Artificial Intelligence and Medical Humanities

The use of artificial intelligence in healthcare has led to debates about the role of human clinicians in the increasingly technological contexts of medicine. Some researchers have argued that AI will augment the capacities of physicians and increase their availability to provide empathy and other uniquely human forms of care to their patients. The human vulnerabilities experienced in the healthcare context raise the stakes of new technologies such as AI, and the human dimensions of AI in healthcare have particular significance for research in the humanities. This article explains four key areas of concern relating to AI and the role that medical/health humanities research can play in addressing them: definition and regulation of “medical” versus “health” data and apps; social determinants of health; narrative medicine; and technological mediation of care. Issues include data privacy and trust, flawed datasets and algorithmic bias, racial discrimination, and the rhetoric of humanism and disability. Through a discussion of potential humanities contributions to these emerging intersections with AI, this article will suggest future scholarly directions for the field.

     

A Functional Analysis of 2004 Ukrainian Presidential Debates

Political leaders’ debates are an important and highly visible instances of public argumentation. As such, they merit scholarly attention. This essay applies the Functional Theory of Political Campaign Discourse to analyze televised presidential debates from the Ukraine in 2004. Overall, this analysis revealed that acclaims were the most common function, followed by attacks and then defenses. Policy was addressed more often than character in these debates, as expected. The incumbent candidate acclaimed significantly more and attacked less than the challenger. The incumbents used past deeds significantly more often to acclaim – and less to attack – than the challengers. Finally, general goals and ideals were used more as the basis for acclaims than attacks in these debates. Implications of these results are discussed.     

Health Care,Capabilities, and AI Assistive Technologies

Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technologies as such or as replacements of human care, they demand us to clarify what is at stake, to develop more comprehensive criteria for good care, and to rethink existing practices of care. In response to these challenges, I propose a (modified) capabilities approach to care and emphasize the inherent social dimension of care. I also discuss the demand for real care by introducing the ‘Care Experience Machine’ thought experiment. I conclude that if we set the standards of care too high when evaluating the introduction of AI assistive technologies in health care, we have to reject many of our existing, low-tech health care practices.     

Supervenience and neuroscience

The philosophical technical term “supervenience” is frequently used in the philosophy of mind as a concise way of characterizing the core idea of physicalism in a manner that is neutral with respect to debates between reductive physicalists and nonreductive physicalists. I argue against this alleged neutrality and side with reductive physicalists. I am especially interested here in debates between psychoneural reductionists and nonreductive functionalist physicalists. Central to my arguments will be considerations concerning how best to articulate the spirit of the idea of supervenience. I argue for a version of supervenience, “fine-grained supervenience,” which is the claim that if, at a given time, a single entity instantiates two distinct mental properties, it must do so in virtue of instantiating two distinct physical properties. I argue further that despite initial appearances to the contrary, such a construal of supervenience can be embraced only by reductive physicalists.     

Relational and Substantival Ontologies, and the Nature and the Role of Primitives in Ontological Theories

Several metaphysical debates have typically been modeled as oppositions between a relationist approach and a substantivalist approach. Such debates include the Bundle Theory and the Substratum Theory about ordinary material objects, the Bundle (Humean) Theory and the Substance (Cartesian) Theory of the Self, and Relationism and Substantivalism about time. In all three debates, the substantivalist side typically insists that in order to provide a good treatment of the subject-matter of the theory (time, Self, material objects), it is necessary to postulate the existence of a certain kind of substance, while the other side, the relationist one, characteristically feels that this is an unnecessary expense and that one can get the job done in an ontologically cheaper way just with inter-related properties or events. In this paper I shall defend the view that there is much less of a disagreement between relational ontologies and substantival ontologies than it is usually thought. I believe that, when carefully examined, the two sides of the debate are not that different from each other, in all three cases of pairs of views mentioned above. As we will see, both the relational side and the substantival side work in the same way, suffer from and answer the same objections, and are structurally extremely similar. It will be an important question—one that I shall discuss in detail, and that is indeed the main point of interest for me in this paper—whether this means that the two sides of the debate are somehow ‘equivalent’ or not, and what ‘equivalent’ could mean.     

ARTIFICIAL INTELLIGENCE AND DE LAS CASAS: A 1492 RESONANCE

Abstract. A comparison is made between two unlikely debates over intelligence. One debate took place in 1550 at Valladolid, Spain, between Bartolomé de las Casas and Juan Gines de Sepúlveda over the intelligence of the Amerindian. The other debate is contemporary, between John Searle and various representatives of the "strong" artificial intelligence (AI) community over the adequacy of the Turing test for intelligence. Although the contemporary debate has yet to die down, the Valladolid debate has been over for four hundred years. The question asked here is whether the contemporary debate can profit from the previous one. The common bond providing the basis for contrast is the issue of the "other" which is present in both debates. From this contrast, the observation is made that the question of meaning is intimately tied to the question of intelligence.     

Health Care Reform: What History Doesn’t Teach

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform.     

