Do large language models have a legal duty to tell the truth?

Careless speech is a new type of harm created by large language models (LLM) that poses cumulative, long-term risks to science, education and shared social truth in democratic societies. LLMs produce responses that are plausible, helpful and confident, but that contain factual inaccuracies, misleading references and biased information. These subtle mistruths are poised to cumulatively degrade and homogenize knowledge over time. This article examines the existence and feasibility of a legal duty for LLM providers to create models that 'tell the truth'. We argue that LLM providers should be required to mitigate careless speech and better align their models with truth through open, democratic processes. We define careless speech against 'ground truth' in LLMs and related risks including hallucinations, misinformation and disinformation. We assess the existence of truth-related obligations in EU human rights law and the Artificial Intelligence Act, Digital Services Act, Product Liability Directive and Artificial Intelligence Liability Directive. Current frameworks contain limited, sector-specific truth duties. Drawing on duties in science and academia, education, archives and libraries, and a German case in which Google was held liable for defamation caused by autocomplete, we propose a pathway to create a legal truth duty for providers of narrow- and general-purpose LLMs.

Experiences of participation in people with intellectual disability, in relation to service support received, and views from professionals in the field of disability.

Purpose: to describe experiences of people with intellectual disability of participating in the cognitive adapted annual national user survey of social services, and their perception of participation in the municipalities' improvement work. Additionally, social service professionals' views of opportunities to involve people with intellectual disability in improvement work based on survey results. Methods: Focus groups of people with intellectual disability and individual interviews with professionals were conducted and analysed, using content analysis. Results: People with intellectual disability expressed they felt listened to, and supported in expressing their views, but there was discrepancy between their and professionals' perceptions of whether their views were considered, and if they were involved in the improvement process. Conclusions: Evaluating services received from social services is important, expressed by people with intellectual disability and professionals, but improvement is needed to feed back results to social services clients, and to involve them in the improvement process.

Reliability and Factor Structure of the Well-Being and Respect for Human Rights Questionnaire in Measuring Caregivers' Perception.

Background: This study has investigated perceptions of respect for users' rights among informal caregivers in mental healthcare settings, aligning with the guidelines outlined in the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the World Health Organization QualityRights initiative. The study has employed the questionnaire on Well-being at Work and Respect for Human Rights (WWRR) among informal caregivers and tested whether the questionnaire's factor structure among informal caregivers aligns with that of users and health workers. We have hypothesized that informal caregivers prioritize users' needs and rights over the care context's climate. Methods: This was a cross-sectional study. The "Well-being at Work and Respect for Human Rights" questionnaire was distributed to 100 caregivers in 4 territorial mental health facilities in Sardinia, Italy. Confirmatory Factor Analysis (CFA) was utilized to assess the participants' responses. Results: Participants reported high satisfaction with their relatives' treatment, perceiving a high level of respect for human rights among users and healthcare professionals. However, they highlighted insufficient resources for services, particularly the need for additional staff. CFA revealed that a scale with the first five items demonstrated good reliability, convergent validity, and discrimination. Mean scores indicated high satisfaction and perception of respect for human rights across the sample, with no significant differences by age or gender. Conclusion: Satisfaction with users' rights is closely correlated with other factors comprising the notion of organizational well-being within a healthcare service.

Mental integrity, autonomy, and fundamental interests.

Many technology ethicists hold that the time has come to articulate neurorights: our normative claims vis-à-vis our brains and minds. One such claim is the right to mental integrity ('MI'). I begin by considering some paradigmatic threats to MI (§1) and how the dominant autonomy-based conception ('ABC') of MI attempts to make sense of them (§2). I next consider the objection that the ABC is overbroad in its understanding of what threatens MI and suggest a friendly revision to the ABC that addresses the objection (§3). I then consider a second objection: that the ABC cannot make sense of the MI of the non-autonomous This objection appears fatal even to the revised ABC (§4). On that basis, I develop an alternative conception on which MI is grounded in a plurality of simpler capacities, namely, those for affect, cognition, and volition Each of these more basic capacities grounds a set of fundamental interests, and they are for that reason worthy of protection even when they do not rise to the level of complexity necessary for autonomy (§5). This yields a fully general theory of MI that accounts for its manifestations in both the autonomous and the non-autonomous.

The Moderating Effect of Human Rights Education: Examining the Relationship Between Parental Abuse, Child Self-Esteem, and Human Rights Attitude.

