Journal of Responsible Technology 18 (2024) 100082
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Journal of Responsible Technology
journal homepage: www.sciencedirect.com/journal/journal-of-responsible-technology
Digital humanism as a bottom-up ethics
Gemma Serrano a, Francesco Striano a, b, *, Steven Umbrello a, b, c
a
Département Humanisme Numérique, Collège des Bernardins, 20 Rue de Poissy, 75005 Paris, France
Department of Philosophy and Education Sciences, Università degli Studi di Torino, Via Sant’Ottavio, 20, 10124 Torino, Italy
c
Center for Religious Studies, Bruno Kessler Foundation, Via Santa Croce, 77, I-38122 Trento, Italy
b
A R T I C L E I N F O
A B S T R A C T
Keywords:
Digital humanism
Utilitarianism
Vienna manifesto
Applied ethics
In this paper, we explore a new perspective on digital humanism, emphasizing the centrality of multi-stakeholder
dialogues and a bottom-up approach to surfacing stakeholder values. This approach starkly contrasts with
existing frameworks, such as the Vienna Manifesto’s top-down digital humanism, which hinges on preestablished first principles. Our approach provides a more flexible, inclusive framework that captures a
broader spectrum of ethical considerations, particularly those pertinent to the digital realm. We apply our model
to two case studies, comparing the insights generated with those derived from a utilitarian perspective and the
Vienna Manifesto’s approach. The findings underscore the enhanced effectiveness of our approach in revealing
additional, often overlooked stakeholder values, not typically encapsulated by traditional top-down methodologies. Furthermore, this paper positions our digital humanism approach as a powerful tool for framing ethics-bydesign, by promoting a narrative that empowers and centralizes stakeholders. As a result, it paves the way for
more nuanced, comprehensive ethical considerations in the design and implementation of digital technologies,
thereby enriching the existing literature on digital ethics and setting a promising agenda for future research.
Introduction
Since the dawn of the digital age, we have witnessed the profound
transformation of our societies, with digital technologies penetrating
nearly every aspect of our lives. Scholars and practitioners have grappled with the ethical implications of this transformation, seeking to
frame and understand the changes within a coherent ethical context.
However, the rapid and unprecedented development of digital technologies poses complex challenges to traditional ethical frameworks,
necessitating novel approaches to address the evolving ethical landscape
(Floridi & Sanders, 2004; Vallor, 2016).
In the burgeoning field of digital ethics, a key concern is the need for
a robust and inclusive ethical approach that can sufficiently navigate the
complexities of digital technologies and their impact on diverse stakeholders. This paper addresses this pressing need by proposing a bottomup approach to digital humanism. Digital Humanism, as a term in the
extant literature, can be broadly understood as an attempt to place
human values and interests at the centre of the digital transformation. It
stems from the recognition that while digital technologies have brought
about unprecedented changes and opportunities, they have also raised
serious ethical, social, and political concerns that need addressing (Cath
et al., 2018). Digital Humanism aims to counterbalance the
technology-driven determinism that often dominates the digital sphere,
emphasizing that humans should actively shape technology and not just
be shaped by it (Fuchs, 2022). The Vienna Manifesto on Digital Humanism,
for instance, posits an interpretation of digital humanism that stresses
the importance of human autonomy, democratic governance, privacy,
and diversity in the context of digital technologies (Werthner et al.,
2022; Werthner, 2020). While it offers a comprehensive framework, it
follows a primarily top-down approach, which this paper argues could
be complemented by a more bottom-up, dialogic perspective. This is not
to say that our approach is necessarily incompatible with the Viennese
approach, nor that the two visions cannot complement each other in
certain aspects. On the contrary, it would be appropriate – and we hope
so – for channels of communication to be opened between the two,
provided that a serious comparative study of the methodologies derived
from them is not disregarded. This paper is, among other things, a first
attempt to do so, as well as an illustration of the specificity of our
approach.
Therefore, unlike conventional ethical frameworks, which often
adhere to a top-down methodology, premised on predetermined first
principles, our approach advocates for multi-stakeholder dialogues as a
* Corresponding author.
E-mail address:
[email protected] (F. Striano).
https://doi.org/10.1016/j.jrt.2024.100082
Available online 29 March 2024
2666-6596/© 2024 The Author(s).
