A neo-aristotelian perspective on the need for artificial moral agents (AMAs)

We examine Van Wynsberghe and Robbins (JAMA 25:719-735, 2019) critique of the need for Artificial Moral Agents (AMAs) and its rebuttal by Formosa and Ryan (JAMA 10.1007/s00146-020-01089-6, 2020) set against a neo-Aristotelian ethical background. Neither Van Wynsberghe and Robbins (JAMA 25:719-735, 2019) essay nor Formosa and Ryan’s (JAMA 10.1007/s00146-020-01089-6, 2020) is explicitly framed within the teachings of a specific ethical school. The former appeals to the lack of “both empirical and intuitive support” (Van Wynsberghe and Robbins 2019, p. 721) for AMAs, and the latter opts for “argumentative breadth over depth”, meaning to provide “the essential groundwork for making an all things considered judgment regarding the moral case for building AMAs” (Formosa and Ryan 2019, pp. 1–2). Although this strategy may benefit their acceptability, it may also detract from their ethical rootedness, coherence, and persuasiveness, characteristics often associated with consolidated ethical traditions. Neo-Aristotelian ethics, backed by a distinctive philosophical anthropology and worldview, is summoned to fill this gap as a standard to test these two opposing claims. It provides a substantive account of moral agency through the theory of voluntary action; it explains how voluntary action is tied to intelligent and autonomous human life; and it distinguishes machine operations from voluntary actions through the categories of poiesis and praxis respectively. This standpoint reveals that while Van Wynsberghe and Robbins may be right in rejecting the need for AMAs, there are deeper, more fundamental reasons. In addition, despite disagreeing with Formosa and Ryan’s defense of AMAs, their call for a more nuanced and context-dependent approach, similar to neo-Aristotelian practical wisdom, becomes expedient.

Learning Practical Wisdom from Moral Case Deliberation Through Morisprudence

"Moral case deliberation is regularly used as a teaching method at our medical school. Besides we facilitate moral case deliberation on the ward in our hospital. In both instances, our assumption is that practicing moral case deliberation will assist our (future) healthcare professionals to cultivate the virtue of practical wisdom. But, is this assumption, right? The answer to this question requires both empirical research and conceptual analysis. This paper focuses on the latter. The claim defended is that we can elucidate the relation between moral case deliberation and practical wisdom through an analysis of so called morisprudence. We start with discussing two divergent but related interpretations of morisprudence: one introduced by Toulmin and Jonsen, related to casuistry, and one related to a Dutch interpretation with a strong relation to moral case deliberation. The combination of the both interpretations shed new light on the conceptual connections between cultivating prudence (practical wisdom) and moral case deliberation, but it also provides new insights into the individual and collective dimensions of practical wisdom, of character formation within organizational contexts. Finally, it may have consequences for how moral case deliberation should actually be employed to teach practical wisdom. "

How to Train and Assess the Quality of Facilitators for Moral Case Deliberation? Experiences with and Evaluation of Self-Reflection and Observation Forms for Facilitators of Moral Case Deliberation

"In Europe, Moral Case Deliberation (MCD) has been well-known and established as a form of Clinical Ethics Support (CES) and implemented in many international (health care) institutions. Since 2007 Amsterdam UMC organizes training for professionals to become a facilitator of MCD. To support and asses the development of those future facilitators MCD, an instrument has been developed which can be used by both trainees and trainers. The instrument consists of a self-reflection form and an observation form. Both forms are almost identical and contain a part of open questions reflecting upon the personal learning goals of the trainee and a part of 56 closed questions. The part of closed questions contains concrete descriptions of preferred skills and attitude of the MCD facilitator trainee, related to MCD in general and the specific steps of the Dilemma method and the Socratic Dialogue in particular. Special attention is being paid to concrete actions for fostering a dialogue and deepening the moral inquiry. The instrument can also be used by trained and more experienced facilitators of MCD to reflect upon their acquired skills and attitude, and indirectly on the quality of CES they provide. In this presentation we will present the instrument and share our experiences in using the two forms in order to train and assess (the quality of) facilitators of MCD. Furthermore, we will present preliminary results of the analysis of more than 1200 forms collected in the past decade from trainings on national and international level. "

Moral Competence, Moral Teamwork, Moral Action – Outcomes of Moral Case Deliberation in the Euro-MCD 2.0 For Evaluating Clinical Ethics Support