This study aims to investigate the mediating role of child self-esteem in the relationship between parental abuse and children's human rights attitude, while exploring the moderating effect of children's participation in human rights education on these associations. Using data from 2020 Children and Youth Human Rights Survey (N = 5,673 students, 50% female, mean age = 15.53), we conducted structural equation modeling to assess the conceptual model's validity. Parental abuse showed a negative relationship with human rights attitude. For children not participating in human rights education, self-esteem acted as a partial mediator, while for participating children, self-esteem served as a full mediator. Paradoxically, human rights education may be linked to lower self-esteem in certain groups of children. The magnitude of the negative association between parental abuse and self-esteem was stronger for those who participated in human rights education compared to those who did not. This implies that the psychological well-being maintained through dysfunctional protective systems may momentarily crumble when faced with contradictory information. These compelling findings furnish valuable perspectives on the significance of equipping children with knowledge and principles related to human rights, a crucial aspect in molding their outlooks, coping mechanisms, and fortitude when confronted with challenging situations. Based on these results, the importance of human rights education and the need for careful composition of human rights education content for abused children were discussed.

Global perceptions of state apologies for human rights violations.

State apologies for human rights violations are often seen as a key mechanism in reconciliation processes. Nevertheless, they are often contested as well and have not been embraced equally by countries around the world. This raises questions about their universal value and potential to address or redress past harmdoing by countries. In a study across 33 countries (n = 11,023), we found that people around the world consider apologies by states for human rights violations to be reasonably important but tend to be less supportive of the idea that their own country should apologize for past harmdoing. We found that this discrepancy was amplified in countries with stronger honour norms and a stronger collective sense of victim- rather than perpetratorhood. Moving beyond the decontextualized approach that has prevailed in previous psychological research on this topic, our findings show that people's attitudes towards apologies by their country do not exist in a cultural and social vacuum but depend on the extent to which the broader context affords a critical reflection on past harmdoing. As such, they help explain why some countries have been reluctant to offer apologies, and why such gestures may also be more controversial in some contexts than in others.

Socio-ecological influences on access to abortion care in Costa Rica: a qualitative analysis of key perspectives from clinical and policy stakeholders.

Costa Rica prohibits abortion except under narrow circumstances to save the pregnant person's life. The country boasts historically strong support for social policy and human rights, while also presenting a complex and restrictive abortion access landscape. From September 2021 to March 2022, we conducted 23 interviews with obstetrician-gynecologist (OB/GYN) physicians, OB/GYN medical residents, and policy stakeholders to explore the socio-ecological influences on abortion access in Costa Rica. We sampled clinicians and policy stakeholders from the Universidad de Ciencias Médicas listserv through snowball sampling and conducted semi-structured in-depth interviews in Spanish. We identified limited access to comprehensive sexual health education, lack of support from interpersonal networks, inadequate provider knowledge and training, financial and migratory status, and both provider and community stigma as substantial barriers to abortion access. This study addresses a gap in published research around the social determinants of abortion in Costa Rica and sheds light on the attitudes and opinions of the medical and policy stakeholder communities about abortion access. The results highlight the need for expanded access to comprehensive sexual health education, abortion-related training for healthcare providers, and increased programming efforts, such as funding, outreach, and implementation, to ensure comprehensive reproductive health services are available and accessible, especially for vulnerable populations in Costa Rica.

Treating infertility as a missing capability, not a disease: a capability approach.

Infertility patients and patient advocates have long argued for classifying infertility as a disease, in the hopes that this recognition would improve coverage for and access to fertility treatment. However, for many fertility patients, including older women, single women and same-sex couples, infertility does not represent a true disease state. Therefore, while calling infertility a 'disease' may seem politically advantageous, it might actually exclude patients with 'social' or 'relational' infertility from treatment. What is needed is a new conceptual framing of infertility that better reflects the profound significance of being infertile for many people and the importance of addressing infertility in order to improve their lives. In this paper, we argue that the capability approach provides this moral underpinning. The capability approach is concerned with what people are able to do, and whether they are able to act in a way that is in keeping with their own values and goals. The ability to procreate and build a family is a fundamental capacity and can be a major part of self-fulfilment, regardless of sexual orientation or family arrangement. Since the capability approach asks us to conceive of equality in terms of equal capabilities, it provides a strong ethical impetus for society to help those who cannot conceive on their own to do so with assisted reproduction.

Non-voluntary BCI explantation: assessing possible neurorights violations in light of contrasting mental ontologies.