Published by Elsevier Ltd on behalf of ORBIT. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
G. Serrano et al.
Journal of Responsible Technology 18 (2024) 100082
means to surface stakeholder values and negotiate the ethical implications of digital technologies. This paper argues that such a bottom-up
approach to digital humanism facilitates a more nuanced and comprehensive understanding of the ethical implications of digital technologies, thereby providing a unique contribution to the extant literature.
In seeking to showcase the comparative novelty and effectiveness of
our proposed approach, we engage with two case studies. By applying
our bottom-up approach and juxtaposing the resultant insights with
those derived from a utilitarian perspective and the Vienna Manifesto’s
approach to digital humanism, we provide a critical evaluation of these
disparate ethical frameworks in action.
The paper is organized as follows. Section two offers an in-depth
explanation of our bottom-up approach to digital humanism, including
its theoretical underpinnings and methodological considerations. In
section three, we present the case studies and discuss the application of
the three distinct ethical approaches to each case and provide a
comparative analysis of the findings from the different approaches.
Section four emphasizes the unique insights garnered from our proposed
methodology and concludes the paper by summarizing key findings and
implications, as well as suggesting avenues for future research.
By adopting a bottom-up approach to digital humanism, this paper
aims to broaden the discourse on digital ethics and illuminate the oftenoverlooked perspectives of diverse stakeholders, thereby offering a more
comprehensive, inclusive, and contextually sensitive approach to navigating the ethical challenges of the digital age.
The great digital turn – or “conversion”, in Doueihi’s (2008) words – is
therefore a technological turn, but also a cultural turn. In this sense, the
humanism we propose as a companion to research and technological
development in our digital civilisation does not take the form of an
attempt to apply pre-constituted values from the outside, so as to regain
or defend a human autonomy at risk. Our humanism is justified as a
philological analysis of the digital “from within” of digital culture itself.
By philological analysis, we mean an analysis of objects, their origins, and cultural continuities, and of their material characteristics and
impact on the human dimension, starting from the physiological level, in
the conviction that culture convinces the body first (Doueihi, 2009).
This approach refrains from imposing pre-packaged values and instead
participates in the intellectual negotiation of technological and cultural
changes.
The humanistic approach advocated by the department of Digital
Humanism (Humanisme Numérique) at the Collège des Bernardins (from
now on Bernardins HN Approach) emphasizes the significance of a relational anthropology and a cultural theory that encompasses the technological dimension. This perspective challenges traditional views of
technology as an isolated entity, instead positioning it within the
broader cultural and social fabric. Relational anthropology here implies
a deep understanding of how individuals interact with each other and
with technology in a symbiotic manner. It seeks to unravel the complex
web of relationships between humans and technology, acknowledging
how these interactions shape both the technology itself and the societal
norms and values.
This approach extends to examining how technology impacts and is
impacted by cultural practices, beliefs, and traditions. It recognizes that
technology is not merely a tool or an outcome of human ingenuity but is
an integral part of our cultural evolution. This recognition leads to a
broader understanding of technology, not just as a set of tools and
processes, but as a cultural phenomenon that reflects and influences
human values, behaviors, and societal structures.
Bernardins’ approach to digital humanism
The College des Bernardins’ approach to Digital Humanism represents a paradigm shift in understanding the ethics of digital technologies.1 Unlike the conventional utilitarian perspective that aligns with the
refined design of digital technologies and prioritizes welfare and harm
calculations (Bednar & Spiekermann-Hoff, 2020), the Bernardins’
approach challenges this belief by advocating for a human-centred
framework.
The reference to humanism or the advocacy of a human-centred
approach can be considered problematic because being humanist is
often understood in the sense of “defending” the human. We, on the
other hand, believe that being a humanist means to take responsibility for
the fact that we are human, and that “being human” cannot be reduced to
a purely biological or taxonomic fact (Serrano, 2021). Which is why our
approach goes beyond preconceived notions of humanity that are independent of technological conditions and instead grounds ethical theory in a profound anthropology. This anthropology involves a detailed
contemplation of our relationships with objects, environments, and the
intersubjective relationships they facilitate, considering the
co-implication of human, social, environmental, and technological
contexts.
