Emilian Mihailov

The uptake of social science methods by bioethics significantly expanded its methodological spectrum, raising new theoretical, methodological, and practical questions. Recently, we are witnessing another trend, adding advanced data science methods to bioethics’ toolkit to aid, for example, in online data analysis, support scholarly writing, and inform clinical ethics. This article explores the emerging field of Digital Bioethics across its dimensions by analysing the tangled relationship between topics and methods, highlighting intersections between Digital Bioethics and Bioethics of the Digital, and advocating for a methods-based definition of the field. The use of advanced data science methods within bioethics must be interpreted in the context of the use of Artificial Intelligence (AI) in health care. At the same time, it presents unique opportunities and challenges. Defining, and thus demarcating, Digital Bioethics can create support for the new field but also requires navigating trade-offs. To do so, we take four kindred academic fields as points of comparison (Digital Humanities, Experimental Philosophical Bioethics, computational medicine and digitised biology) to analyse what each of them teaches for critically assessing and further developing Digital Bioethics. The article discusses potential pitfalls and concludes with recommendations on how the field can fully develop its potential to promote bioethical research and argument. Furthermore, the article discusses how a critical reflection of the use of AI methods within bioethics itself will also contribute to the ethical oversight of increasingly AI-driven branches of healthcare.

This paper maps the ethical concerns involved in using new technologies in the care of older persons by type of participant group and technology used. The study presents data from sixty-seven participants in total from three stakeholder groups (older persons, professional caregivers, and family caregivers) who relayed their opinions on three types of technologies: wearables, ambient sensors, and social assistive robots. The interview data collected was analysed using content analysis. Participants raised ethical concerns about user control, stigma, over-reliance on technology, isolation, deception, privacy breaches, and the replacement of human care. However, these concerns were not uniformly emphasized across participant groups, and not all concerns applied to each of the three technologies. Our findings revealed a reduced ethical sensitivity and preparedness for risk in the case of certain technologies. These ethical blind spots evident in our results pertained to privacy, stigma, and deception. With technologies continuously developing, such blind spots are a cause for concern.

The volume aims to capture a European gist of theoretical sensibilities, conceptual resources, and research interests, but not in an adversarial way, as opposed to American bioethics. The volume gathers contributions from European scholars as they collaborate and form a research network, drawing on a diversity of philosophical traditions and local knowledge, with the aim of debating universal bioethical problems. ABSTRACTING & INDEXING Contemporary Debates in Bioethics: European Perspectives is covered by the following services: Web of Science - Book Citation Index - Social Sciences & Humanities.

As the world population is rapidly aging, stakeholders must address the care of the elderly with great concern. Also, loss of dignity is often associated with aging due to dementia, mobility problems and diminished functional autonomy. However, dignity is a polysemic term that is deemed useless by some ethicists. To counter this claim, we propose four concepts to define it better and make use accurately of this notion. These are human dignity, dignity of identity, dignities of excellence and attributed dignities. Finally, we explain the importance of solicitude and human dignity in the care of the elderly. This will ensure the respect, friendship and dignity of the elderly in providing geriatric ethical care.

While social robots offer potential benefits like task assistance and companionship, their integration raises concerns about the erosion of human connection and the dehumanization of care. Through a qualitative study of older adults, family caregivers, and professional caregivers in Switzerland, we examined their perceptions of social robots and their understanding of the “human contact” in eldercare. Findings revealed the importance of emotional warmth, complex social interactions, and empathy. However, participants also acknowledged the potential benefits of such robots in specific tasks. We argue that the ethical assessment of care robots should focus on determining when robotic contact is desirable. By understanding the limitations of human connection and that humanness is a dual character concept (both descriptive and normative), we identify scenarios where social robots may offer advantages, such as providing care without judging and stimulate social engagement. Robotic “touch” can potentially complement human care in certain situations, preserving older persons’ dignity and improving their quality of life.

In this paper I develop a Kantian alternative to effective altruism, which I call enlightened beneficence. Firstly, I argue that a Kantian framework, based on the standard of universalizability and the ideal of humanity as an end in itself, is strongly committed to impartial beneficence. In fact, Kant anticipated the idea of the expanding circle of morality as an inclusive shift toward a point of view that is universally impartial. Secondly, I propose a distinction between absolute effectiveness, aligned with utilitarian maximization, and relative effectiveness, which focuses on optimizing outcomes within given constraints and is integrated in a Kantian framework that combines value pluralism with procedural monism. I argue that while consequence evaluation is contentious at a foundational level in Kantian ethics, it is inherent in fulfilling the imperfect duty of beneficence. Kant’s practical considerations about effective aid reflect a concern for impact and evidence-based decision-making. In the third section, I will illustrate how a Kantian approach broadens the scope of global aid to include interventions that effectively improve human agency, not just people’s welfare. Finally, I argue that the intellectual sources of using reason and evidence to improve society lie in the Enlightenment movement and the rise of experimental social sciences. Enlightened beneficence can overcome some of the limitations of effective altruism by focusing on rational compassion rather than strict calculations of lives saved.

