Hodges' Model: Welcome to the QUAD: bioethics

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label bioethics. Show all posts
Showing posts with label bioethics. Show all posts

Wednesday, October 23, 2024

Book received: 'Handbook on the Ethics of Artificial Intelligence'

Many thanks to Edward Elgar Publishing for a review copy of this book which arrived today:

Edited by David J. Gunkel, Professor of Communication, Northern Illinois University, US, and Professor of Applied Ethics, Łazarski University, Poland

Publication Date: 2024 ISBN: 978 1 80392 671 1 Extent: 336 pp
This engaging Handbook identifies and critically examines the moral opportunities and challenges typically attributed to artificial intelligence. It provides a comprehensive overview and examination of the most pressing and urgent problems with this technology by drawing on a wide range of analytical methods, traditions, and approaches.

This is timely, prior to next month's event on AI and Planetary Health, about which news to follow shortly, especially if you are based near London and southern England.

I also can't believe it is 34 years since publication of the following case study:

Davies, M. and Owen, K. ‘Complex uncertain decisions: medical diagnosis’, Case Study 10 in Expert System Opportunities from the DTI’s Research Technology Initiative, HMSO 1990.

Ethics in AI 2024 :: Expert Systems 1990

Sunday, February 12, 2023

Tuskegee Healing, the Moral Determinants of Health, and the Ethics of Research on Black Health

My source: SpiritOf1848 list - Lachlan Forrow

This will build from two November 2022 events (see their flyers below) commemorating the 90th/50th/25th anniversaries of the USPHS Study of Untreated Syphilis in the Negro Male at Tuskegee and Macon County, the first organized/hosted by the National Center for Bioethics at Tuskegee University, the second organized/hosted by CDC (see details and video of that here; the first 2min30sec include Dr. Termika Smith’s wonderful intro [60 seconds] and President Biden’s remarks [90 seconds]. 

I would also strongly recommend watching ~5 minutes starting at 11min45sec – Mrs. Lillie Head, daughter of Fred Tyson, one of the men in the Study, and founder/leader of Voices for Our Fathers Legacy Foundation, explaining what the Study was really about (i.e. the moral issues were racism, dehumanization, etc. etc., not just “failures of informed consent”). 

For our Feb 17 session, after presentations by Carmen J. Thornton (Lillie Head’s daughter, i.e. granddaughter of Fred Tyson) and Susan Reverby (arguably the leading historian of the Study), and then presentations about applying this framework to 3 concrete areas of severe and ongoing “Black health disparities” (Jesse Milan, President/CEO of AIDSUnited on HIV/AIDS; Wangui Muigai on the history and current realities of Black maternal/infant mortality; and I hope [not yet confirmed] Rev. Jeffrey Brown [co-chair of Embrace Boston] on gun violence) the “Commentators” will be Dr. David Hodge, Associate Director of the National Center, who organized their Nov 2022 event, and Dr. Termika Smith, who organized and moderated the CDC event. Then Carmen J. Thornton, as granddaughter, will have closing words -- what her grandfather might say, and what she herself thinks, about MLK’s question: Where Do We Go From Here? 

Friday, April 03, 2020

Inverse Care Law ... at Social Care's Door

Since 2015 I've had four 'conversations' with the doctors at A&E upon mum's attendance and subsequent admission on a couple of occasions. Initially, I was surprised if not shocked by the speed with which the 'conversation' followed on treatment, the extent of this and the question of resus. The further interactions were still emotionally jarring, even when expected and telegraphed. I also understand: to an extent. Repeated chest infection or urine infection had resulted in confusion, delirium that varied. on one occasion, at the nursing home there was also suddenly talk of a diagnosis of dementia, which prompted social services to wonder, like family and staff, where exactly this diagnosis had come from and investigate. (Another post?)

Mum has been very poorly, most recently in November. What surprised and shocked was the 'conversation' at the end of the bed when I knew mum - with mental capacity at that time was most likely listening. The primacy of person-centredness seemed to be by-passed. I suggested the doctor ask mum since once hydrated she would be fine. There has been a sense of a script being followed with some pressure - urgency behind it, if not a 'prescription'. I empathised with the doctors, often FY1 FY2; such matters are never easy. Now amid COVID-19 there is alarm as social care are challenged with taking on a new role, for which they are ill-equipped. 

In health care you are always conscious of the inverse care law, it seems there is another care law in operation that gives cause to worry for those who cannot advocate for themselves or have no independent advocate. Perhaps there is another inverse law that runs concurrently concerning ethics. Triage, is real. Objectively, as a nurse you think "Am I being selfish?". But, as eldest son - absolutely not. These conversations, and the future aside, the doctors and team as a whole have worked (absolute) wonders for which mum and the family will always be grateful.

Be Well, Be Safe All.
 
individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

"There should be no wrong door and every 
service should reverse the ...


... Inverse Care Law, which simply states those people in need of health and social care the most 
get them the least."



https://www.smithsltd.co.uk/doors/composite


By MrPanyGoff - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19702555


A comment at The King’s Fund, by Lord Victor Adebowale.

Partnership Working, Time to Talk, Drink and Drugs News, October 2018, pp.10-11
https://drinkanddrugsnews.com/wp-content/uploads/2018/10/DDN-October-2018.pdf

If anyone has a photo of a red door at a care or nursing home that I can display above please let me know.

Tuesday, January 14, 2020

'Dumping': Waste and Ethics?

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population
Individual:
general literacy
health literacy
economic literacy ...
...
Individual:
morality, values, integrity ...


"South Africa's Northern Cape is one of the most ethnographically unique locations on Earth. It is home to the San people, a nomadic hunter-gatherer group that carries some of the oldest human DNA." p.90.