Building on Milad Doueihi’s (2011) reflection and the Vichian
philological approach, the Bernardins’ humanism integrates technology
with culture, treating the digital as a civilisation (Doueihi & Domenicucci, 2018), i.e., a set of symbolic and material structures (languages,
institutions, cultures, new objects of worship, new collective beliefs).
Advocacy for a bottom-up methodology
The philological clarification described in the previous section serves
to identify problematic plexuses and to understand what anthropological changes they underlie or contribute to. But the ultimate aim of
digital humanism must be to participate in the intellectual negotiation
(Doueihi & Domenicucci, 2018) of the changes taking place: if technology is culture and the digital is civilisation, then philosophical and
cultural work also participates, not by imposing values, but by negotiating them and taking on the task of accompanying anthropological
changes, constantly mediating between automation and autonomy. This
must, therefore, result in a bottom-up ethic.
The bottom-up methodology advocated in this approach emphasizes
the active involvement of all stakeholders in the decision-making process related to technological development and implementation. This is
along the lines of other approaches that emphasise stakeholder
involvement, such as Value Sensitive Design (VSD) (Friedman & Hendry, 2019), especially versions such as that in the wake of the Vienna
Manifesto by Zuber et al. (2024), where ethical deliberation takes place
in multiple moments and is thus consistent with the concept of negotiation. What distinguishes us is that collectively held values guide
deliberative moments in the VSD methodology, while, as will be seen in
the following sections, we propose to also focus on narrative dimensions
and their influence on value definition. We also sympathise with
virtue-oriented approaches (even more so with a civic virtue-oriented
approach such as Reijers, 2023), but we believe that while it is important to cultivate agential disposition, it must also be considered that
dispositions are sometimes enabled or disabled by the technologies
themselves.
Our methodology contrasts with top-down approaches that often see
decisions made by a select few, typically those in positions of power or
with technical expertise. In contrast, a bottom-up approach
1
The Humanisme Numérique department of the Collège des Bernardins in
Paris is the most advanced French language centre on digital humanism.
Inspired by the Syrian-Lebanese scholar Milad Doueihi’s theoretical elaborations, the research team that has built up around the Collège over the years has
critically analysed the changes induced by digitalisation in culture, the new
digital cultural products, and human practices related to virtual environments,
through seminars, series of meetings, public lectures, and publications. In May
2024, the department will present its own position paper on digital humanism
that will condense almost 10 years of work, which began with the chair
“L’humain au défi du numérique” held by Doueihi and continued by the
department co-chaired by Gemma Serrano and Graziano Lingua.
2
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Journal of Responsible Technology 18 (2024) 100082
democratizes the process, ensuring that voices from various sectors of
society, including those often marginalized or overlooked, are heard and
considered.
This inclusive approach is particularly crucial in the digital realm,
where technologies can have far-reaching and unforeseen impacts on
diverse groups (cf., Trittin-Ulbrich et al., 2021). By involving stakeholders such as end-users, developers, ethicists, cultural theorists, and
representatives from marginalized communities, this approach ensures a
more holistic understanding of the ethical, social, and cultural implications of digital technologies.
are shaped and the values and assumptions that drive their development. This transparency can lead to more informed discussions about
the ethical and social implications of technology.
A crucial aspect of this approach is challenging the widespread belief
in the existence of intelligent machines. This involves questioning the
anthropomorphization of technology and highlighting the differences
between human intelligence and artificial computation. By doing so, it
aims to prevent the overestimation of technology’s capabilities and the
underestimation of its potential risks and ethical implications.
Furthermore, this approach proposes alternative narratives to the
dominant ideologies of an inevitable digital future and the pursuit of
maximum profit at the lowest cost. It questions the assumption that
technological advancement is always synonymous with progress and
challenges the idea that efficiency and profit should be the primary
drivers of technological development. By presenting alternative narratives, this approach advocates for a more balanced view of technology,
one that considers human values, societal needs, and ethical implications alongside innovation and economic incentives.