The debate about how neurotechnologies impact authenticity has focused on two inter-related dimensions: self-discovery and self-creation. In this paper, we develop a broader framework that includes the experimental and relational dimensions of authenticity, both understood as decisive for shaping one’s narrative identity. In our view, neurointerventions that alter someone’s personality traits will also impact her very own self-understanding across time. We argue that experimental authenticity only needs a minimum conception of narrative coherence of the self and that reversibility should remain a key feature in the ethical assessment of neurotechnologies. The relational dimension of authenticity derives from the fact that a process of self-constitution is never a solitary business. The significant others act not just as subsequent judges of one’s life decisions, but as real co-authors of one’s self. We discuss relevant cases in which others are actively contributing to the meaning-making process, as to the direction one’s life is taking. We also claim that the experimental and the relational dimensions of authenticity should aim to correct each other. The relational dimension introduces socially approved standards as well as limitations to the array of available possibilities of self-fashioning or human enhancement. The experimental side enables us to avoid confusing one’s personal identity with a social and narrative construct that only bears the mark of social pressure and conformism.

This paper explores the ways in which health care professionals, family carers, and older persons expressed attitudes and opinions on using Paro, a social robot designed to stimulate patients with dementia. Thereafter, we critically evaluate existing prejudicial views toward Paro users to provide recommendations for its future use. Using an exploratory qualitative interview method, we recruited a total of 67 participants in Switzerland. They included 23 care professionals, 17 family carers, and 27 older persons. Data obtained were analyzed thematically. Study findings present general agreement that Paro is an appealing and beneficial social robot, but it is not a tool that everyone feels comfortable with. Because it is perceived as “child play,” it would be demeaning for competent adults to play with such things. Consequently, Paro is appropriate only for persons with dementia. These findings brought forth ethical concerns about deception, infantilization, and respecting older persons' dignity. The idea of who is an appropriate Paro user led to our discussions on predicting future Paro users. The meaning of using social robotics in nursing homes can be conditioned by a rigid interpretation of adulthood and playful behavior. To protect future selves when one is living with dementia from prejudices, it may be useful for older persons and their loved ones to plan their future care situations to ensure that they are treated in accordance with their delineated decisions.

As the world population is rapidly aging, stakeholders must address the care of the elderly with great concern. Also, loss of dignity is often associated with aging due to dementia, mobility problems and diminished functional autonomy. However, dignity is a polysemic term that is deemed useless by some ethicists. To counter this claim, we propose four concepts to define it better and make use accurately of this notion. These are human dignity, dignity of identity, dignities of excellence and attributed dignities. Finally, we explain the importance of solicitude and human dignity in the care of the elderly. This will ensure the respect, friendship and dignity of the elderly in providing geriatric ethical care.

The integration of normative analysis with empirical data often remains unclear despite the availability of many empirical bioethics methodologies. This paper sought bioethics scholars’ experiences and reflections of doing empirical bioethics research to feed these practical insights into the debate on methods. We interviewed twenty-six participants who revealed their process of integrating the normative and the empirical. From the analysis of the data, we first used the themes to identify the methodological content. That is, we show participants’ use of familiar methods explained as “back-and-forth” methods (reflective equilibrium), followed by dialogical methods where collaboration was seen as a better way of doing integration. Thereafter, we highlight methods that were deemed as inherent integration approaches, where the normative and the empirical were intertwined from the start of the research project. Second, we used the themes to express not only how we interpreted what was said but also how things were said. In this, we describe an air of uncertainty and overall vagueness that surrounded the above methods. We conclude that the indeterminacy of integration methods is a double-edged sword. It allows for flexibility but also risks obscuring a lack of understanding of the theoretical-methodological underpinnings of empirical bioethics research methods.

We propose to expand the conversation around moral enhancement from direct brain-altering methods to include technological means of modifying the environments and media through which agents can achieve moral improvement. Virtual Reality (VR) based enhancement would not bypass a person’s agency, much less their capacity for reasoned reflection. It would allow agents to critically engage with moral insights occasioned by a technologically mediated intervention. Users would gain access to a vivid ‘experience machine’ that allows for embodied presence and immersion in a virtual world that meaningfully replicates relevant aspects of real life. We explore how VR can train empathy and foster moral growth in complex ways that would be inaccessible even for traditional moral education. Virtual Reality Perspective Taking is a unique medium for making empathy more reflective.