In research involving patients with implantable brain-computer interfaces (BCIs), there is a regulatory gap concerning post-trial responsibilities and duties of sponsors and investigators towards implanted patients. In this article, we analyse the case of patient R, who underwent non-voluntary explantation of an implanted BCI, causing a discontinuation in her sense of agency and self. To clarify the post-trial duties and responsibilities involved in this case, we first define the ontological status of the BCI using both externalist (EXT) and internalist (INT) theories of cognition. We then give particular focus to the theories of extended and embedded cognition, hence considering the BCI either as a constitutive component of the patient's mind or as a causal supporter of her brain-based cognitive capacities. We argue that patient R can legitimately be considered both as an embedded and extended cognitive agent. Then, we analyse whether the non-voluntary explantation violated patient R's (neuro)rights to cognitive liberty, mental integrity, psychological continuity and mental privacy. We analyse whether and how different mental ontologies may imply morally relevant differences in interpreting these prima facie neurorights violations and the correlational duties of sponsors and investigators. We conclude that both mental ontologies support the identification of emerging neurorights of the patient and give rise to post-trial obligations of sponsors and investigators to provide for continuous technical maintenance of implanted BCIs that play a significant role in patients' agency and sense of self. However, we suggest that externalist mental ontologies better capture patient R's self-conception and support the identification of a more granular form of mental harm and associated neurorights violation, thus eliciting stricter post-trial obligations.

Health, human rights and freedom at stake? A critical discourse analysis of the Swedish media debate on the national COVID-19 pandemic strategy.

PURPOSE: The aim of this study is to, in the Swedish media debate, explore the discursive constructions of challenges in human rights and freedoms following the national spatial strategy for health and survival during the COVID-19 pandemic. METHODS: The study, inspired by a critical discourse analytic approach, focused particularly on the issues addressed, subject positions, relations and rhetoric. Seventeen opinion articles published in Swedish national newspapers December 2019 - February 2022 were analysed. RESULTS: The main contents were threats to democracy, threats to the freedom and rights of specific groups, and threats to the debate itself. Contents were expressed through three discourse dichotomies: contribution vs interjection, documented vs alarmistic, and active on the stage vs commenting from the balcony. CONCLUSIONS: Striking about the results is the absence of dialogue, the one-way communication, and the absent politicians. It seems that the analysed debate on the challenges of the Swedish COVID-19 pandemic strategy, based on its impact on overall freedoms and rights, has not been the focus of decision-makers during the pandemic. They have neither addressed the threats highlighted in the articles, nor contributed to the discourse. This is worrying for the long-term maintenance and development of a healthy democracy.

Good character: the implications of personality development and psychopathology for citizenship.

The introduction of new legislation in 2006 brought about changes to the way citizenship applications were considered in the UK. Over the intervening years, several hundred children born in the UK have been denied British citizenship as a result of changes to the 'good character' requirement in the legislation - namely its extension to cover all those aged 10 years or older applying for citizenship, including individuals who were born in the UK. As a result of the formulaic way in which this requirement is assessed, citizenship can be denied on the basis of historical patterns of behaviour or offending from childhood. This article will consider whether the current approach to assessment of character in the context of applications for British citizenship is meaningful or appropriate, given developments in our understanding of normative psychological and neurological development and also the impact of psychosocial adversity, trauma, and broader psychopathological or neurodevelopmental conditions.

[High-cost medicines: the difficult balance between individual and collective rightsMedicamentos de alto custo: o difícil equilíbrio entre direitos individuais e coletivos]. / Medicamentos de alto costo: el difícil equilibrio entre los derechos individuales y los derechos colectivos.

Medicines are special goods that cover the health needs of the population. In recent decades, the pharmaceutical industry has changed its research and development strategy, shifting its focus from the exploration of medicines for chronic diseases affecting a large part of the population to the search for drugs for rare diseases that affect a small number of people.This lack of a mass consumer base is reflected in a selective offer of a few very high-cost products aimed at certain diseases, which hinders both patient access and financial coverage.This article reviews the issue of high-cost medicines, including its cultural, legal, political, economic, and health aspects. It emphasizes the differences between various medicines in terms of their efficacy in changing the natural course of diseases, their market price, the consequences of their cost for healthcare funders, and the cost-opportunity ratio of having to pay for them at the expense of other essential resources.Finally, the article reflects on the legitimate rights of each individual to claim access to high-cost medicines when they are considered essential to recover a person's health, and on how guaranteeing such coverage can affect the collective rights of the population. Concrete examples that illustrate this situation are provided.