Emphasizing diverse narratives
Central to this humanistic approach is the emphasis on the importance of narratives that reflect diverse perspectives. This aspect acknowledges the power of storytelling and narrative in shaping our
understanding and relationship with technology (Reijers & Coeckelbergh, 2020). Narratives from different social, cultural, and economic
backgrounds provide a richer, more nuanced view of the digital world
and its impacts. They allow for the exploration of how technology affects
various groups in society differently, highlighting issues of access, equity, and representation.
Incorporating these diverse narratives into the decision-making and
developmental process of digital technologies ensures that the resulting
products and policies are more equitable, accessible, and culturally
sensitive. This not only enhances the ethical development of technology
but also fosters a sense of ownership and responsibility among all
stakeholders, leading to more sustainable and beneficial technological
solutions.
By expanding on relational anthropology, advocating for a bottomup methodology, and emphasizing diverse narratives, the Bernardins
HN Approach offers a comprehensive framework for understanding and
shaping the role of technology in society. It underscores the need for a
collaborative, inclusive, and culturally aware approach to the ethical
challenges of the digital age.
Analyzing rhetorical devices and establishing forms of resistance
Analyzing rhetorical devices used in the discourse surrounding digital technologies is another key action. This analysis aims to uncover
how language and rhetoric shape perceptions and attitudes towards
technology, potentially masking underlying issues or biases. For
instance, examining how certain technologies are marketed or discussed
in public forums can reveal hidden agendas or unacknowledged risks. In
other words, to examine the rhetorical regimes that accompany the
design and use of technologies is to understand and discuss the practices
that these technologies enable or disable.
Establishing forms of resistance (De Certeau, 1984), criticism, and
analysis is an integral part of this approach. This means creating spaces
and opportunities for critical engagement with technology, where assumptions can be challenged, and alternative perspectives can be heard.
Such spaces are essential for preventing the uncritical acceptance of
technological solutions and for encouraging a more reflective and
deliberative culture around technology development and use.
In sum, the Bernardins HN Approach is not just theoretical but aims
to clarify and intervene. It does so by identifying problematic plexuses
and understanding anthropological changes, thereby participating in the
negotiation of these changes without imposing values but rather mediating them, thus enriching the ethical discourse in the digital age. This
approach stands as a non-rigidly normative, context-dependent, attitude-dependent, situation-dependent ethics, which is why we call it
“situative ethics.”2
Demystifying metaphors and describing design processes
This humanistic approach places significant emphasis on demystifying the metaphors commonly used in the realm of digital technology (cf.,
Shneiderman, 2022). Metaphors, while useful for simplifying complex
concepts, can often lead to misconceptions or oversimplified understanding of technology. For example, referring to advanced algorithms
as “intelligent” or “thinking” machines can obscure the limitations and
programmed nature of these systems. By critically examining and
demystifying these metaphors, this approach seeks to foster a more accurate and grounded understanding of digital technologies and their
capabilities.
With regard to artificial intelligence systems, there are also those
who have proposed replacing the term “artificial intelligence” with the
term “artificial agent”. Luciano Floridi (2023) sees an authentic revolution consisting in having “decoupled the ability to act successfully
from the need to be intelligent”: a machine cannot “understand, reflect,
consider or grasp anything”, but that is not necessary to act either. This
attempt to focus on agency rather than intelligence may be a first step in
the direction of demystifying metaphors, but the step we propose here is
a more significant one: what is relevant in order to found an ethical
methodology that responds effectively to the challenges of the digital
society is the analysis of the structures of a technological object in order
to understand what practices it enables and how it modifies human relations with the environment.
In addition to demystifying metaphors, there is a focus on thoroughly
describing the design processes behind digital technologies. This involves illuminating the decisions, trade-offs, and considerations that go
into the development of technology. By making these processes more
transparent, stakeholders gain a deeper insight into how technologies
Application and use cases
In this section of the paper, we aim to demonstrate the practical
application and effectiveness of the Bernardins HN Approach through an
in-depth analysis of two selected case studies. This analysis will not only
underscore the novelty and efficacy of our approach but also provide a
comparative understanding of how different ethical frameworks interpret and address ethical dilemmas in the realm of digital technologies.