Should the development of pharmacological cognitive enhancers raise worries about doping in cognitively demanding activities? In this paper, we argue against using current evidence relating to enhancement to justify a ban on cognitive enhancers using the example of chess. It is a mistake to assume that enhanced cognitive functioning on psychometric testing is transferable to chess performance because cognitive expertise is highly complex and in large part not merely a function of the sum specific sub-processes. A deeper reason to doubt that pharmacological cognitive enhancers would be as significant in mind sports is the misleading parallel with physical enhancement. We will make the case that cognitive performance is less mechanical in nature than physical performance. We draw lessons from this case example of chess for the regulation of cognitive enhancement more generally in education and the professions. Premature regulation runs the risk of creating a detrimental culture of suspicion that ascribes unwarranted blame.

In this paper we develop test cases to adjudicate between dual-process and the causal mapping explanations of order effects. Using dilemmas with minimized emotional force, we explore new conditions for order effects to occur. Overall, the results support causal model theory. We produced novel evidence that order effects extend not only to cases with low emotional engagement, but also to specialized judgments about whether an action violates a rule. However, when objects are sacrificed instead of persons the order effect either disappears or becomes symmetrical, contrary to previous theorizing that it is an asymmetrical transfer effect. Causal model theory needs to be developed to include interplays between the moral status of sacrificed entities and computational models of causal mapping. Symmetric order effects remain a puzzle, motivating future research. Though we do not know how to explain them yet, we discuss how symmetric order effects can influence policy decision making.

Moral outrage is often characterized as a corrosive emotion, but it can also inspire collective action. In this article we aim to deepen our understanding of the dual nature of online moral outrage which divides people and contributes to inclusivist moral reform. We argue that the specifics of violating different types of moral norms will influence the effects of moral outrage: moral outrage against violating harm-based norms is less antagonistic than moral outrage against violating loyalty and purity/identity norms. We identify which features of social media platforms shape our moral lives. Connectivity, omniculturalism, online exposure, increased group identification and fostering what we call “expressionist experiences”, all change how moral outrage is expressed in the digital realm. Finally, we propose changing the design of social media platforms and raise the issue of moral disillusion when ample moral protest in the online environment does not have the expected effects on the offline world.

BackgroundThis is the first qualitative study to investigate how researchers, who do empirical work in bioethics, relate to objectives of empirical research in bioethics (ERiB). We explore reasons that make some objectives more acceptable, while others are deemed less acceptable.MethodsUsing qualitative exploratory study design, we interviewed bioethics researchers, who were selected to represent different types of scholars working in the field. The interview data of 25 participants were analyzed in this paper using thematic analysis. ResultsFrom the eight objectives presented to the study participants, understanding the context of a bioethical issue and identifying ethical issues in practice received unanimous agreement. Participants also supported other objectives of ERiB but with varying degrees of agreement. The most contested objectives were striving to draw normative recommendations and developing and justifying moral principles. The is-ought gap was not considered an obstacle to ERiB, but rather a warning sign to critically reflect on the normative implications of empirical results.ConclusionsOur results show that the most contested objectives are also the more ambitious ones, whereas the least contested ones focus on producing empirical results. The potential of empirical research to be useful for bioethics was mostly based on the reasoning pattern that empirical data can provide a testing ground for elements of normative theory. Even though empirical research can inform many parts of bioethical inquiry, normative expertise is recommended to guide ERiB. The acceptability of ambitious objectives for ERiB boils down to finding firm ground for the integration of empirical facts in normative inquiry.

The debate about how neurotechnologies impact authenticity has focused on two inter-related dimensions: self-discovery and self-creation. In this paper, we develop a broader framework that includes the experimental and relational dimensions of authenticity, both understood as decisive for shaping one’s narrative identity. In our view, neurointerventions that alter someone’s personality traits will also impact her very own self-understanding across time. We argue that experimental authenticity only needs a minimum conception of narrative coherence of the self and that reversibility should remain a key feature in the ethical assessment of neurotechnologies. The relational dimension of authenticity derives from the fact that a process of self-constitution is never a solitary business. The significant others act not just as subsequent judges of one’s life decisions, but as real co-authors of one’s self. We discuss relevant cases in which others are actively contributing to the meaning-making process, as to the direction one’s life is taking. We also claim that the experimental and the relational dimensions of authenticity should aim to correct each other. The relational dimension introduces socially approved standards as well as limitations to the array of available possibilities of self-fashioning or human enhancement. The experimental side enables us to avoid confusing one’s personal identity with a social and narrative construct that only bears the mark of social pressure and conformism.

To capture genuine utilitarian tendencies, (Kahane et al., Psychological Review 125:131, 2018) developed the Oxford Utilitarianism Scale (OUS) based on two subscales, which measure the commitment to impartial beneficence and the willingness to cause harm for the greater good. In this article, I argue that the impartial beneficence subscale, which breaks ground with previous research on utilitarian moral psychology, does not distinctively measure utilitarian moral judgment. I argue that Kantian ethics captures the all-encompassing impartial concern for the well-being of all human beings. The Oxford Utilitarianism Scale draws, in fact, a point of division that places Kantian and utilitarian theories on the same track. I suggest that the impartial beneficence subscale needs to be significantly revised in order to capture distinctively utilitarian judgments. Additionally, I propose that psychological research should focus on exploring multiple sources of the phenomenon of impartial beneficence without categorizing it as exclusively utilitarian.

