More Process, Less Principles: The Ethics of Deploying AI and Robotics in Medicine.

Current national and international guidelines for the ethical design and development of artificial intelligence (AI) and robotics emphasize ethical theory. Various governing and advisory bodies have generated sets of broad ethical principles, which institutional decisionmakers are encouraged to apply to particular practical decisions. Although much of this literature examines the ethics of designing and developing AI and robotics, medical institutions typically must make purchase and deployment decisions about technologies that have already been designed and developed. The primary problem facing medical institutions is not one of ethical design but of ethical deployment. The purpose of this paper is to develop a practical model by which medical institutions may make ethical deployment decisions about ready-made advanced technologies. Our slogan is "more process, less principles." Ethically sound decisionmaking requires that the process by which medical institutions make such decisions include participatory, deliberative, and conservative elements. We argue that our model preserves the strengths of existing frameworks, avoids their shortcomings, and delivers its own moral, practical, and epistemic advantages.

Organizing a transnational solidarity for social change through participatory practices: The case of People Powered-Global Hub for Participatory Democracy.

In the context of global democratic crises and pervasive neoliberal policies, civil society organizations (CSOs) play a critical role in promoting democratic processes and advancing social change on local, national, and transnational scales. However, such organizations also (need to) grapple with how they themselves put social justice and democratic principles into practice, and resist coloniality within. This article examines these questions in the case of People Powered-Global Hub for Participatory Democracy, a recently found transnational CSO that advocates globally for participatory democracy as a mechanism for social change and employs these principles in its own governance and operations. The analysis focusses on the creation of People Powered and its first year of practice. Drawing upon decolonial frameworks-and based on our own experiences as founding members of People Powered and our reading of interviews and documents-we identify concrete practices through which the organization seeks to enact epistemic justice, shift power, and emphasize relationality. We argue that People Powered's decolonial roots, collectively articulated values and commitments, radical transparency, and its consistent employment of meaningful participation and reflexivity have built and are likely to sustain this transnational solidarity for social change. At the same time and perhaps critical for fostering solidarity and social change in the long term, People Powered embraces, rather than evades, tensions and contradictions that emerge in these efforts.

The Kerala model in the time of COVID19: Rethinking state, society and democracy.

Kerala, a small state in South India, has been celebrated as a development model by scholars across the world for its exemplary achievements in human development and poverty reduction despite relatively low GDP growth. It was no surprise, then, that the Covid 19 pandemic that hit Kerala before any other part of India, became a test case for the Kerala model in dealing with such a crisis. Kerala was lauded across the world once again as a success story in containing this unprecedented pandemic, in treating those infected, and in making needed provisions for those adversely affected by the lockdown. But as it turned out, this celebration was premature as Kerala soon faced a third wave of Covid 19 infections. The objective of this paper is to examine Kerala's trajectory in achieving the success and then confronting the unanticipated reversal. It will examine the legacy of the Kerala model such as robust and decentralized institutions and provisions for healthcare, welfare and safety nets, and especially the capacity of a democratic state working in synergy with civil society and enjoying a high degree of consensus and public trust. It will then examine the new surge of the virus and attempts to establish if this was due to any mistakes made by the state or some deficits in its model of "public action" that includes adversarial politics having a disruptive tenor about it. We will conclude by arguing that the Kerala model is still relevant, and that it is still a model in motion.

Participation as a mechanism to favour psychological empowerment and positive interaction: The "Ágora Infantil" participatory democracy programme.

This investigation aims to show the relationship between participation and psychological empowerment and between participation and interaction under an institutional political participation programme. This initiative known as Ágora Infantil (AI) is characterised by an obligatory draw-based deliberative participation methodology with superordinate goals based on group dynamics, with games playing a central role. The evaluation was carried out using a quasi-experimental design, with quantitative measurements of the experimental and control groups, along with systematic observation of the target group. The results support the hypotheses proposed: Participation in the AI programme led to an increase in psychological empowerment and positive interactions between the participants. These results offer information as to what design should be used for these types of political initiatives to favour inclusion and empowerment of children, while at the same time improving classroom relationships.

Urban trees as a lever for citizen engagement in public consultation processes: the case of Paris, France.