Each case study will be presented in a structured manner, starting
with a detailed description of the case. This will set the stage for a multifaceted analysis, where the case will first be examined through the lens
of utilitarian ethics. This examination will highlight how a utilitarian
approach, which focuses on the outcomes and consequences of actions,
interprets the ethical dimensions of the case. Following this, we will
explore the case from the perspective of the Vienna Manifesto’s understanding of digital humanism. This will involve assessing the case based
2
We owe the introduction of this term to Antonio Lucci, researcher at the
University of Turin and collaborator of the Collège des Bernardins.
3
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Journal of Responsible Technology 18 (2024) 100082
on the principles outlined in the Manifesto, such as human autonomy,
democratic governance, privacy, and diversity, providing insights into
how this top-down approach addresses the ethical challenges presented
in the case. Finally, we will apply the Bernardins HN Approach to the
same case. This will involve a thorough analysis that incorporates the
Collège’s emphasis on relational anthropology, the demystification of
technology, and the importance of including diverse narratives and
stakeholders in the ethical discourse. By juxtaposing our approach with
the utilitarian and Vienna Manifesto perspectives, we aim to highlight its
unique contributions to the field of digital ethics.
addition, the use of nudges to influence student behavior based on data
collected from them raises ethical concerns about the potential for
manipulation and coercion. It seems important to ensure that the
collection of student data is transparent, justified, and balanced with
respect for privacy and individual rights.
This need seems to be met by the ethical approach that can be
derived from Digital Humanism as conceived by the Vienna Manifesto.
This approach to student data tracking considers the right to privacy as
non-negotiable and requires explicit consent from students for the
collection of data. The results of the analysis should only be used for
purposes established by the students themselves. There is also data that
should not be collected. Once the parties involved have been consulted,
the values chosen should be “instilled” in tracking technologies and any
limitations to the pervasiveness of such technologies should be made.
The limits of this approach are that it considers privacy a universal right
that is not negotiable, even if some students were willing to admit to a
certain degree of tracking in exchange for access to data that they would
not be able to measure on their own. The rules, regulations, and any
intervention aimed at limiting data collection must be established by a
public decision-maker, without necessarily going through the parties
involved, except in the form of public debate (and consider that, in this
case, the university could be the same public entity that decides).
Finally, it is more oriented towards modifying existing technologies to
make them more ethical than towards rethinking technological
solutions.
The applied ethical approach derived from the Bernardins HN
Approach, on the other hand, as explained in Section 2, is embodied in a
threefold practice, the first of which consists of identifying and demystifying the narratives underlying a certain technology and its application. In the application of these tracking technologies, two narratives are
implicit: the first is that of the neutrality of technology, which sees the
simple recording of data as something that could become a form of
control; the second is the neoliberal narrative that measures academic
success in terms of performance. Digital humanism, in its critical part,
should be able to reconstruct the genealogy of these narratives and show
that other narratives are possible.
Next, one must ask what kind of practices are or can be enabled by
the use of the technologies discussed. Students’ tracking practices can
enable the use of digital technologies to pursue the control of the student
population. In this case, it is not a matter of understanding how to make
such use more equitable and transparent, but it may be the case of
rejecting this application in the name of the interest of the student
component in maintaining a certain degree of freedom within the
institution. At the same time, the possibility for students to have access
to their own data to better design their paths and careers could be
enabled based on them. In this case, it would be necessary to understand
how to exploit this possibility.
Finally, it is necessary to ensure that the design of technological
solutions is truly multi-stakeholder and to think about what types of
digital technologies to prepare (free software, decentralized and nonproprietary systems, etc.), as well as who should manage the collection and analysis of data and based on what principles (access and
consultation for female students, help on request for their academic
decisions, etc.). In addition, space for feedback and the continuous
possibility of renegotiation or withdrawal from tracking by those being
tracked should be maintained.
Students and sensors: data, education, privacy, and research
The first case study focuses on the use of student data by universities
for various purposes, highlighting a specific instance at the University of
Arizona.3 Here, a researcher analyzed student ID card swipes across
campus locations over three years to study student routines and relationships. The aim was to understand these patterns in relation to
student retention after their freshman year.
