Machine Ethics: Do Androids Dream of Being Good People?

Is ethics a computable function? Can machines learn ethics like humans do? If teaching consists in no more than programming, training, indoctrinating… and if ethics is merely following a code of conduct, then yes, we can teach ethics to algorithmic machines. But if ethics is not merely about following a code of conduct or about imitating the behavior of others, then an approach based on computing outcomes, and on the reduction of ethics to the compilation and application of a set of rules, either a priori or learned, misses the point. Our intention is not to solve the technical problem of machine ethics, but to learn something about human ethics, and its rationality, by reflecting on the ethics that can and should be implemented in machines. Any machine ethics implementation will have to face a number of fundamental or conceptual problems, which in the end refer to philosophical questions, such as: what is a human being (or more generally, what is a worthy being); what is human intentional acting; and how are intentional actions and their consequences morally evaluated. We are convinced that a proper understanding of ethical issues in AI can teach us something valuable about ourselves, and what it means to lead a free and responsible ethical life, that is, being good people beyond merely "following a moral code". In the end we believe that rationality must be seen to involve more than just computing, and that value rationality is beyond numbers. Such an understanding is a required step to recovering a renewed rationality of ethics, one that is urgently needed in our highly technified society.

Early Outcomes of Liver Transplantation Using Donors After Circulatory Death in Patients With Hepatocellular Carcinoma: A Comparative Study

INTRODUCTION

Donation after circulatory death (DCD) has increased in the last decade, although a slight increase in surgical complications has been reported in liver transplantation (LT). Therefore, DCD is not overall recommended because it entails an added risk. However, DCD in selected patients shows acceptable results.

OBJECTIVE

The objective was to analyze the characteristics, early outcomes, and survival at 1 year post-LT from a single institute (January 2015 to May 2017).

MATERIALS AND METHODS

We included 18 DCD-LTs and compared them with a control group of 18 donation after brain death (DBD) LTs. We analyzed pre- and posttransplant variables related to donors, recipients, and intraoperative early outcomes within patients transplanted due to hepatocellular carcinoma (HCC). A descriptive analysis, Mann-Whitney U test, χ², or Fisher test was performed when appropriate, as well as multivariate analysis in case of statistical significance. A variable is considered as statistically significant when it reaches a value of P < .05.

RESULTS

In DBD, we found a lower length of stay in the intensive care unit before retrieval and a higher rate of alcoholism and diabetes mellitus, Model for End-Stage Liver Disease score, and Child B and C score (P < .05). Most of the DCD were originally from the same LT recipient center, and a higher donor mean post-LT alanine aminotransferase level was found (P < .05). Survival for the DBD group was 88% and 75% in the DCD group at 1 year post-LT, being not significant (NS).

CONCLUSION

HCC recipients who are transplanted with good quality DCD livers do no worse than those transplanted with livers from DBD donors, although a good selection of them is crucial.

Importance for the Elderly of Discussion in the Family and Society About Attitude Toward Organ Donation

BACKGROUND

The aging of the population has changed some of the approaches to the organ donation and transplant (ODT) process, such as considering elderly people as potential donors. We aimed to assess social and family discussions among the elderly about ODT and its effect on their attitude toward organ donation.

METHODS

A study was carried out at 2 publicly-funded social centers for the elderly. Contact was made with individuals >65 years of age (n = 120) to seek their participation in the study. A questionnaire was distributed to them with questions about ODT. A descriptive assessment was performed with the Student t test and χ² test used for statistical analysis.

RESULTS

The completion rate was 87% (n = 104). Of the respondents with a partner and children, 48% had discussed the topic of ODT. It was found that talking about the subject with one's partner, children, or friends had a favorable influence on attitude compared with when this was not done (93%, 86%, and 83% vs 19%, 30%, and 31%, respectively; P < .001). In addition, the opinion of one's partner and children toward ODT also had an influence; if favorable, the respondent's attitude was more favorable, compared with when they did not know their opinion (92% to 88% vs 58% to 37%, respectively; P < .001). Other ODT-related variables did not affect their attitude (P > .05).

CONCLUSIONS

Almost half of the elderly people had discussed ODT socially or with their family. This discourse has a favorable influence on their attitude toward organ donation and, therefore, it is important to encourage social and family dialog among this group.