In the present context of increasing human population demography, worldwide social crises, and rapid ecological global change, large cities are facing major socio-environmental challenges. This convokes authorities to adapt their governance and urban planning to reconcile urban development, ecological systems, and city dwellers in the most sustainable way. To achieve such goals, local officials have to associate all local actors, including city-dwellers, to the decision-making process through participatory governance and/or participatory systems. Here, we elaborated an original pilot project governance system for a "Participatory System Combining Town Planning and Science" (the 2PS-CiTy), as part of the revision of the Local Urban Plan (LUP) of Paris, France, into a Bioclimatic LUP held from 2020 to 2024. By implementing 2PS-CiTy, we aimed to answer "How to turn trees into a lever for inhabitants' engagement in urban consultation systems?" Trees were chosen because they are emblematic elements of nature with significant roles in ecosystemic services such as urban climate regulation. Parisians were invited to (i) share in the first questionnaire some information on their knowledge about the LUP and their engagement in it, (ii) identify urban trees they consider remarkable, (iii) explain their choice in a second questionnaire, (iv) contribute to the urban consultation as part of the LUP revision, and finally, (v) give their feedback during a dedicated survey. Out of the 41 Parisians who took part in 2PS-City, 83% declared they were motivated to participate because they could contribute to the tree census, which in turn can constructively contribute to the Parisian LUP revision to bring more nature and sustainability in town. This study demonstrates that trees can be used as a lever for inhabitants' engagement in urban consultation systems to make cities more sustainable. Our survey also showed that the 2PS-CiTy governance system could be improved by (1) developing a participatory culture among decision-makers and (2) preventing nowadays silo governance from developing the most promising public governance systems that involve the departments of green space, urban planning, and local democracy.

Democracy underwater: public participation, technical expertise, and climate infrastructure planning in New York City.

This article provides an explanation for how increased public participation can paradoxically translate into limited democratic decision-making in urban settings. Recent sociological research shows how governments can control participatory forums to restrict the distribution of resources to poor neighborhoods or to advance private land development interests. Yet such explanations cannot account for the decoupling of participation from democratic decision-making in the case of planning for climate change, which expands the substantive topics and public funding decisions that involve urban residents. Through an in-depth case study of one of the largest coastal protection projects in the world and drawing on global scholarship on participation, this article narrates the social production of resistance to climate change infrastructure by showing how the state sidestepped public input and exercised authority through appeals to the rationality of technical expertise. After a lengthy participation process wherein participants reported satisfaction with how their input was included in designs, city officials switched decision-making styles and used expertise from engineers to render the publicly-supported plan unfeasible, while continuing to involve residents in the process. As a result, conflict arose between activists and public housing representatives, bitterly dividing the neighborhood over who could legitimately claim to represent the interests of the "frontline community." By documenting the experience of participants in the process before and after the switch in decision-making styles, this article advances a sociological description of public influence in policy: The ability for participants in a planning process to recognize their own input reflected in finished plans.

Active participation or legal obligation? A qualitative study of the effectiveness of participatory methods designed for local participation.

The most effective structure in designing the participation process is local government units. It is much easier for local governments to establish closer dialogue with citizens, create negotiation environments for them and identify appropriate needs for participation. The intense feeling of centralization in terms of the duties and responsibilities of local governments in Turkey leads to the inability to transfer the negotiation processes in participation practices to realistic/realizable practices. As a result, permanent institutional practices do not carry on sustainably; they turn into structures established to fulfill legal obligations only. The transition from government to governance, with the winds of change began after 1990 in Turkey, revealed the necessity of reorganizing the duties and responsibilities of executives at both local and national levels regarding active citizenship; the necessity of activating local participation mechanisms was emphasized. For this reason, the application of the Headmen's (Headman means "Muhtar" in Turkish. Sometimes "Mukhtar" uses instead of Headman in some studies. But in this study Headman used to descripe partipatory process. In Turkey, there two types of "Headman". One of them is village headman. Villages are legal entities, so village headmen have much more authority. The second one is neigborhood headmen. Neigborhoods are not legal entities. So that, neigborhood headman is responsible to City Mayor.). Workshop, designed by the Tekirdag Metropolitan Municipality, was periodically subject to the research as an ongoing method, and its effectiveness for citizen participation was analyzed using the qualitative research method in the study. The reason why Tekirdag was chosen in the study is that it has the only metropolitan municipality in the Thrace Region, periodic meetings and participatory democracy discourses on the sharing of duties and powers with new regulations increase. The practice was examined through 6 meetings held until 2020 since there were disruptions in the planned meetings of the practice on account of the fact that the study coincided with the COVID-19 pandemic process.

