Andreas F. X. Wolkenstein

In the ethics of algorithms, a specifically epistemological analysis is rarely undertaken in order to gain a critique (or a defense) of the handling of or trust in medical black box algorithms (BBAs). This article aims to begin to fill this research gap. Specifically, the thesis is examined according to which such algorithms are regarded as epistemic authorities (EAs) and that the results of a medical algorithm must completely replace other convictions that patients have (preemptionism). If this were true, it would be a reason to distrust medical BBAs. First, the author describes what EAs are and why BBAs can be considered EAs. Then, preemptionism will be outlined and criticized as an answer to the question of how to deal with an EA. The discussion leads to some requirements for dealing with a BBA as an EA.

For almost two decades, the concept of epistemic injustice has been a point of reference to discuss the extent to which persons can be disadvantaged in their role as knowers and what morally relevant consequences might follow from such violations. This volume brings together contributions that have significantly shaped debates about the concept of epistemic injustice and its meaning, as well as recent contributions on its implications and possible consequences of situations of epistemic injustice. With contributions by David Coady | Katharina Eisenhut | Miranda Fricker | Orsolya Friedrich | Agomoni Ganguli-Mitra | Axel Gelfert | Hilkje C. Hänel | Julia A. Harzheim | Lars Leeten | José Medina | Ruben Sakowsky | Ela Sauerborn | Sebastian Schleidgen | Katharina Trettenbach | Verina Wild | Andreas Wolkenstein.

Definition of the problemThe upcoming reforms according to the specifications of the Master Plan 2020 provide for a competency-oriented restructuring of medical studies. This article aims to develop perspectives on how teaching ethics in medical studies can be more strongly oriented at building competencies. In this way, it pursues the goal of making the concept of competency more tangible for medical ethics and usable for the design of medical ethics education.ArgumentsWe understand competencies as dispositions for actions that enable problem solving. By transferring the concept of moral intelligence to the moral actions of physicians in patient care, we specify five ethical–moral competencies that must be present for morally appropriate, ethically reflected actions by future physicians: (1) the ability to form a professional moral compass, (2) the willingness to align oneself with professional ethical norms and values, (3) the ability to perceive moral dimensions of medical action, (4) the ability to make moral judgments based on ethical considerations about the right action, and (5) the willingness to realize ethically justified action. We illustrate their importance for teaching medical ethics using the example of teaching clinical ethics in medical studies.ConclusionOur conceptualization of moral–ethical competencies can be used to design concrete courses in a competency-oriented way. Our approach could be applied analogously to other areas of teaching ethics in health care.

Die anstehenden Reformen des Medizinstudiums nach den Vorgaben des Masterplans 2020 sehen eine kompetenzorientierte Neustrukturierung des Medizinstudiums vor. Dieser Artikel zielt darauf ab, Perspektiven aufzuzeigen, wie der Ethik-Unterricht im Medizinstudium noch stärker kompetenzorientiert ausgerichtet werden kann. Er verfolgt damit das Ziel, den Kompetenzbegriff für die Medizinethik greifbarer und für die Gestaltung der Medizinethik-Lehre nutzbar zu machen. Kompetenzen verstehen wir als Handlungsdispositionen, die zur Problemlösung befähigen. Durch Übertragung des Konzepts der moralischen Intelligenz auf das moralische Handeln von Ärzt:innen in der Patient:innenversorgung spezifizieren wir fünf ethisch-moralische Kompetenzen, die für moralisch angemessenes, ethisch reflektiertes professionelles Handeln angehender Ärzt:innen angelegt sein müssen: 1.) die Fähigkeit zur Ausgestaltung eines professionellen moralischen Kompasses, 2.) die Ausrichtungsbereitschaft an professionsethischen Normen und Werten, 3.) die Fähigkeit zur Wahrnehmung moralischer Dimensionen ärztlichen Handelns, 4.) die Fähigkeit zum moralischen Urteilen anhand ethischer Überlegungen über das richtige Handeln und 5.) die Realisierungsbereitschaft ethisch begründeten Handelns. Wir illustrieren ihre Bedeutung für die Medizinethik-Lehre am Beispiel des Unterrichts zur Ethik der Patient:innenversorgung im Medizinstudium. Unsere Konzeptualisierung ethisch-moralischer Kompetenzen kann dazu verwendet werden, konkrete Lehrangebote kompetenzorientiert auszugestalten. Unser Vorgehen kann analog auf andere Bereiche der Lehre von Ethik im Gesundheitswesen übertragen werden.

:Brain–computer interfaces are driven essentially by algorithms; however, the ethical role of such algorithms has so far been neglected in the ethical assessment of BCIs. The goal of this article is therefore twofold: First, it aims to offer insights into whether the problems related to the ethics of BCIs can be better grasped with the help of already existing work on the ethics of algorithms. As a second goal, the article explores what kinds of solutions are available in that body of scholarship, and how these solutions relate to some of the ethical questions around BCIs. In short, the article asks what lessons can be learned about the ethics of BCIs from looking at the ethics of algorithms. To achieve these goals, the article proceeds as follows. First, a brief introduction into the algorithmic background of BCIs is given. Second, the debate about epistemic concerns and the ethics of algorithms is sketched. Finally, this debate is transferred to the ethics of BCIs.

Self-driving cars currently face a lot of technological problems that need to be solved before the cars can be widely used. However, they also face ethical problems, among which the question of crash-optimization algorithms is most prominently discussed. Reviewing current debates about whether we should use the ethics of the Trolley Dilemma as a guide towards designing self-driving cars will provide us with insights about what exactly ethical research does. It will result in the view that although we need the ethics of the Trolley Dilemma as important input for self-driving cars, the route towards simply implementing it into automated cars is blocked.