Educational Encounters of the Third Kind

An engineer who becomes an educator in a school of software engineering has the mission to teach how to design and construct software systems, therein applying his or her knowledge and expertise. However, due to their engineering background, engineers may forget that educating a person is not the same as designing a machine, since a machine has a well-defined goal, whilst a person is capable to self-propose his or her own objectives. The ethical implications are clear: educating a free person must leave space for creativity and self-determination in his or her own discovery of the way towards personal and professional fulfillment, which cannot consist only in achieving goals selected by others. We present here an argument that is applicable to most fields of engineering. However, the dis-analogy between educating students and programming robots may have a particular appeal to software engineers and computer scientists. We think the consideration of three different stages in the educational process may be useful to engineers when they act as educators. We claim that the three stages (instructing, training and mentoring) are essential to engineering education. In particular, education is incomplete if the third stage is not reached. Moreover, mentoring (the third stage aimed at developing creativity and self-determination) is incompatible with an educational assessment framework that considers the goals of the engineer are always given by others. In our view, then, an integral education is not only beyond programming the behavior of students, but also beyond having them reach those given goals.

Benefits of Group Psychotherapy in Cirrhotic Patients on the Liver Transplant Waiting List

INTRODUCTION

It is well-known that patients on the liver transplant (LT) waiting list experience a high rate of psychopathologic symptoms. However, few studies have been published about the use of group psychotherapy for these patients. We sought to assess (1) the psychopathologic data in patients on the LT waiting list and (2) the attitude toward a group psychotherapy procedure and its efficacy.

MATERIAL AND METHODS

In the pretransplant consultation phase, group therapy was offered to 20 patients on the LT waiting list. Patients who received psychotherapy were assessed previously using the Beck Depression Inventory.

RESULTS

Fifteen patients were included in the study. Significant differences were found between the psychopathologic assessment and the level of hepatopathy. In the first session, we observed that patients with hepatocarcinoma were much more reluctant to participate in the group therapy. In the second session, the group showed a high level of anxiety connected with a fear of transplantation. In the third session, a transplant physician answered all their questions, and at the end of the session patient anxiety had decreased. During the following sessions, family bonds and sharing experiences with other transplant patients were emphasized.

CONCLUSIONS

Patients were initially reluctant to participate in the group psychotherapy, although this changed as sessions proceeded. It is necessary to provide more information about the transplant procedure itself to decrease anxiety. Group therapy was valued positively by all patients who participated.

Teaching Ethics to Engineers: A Socratic Experience

In this paper we present the authors' experience of teaching a course in Ethics for Engineers, which has been delivered four times in three different universities in Spain and Chile. We begin by presenting the material context of the course (its place within the university program, the number of students attending, its duration, etc.), and especially the intellectual background of the participating students, in terms of their previous understanding of philosophy in general, and of ethics in particular. Next we set out the objectives of the course and the main topics addressed, as well as the methodology and teaching resources employed to have students achieve a genuine philosophical reflection on the ethical aspects of the profession, starting from their own mindset as engineers. Finally we offer some results based on opinion surveys of the students, as well as a more personal assessment by the authors, recapitulating the most significant achievements of the course and indicating its underlying Socratic structure.

Generation of human-to-pig chimerism to induce tolerance through transcutaneous in utero injection of cord blood-derived mononuclear cells or human bone marrow mesenchymals cells in a preclinical program of liver xenotransplantation: preliminary results

OBJECTIVE

Using a percutaneous ecoguided injection system to obtain chimeric piglets through a less invasive and traumatic technique than previously reported.

MATERIALS AND METHODS

The two types of human cells included umbilical cord blood mononuclear elements and mesenchymal stem cells cultured from bone marrow. Four sows at gestational day 50 were anesthetized. A needle was inserted through the skin and uterine wall to reach the peritoneal cavity of the fetuses under continuous ultrasound guidance. Fourteen piglets were injected with various cell concentrations.

RESULTS

All sows carried pregnancies to term yielding 69 piglets, among which 67 were alive and two mummified. Two piglets died during the first 48 hours of life. Chimerism was detected using flow cytometry and by quantitative polymerase chain reaction (q-PCR) to detect Alu gene in blood or tissues samples. The analysis detected blood chimerism in 13 piglets (21%) by flow cytometry and the presence of the human Alu gene in 33 (51%) by q-PCR. The results suggest cell trafficking between littermates after in utero injection.

CONCLUSIONS

Transcutaneous echo-guided injection succeeded to produce chimeric piglets without disadvantages to the sow or the fetuses and avoiding abortions or fetal death.

[Infection by human papilloma virus amongst female inmates in a social re-adaptation centre in South-West Mexico]

INTRODUCTION

The aim of this work is describe the epidemiology of HVP amongst female inmates.