Creative Democracy-the Task Still before Us.

This essay looks to Thomas Jefferson and John Dewey, as well as a contemporary political theorist, Kevin O'Leary, for some guidance in confronting the present crisis in American democratic norms and practices-including that swirling around issues of public health.

[End-of-life debate: Citizen's point of view about deep and continuous sedation]. / Débat sur la fin de vie en France : regard du citoyen sur la sédation profonde et continue.

INTRODUCTION: Sedation in palliative care meets a precise definition and corresponds to a medical practice. We assessed the comprehension of this practice by the French population. METHOD: In 2015, citizen expressed their views on the Claeys-Leonetti bill by means of a consultative forum made available on the Internet site of the National Assembly. The content of the messages filed, regarding the right to deep and continuous sedation until death was analyzed using the ALCESTE textual data analysis software, supplemented by a thematic analysis in order to identify the perception that Internet users had of this practice. RESULTS: Among the 1819 Internet users who participated in the forum, 67 expressed their views as Health professionals, 25 of whom were directly involved in palliative care, as well as 10 sick persons. Analysis with the ALCESTE software highlighted two classes of statements. The first dealing with deep and continuous sedation, reflecting the specificity of the discourse of the Internet users. The second one consisted of textual units in which the modal verbs were dominant and overrepresented, thus providing information on the participants' perceptions. The thematic analysis highlighted four themes: death, intent, treatment and fear. CONCLUSION: Deep and continuous sedation is perceived as a euthanasic practice or raises fear of such a drift. Provision of extended and accurate information to the population and health professionals is essential to ensure that this new model of sedation is integrated into the care of the terminally ill patients and their families.

Governança participativa e a expansão do conceito de saúde na experiência do community lab na itália / Participatory governance and the expansion of the health concept in the community lab experience in italy / Gobernanza participativa y la expansión del concepto de salud en la experiencia del community lab en italia

Este artigo estuda a metodologia do Community Lab (CL), um projeto de welfare participativo desenvolvido na região da Emilia Romana na Itália, que envolve movimentos sociais e comunitários e atores governamentais. Investigaremos duas experiências desse projeto, analisando os efeitos do processo participativo para os atores e para as políticas de saúde. A pesquisa qualitativa, de cunho etnográfico, combinou técnicas como diário de campo e entrevistas, com oficinas de escrita estruturadas em uma pesquisa-ação que envolveu participantes do CL. Destaca-se a flexibilidade metodológica, que responde mais às dinâmicas sócio-culturais e organizacionais dos territórios, do que às normativas institucionais, conciliando os efeitos na gestão, a democratização do processo decisório e a implementação das políticas públicas. O CL amplia as categorias de atores envolvidos e, com isso, as noções de saúde, fomentando a intersetorialidade e transformação dos aparatos estatais..

This article studies the methodology of the Community Lab (CL), a participatory welfare project developed in the Emilia Romana region in Italy, which involves social and community movements and government actors. We will investigate two experiences of this project, analyzing the effects of the participatory process for the actors and for health policies. The qualitative research, of an ethnographic nature, combined techniques such as field diaries and interviews, with writing workshops structured in an action research that involved CL participants. The methodological flexibility stands out, which responds more to the socio-cultural and organizational dynamics of the territories, than to the institutional regulations, reconciling the effects on management, the democratization of the decision-making process and the implementation of public policies. The CL expands the categories of actors involved and, with this, the notions of health, fostering the intersectoriality and transformation of state apparatus.

