Pub Date : 2025-01-13DOI: 10.1017/S0963180124000781
Sankalpa Ghose, Matti Häyry, Peter Singer
This interview with Peter Singer AI serves a dual purpose. It is an exploration of certain-utilitarian and related-views on sentience and its ethical implications. It is also an exercise in the emerging interaction between natural and artificial intelligence, presented not as just ethics of AI but perhaps more importantly, as ethics with AI. The one asking the questions-Matti Häyry-is a person, in the contemporary sense of the word, sentient and self-aware, whereas Peter Singer AI is an artificial intelligence persona, created by Sankalpa Ghose, a person, through dialogue with Peter Singer, a person, to programmatically model and incorporate the latter's writings, presentations, recipes, and character qualities as a renowned philosopher. The interview indicates some subtle differences between natural perspectives and artificial representation, suggesting directions for further development. PSai, as the project is also known, is available to anyone to chat with, anywhere in the world, on almost any topic, in almost any language, at www.petersinger.ai.
这次对彼得·辛格的采访有双重目的。它是对某些功利主义和相关的感知观点及其伦理含义的探索。这也是自然智能和人工智能之间新兴互动的一种实践,不仅是人工智能的伦理,也许更重要的是,是人工智能的伦理。提出问题的人- matti Häyry-is是一个人,在当代意义上,有知觉和自我意识,而Peter Singer AI是一个人工智能角色,由Sankalpa Ghose创造,一个人,通过与Peter Singer的对话,以编程方式建模并结合后者的著作,演讲,食谱和著名哲学家的性格品质。访谈显示了自然视角与人工表征之间的一些微妙差异,为进一步的发展指明了方向。PSai,这个项目的另一个名字,在www.petersinger.ai上,任何人都可以在世界上任何地方,用几乎任何语言,就几乎任何话题进行聊天。
{"title":"Sentience and Beyond-A Representative Interview With Peter Singer AI.","authors":"Sankalpa Ghose, Matti Häyry, Peter Singer","doi":"10.1017/S0963180124000781","DOIUrl":"https://doi.org/10.1017/S0963180124000781","url":null,"abstract":"<p><p>This interview with Peter Singer AI serves a dual purpose. It is an exploration of certain-utilitarian and related-views on sentience and its ethical implications. It is also an exercise in the emerging interaction between natural and artificial intelligence, presented not as just ethics of AI but perhaps more importantly, as ethics with AI. The one asking the questions-Matti Häyry-is a person, in the contemporary sense of the word, sentient and self-aware, whereas Peter Singer AI is an artificial intelligence persona, created by Sankalpa Ghose, a person, through dialogue with Peter Singer, a person, to programmatically model and incorporate the latter's writings, presentations, recipes, and character qualities as a renowned philosopher. The interview indicates some subtle differences between natural perspectives and artificial representation, suggesting directions for further development. PSai, as the project is also known, is available to anyone to chat with, anywhere in the world, on almost any topic, in almost any language, at www.petersinger.ai.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1017/S0963180124000641
Grant Gillett
This is a personal narrative of my stroke and recovery experience, and the medical, psychological, and social circumstances surrounding it.
这是我对中风和康复经历的个人叙述,以及围绕它的医疗、心理和社会环境。
{"title":"Both Sides, Now: A Personal Stroke Recovery Journey.","authors":"Grant Gillett","doi":"10.1017/S0963180124000641","DOIUrl":"https://doi.org/10.1017/S0963180124000641","url":null,"abstract":"<p><p>This is a personal narrative of my stroke and recovery experience, and the medical, psychological, and social circumstances surrounding it.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1017/S0963180124000744
Lorenzo F Sempere
This essay focuses on the ethical considerations and implications of providing a universal multi-cancer screening test as the best approach to reduce societal cancer burden in a society with limited funds, resources, and infrastructure. With 1.9 million cancer diagnoses each year in the United States, with 86% of all cancers diagnosed in individuals over the age of 50, and with screening tools approved for only four cancer types (breast, cervical, colorectal, and lung cancer), it seems that a multi-cancer screening test to detect most cancer early that is easy to administer, and is accurate and cost-effective, would be worth considering. Whole-body magnetic resonance imaging and a multi-marker blood test are the two main technologies that we will discuss as a universal screening test. However, to understand and appreciate the societal and clinical breakthrough of such a screening test, we must first consider the accessibility and efficacy of current screening methods. We conclude with a closer examination of the ethical implications of implementing the Galleri test as a multi-cancer detection screening tool as adamantly advocated by the company that developed this blood-based test.