Medicamentos são bens especiais que atendem às necessidades de saúde da população. Nas últimas décadas, a indústria farmacêutica mudou sua estratégia de pesquisa e desenvolvimento, deixando de explorar medicamentos para doenças crônicas que afetam grande parte da população e passando a buscar medicamentos para poucas pessoas com doenças raras.Esse número limitado de consumidores se reflete em uma oferta seletiva de poucos produtos de preço elevado para determinadas doenças, dificultando o acesso dos pacientes e a obtenção de cobertura dos agentes financiadores da saúde.Neste artigo, analisa-se a questão dos medicamentos de alto custo e incorpora-se ao debate o contexto sanitário, cultural, jurídico, político e econômico. São enfatizados os seguintes aspectos: diferenças entre os diferentes medicamentos em termos da eficácia em mudar o curso natural das doenças para as quais são indicados; determinação do preço pelo qual esses medicamentos são vendidos no mercado; consequências desse preço para os agentes financiadores da saúde; e a relação custo-oportunidade de ter de pagar por esses medicamentos em detrimento de outros recursos considerados essenciais.Por fim, reflete-se sobre os direitos legítimos de cada indivíduo de reivindicar acesso a medicamentos de alto custo, por considerá-los essenciais para recuperar a própria saúde, e como a garantia dessa cobertura pode afetar os direitos coletivos da população; também são fornecidos exemplos concretos que ilustram essa situação.

Forbidden Conversations: A Comprehensive Exploration of Taboos in Sexual and Reproductive Health.

This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled "Forbidden Conversations," it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, "Forbidden Conversations" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.

Regimes of truth regarding 'sexual justice' in academic literature from 2012 to 2022: a scoping review.

The notion of 'sexual justice' has gained traction in academic and policy arenas in recent years. This paper presents a scoping literature review of the regimes of truth, following Foucault, of 'sexual justice' appearing in the scientific literature from 2012 to 2022. Thirty-eight papers were coded using (1) content analysis of the studies' central problematics, the programmes referred to, and institutional location(s); and (2) thematic analysis of how the notion was deployed. Central problematics centred on (1) critiques of, or alternatives to, dominant approaches to sexual and reproductive health; and (2) highlighting injustices. As such, 'sexual justice' is fighting for legitimacy in the truth stakes. There is a distinct paucity of papers tackling the translation of 'sexual justice' into practice. South Africa dominates as the site in which papers on 'sexual justice' have been produced, but there is a lack of South-South collaboration. Two themes were apparent around which conceptions of sexual justice cohere. Firstly, sexual justice is seen as a vital, yet politically ambivalent goal, with neoliberal co-optation of progressive rights agendas being warned against. Secondly, sexual justice is viewed as a means, in which sexual justice is described as having potential to repair established frameworks' shortcomings and oppressive legacies.

Derecho de acceso a la salud en los establecimientos penitenciarios de mujeres del Perú

Introducción: En el Perú las mujeres en los establecimientos penitenciarios carecen de acceso a la salud ante la falta de políticas públicas que conduce a una brecha de desigualdad en dicho acceso. La investigación tiene por objetivo diagnosticar la situación del acceso a los servicios de la salud en los establecimientos penitenciarios de mujeres del Perú durante el año 2021. Métodos: Se realizó un estudio descriptivo, transversal, con datos de los 13 establecimientos, que constituyen la totalidad de los establecimientos penitenciarios de mujeres en el Perú. Resultados: Los resultados señalan que las atenciones en salud se concentraron en la región penitenciaria de Lima, se encontró que las regiones que no presentaban profesionales de la salud permanentes carecían de atención adecuada. Discusión: el Estado peruano no ha cumplido con su rol como garante en relación con el derecho fundamental al acceso a los servicios de salud por parte de las entidades penitenciarias en beneficio de todas las mujeres internas que integran los Establecimientos Penitenciarios de Mujeres en el Perú. Se recomienda, bajo los principios de razonabilidad y proporcionalidad, es más que urgente definir nuevas directrices de acceso a la salud femenina, coadyuvando a que el personal de salud desempeñe un enfoque preventivo, con la capacidad de integrar la buena cultura de la institución penitenciaria.

Introduction: In Peru, women in prisons lack access to health due to the lack of public policies that lead to an inequality gap in said access. The objective of the research is to diagnose the situation of access to health services in women's penitentiary establishments in Peru during the year 2021. Method: A descriptive, cross-sectional study was carried out with data from the 13 establishments, which constitute all of the women's penitentiary establishments in Peru. The results indicate that health care was concentrated in the prison region of Lima; it was found that regions that did not have permanent health professionals lacked adequate care. Results: Therefore, the importance of placing permanent health professionals in penitentiary centers is accentuated to guarantee care for women. Discussion: The peruvian state has not fulfilled its role as guarantor in relation to the fundamental right of access to health services by penitentiary entities for the benefit of all female inmates who make up the Women's Penitentiary Establishments in Peru. It is recommended, under the principles of reasonableness and proportionality, that it is more than urgent to define new guidelines for access to women's health, helping health personnel to carry out a preventive approach, with the ability to integrate the good culture of the penitentiary institution.

