准方法如何排除继发于严重脑损伤的沟通障碍患者。其次,我们提出了一种改进的医疗决策方法。我们认为,这种方法可能保证在低风险决策中纳入一些严重脑损伤患者,或表达偏好。第三,我们提出了一个支持决策模型来解决顽固性不确定性。我们的结论是,改进的决策方法和支持决策可能允许严重脑损伤患者参与一些医疗决策。我们的分析是暂时的,还没有付诸实践。我们的讨论旨在进一步讨论如何提高严重运动和认知障碍患者的自主性。
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引用次数: 4
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Neuroethics
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