Nathaniel Sharadin

Patient preference predictors take us from known demographic descriptors to unknown facts about patients’ preferences over treatment options. However, the use of PPPs to make treatment decisions on behalf of incapacitated patients faces an apparent normative problem: their use in certain contexts appears to involve treating patients paternalistically. In this paper, I consider whether PPPs can find a home in the context of military medicine. On the assumptions that military organizations sometimes permissibly treat their members paternalistically, I identify the specific circumstances in which PPPs can play a role in making treatment decisions on behalf of patients. I show that these circumstances are not only the natural home of PPPs, PPPs – or something very much like them – are precisely the sort of device required for it to be permissible to paternalistically override a patient’s expressed preferences.

The Morality First strategy for developing AI systems that can represent and respond to human values aims to first develop systems that can represent and respond to moral values. I argue that Morality First and other X-First views are unmotivated. Moreover, according to some widely accepted philosophical views about value, these strategies are positively distorting. The natural alternative, according to which no domain of value comes “first” introduces a new set of challenges and highlights an important but otherwise obscured problem for e-AI developers.