{"title":"Ethical Considerations and Implications of Multi-Cancer Early Detection Screening: Reliability, Access and Cost to Test and Treat.","authors":"Lorenzo F Sempere","doi":"10.1017/S0963180124000744","DOIUrl":"10.1017/S0963180124000744","url":null,"abstract":"<p><p>This essay focuses on the ethical considerations and implications of providing a universal multi-cancer screening test as the best approach to reduce societal cancer burden in a society with limited funds, resources, and infrastructure. With 1.9 million cancer diagnoses each year in the United States, with 86% of all cancers diagnosed in individuals over the age of 50, and with screening tools approved for only four cancer types (breast, cervical, colorectal, and lung cancer), it seems that a multi-cancer screening test to detect most cancer early that is easy to administer, and is accurate and cost-effective, would be worth considering. Whole-body magnetic resonance imaging and a multi-marker blood test are the two main technologies that we will discuss as a universal screening test. However, to understand and appreciate the societal and clinical breakthrough of such a screening test, we must first consider the accessibility and efficacy of current screening methods. We conclude with a closer examination of the ethical implications of implementing the Galleri test as a multi-cancer detection screening tool as adamantly advocated by the company that developed this blood-based test.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1017/S0963180124000446
Matthew Owen, Darren Hight, Anthony G Hudetz
Studies have shown that some covertly conscious brain-injured patients, who are behaviorally unresponsive, can reply to simple questions via neuronal responses. Given the possibility of such neuronal responses, Andrew Peterson et al. have argued that there is warrant for some covertly conscious patients being included in low-stakes medical decisions using neuronal responses, which could protect and enhance their autonomy. The justification for giving credence to alleged neuronal responses must be analyzed from various perspectives, including neurology, bioethics, law, and as we suggest, philosophy of mind. In this article, we analyze the warrant for giving credence to neuronal responses from two different views in philosophy of mind. We consider how nonreductive physicalism's causal exclusion problem elicits doubt about interpreting neural activity as indicating a conscious response. By contrast, such an interpretation is supported by the mind-body powers model of neural correlates of consciousness inspired by hylomorphism.
{"title":"Neural Voices of Patients with Severe Brain Injury?","authors":"Matthew Owen, Darren Hight, Anthony G Hudetz","doi":"10.1017/S0963180124000446","DOIUrl":"https://doi.org/10.1017/S0963180124000446","url":null,"abstract":"<p><p>Studies have shown that some covertly conscious brain-injured patients, who are behaviorally unresponsive, can reply to simple questions via neuronal responses. Given the possibility of such neuronal responses, Andrew Peterson et al. have argued that there is warrant for some covertly conscious patients being included in low-stakes medical decisions using neuronal responses, which could protect and enhance their autonomy. The justification for giving credence to alleged neuronal responses must be analyzed from various perspectives, including neurology, bioethics, law, and as we suggest, philosophy of mind. In this article, we analyze the warrant for giving credence to neuronal responses from two different views in philosophy of mind. We consider how nonreductive physicalism's causal exclusion problem elicits doubt about interpreting neural activity as indicating a conscious response. By contrast, such an interpretation is supported by the mind-body powers model of neural correlates of consciousness inspired by hylomorphism.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-22"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1017/S096318012400077X
Trevor M Bibler
Language is the primary technology clinical ethicists use as they offer guidance about norms. Like any other piece of technology, to use the technology well requires attention, intention, skill, and knowledge. Word choice becomes a matter of professional practice. The Brief Report offers clinical ethicists several reasons for rejecting the phrase "aggressive care." Instead, ethicists should consider replacing "aggressive care" with the adjacent concept of a "recovery-focused path." The virtues of this neologism include: the opportunity to set aside the emotion of "aggression," the phrase's accuracy when capturing the intention of the patient or their representative, and an unappreciated rhetorical force-and transparent logic-that arises when the patient's recovery is unlikely.
{"title":"Against the Phrase \"Aggressive Care\".","authors":"Trevor M Bibler","doi":"10.1017/S096318012400077X","DOIUrl":"https://doi.org/10.1017/S096318012400077X","url":null,"abstract":"<p><p>Language is the primary technology clinical ethicists use as they offer guidance about norms. Like any other piece of technology, to use the technology well requires attention, intention, skill, and knowledge. Word choice becomes a matter of professional practice. The Brief Report offers clinical ethicists several reasons for rejecting the phrase \"aggressive care.\" Instead, ethicists should consider replacing \"aggressive care\" with the adjacent concept of a \"recovery-focused path.\" The virtues of this neologism include: the opportunity to set aside the emotion of \"aggression,\" the phrase's accuracy when capturing the intention of the patient or their representative, and an unappreciated rhetorical force-and transparent logic-that arises when the patient's recovery is unlikely.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1017/S0963180124000768
Juan D Moreno-Ternero, Lars Peter Østerdal
The normative principle that every individual is equally entitled to continued life is a subject of debate in ethics, health economics and policy. We reconsider this principle in the context of setting priorities for healthcare interventions. When applied without restriction, the principle overlooks quality of life concerns entirely. However, we contend that it remains ethically relevant in certain situations, particularly when patients suffer from conditions unrelated to the therapeutic areas and treatments under consideration. Thus, we defend the principle while also emphasizing the need for its application within tight limits.
