•  677
    Good physical experiments conform to the basic methodological standards of experimental design: they are objective, reliable, and valid. But is this also true of thought experiments? Especially problems of personal identity have engendered hypothetical scenarios that are very distant from the actual world. These imagined situations have been conspicuously ineffective at resolving conflicting intuitions and deciding between the different accounts of personal identity. Using prominent examples fro…Read more
  •  520
    Algorithms for Ethical Decision-Making in the Clinic: A Proof of Concept
    with Alice Hein, Klaus Diepold, and Alena Buyx
    American Journal of Bioethics 22 (7): 4-20. 2022.
    Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report on…Read more
  •  256
    Systemising Triage: COVID-19 Guidelines and Their Underlying Theories of Distributive Justice
    Medicine, Health Care and Philosophy 25 (4): 703-714. 2022.
    The COVID-19 pandemic has been overwhelming public health-care systems around the world. With demand exceeding the availability of medical resources in several regions, hospitals have been forced to invoke triage. To ensure that this difficult task proceeds in a fair and organised manner, governments scrambled experts to draft triage guidelines under enormous time pressure. Although there are similarities between the documents, they vary considerably in how much weight their respective authors p…Read more
  •  153
    What Matters in the Mirror of Time: Why Lucretius’ Symmetry Argument Fails
    Australasian Journal of Philosophy 97 (4): 651-660. 2019.
    abstractBy appealing to the similarity between pre-vital and post-mortem nonexistence, Lucretius famously tried to show that our anxiety about death was irrational. His so-called Symmetry Argument has been attacked in various ways, but all of these strategies are themselves problematic. In this paper, I propose a new approach to undermining the argument: when Parfit’s distinction between identity and what matters is applied, not diachronically but across possible worlds, the alleged symmetry can…Read more
  •  144
    Brain Death: What We Are and When We Die
    Dissertation, University of St. Andrews. 2020.
    When does a human being cease to exist? For millennia, the answer to this question had remained largely unchanged: death had been diagnosed when heartbeat and breathing were permanently absent. Only comparatively recently, in the 1950s, rapid developments in intensive-care medicine called into question this widely accepted criterion. What had previously been deemed a permanent cessation of vital functions suddenly became reversible. A new criterion of death was needed. It was suggested that the…Read more
  •  130
    The Demise of Brain Death
    British Journal for the Philosophy of Science 73 (2): 487-508. 2022.
    Fifty years have passed since brain death was first proposed as a criterion of death. Its advocates believe that with the destruction of the brain, integrated functioning ceases irreversibly, somatic unity dissolves, and the organism turns into a corpse. In this article, I put forward two objections against this assertion. First, I draw parallels between brain death and other pathological conditions and argue that whenever one regards the absence or the artificial replacement of a certain functi…Read more
  •  107
    Is Brain Death Death?
    Dissertation, University of Oxford. 2016.
    For hundreds of years, death had been defined by cardiopulmonary criteria. When heart and respiratory functions were permanently absent, doctors declared their patients dead. Three developments in intensive care medicine called into question these widely-accepted criteria, however: the advent of positive pressure ventilation and the promotion of cardiopulmonary resuscitation, both in the early 1950s, and the first successful heart transplantation in 1967. What had previously been diagnosed as th…Read more
  •  86
    When an individual is comatose while parts of her brain remain functional, the question arises as to whether any mental characteristics are still associated with this brain, that is, whether the person still exists. Settling this uncertainty requires that one becomes clear about two issues: the type of functional loss that is associated with the respective profile of brain damage and the persistence conditions of persons. Medical case studies can answer the former question, but they are not conc…Read more
  •  64
    ChatGPT’s Responses to Dilemmas in Medical Ethics: The Devil is in the Details
    American Journal of Bioethics 23 (10): 63-65. 2023.
    In their Target Article, Rahimzadeh et al. (2023) discuss the virtues and vices of employing ChatGPT in ethics education for healthcare professionals. To this end, they confront the chatbot with a moral dilemma and analyse its response. In interpreting the case, ChatGPT relies on Beauchamp and Childress’ four prima-facie principles: beneficence, non-maleficence, respect for patient autonomy, and justice. While the chatbot’s output appears admirable at first sight, it is worth taking a closer loo…Read more
  •  35
    Memories without Survival: Personal Identity and the Ascending Reticular Activating System
    Journal of Medicine and Philosophy 48 (5): 478-491. 2023.
    Lockean views of personal identity maintain that we are essentially persons who persist diachronically by virtue of being psychologically continuous with our former selves. In this article, I present a novel objection to this variant of psychological accounts, which is based on neurophysiological characteristics of the brain. While the mental states that constitute said psychological continuity reside in the cerebral hemispheres, so that for the former to persist only the upper brain must remain…Read more
  •  30
    A Fuzzy-Cognitive-Maps Approach to Decision-Making in Medical Ethics
    with Alice Hein, Alena Buyx, and Klaus Diepold
    2022 IEEE International Conference on Fuzzy Systems (FUZZ-IEEE). 2022.
    Although machine intelligence is increasingly employed in healthcare, the realm of decision-making in medical ethics remains largely unexplored from a technical perspective. We propose an approach based on fuzzy cognitive maps (FCMs), which builds on Beauchamp and Childress’ prima-facie principles. The FCM’s weights are optimized using a genetic algorithm to provide recommendations regarding the initiation, continuation, or withdrawal of medical treatment. The resulting model approximates the an…Read more
  •  23
    Clinical Ethics – To Compute, or Not to Compute?
    with Alice Hein, Klaus Diepold, and Alena Buyx
    American Journal of Bioethics 22 (12). 2022.
    Can machine intelligence do clinical ethics? And if so, would applying it to actual medical cases be desirable? In a recent target article (Meier et al. 2022), we described the piloting of our advisory algorithm METHAD. Here, we reply to commentaries published in response to our project. The commentaries fall into two broad categories: concrete criticism that concerns the development of METHAD; and the more general question as to whether one should employ decision-support systems of this kind—th…Read more
  •  18
    Changes in Personality, Mood, and Behavior Following Deep Brain Stimulation: No Progress Without Concepts
    American Journal of Bioethics Neuroscience 14 (3): 312-314. 2023.
    Zuk et al. (2023) examined researchers’ views on how deep brain stimulation may impact patients’ personality, mood, and behaviour (PMB). The team found that experts vary substantially in the notion of personality they employ. However, despite noting the lack of conceptual precision, no attempt was made at scientifically defining any of the involved concepts, so that the results of the different interviews remain largely incommensurable. In this comment, I am doing the interpretative work that th…Read more
  •  11
    Translating theories of justice into a practice model for triage of scarce intensive care resources during a pandemic
    with Kathrin Knochel, Eva-Maria Schmolke, and Alena Buyx
    Bioethics 38 (3): 223-232. 2024.
    During the COVID‐19 pandemic, national triage guidelines were developed to address the anticipated shortage of life‐saving resources, should ICU capacities be overloaded. Rationing and triage imply that in addition to individual patient interests, interests of population health have to be integrated. The transfer of theoretical and empirical knowledge into feasible and useful practice models and their implementation in clinical settings need to be improved. This paper analyzes how triage protoco…Read more