The research involved creating large networks mapping student interactions and analyzing how these interactions and social circles
evolved over time. The data used in the study was anonymized, but there
was a possibility of sharing personal details with academic advisors to
improve student retention. Additionally, the researcher expressed interest in incorporating data from campus Wi-Fi hubs to gain a more
accurate picture of student movements and behaviors. The university’s
use of predictive analytics, which includes about 800 data points per
student, was aimed at supporting students in their programs and practices. However, this initiative sparked discussions and concerns about
digital privacy. These concerns were highlighted in an Arizona Public
Media article (Jess, 2018), where a university professor discussed the
lack of student awareness regarding the collection of their data.
Subsequently, an EDUCAUSE Review article titled “Setting the Table:
Responsible Use of Student Data in Higher Education” (Kurzweil &
Stevens, 2018) reported on a meeting of experts who discussed ethical
frameworks for using student data. The article emphasized the need for
transparency and clarity in the data collection process, including how
students are assessed and the governance of these assessments. However, it did not advocate for students to have the option to opt out of data
collection. In contrast, the assistant provost for institutional research at
Arizona University suggested that any future use of student ID card
tracking for retention efforts would be preceded by a campus conversation, and students would have the option to opt out.
The analysis of on-campus behaviour as well as the application of
learning analytics can bring benefits in improving student performance
as well as their social interactions. However, there are ethical issues
related to privacy concerns, or even to the actual ability to intervene or
manage the enormous amount of data generated, which may give rise to
some concern (Willis, 2014). This concern can be addressed through
different ethical approaches.
The utilitarian approach to student data tracking is based on the
maximization of individual and collective well-being. This approach
could justify the collection of student data to promote academic success
or social relationships of students, but only if it is balanced with respect
for privacy and if data collection is justified by a legitimate need and
adequately communicated to students. The advantage of applying a
utilitarian ethics in the design of such algorithms is that it is an ethics
that is immediately applicable, result-oriented, and very suitable for
computer technologies that can easily be designed to compute on values
of well-being and harm. However, the limitation of this approach is that
a calculation on the most functional solution does not necessarily take
into account the rights or preferences of the individuals involved. In
Using predictive software in the medical field
The rapid growth of AI in healthcare is accompanied by ethical
challenges, including informed consent, algorithmic biases, and data
privacy concerns. One key challenge is the complexity of informed
consent in AI healthcare applications. Questions arise regarding the
extent to which providers should educate patients about AI intricacies,
including the types of machine learning used, data inputs, and potential
biases. Additionally, the “black box” nature of many AI algorithms,
3
https://www.scu.edu/ethics/focus-areas/internet-ethics/resources/stude
nts-and-sensors-data-education-privacy-and-research/
4
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Journal of Responsible Technology 18 (2024) 100082
where even creators do not fully understand how decisions are reached,
complicates informed consent (Silvers, 2022).
Another concern is ensuring fairness and trustworthiness in AI algorithms. Biases in training data sets can lead to discriminatory outcomes, as evidenced by an AI-based clinical decision-support software
that was less accurate for non-white patients due to training on predominantly white patient data. Data privacy is also a critical issue,
particularly regarding health care records. The potential misuse or
leakage of AI-analyzed health data could impact insurance premiums,
employment opportunities, and personal relationships.
In light of these issues, it is possible to imagine a case study on
software design in the medical field. Imagine the case of a person who
has to decide whether or not to undergo invasive, non-life-saving surgery. Imagine a woman with BRCA1 or BRCA2 gene mutations, or a
woman with a relapse of a complex fibroadenoma of the breast. In the
first case, she must decide whether to undergo a preventive mastectomy
or wait until the carcinoma develops. In the second case, she has to
decide whether to have a more conservative operation or a total mastectomy to prevent further relapses. Now imagine a software programme
designed to help with decision-making in such situations: its algorithm
must be written in such a way that the programme can collect data that
takes into account medical, psychological (e.g. satisfaction of previous
patients after surgery), aesthetic and social variables; but it must also be
able to interact and negotiate with the individual user from time to time,
taking into account individual values and preferences. In the end, the
software will be able to suggest different outcomes such as success rates,
satisfaction rates, testimonials of satisfied or dissatisfied patients.