{"title":"Setting Limits for the Principle of Equal Entitlement to Continued Life.","authors":"Juan D Moreno-Ternero, Lars Peter Østerdal","doi":"10.1017/S0963180124000768","DOIUrl":"https://doi.org/10.1017/S0963180124000768","url":null,"abstract":"<p><p>The normative principle that every individual is equally entitled to continued life is a subject of debate in ethics, health economics and policy. We reconsider this principle in the context of setting priorities for healthcare interventions. When applied without restriction, the principle overlooks quality of life concerns entirely. However, we contend that it remains ethically relevant in certain situations, particularly when patients suffer from conditions unrelated to the therapeutic areas and treatments under consideration. Thus, we defend the principle while also emphasizing the need for its application within tight limits.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1017/S0963180124000756
Leonard M Fleck
A screening test for more than 50 cancers at earlier stages would strike many as a godsend. Such a test would promise, prima facie, to save 160,000 lives annually from a premature death from cancer, reduce the intensity of medical treatment, and reduce social costs. In brief, this is what is promised by the Galleri test. We will delineate those claims in greater detail and critically assess them from medical, economic, and ethical perspectives. We conclude, with many others, that this test lacks clinical validity and clinical utility. In addition, annual public funding of $100 billion for this test would be socially unaffordable; the opportunity costs would be unacceptable for both ethical and economic reasons. Further, the least well off with respect to cancer care would be made worse off if this test were publicly funded for everyone over the age of fifty.
{"title":"Multicancer Early Detection Screening Tools: Not Economically Efficient, Not Ethically Equitable, Marginally Medically Effective.","authors":"Leonard M Fleck","doi":"10.1017/S0963180124000756","DOIUrl":"https://doi.org/10.1017/S0963180124000756","url":null,"abstract":"<p><p>A screening test for more than 50 cancers at earlier stages would strike many as a godsend. Such a test would promise, prima facie, to save 160,000 lives annually from a premature death from cancer, reduce the intensity of medical treatment, and reduce social costs. In brief, this is what is promised by the Galleri test. We will delineate those claims in greater detail and critically assess them from medical, economic, and ethical perspectives. We conclude, with many others, that this test lacks clinical validity and clinical utility. In addition, annual public funding of $100 billion for this test would be socially unaffordable; the opportunity costs would be unacceptable for both ethical and economic reasons. Further, the least well off with respect to cancer care would be made worse off if this test were publicly funded for everyone over the age of fifty.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1017/S0963180124000690
Robert Burton
{"title":"That Is My Mind.","authors":"Robert Burton","doi":"10.1017/S0963180124000690","DOIUrl":"https://doi.org/10.1017/S0963180124000690","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1017/S0963180124000677
Robert A Burton
Delisted in the building directory, my name stripped from my cramped quarters just off the corpus callosum, I am impossible to find. In petitioning for official reinstatement, I have agreed to the humiliating lab investigations required for documentation. I have waved, howled, screamed, pleaded, and moaned into the latest scanners, and generally made a fool of myself. But researchers, after extensive soul-searching, and being unable to capture me as pixels and waveforms, have moved on to greener pastures. So be it. I accept official non-existence.
{"title":"Ghost in the Machine.","authors":"Robert A Burton","doi":"10.1017/S0963180124000677","DOIUrl":"https://doi.org/10.1017/S0963180124000677","url":null,"abstract":"<p><p>Delisted in the building directory, my name stripped from my cramped quarters just off the corpus callosum, I am impossible to find. In petitioning for official reinstatement, I have agreed to the humiliating lab investigations required for documentation. I have waved, howled, screamed, pleaded, and moaned into the latest scanners, and generally made a fool of myself. But researchers, after extensive soul-searching, and being unable to capture me as pixels and waveforms, have moved on to greener pastures. So be it. I accept official non-existence.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1017/S0963180124000689
Robert A Burton
While the Big Bang was cooling and the laws of physics were congealing, authorities remained undecided whether God would provide comfort against the expanding darkness. To answer the question, one planet was seeded with humans equipped with conviction receptors tweaked either to an absolute faith in or complete denial of God. If, after a suitable period of mingling between the two groups, believers prevailed over doubters, God would be established in the firmament. If not, God would be scrapped.
{"title":"Written in Stone.","authors":"Robert A Burton","doi":"10.1017/S0963180124000689","DOIUrl":"https://doi.org/10.1017/S0963180124000689","url":null,"abstract":"<p><p>While the Big Bang was cooling and the laws of physics were congealing, authorities remained undecided whether God would provide comfort against the expanding darkness. To answer the question, one planet was seeded with humans equipped with conviction receptors tweaked either to an absolute faith in or complete denial of God. If, after a suitable period of mingling between the two groups, believers prevailed over doubters, God would be established in the firmament. If not, God would be scrapped.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}