Relative Values: Perspectives on a Neuroimaging Technology From Above and Within the Ethical Landscape

Abstract

In this paper we contribute to Bsociology in bioethics^and help clarify the range of ways sociological work can contribute to ethics scholarship. We do this using a case study of an innovative neurotechnology, functional magnetic resonance imaging, and its use to attempt to diagnose and communicate with severely brain-injured patients. We compare empirical data from interviews with relatives of patients who have a severe brain injury with perspectives from mainstream bioethics scholars. We use the notion of an Bethical landscape^as an analogy for the different ethical positions subjects can take-whereby a person's position relative to the landscape makes a difference to the way they experience and interact with it. We show that, in comparison to studying abstract ethics Bfrom above^the ethical landscape, which involves universal generalizations and global judgements, studying ethics empirically Bfrom the ground,^within the ethical landscape foregrounds a more plural and differentiated picture. We argue it is important not to treat empirical ethics as secondary to abstract ethics, to treat on-the-ground perspectives as useful only insofar as they can inform ethics from above. Rather, empirical perspectives can illuminate the plural vantage points in ethical judgments, highlight the Blived^nature of ethical reasoning, and point to all ethical vantage points as being significant. This is of epistemic importance to normative ethics, since researchers who pay attention to the various positions in and trajectories through the ethical landscape are unlikely to think about ethics in terms of abstract agency-as can happen with top-down ethics-or to elide agency with the agency of policymakers. Moreover, empirical perspectives may have transformative implications for people on the ground, especially where focus on the potential harms and benefits they face brings their experiences and interests to the forefront of ethical and policy discussion.

Forensic DNA phenotyping in Europe: views “on the ground” from those who have a professional stake in the technology

“…Indeed, the heterogeneity of views highlighted in our findings, which resonates with findings from the ethical boundary literature previously (Hobson-West 2012; Wainwright et al 2006), illustrate the pluralistic and contested nature of ethical values "on the ground" between different individuals and different professional stakeholders in the criminal justice system. Similar findings have been described in other areas of science where different professional or individual stakeholders adopt different ethical "role positions" (Cribb et al 2008;Samuel et al 2016), and findings by Williams and Johnson (2004) show how various actors in the criminal justice system represent forensic DNA technologies differently. This raises questions about how best to weigh up such role positions/representations given their social, cultural and political contexts.…”

Perceptions of artificial intelligence in healthcare: findings from a qualitative survey study among actors in France

“…In 2016, an English study proved that "studying ethics empirically "from the ground, " within the ethical landscape provides more plural and differentiated pictures". This 2016 study concluded:"if […] policymakers want to make defensible decisions they need to make them whilst also being responsive to and ideally in conversation with other actual agents" [38]. Thus, because we present the point of view of the involved actors, institutions and others concerned, it is possible to grasp the subject in its numerous dimensions and address the expressed ethical concerns that a top-down approach would never show.…”

Austerity and Professionalism: Being a Good Healthcare Professional in Bad Conditions

“…Elsewhere we have argued that normative arguments must be empirically informed and, more specifically, that claims about what agents ought to do must be informed by attention to the constraints and affordances that they face [33]. At least some of the time ethical analyses and conclusions should be informed by the view from 'inside the ethical landscape', that is with an awareness of the actual context and conditions agents face, rather than from some abstract and idealised position 'above' it.…”