Perception of human rights in health care: A cross-sectional study among tribal young adults of Puruliya, West Bengal.

Background: Human rights provide a universal foundation for pursuing justice in public health in order to achieve the dignity of all individuals. In spite of international attempts to promote human rights in the context of health, a significant portion of India's indigenous population continues to have a limited understanding of these rights. Objective: This study aims to analyze tribal people's attitudes towards human rights in health care. The population consists of tribal residents from Manbazar - I and Puncha Blocks in the Puruliya district of West Bengal, India. Tribal young adults between the ages of 18 and 35 were the subject of a cross-sectional study. Methods: A pretested questionnaire was used to collect data. MS Excel and SPSS 27 were used for analysis. A descriptive analysis was carried out. Results: The participants' mean scores for awareness, accessibility and communication, autonomy and sexual and reproductive health and sexual and reproductive health rights (SRHR) were 8.06, 15.76, 7.35 and 32.52 revealing a moderate perception level among the young adult tribal population in the selected blocks. Conclusion: A holistic focus of the governmental and other non-governmental organizations towards the tribals is required. Introducing various aspects of human rights in healthcare in the education curriculum along with community outreach would by all likelihood improve the perception of 'Human Rights' and thus help in better utilization of various services including health among tribal populations in India.

Social Justice and the Political Organization of Behavior Analysts: Changing the Institutional Practices of a Brazilian Association.

Given the advancement of behavioral research in culture and social behavior, it seems natural for the community of behavior analysts to progress towards increased political engagement and a dedication to social justice. To reach this goal, it is necessary to act inside one's own communities and organizations. The purpose of this article is to report on the efforts of the Brazilian Association for Behavioral Psychology and Medicine (ABPMC) to increase equity and social justice during the 2017-2018 term. First, we present an overview of the ABPMC. Next, we describe the process of identifying, planning, and implementing equity and social justice actions in the association. The problems targeted were the discontinuation of policies from one term to another, elitism and centralization, the lack of topics with social and political relevance in the annual conference's scientific program, and the lack of support for the participation of women (especially mothers) in clinical and academic practice. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-020-00510-2.

Genetic Enhancement, Human Rights, and Regioglobal Bioethics.

This article examines the cross-cultural bioethical concerns stemming from the potential use of CRISPR-Cas9 for genetic enhancement projects. It emphasizes the need to differentiate between basic and non-basic human rights when considering genetic enhancement, as recent international declarations lack this distinction. Basic rights possess a universal nature and are applicable across cultures, while non-basic rights are culturally specific and should be determined within respective regions. To illustrate this, the study explores the acceptance or rejection of non-basic rights related to genetic enhancement in two distinct cultural categories: Type-A and Type-B cultures. Type-A cultures predominantly adhere to a liberal moral framework, while Type-B cultures are rooted in Confucian morality. Additionally, the article argues for two basic rights in genetic enhancement: the right to be free from bodily harm and the right to be free from deception. These rights differ from non-basic rights and should be universally upheld in all cultures. By analyzing a hypothetical case and drawing parallels with the He Jiankui incident, the article investigates the violation of these two basic rights in each scenario, regardless of cultural context. Consequently, both cases should be unequivocally rejected in both Type-A and Type-B cultures.

Safe Access Zone Legislation and Its Compliance with the Human Rights of Anti-Abortion Protesters in Australia.

Terminating a pregnancy is now lawful in all Australian jurisdictions, although on diverse bases. While abortions have not been subject to the same degree of heated debate in Australia as elsewhere, protests aimed at persuading women not to have a termination of their pregnancy have occurred outside abortion service providers in the past. Over the last decade, this has led to the introduction of laws setting out so-called safe access zones around provider premises. Anti-abortion protests are prohibited within a specific distance from abortion services and infringements attract criminal liability. As safe access zone laws prevent protesters from expressing their views in certain spaces, the question arises as to the laws' compliance with protesters' human rights. This article analyses this by considering the human rights compliance of the Queensland ban in light of Queensland human rights legislation. It concludes that the imposed prohibition of anti-abortion protests near abortion clinics is compatible with human rights.

A Meta-Synthesis on Sexuality in Persons with Dementia Mapped Using the Model of Human Occupation.

Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.