Este manuscrito apunta a La posibilidad de que una discusión debate integra lãs nociones de juventud, territorio y seguridad. Piensar que esas nociones y entrelazamientos se vuelven relevantes como medio de análisis y justificacion esperpassan y mantener El control como formas de juventuden Brasil. Los analizadores de três investigaciones, como los que atravesan este tema son usados: El primero discute un problema de seguridad em escuelas públicas del Estado; un segundo sobre adolescentes insertados sistema de justicia juvenil, pero también el estado de Río; y una final, com el análisis sobre la política de drogas en Brasil. Afirmando que La diversidad y multiplicidad de formas son jóvenes líneas, se trazan líneas de segregación que delimitan a algunas juventudes como más peligrosas, que se convierten em um mayor objetivo de control social. Así, La seguridad y El territorio se sostienen como líneas transversales a las temáticas de cada investigación y se delinean como racionalidades que concurren em la construcción de las políticas públicas para cierta juventud en Brasil.

Education, outreach, and inclusive engagement: Towards integrated indicators of successful program outcomes in participatory science.

The use and utility of science in society is often influenced by the structure, legitimacy, and efficacy of the scientific research process. Public participation in scientific research (PPSR) is a growing field of practice aimed at enhancing both public knowledge and understanding of science (education outreach) and the efficacy and responsiveness of scientific research, practice, and policy (participatory engagement). However, PPSR objectives focused on "education outreach" and "participatory engagement" have each emerged from diverse theoretical traditions that maintain distinct indicators of success used for program development and evaluation. Although areas of intersection and overlap among these two traditions exist in theory and practice, a set of comprehensive standards has yet to coalesce that supports the key principles of both traditions in an assimilated fashion. To fill this void, a comprehensive indicators framework is proposed with the goal of promoting a more integrative and synergistic PPSR program development and assessment process.

Governança participativa no âmbito dos conselhos de saúde locais: entrevistas com seis presidentes de conselhos de saúde locais no nordeste do Brasil / Participatory governance in the context of local health councils: interviews with six local health council presidents in Northeastern Brazil

Abstract The aim of this study was to describe the challenges and opportunities faced by local health council presidents in their practice of participatory governance. In-depth interviews were conducted with six presidents at health posts at six neighborhoods located in a single region in a peripheral neighborhood in Fortaleza. The interviews were complemented by participant observation of local health council meetings conducted over a three-year period (2015-2017), and interviews with presidents of the municipal, regional and state health councils, as well as with more than twenty actors from government agencies and local associations. The data were analyzed with the help of Atlas.ti, and resulted in the identification of four core topics: the weakness of community representation, the generation of new health initiatives, the concern with the physical and material infrastructure of the councils, and the linkages between council Presidents and the historical network of community-based organizations (Associações Voluntárias) in the region in which the health posts were situated. The local health councils included in this study faced similar challenges to those documented by prior scholars, but also demonstrated the potential to cultivate local ideas for new health initiatives.

Resumo O objetivo deste estudo foi descrever os desafios e oportunidades enfrentadas pelos presidentes de conselhos de saúde locais em executar governança participativa. Foram realizadas entrevistas a fundo com seis presidentes de postos de saúde em seis bairros localizados em uma única região em um bairro da periferia de Fortaleza. As entrevistas foram complementadas por observação participante de reuniões de cada conselho de saúde local, realizado durante um período de três anos (2015-2017), e entrevistas com os presidentes dos conselhos de saúde municipais, regionais e estaduais, bem como com mais de vinte atores de agências governamentais e associações locais. Os dados foram analisados usando o Atlas.ti, resultando na identificação de quatro temas principais: a fragilidade de representação da comunidade, a criação de novas iniciativas de saúde, a preocupação com a infra-estrutura física e material dos conselhos, e os vínculos entre presidentes de conselho e a histórica rede de organizações de base comunitária (Associações Voluntárias) na região em que os postos de saúde se localizavam. Os conselhos de saúde locais incluídos neste estudo enfrentaram desafios semelhantes àqueles documentadas pelos estudiosos anteriores, mas também demonstraram potencial para cultivar ideias locais para novas iniciativas de saúde.

