Suchergebnisse

Background Societies are facing medical resource scarcities, inter alia due to increased life expectancy and limited health budgets and also due to temporal or continuous physical shortages of resources like donor organs. This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair. The purpose of this study was to explore how lay people, general practitioners, medical students and other health professionals evaluate the fairness of ten allocation principles for scarce medical resources: 'sickest first', 'waiting list', 'prognosis', 'behaviour' (i.e., those who engage in risky behaviour should not be prioritized), 'instrumental value' (e.g., health care workers should be favoured during epidemics), 'combination of criteria' (i.e., a sequence of the 'youngest first', 'prognosis', and 'lottery' principles), 'reciprocity' (i.e., those who provided services to the society in the past should be rewarded), 'youngest first', 'lottery', and 'monetary contribution'. Methods 1,267 respondents to an online questionnaire were confronted with hypothetical situations of scarcity regarding (i) donor organs, (ii) hospital beds during an epidemic, and (iii) joint replacements. Nine allocation principles were evaluated in terms of fairness for each type of scarcity along 7-point Likert scales. The relationship between demographic factors (gender, age, religiosity, political orientation, and health status) and fairness evaluations was modelled with logistic regression. Results Medical background was a major predictor of fairness evaluations. While general practitioners showed different response patterns for all three allocation situations, the responses by lay people were very similar. Lay people rated 'sickest first' and 'waiting list' on top of all allocation principles—e.g., for donor organs 83.8% (95% CI: [81.2%–86.2%]) rated 'sickest first' as fair ('fair' is represented by scale points 5–7), and 69.5% [66.2%–72.4%] rated 'waiting list' as fair. The corresponding results for general practitioners: 'prognosis' 79.7% [74.2%–84.9%], 'combination of criteria' 72.6% [66.4%–78.5%], and 'sickest first' 74.5% [68.6%–80.1%); these were the highest-rated allocation principles for donor organs allocation. Interestingly, only 44.3% [37.7%–50.9%] of the general practitioners rated 'instrumental value' as fair for the allocation of hospital beds during a flu epidemic. The fairness evaluations by general practitioners obtained for joint replacements: 'sickest first' 84.0% [78.8%–88.6%], 'combination of criteria' 65.6% [59.2%–71.8%], and 'prognosis' 63.7% [57.1%–70.0%]. 'Lottery', 'reciprocity', 'instrumental value', and 'monetary contribution' were considered very unfair allocation principles by both groups. Medical students' ratings were similar to those of general practitioners, and the ratings by other health professionals resembled those of lay people. Conclusions Results are partly at odds with current conclusions proposed by some ethicists. A number of ethicists reject 'sickest first' and 'waiting list' as morally unjustifiable allocation principles, whereas those allocation principles received the highest fairness endorsements by lay people and to some extent also by health professionals. Decision makers are advised to consider whether or not to give ethicists, health professionals, and the general public an equal voice when attempting to arrive at maximally endorsed allocations of scarce medical resources. ; ISSN:1932-6203

The paper's two theses are: First, that the historical and philosophical roots of argumentation are in ethics and politics, and not in any formal ideal, be it mathematical, scientific or other. Furthermore, argumentation is a human invention, deeply tied up with the emergence of democracy in ancient Greece. Second, that argumentation presupposes and advances concurrently humanistic values, especially the autonomy of the individual to think and decide in a free and uncoerced manner.

Abstract
As automation in artificial intelligence is increasing, we will need to automate a growing amount of ethical decision making. However, ethical decision- making raises novel challenges for engineers, ethicists and policymakers, who will have to explore new ways to realize this task. The presented work focuses on the development and formalization of models that aim at ensuring a correct ethical behaviour of artificial intelligent agents, in a provable way, extending and implementing a logic-based proving calculus that is based on argumentation reasoning with support and attack arguments. This leads to a formal theoretical framework of ethical competence that could be implemented in artificial intelligent systems in order to best formalize certain parameters of ethical decision-making to ensure safety and justified trust.

A relevant problem in political philosophy and political theory is the distinction between political and utopian arguments. The boundary between these two types of argumentation may be blurred, which leads us to the point when we often deal with contaminations of both ways of thinking in individual positions. This involves, for example, presenting a utopian argument as a political argument and vice versa. The main purpose of the article is to organize these issues by applying the argumentation model developed by Stephen Toulmin to the analysis of both theoretical approaches. The three main problems of this work are: 1) the distinction between political and ethical arguments; 2) identifying the proper structure of political argumentation; 3) evaluation of the coherence of the idea of a realistic utopia (proposed by John Rawls)