"Background: For Moral Case Deliberation (MCD), like any form of Clinical ethics support (CES), it is important to know whether it reaches its presumed goal of supporting healthcare professionals in their ethical challenges. Evaluation is needed to gain insight in the value of MCD. Therefore, the Euro-MCD instrument was developed to assess outcomes of MCD, and has now been revised. The aim of this presentation is to present the revised Instrument: the Euro-MCD 2.0. Methods: The revision process was an iterative dialogue in which field study findings were integrated with theoretical reflections and expert-input. Results: The Euro-MCD 2.0 has three domains: 1) Moral Competence, 2) Moral Teamwork and 3) Moral Action. Moral Competence includes items on moral sensitivity, analytical skills and a virtuous attitude, like ‘I speak up in ethically difficult situations’. Moral Teamwork refers to open dialogue and supportive relationships, for example ‘We feel secure to share emotions in ethically difficult situations’. Moral Action includes items about moral decision-making and responsible care, like ‘We are able to explain and justify our care towards patients and their families’. Discussion: The Euro-MCD 2.0 is shorter and more strongly substantiated by empirical data and theoretical reflections. At the conference, we will reflect on the revision process and the underlying foundations of the domains. The revised instrument helps to get insight in the MCD related outcomes for healthcare professionals in their daily practice. Our research can further improve implementation of MCD and contribute to the research field of evaluation of CES in general. "

Moral Challenges of Ethics Support Staff. Developing a Moral Compass for Facilitators of Moral Case Deliberation

"Ethics support staff often help others to deal with moral challenges. However, they themselves can also experience moral challenges when practicing ethics support. Facilitators of Moral Case Deliberation (MCD) sometimes for example experience ethical questions when it comes to (breaking) confidentiality. Facilitators might find themselves compelled to intervene or act upon things they hear or see whilst facilitating a MCD. For example, a MCD facilitator finds out that a participant does something illegal. Or, what to do if a MCD facilitator is asked to inform the Inspectorate about details of a MCD? When is a facilitator allowed or obligated to break confidentiality and share information with others? How to make such a decision? And, if allowed to break confidentiality, how to do this in a morally sound way? Currently there are no moral guidelines on how to act upon these questions. We conducted empirical research that explores moral challenges of MCD facilitators related to confidentiality and develops a moral compass which provides directions to approach these challenges. Data collection consists of three complementary methods: * analyses of 3 a 4 audiotaped and transcribed MCD sessions about how and when to break confidentiality; * in-depth interviews about the topic; * focus group to validate the findings and co-create a moral compass. In our presentation, we will reflect upon both the theoretical and normative considerations concerning confidentiality in ethics support and the empirical results of this study. Furthermore, we will present a preliminary version of a moral compass in order to strengthen the moral competency of MCD facilitators. "

Mapping Emerging and Legacy Outlets Online by Their Democratic Functions—Agonistic, Deliberative, or Corrosive?

In this study, we offer a novel approach to research on migration reporting by focusing on the argumentative substance prevalent in different online outlets. Taking German refugee policy as our case in point we map the role that moral, ethical–cultural, legal, and pragmatic argumentations play within journalistic, partisan, and activist outlets; and how these coincide with incivility and impoliteness. Using dictionary-based content analysis on a data set of 34,819 articles from thirty online news outlets published between April 10, 2017, and April 10, 2018, we find that legacy mainstream media, partisan media, and activist media perform vastly different functions for the larger public sphere. We observe that human rights activist media perform an advocatory function by making the moral case for refugees, whereas corrosive partisan media at the fringe—particularly within the contra-refugee camp—often present opponents as inherently illegitimate enemies. Implications for public sphere theory and directions for future research on emerging and legacy media are discussed.

The role of emotions in Moral Case Deliberation: Visions and experiences of facilitators

Moral Case Deliberation is intended to assist healthcare professionals faced with difficult dilemmas in their work. These are situations that involve emotions. During Moral Case Deliberation, participants are invited to reflect on moral views and deliberate on them. Emotions are not explicitly addressed. This article aims to elucidate the role of emotions in Moral Case Deliberation, by analysing experiences of Moral Case Deliberation facilitators. Our research shows the role of emotions varies according to the phase of the Moral Case Deliberation process. One negative aspect of emotions is that they can obstruct the Moral Case Deliberation discussion or distract from the moral question. A positive aspect is that they bring the dilemma into sharper focus. Devoting attention to emotions can help to ensure that responsible decisions are made, while also increasing the moral resilience of participants.