The SAN people


"Our knowledge has been taken by clever
people who come and tempt us -


TRUST Project

'National' ethics standards

-  with 10 rand or five rand." p.90.





The Centre for Professional Ethics, UCLAN.

Perryer, S. Foreign Bodies, The New Economy, Spring/Summer 2019, pp.90-93.

Knowles, T. Ancestry firm uses DNA of customers to develop drug. The Times, January 14th, 2020. p.4.

Thursday, May 30, 2019

[4-5 page...?] Book: "Homage to Humanity"

SELF - individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - POPULATION

You speak ...
I do not understand...
But that is a wonder...
I do see you...
 and the great happening
of the place and way you live ...
And, now I understand...


Geography



Homage to Humanity by Jimmy Nelson


GeoPolitics
@GeoPsychiatry





My source: LUXX, The Times, p.39; book cover Blackwell's

Tuesday, May 08, 2018

CfP: Lancaster - Philosophy of Psychiatry Work in Progress Day 2018

Thursday 31st May 2018

PhD students and more established academics are invited to present work in progress in the philosophy of psychiatry (20 min talks, 10 mins discussion). Paper slots will be given out on a first come, first served basis. If you’d like to give a paper please email Rachel Cooper (r.v.cooper AT lancaster.ac.uk) with a title. There is no budget for this workshop, so speakers will need to cover their own expenses!

Speakers accepted so far are:

  • Hane Maung (Manchester) – Is suicide a psychiatric problem?
  • Richard Hassall (Sheffield) – What does a psychiatric diagnosis mean for those who are given a diagnosis?
  • Phoebe Friesen (Oxford) – Distancing medically assisted dying and suicide: Is it justified?
  • Rachel Cooper (Lancaster) – Puzzles in psychiatric classification
  • Sam Fellowes (Lancaster) – Continuity and discontinuity in the history of psychiatry
An up-to-date list of accepted papers can be found here:

http://wp.lancs.ac.uk/bioethics-and-philosophy-of-medicine/2018/04/20/cfp-lancaster-philosophy-of-psychiatry-work-in-progress-day-2018/


My source: Philos-L

 

Monday, September 04, 2017

Ethical concerns: Four principles approach (in Hodges' model)

individual
|
INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group
autonomy
non-maleficence
beneficence
justice


Noordraven, E.L., Maartje H. N. Schermer, M.H.N., Blanken, P., Mulder, C.L. & Wierdsma, A.I. (2017). Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: patients’ and clinicians’ perspectives after a 12-month randomized controlled trial. BMC Psychiatry, 17: 313. https://doi.org/10.1186/s12888-017-1485-x

Priebe, S., Bremner, S.A., Lauber, C., Henderson, C. & Burns, T. (2016). Financial incentives to improve adherence to antipsychotic maintenance medicationin non-adherent patients: a cluster randomised controlled trial. Health Technology Assessment, 20 (70). pp. 1-122. ISSN 1366-5278 DOI: 10.3310/hta20700

My source:

Gillon (below) highlights a debate that is ongoing and even more acute given the ethical challenges of today. Interesting also that in 1994 attention to scope could provide a level of assurance(?):

Gillon, R. Medical ethics: four principles plus attention to scope. BMJ. 1994;309(6948):184–8.


Monday, June 21, 2010

Philosophy of information empowers philosophy of care

The moral and ethical dimensions of nursing quickly become apparent to individual practitioners and professional associations. Philosophy in nursing boasts specific courses, journals and groups, for example:

International Philosophy of Nursing Society (IPONS)

Here on W2tQ, in papers and on the (former) website I have stressed the importance of the health career model as a framework that can utilise information as a fundamental and potentially unifying concept.

Expanding on the post last week about the philosophers' magazine [tpm50] let's look at Floridi's piece on the philosophy of information (PI). The 50 ideas featured are each only granted two pages, but this has a definite philosophical equivalent twitter-styled appeal. On page 42 (- 43) Floridi notes that:

... PI possesses one of the most powerful conceptual vocabularies ever devised in philosophy. This is because one can rely on informational concepts whenever a complete understanding of some series of events is unavailable or unnecessary for providing an explanation. Virtually any issue can be rephrased informationally. Such semantic power is a great advantage of PI, understood as a methodology. ...

It shows that we a dealing with an influential paradigm. But it may also be a disadvantage, because a metaphorically pan informational approach can lead to a dangerous equivocation, namely, thinking that since any x can be described in (more or less metaphorically) informational terms, then the nature of any x is genuinely informational. (Luciano Floridi, 2010).
Admittedly Floridi's context is the position and status of PI as an emerging discipline within philosophy. As he notes the vocabulary while powerful lies in the discipline of philosophy.

Given my preoccupation with information, Floridi's observation above is a timely warning for me and the many nurses who in the past saw a concomitant risk that in adopting the nursing process, patients (and carers) would be processed. Ironically, this processing concerned information. The workflow - form and layout of the documentation - was prescribed. This is an old tale, with the nursing process being subsumed within the routine work of nursing. Perhaps though this also demonstrates a need for a new debate?

My interest in information is as a trope to explain the significance of the care (knowledge) domains that underpin Hodges' model. Crucially, though these can stand on their own as nursing philosophy issues. Joining the efforts of the nursing philosophers above, this can bring information and philosophy out of the academic realm to include a more practical and grounded variety of topics:

FROM: personal identity,
definitions and ownership of computer based records,
utility versus security of information (summary care record ...),
definitions of information (data, knowledge) - through
TO: patient information and patient informatics, ...
where is collective informatics# heading?

Taking Floridi's lead - which of the above .... are core nursing (health) information concepts (and not just freeloading info-masqueraders along for the ride)? Well, that is a question for a new community of scholars to decide?

Philosophy resources: Interpersonal care domain

#Collective informatics = all the claimed informatics disciplines combined?