Jason Branford

There is a global mental health crisis. Although several barriers to mental health treatments exist, one that almost certainly contributes to this problem is the insufficient number of mental health professionals available to meet the demand. To combat this, several companies have set to work creating digital mental health interventions (DMHI) that may relieve the pressure on the already overburdened mental health professional population. Although its promise to reach patients otherwise unable to receive treatment represents a revolution in mental health care, several ethical concerns accompany DMHI that are sometimes obscured by their great promise. This article explores eleven ethical challenges to DMHI that arise across the “lifecycle” of DMHI’s development, deployment, and regulation, seeking to foreground how these technologies might influence the practice of psychotherapy.

With this contribution, we propose an initial, relational ethics approach to epistemic inclusion in the development and application of medical decision support systems. We revisit issues of epistemic injustice in various forms of medical AI and consider different orders of epistemic oppression. We argue that AI-based decision support risks excluding patients and medical personnel from relevant epistemic processes vital to good medical practice. For example, relating to a subject’s lifeworld, value sets, assumptions concerning good health, and means of overcoming or living with disease. By recognizing medical decision support systems as mediators of shared epistemic resources between patients, medical personnel, and medical research, we contend that a concern for epistemic inclusion ought to guide their conception and development. A relational ethics-based consideration of these epistemic processes further illuminates the structural character of these forms of epistemic exclusion. Ultimately, our approach seeks to reinstate the epistemic privilege of those perspectives being marginalized by these technologies and challenges the proclaimed impending epistemic obligation to utilize AI-based tools as the state-of-the-art in medical diagnosis and, perhaps even, therapy and its planning.

The purported threats that the algorithmic creation, ordering, and manipulation of information in the digital sphere may pose to democracy have received considerable academic attention in recent years. In seeking to extend this discussion beyond the focus on formal and procedural aspects of democracy, this paper adopts a Deweyan conception of democracy and considers specifically the potential impact of generative-AI technologies (genAI) on _democratic culture_. This, we argue, reveals underexplored democratic challenges posed by such increasingly ubiquitous technologies. As a flourishing democratic culture is fundamentally dependent on its epistemic richness and diversity, this directs one to consider if and how the use of genAI technologies might undermine these aspects. Both the technical architecture of genAI and the specific ways they are used in ordinary life demonstrate their ability to intercede in or mediate epistemic participation in democratic culture and, importantly, their tendency to advance dominant epistemic norms and practices. As such, we discuss how genAI might further epistemic injustices that negatively impact democratic culture in still underappreciated but salient ways.

Hate speech is endemic in digital space, and it does not spare academia. Especially scholars working in fields prone to political debate - from migration to climate change, from gender to refugee integration, and many more topics - find themselves increasingly attacked. With this chapter, we hope to raise awareness for the increasingly prevalent phenomenon of cyberhate targeting academics. Our intention is to shed light on some of its harmful effects, and, by providing some conceptual analysis, to contribute to individual and organisational prevention and coping strategies. We conclude that guarding against cyberhate is now part of academics’ and their institutions’ responsibility.