In addition to the aforementioned privacy issues, one might wonder
whether it is licit to delegate a medical consultation to software or
whether the doctor-patient relationship is dispensable in the name of
efficiency. At the same time, one might consider such software to be a
powerful aid in terms of informed consent. Again, following different
ethical approaches leads to different conclusions regarding the relationship with the digital technology under consideration.
The utilitarian approach, which aims to maximise the efficacy and
speed of surgery and is guided by the patient’s best interests, would
recommend the use of such technology if it can be shown to increase the
likelihood of surgical success and reduce risks to the patient (and this
could be the case because it has much greater access to a large amount of
data than a human doctor and high computing speed). Furthermore, a
technology that takes utilitarian ethical principles into account would
recommend surgery if there is strong evidence that the patient would
benefit from the procedure. At the same time, however, a utilitarian
approach might also consider the social costs of surgery and therefore
advise against it if the public health costs and long hospital stays would
be too high for patients. Thus, it seems that the utilitarian approach
could reach an impasse when it comes to negotiating between individual
and collective well-being. Moreover, it could recommend surgery based
on the high probability of success without taking into account the
impact that considering even a low probability of failure could have on a
patient’s decision.
The humanist approach of the Vienna Manifesto would allow the use
of machine learning to develop technologies that help humans make
decisions, but would recommend that the universal values of human
dignity and the protection and promotion of health be incorporated into
the design. It would also want technology to focus on putting human
interests first, even at the expense of greater economic expenditure.
However, it would likely want this technology to be used as an aid in the
doctor-patient relationship, not as a replacement. The limitation of this
approach might still be to focus solely on placing limits on the algorithm
(which is always developed based on utilitarian principles to calculate
the probability of success) to respect universal human rights, neglecting
the concreteness of the doctor- technology-patient relationship, as well
as the goal of health as a state of physical, mental, and social well-being
and not just the absence of disease or infirmity.
For the Bernardins HN Approach, it is first of all important to clarify
that the decision in favour of a surgical procedure is not only about the
probability of success or the economic costs, but that dimensions of
individual psychological well-being and individual value decisions must
also be taken into account.
Secondly, it must be recognised that the use of decision-making
software could disable the patient’s freedom of choice, as they would
be relying entirely on a black box. Conversely, it could enable more
informed decisions if access to information is guaranteed.
Finally, in terms of the practice of designing spaces of resistance,
software that follows Bernardins’ approach should be software that can
collect data on medical, psychological (e.g. satisfaction of other patients), aesthetic and social variables on multiple levels. It should also be
able to interact with individual users and negotiate with them about
their individual preferences. Ultimately, the software will be able to
suggest various outcomes, such as success rates, satisfaction rates and
testimonials from satisfied or dissatisfied patients. The software should
select and suggest the data and testimonials that best match the main
interests of the person deciding in favour of or against surgery (e.g.
aesthetic factors, desire to avoid future surgery, etc.). Although the
software selects the sources on behalf of the user, it should always leave
open the possibility of consulting other sources and make the selection
process transparent.
Conclusion
Compared to other approaches, our proposal of a bottom-up ethics is
the only one that proposes a truly multi-stakeholder attitude and, by
keeping the space for feedback open, allows for genuine democratic
renegotiation. For these very reasons, moreover, it would be less likely
to be at an impasse due to conflicts of values. The digital ethics derived
from the Bernardins HN Approach might be considered by some as
difficult to implement due to the amount of time and resources required,
since it requires a high degree of collaboration between different
stakeholders. We have shown, however, how such an approach can,
following a rigorous “philological” methodology, achieve concrete results and provide guidance on both the design and use of digital
technologies.
Notwithstanding, we would like to note one last point: digital humanism must be a collective cultural enterprise. When we speak of
digital humanism, we do not believe that humanists (philosophers, literary scholars, etc.) should impose rules on their work. Digital humanists are the designers, engineers, linguists, public decision-makers,
theologians, philosophers, intellectuals, producers, and users who
engage in the enterprise of renegotiating the changes taking place. Our
proposal aims to be a contribution to this enterprise, in an attempt to
provide guidance to overcome the “alienation that a civilization contains or produces” (Simondon, 2017, 118).
Declaration of competing interest
The author is an Guest Editor for Journal of Responsible Technologies
and was not involved in the editorial review or the decision to publish
this article.
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