Parents frequently attempt to shield their children from distressing prognostic information. Pediatric oncology providers sometimes follow parental request for non-disclosure of prognostic information to children, invoking what we call the stability of the family argument. They believe that if they inform the child about terminal prognosis despite parental wishes, cohesion and family structure will be severely hampered. In this paper, we argue against parental request for non-disclosure. Firstly, we present the stability of the family argument in more detail. We, then, set out the (conceptual, legal, systemic) entitativity of the family and the kind of value the stability of the family argument assumes, before we set on to critically evaluate the argument. Our analysis shows that disclosure of prognostic information to children does not necessarily destabilize the family to a greater extent than non-disclosure. In fact, a systemic perspective suggests that mediated disclosure is more likely to result in a (long-term) stability of the family than non-disclosure. It is in the interest of the family to resist the initial aversive reaction to delivering bad news. In the final part, we draw a set of recommendations on how to facilitate decision-making in face of parental request for non-disclosure.

Despite the promise to boost human potential and wellbeing, enhancement drugs face recurring ethical scrutiny. The present studies examined attitudes toward cognitive enhancement in order to learn more about these ethical concerns, who has them, and the circumstances in which they arise. Fairness-based concerns underlay opposition to competitive use—even though enhancement drugs were described as legal, accessible and affordable. Moral values also influenced how subsequent rewards were causally explained: Opposition to competitive use reduced the causal contribution of the enhanced winner’s skill, particularly among fairness-minded individuals. In a follow-up study, we asked: Would the normalization of enhancement practices alleviate concerns about their unfairness? Indeed, proliferation of competitive cognitive enhancement eradicated fairness-based concerns, and boosted the perceived causal role of the winner’s skill. In contrast, purity-based concerns emerged in both recreational and competitive contexts, and were not assuaged by normalization.

The Internet has been identified in human enhancement scholarship as a powerful cognitive enhancement technology. It offers instant access to almost any type of information, along with the ability to share that information with others. The aim of this paper is to critically assess the enhancement potential of the Internet. We argue that unconditional access to information does not lead to cognitive enhancement. The Internet is not a simple, uniform technology, either in its composition, or in its use. We will look into why the Internet as an informational resource currently fails to enhance cognition. We analyze some of the phenomena that emerge from vast, continual fluxes of information–information overload, misinformation and persuasive design—and show how they could negatively impact users’ cognition. Methods for mitigating these negative impacts are then advanced: individual empowerment, better collaborative systems for sorting and categorizing information, and the use of artificial intelligence assistants that could guide users through the informational space of today’s Internet.

„E o plăcere să citeşti o carte filosofică în care este atât de evidentă preocuparea autorului pentru a se face cât mai bine înţeles, iar rezultatele sunt pe măsura acestei preocupări. Sobrietatea scrierii este, în acest caz, expresia unei onestităţi intelectuale lipsite de cusur. Sunt atribute, din păcate mai rar întâlnite, care constituie apanajul acelora care îşi pot permite să renunţe la orice încercări de a-şi impresiona cititorii prin efecte exterioare. şi aceasta deoarece ei pot convinge pe deplin numai şi numai prin substanţa ideilor şi forţa argumentelor.” Mircea Flonta

„Strategia noastră a fost de a gândi un text util pentru profesori, dar de a-l scrie mai ales pentru studenți. Etica este interesantă cu precădere atunci când pune în joc intuiții morale sau valori diferite și când ne confruntăm cu dileme în care decizia nu este evidentă, iar dezacordul este rezonabil. Prin urmare, am încercat să ne ferim pe cât a fost posibil de verdicte și de simpla enumerare a unor interdicții. Veți observa că, de cele mai multe ori, exercițiile și temele de discuție nu au soluții impuse. Nu pentru că autorii manualului nu ar adera la anumite soluții (poate nu la aceleași!), ci pentru că ni s-a părut mult mai importantă conturarea problemelor. Dilemele și întrebările deschise generează dezbateri și prilejuiesc reflecție. Sentințele, pe de altă parte, tind să ucidă discuția și să prilejuiască mai curând reacții de îmbrățișare sau de respingere vehementă. Dacă vom ajunge, în comunitățile noastre profesionale și în societate, să vorbim mai mult unii cu alții și mai puțin unii la alții, vom fi făcut probabil un pas major în direcția corectă pentru dezvoltarea unei atitudini morale.” (Autorii)