Reflections on local participatory democracy in Latin America / Reflexiones sobre democracia participativa en América Latina / Reflexões sobre democracia participativa na América Latina

Abstract This work presents reflections on the field of participatory democracy in Latin America, based on the analysis of the experiences of Cotacachi in Ecuador, and Torres in Venezuela, which are examples of great popular participation at the local level. The study proposes to interpret the experiences from a Latin American point of view, considering the singularities of each municipality analyzed. The aim is to identify which factors contribute to the emergence and consolidation of mechanisms of participation in the public policy decision-making process. In order to approximate the democratic theory of the context of Latin America, the study presents an analysis structured in two relevant concepts for the theory: agency and public space. These concepts were essential to identify which factors allowed the creation and consolidation of practices of participatory democracy at the local level. The analysis of the experiences resulted in a list of seven factors that were fundamental for their advancement and diffusion, factors that may represent important guidelines for the development of new democratic practices in countries of the region. Finally, the study present some reflections on the challenges that must be overcome to expand the local power and popular participation in Latin America.

Resumen Presentamos en este artículo las reflexiones desarrolladas en el campo de la democracia participativa en América Latina a partir del análisis de dos experiencias de participación popular en el ámbito local. Nuestro objetivo es hacer una relectura de esas experiencias a partir de una perspectiva teórica latinoamericana, que considere sus singularidades. Pretendemos, con eso, identificar qué factores contribuyeron a la emergencia y consolidación de los mecanismos de participación en los procesos de toma de decisión sobre políticas públicas. Buscando revisar la teoría democrática, para aproximarla a la realidad latinoamericana, construimos un análisis estructurado en dos conceptos caros a la teoría democrática: agencia y espacio público. Basados en los dos conceptos, buscamos identificar cuáles son los factores que permitirán la creación y consolidación de prácticas de democracia participativa local. Analizando las experiencias de Cotacachi, Ecuador, y Torres, Venezuela, identificamos siete elementos fundamentales que, a partir de nuestra perspectiva, son directrices para el desarrollo de nuevas prácticas democráticas en países latinoamericanos. Por ende, presentamos algunas reflexiones sobre los retos para la ampliación del poder local e de la participación popular en Nuestra América.

Resumo Apresentamos neste trabalho as reflexões desenvolvidas no campo da democracia participativa na América Latina a partir da análise de duas experiências que permitiram uma maior participação popular no âmbito local. Nosso objetivo é fazer uma releitura dessas experiências a partir de uma perspectiva teórica latino-americana, que considere suas singularidades. Pretendemos, dessa forma, identificar quais fatores contribuíram para a emergência e consolidação dos mecanismos de participação nos processos de tomada de decisão sobre políticas públicas. Buscando revisar a teoria democrática, de forma a aproximá-la da realidade latino-americana, construímos uma análise estruturada em dois conceitos caros à teoria democrática: agência e espaço público. Baseados nesses conceitos, buscamos identificar os fatores que permitiram a criação e a consolidação de práticas de democracia participativa local. Analisando as experiências de Cotacachi, no Equador, e Torres, na Venezuela, elencamos sete fatores que consideramos fundamentais para o avanço e difusão das duas experiências, podendo estes representar importantes diretrizes para o desenvolvimento de novas práticas democratizantes nos países latino-americanos. Por fim, trazemos algumas reflexões sobre desafios relevantes que devem ser considerados para a ampliação do poder local e da participação popular em Nuestra América.

Who governs in (local) governance? Theoretical considerations and empirical evidence / ¿Quién gobierna en la gobernanza (local)? Reflexiones teóricas y evidencias empíricas / Quem governa na governança (local)? Reflexões teóricas e evidências empíricas

Abstract This article aims to discuss the possible actors that can determine public policies, and the influence of new decisional arenas on politics. This theoretical work presents the evolution of different models of producing public policies, to the transformations taking place with the adoption of the governance model. Using empirical evidence from the Italian case, the study of new decisional arenas for the determination of public policies shows that there are still several problems to be addressed. Such problems are connected, above all, with the uncertain democratic nature of these arenas, as well as with the impossibility to clearly attribute political responsibility to the choices adopted in these spaces. These are issues and future research questions to be resolved, limiting the analysis to specific case studies, preferably related to the local sphere.