MATERIAL AND METHODS

A total of 82 women were studied in a cross sectional study. Epidemiological data were collected through a direct interview. Samples of cervical cells were taken. HPV and genotypes were identified by molecular test.

RESULTS

Global HPV prevalence was 20.7%. Fifteen different genotypes were identified 60% low risk HPV, 26.7% high risk HPV and 13.3% were not classified in any of the two groups. Types 6/11 were the most common. 23.5% (04/17) of HPV positives samples had multiple infections, 3 with 2 genotypes and one with 3. Association between infection with HPV and smoking was found, p= 0.0258, OR 3.79 IC 95% (1.01-15.58).

Ethical education in software engineering: responsibility in the production of complex systems

Among the various contemporary schools of moral thinking, consequence-based ethics, as opposed to rule-based, seems to have a good acceptance among professionals such as software engineers. But naïve consequentialism is intellectually too weak to serve as a practical guide in the profession. Besides, the complexity of software systems makes it very hard to know in advance the consequences that will derive from professional activities in the production of software. Therefore, following the spirit of well-known codes of ethics such as the ACM/IEEE's, we advocate for a more solid position in the ethical education of software engineers, which we call 'moderate deontologism', that takes into account both rules and consequences to assess the goodness of actions, and at the same time pays an adequate consideration to the absolute values of human dignity. In order to educate responsible professionals, however, this position should be complemented with a pedagogical approach to virtue ethics.

Effects of indomethacin and iloprost on contraction of the afferent arterioles by endothelin-1 in juxtamedullary nephron preparations from normotensive Wistar-Kyoto and spontaneously hypertensive rats

The contractile effects of endothelin-1 on the afferent arterioles of normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) and the modulation of these responses by cyclooxygenase blockade or by the prostacyclin analog iloprost were investigated. For this, the preglomerular vasculature was visualized by using the juxtamedullary nephron preparation. Endothelin-1 (100 pM-1 microM) induced concentration-dependent reduction of afferent diameters either in WKY and SHR kidneys, which were inhibited by 1 microM nifedipine, indicating its dependence on extracellular calcium. After incubation with 20 microM indomethacin, the endothelin-1-induced contractions were potentiated in WKY but abolished in SHR vessels. These results could be explained if endothelin-1 is releasing vasodilator prostanoids in WKY, whereas in SHR preparations, vasoconstrictor prostanoids predominate. The prostacyclin analog iloprost (1 nM-1 microM) did not modify basal diameters of the WKY afferent arterioles, whereas a weak vasodilatatory effect was observed in the SHR afferent vasculature. Both in WKY and SHR preparations, iloprost (10 nM-1 microM) abolished the afferent contractility by endothelin-1, this effect being more prominent in SHR. We conclude that a defective production of vasodilator prostanoids or an enhanced release of vasoconstrictor cyclooxygenase derivatives may determine the renovascular effects of endothelins in SHR kidneys.

Prevalence of anticardiolipin antibodies in subacute cutaneous lupus erythematosus

We examined the prevalence of the antibodies to cardiolipin measured by solid-phase enzyme immunoassay during a prospective study of patients with subacute cutaneous lupus erythematosus (SCLE). Seven of 44 (16%) consecutive patients with SCLE had positive anticardiolipin antibodies; of these only three satisfied the American Rheumatism Association's revised criteria for the classification of systemic lupus erythematosus. Clinical findings probably associated with the positive anticardiolipin antibodies were found in four cases, including clotting abnormalities, thrombocytopenia, hemolytic anemia, livedo reticularis, chilblain lupus erythematosus lesions, migraine, leg venous thrombosis and pulmonary embolism after surgery, and spontaneous abortion. Our data suggest that it is reasonable to screen SCLE patients for these antibodies to confirm the presence of the antiphospholipid syndrome.

Role of rotavirus and enteric adenovirus in acute paediatric diarrhoea at an urban hospital in Mexico

Of 150 acute diarrhoea paediatric cases admitted to the General Hospital Augustín O'Horán in Mérida, Yucatán, México between January 1986 and December 1986, human rotavirus was detected in the faeces of 48 (32%) either as the sole aetiological agent or in association with other viruses. Adenovirus was detected in faeces of 18 (12%) patients. Rotavirus of the long pattern type (antigenic subgroup II) predominated. Children aged 7 to 12 months were most commonly infected. Rotavirus was detected throughout the year, whereas adenovirus was detected between January and September only. Clinical features of patients with rotavirus and adenovirus infections are compared.