Two claims about epistemic propriety

This paper has two main parts. In the first part, I argue that prominent moves in two related current debates in epistemology—viz., the debates over classical invariantism and the knowledge first movement—depend on one or the other of two claims about epistemic propriety: (1) Impropriety due to lack of a particular epistemic feature suffices for epistemic impropriety; and (2) Having justification to believe P suffices for having warrant to assert P. In the second part, I present and defend novel arguments against both claims.     

American Indian Historical Trauma: Community Perspectives from Two Great Plains Medicine Men

The field of community psychology has long been interested in the relations between how community problems are defined, what interventions are developed in response, and to what degree power is distributed as a result. Tensions around these issues have come to the fore in debates over the influence of historical trauma (HT) in American Indian (AI) communities. After interviewing the two most influential medicine men on a Great Plains reservation to investigate how these tensions were being resolved, we found that both respondents were engaging with their own unique elaboration of HT theory. The first, George, engaged in a therapeutic discourse that reconfigured HT as a recognizable but malleable term that could help to communicate his “spiritual perspective” on distress and the need for healing in the reservation community. The second, Henry, engaged in a nation-building discourse that shifted attention away from past colonial military violence toward ongoing systemic oppression and the need for sociostructural change. These two interviews located HT at the heart of important tensions between globalization and indigeneity while opening the door for constructive but critical reflection within AI communities, as well as dialogue with allied social scientists, to consider how emerging discourses surrounding behavioral health disparities might be helpful for promoting healing and/or sociostructural change.     

The Case for Psychologism in Default and Inheritance Reasoning

Default reasoning occurs whenever the truth of the evidence available to the reasoner does not guarantee the truth of the conclusion being drawn. Despite this, one is entitled to draw the conclusion “by default” on the grounds that we have no information which would make us doubt that the inference should be drawn. It is the type of conclusion we draw in the ordinary world and ordinary situations in which we find ourselves. Formally speaking, ‘nonmonotonic reasoning’ refers to argumentation in which one uses certain information to reach a conclusion, but where it is possible that adding some further information to those very same premises could make one want to retract the original conclusion. It is easily seen that the informal notion of default reasoning manifests a type of nonmonotonic reasoning. Generally speaking, default statements are said to be true about the class of objects they describe, despite the acknowledged existence of “exceptional instances” of the class. In the absence of explicit information that an object is one of the exceptions we are enjoined to apply the default statement to the object. But further information may later tell us that the object is in fact one of the exceptions. So this is one of the points where nonmonotonicity resides in default reasoning. The informal notion has been seen as central to a number of areas of scholarly investigation, and we canvass some of them before turning our attention to its role in AI. It is because ordinary people so cleverly and effortlessly use default reasoning to solve interesting cognitive tasks that nonmonotonic formalisms were introduced into AI, and we argue that this is a form of psychologism, despite the fact that it is not usually recognized as such in AI. We close by mentioning some of the results from our empirical investigations that we believe should be incorporated into nonmonotonic formalisms.     

AI,ME AND LEWIS (ABELIAN IMPLICATION,MATERIAL EQUIVALENCE AND C I LEWIS 1920)

C I Lewis showed up Down Under in 2005, in e-mails initiated by Allen Hazen of Melbourne. Their topic was the system Hazen called FL (a Funny Logic), axiomatized in passing in Lewis 1921. I show that FL is the system MEN of material equivalence with negation. But negation plays no special role in MEN. Symbolizing equivalence with → and defining ∼A inferentially as A→f, the theorems of MEN are just those of the underlying theory ME of pure material equivalence. This accords with the treatment of negation in the Abelian l-group logic A of Meyer and Slaney (Abelian logic. Abstract, Journal of Symbolic Logic 46, 425–426, 1981), which also defines ∼A inferentially with no special conditions on f. The paper then concentrates on the pure implicational part AI of A, the simple logic of Abelian groups. The integers Z were known to be characteristic for AI, with every non-theorem B refutable mod some Zn for finite n. Noted here is that AI is pre-tabular, having the Scroggs property that every proper extension SI of AI, closed under substitution and detachment, has some finite Zn as its characteristic matrix. In particular FL is the extension for which n = 2 (Lewis, The structure of logic and its relation to other systems. The Journal of Philosophy 18, 505–516, 1921; Meyer and Slaney, Abelian logic. Abstract. Journal of Symbolic Logic 46, 425–426, 1981; This is an abstract of the much longer paper finally published in 1989 in G. G. Priest, R. Routley and J. Norman, eds., Paraconsistent logic: essays on the inconsistent, Philosophica Verlag, Munich, pp. 245–288, 1989). Meyer was supported in this work as a Visiting Fellow in the College of Engineering and Computer Science, ANU.     

How to be a structuralist all the way down

This paper considers the nature and role of axioms from the point of view of the current debates about the status of category theory and, in particular, in relation to the “algebraic” approach to mathematical structuralism. My aim is to show that category theory has as much to say about an algebraic consideration of meta-mathematical analyses of logical structure as it does about mathematical analyses of mathematical structure, without either requiring an assertory mathematical or meta-mathematical background theory as a “foundation”, or turning meta-mathematical analyses of logical concepts into “philosophical” ones. Thus, we can use category theory to frame an interpretation of mathematics according to which we can be structuralists all the way down.     