Resumen El objetivo de este artículo -de naturaleza teórica- es discutir los posibles actores que pueden determinar políticas públicas, así como la influencia que nuevos espacios decisorios ejercen con relación a la política. El artículo rescata desde la evolución de diferentes modelos de producción de políticas públicas hasta las transformaciones que están teniendo lugar con la adopción del modelo de gobernanza. Por medio de evidencias empíricas obtenidas a partir del caso italiano, el estudio de los nuevos espacios decisorios que influencian en la determinación de políticas públicas muestra que existen diversos problemas relacionados, sobre todo, la incertidumbre sobre la naturaleza democrática de esos espacios y la imposibilidad de atribuir, claramente, responsabilidad política por las decisiones tomadas. Esas son cuestiones y futuras preguntas de investigación que deben responderse y que limitan el análisis a estudios de caso específicos, relacionados preferentemente a la esfera local.

Resumo O objetivo deste artigo — de natureza teórica — é discutir os possíveis atores que podem definir políticas públicas, bem como a influência que novas arenas decisórias exercem em relação à política. O artigo resgata a evolução de diferentes modelos de formulação de políticas públicas, até as transformações que vêm acontecendo com a adoção do modelo de governança. Por meio de evidências empíricas obtidas a partir do caso italiano, o estudo das novas arenas decisórias que influenciam na definição de políticas públicas mostra que existem diversos problemas relacionados, acima de tudo, com a incerteza sobre a natureza democrática dessas arenas e com a impossibilidade de claramente atribuir responsabilidade política pelas escolhas feitas. Essas são questões e futuras perguntas de pesquisa que devem ser respondidas e que limitam a análise a estudos de caso específicos, relacionados preferencialmente com a esfera local.

A new spin on research translation: the Boston Consensus Conference on Human Biomonitoring.

BACKGROUND: Translating research to make it more understandable and effective (research translation) has been declared a priority in environmental health but does not always include communication to the public or residents of communities affected by environmental hazards. Their unique perspectives are also commonly missing from discussions about science and technology policy. The consensus conference process, developed in Denmark, offers a way to address this gap. OBJECTIVES: The Boston Consensus Conference on Human Biomonitoring, held in Boston, Massachusetts, in the fall of 2006, was designed to educate and elicit input from 15 Boston-area residents on the scientifically complex topic of human biomonitoring for environmental chemicals. This lay panel considered the many ethical, legal, and scientific issues surrounding biomonitoring and prepared a report expressing their views. DISCUSSION: The lay panel's findings provide a distinct and important voice on the expanding use of biomonitoring. In some cases, such as a call for opt-in reporting of biomonitoring results to study participants, they mirror recommendations raised elsewhere. Other conclusions have not been heard previously, including the recommendation that an individual's results should be statutorily exempted from the medical record unless permission is granted, and the opportunity to use biomonitoring data to stimulate green chemistry. CONCLUSION: The consensus conference model addresses both aspects of a broader conception of research translation: engaging the public in scientific questions, and bringing their unique perspectives to bear on public health research, practice, and policy. In this specific application, a lay panel's recommendations on biomonitoring surveillance, communication, and ethics have practical implications for the conduct of biomonitoring studies and surveillance programs.

Trípode en el que se sustenta una sociedad civilizada: ciudadanía activa, estado democrático y economía ética / Trípode na qual se sustenta uma sociedade civilizada: cidadania ativa, estado democrático e economia ética / A tripod on which civic ethics rests: a participatory democracy, an economy exerted from ethical companies and an active citizenship

The work produced is a thematic review that aims to reflect on civic ethics, from the look of Adela Cortina, who offers a clear exposition, allowing conceptual understanding of it, as well as the urgency of their quest. The approach is performed in relation to the role of three key elements, which are useful at time to trying to build a better society. Those three elements constitute a tripod on which civic ethics rests: a participatory democracy, an economy exerted from ethical companies and active citizenship...

O trabalho elaborado constitui uma revisão temática que pretende a reflexão em torno da ética cívica a partir da visão de Adela Cortina, que com sua claridade expositiva permite a compreensão conceitual da mesma e também a urgência de sua busca. O enfoque é dado ao papel que exercem três elementos fundamentais na hora de se tentar construir uma sociedade melhor, constituídos em uma trípode sobre a qual esta repousa: uma democracia participativa, uma economia exercida por empresas éticas e uma cidadania ativa...