The new grammar of Otherness: Europe,the Shoah,and the Jews

The essay discusses the passage from an ideological, patriotic and anti-fascist memory of the deportations and the extermination to what the author describes as the “ethnic” memory of the Shoah, which has played, and continues to play, a central role in constructing the European historical narrative as that narrative depicts the Jews as Europe’s “other”. Theoretical reflection on memory is intertwined with historical analysis of the period between 1945 until the end of the twentieth century. Two, binary perspectives are featured, one, which examines memory from a cognitive point of view and the other, which examines memory from a cultural, ideological, moral and political perspective. These perspectives come to the fore in memoire-literature, movies, plays, historiographic and philosophical debates, which illustrate the two perspectives and their articulation, as well as they justify the essay’s periodization.     

The global community, religion, and education: the modernity of Dewey’s social philosophy

As a starting point this paper takes Dewey’s nowadays often stressed modernity and examines his social philosophy against the background of the current debates on republicanism and communitarianism. Particularly, the anaysis of Dewey’sThe Public and its Problem (1927) concludes that the attention being paid to Dewey is problematic as specific religious assumptions — explicitly developed inA Common Faith (1934) -lie in the background of his social philosophy, and are hardly being recognized. However, as it shall be shown, without considering the religious basis, neither Dewey’s social philosophy nor his educational theory can be properly understood.     

Lean sexuality: On cultural transformations of sexuality and gender in recent decades

The seemingly uniform cultural phenomenon of sexuality is subject to a constant process of disassembly and reassembly involving the allocation of new desires, the introduction of new knowledge and the harvesting of new consummations. Western cultures have witnessed a tremendous cultural and social transformation of sexuality in the years since the sexual revolution. Apart from a few public debates and scandals, the process has moved along gradually and quietly. Yet its real and symbolic effects are probably much more consequential than those generated by the sexual revolution of the sixties. The author refers to the broad-based recoding and reassessment of the sexual sphere during the eighties and nineties as the “neosexual revolution”. The outcome of this revolution may be described as “lean sexuality” and “self-sex”. Translated from the German by John S. Southard. This essay is dedicated to Reimut Reiche.     

A Minor Philosophy

This article surveys the output of contemporary Italian philosophers and distinguishes three principal ways of approaching their intellectual endeavor: denial, the “evil-queen syndrome,” and compliance. Philosophers in a state of denial seem unaware of the loss in status that Italian philosophy as an academic discipline suffers in international forums. The evil-queen syndrome concerns the habit of compiling surveys of past philosophies, focusing on traditions of which one considers oneself the privileged inheritor. Compliance—in its commendable aspect—refers to the growing number of philosophers who participate in international debates, whose forums are for the most part Anglo-American peer-refereed journals. This article urges a less subservient intellectual attitude, capable of contributing new ideas and arguments to the international philosophical forum.     

Implementing the Scientist–Practitioner Model in the Hospital Setting

Psychologists who work in hospital settings confront assorted challenges in implementing the scientist–practitioner model. Clinical psychologists must deal with the tension between an evidence-based model and the realities of clinical practice. Psychologists can gain a better understanding of what it means to function as a scientist–practitioner by understanding current debates in both psychology and medicine on the relationship between research and practice. Psychologists are not unique in the slow pace of implementing research into practice. Psychologists in hospitals can make a contribution to the treatment of medical patients by emphasizing the role of the treatment relationship in health-care outcomes. Medicine’s use of practice-based research networks provides a valuable structure for psychologists to emulate in order to function as active participants in the collection of practice-based evidence rather than passively accommodating to the evidence-based clinical practice guidelines.     

De-Ontologizing the Debate on Social Explanations: A Pragmatic Approach Based on Epistemic Interests

In a recent paper on realism and pragmatism published in this journal, Osmo Kivinen and Tero Piiroinen have been pleading for more methodological work in the philosophy of the social sciences—refining the conceptual tools of social scientists—and less philosophically ontological theories. Following this de-ontologizing approach, we scrutinize the debates on social explanation and contribute to the development of a pragmatic social science methodology. Analyzing four classic debates concerning explanation in the social sciences, we propose to shift the debate away from (a) the ontologizing defenses of forms of social explanation, and (b) a winner-takes-all-approach. Instead, we advocate (c) a pragmatic approach towards social explanation, elaborating a rigorous framework for explanatory pluralism detached from the debates on social ontology.

Gender Differences in Preferences for Singles Ads that Proclaim Extrinsic Versus Intrinsic Values

Two studies (Ns = 1,113 and 98) examined University men and womens’ differing preferences for singles ads as a function of the values declared by ad-writers, using Kasser and colleagues’ distinction between extrinsic values (financial success, status/fame, and image/attractiveness) and intrinsic values (emotional intimacy, community contribution, and personal growth). In general, participants preferred writers espousing intrinsic values. Women, compared to men, especially preferred partners espousing intrinsic values. They also expressed less interest in partners espousing extrinsic values, with one exception: compared to men, they were more interested in partners espousing financial success values. Implications for debates regarding the evolved versus sociological origins of gender differences are discussed, as well as implications for theories of attraction based on the matching hypothesis.