PHILOSOPHY AND AI

HOUSE AND PHILOSOPHY

P50

Further, we cannot simply choose what we are going to take responsibility for and what we are not. Just as we expect the faultless driver to feel some sort of regret for killing a child. Walker suggests that  “responsibilities outrun control.” The larger context of our lives requires us take to responsibility for many events and outcomes that we would not have chosen. This is a part of what it is to be human, and the reason that we praise those whose grace and integrity allow them to deal with events and outcomes well. If this is true, then moral luck does not undermine human moral agency, but rather offers it more opportunities in which to practice different virtues.

Certainly House would be the wrong show from which to expect too much moral purity. A consideration of the problems involved in moral luck shows us that maybe we should not even try. Rather than thinking that moral responsibility means having control over all of our actions and their consequences, we should recognize the large degree to which actions and consequences are beyond our control. House teaches us that in the midst of this uncertainty, we must have the confidence to act when not to act is almost certainly fatal. We must do the best we can, and be realistically prepared to accept, and take responsibility for , dire consequences.

这一段论证了道德的重要性。我们不可能控制事物的发生，但当灾难性的事件发生时，负罪感与责任感是我们最基本的人性。只有这样，我们才能在面对灾难性事件的不确定性发生时，有信心从现实出发做出决定，并做出行动。这是人性的基本必要条件，也是做为一个有道德思想的人必有的情操。也就是所谓的“道德的造化”，其暗示了正是因为道德感的存在，影响了事物往正面的方向发展。

         掠夺是动物的天性，是在大自然里物竞天择，适者生存这一规律下体现的生物的本能。但在人类社会里，野蛮也许在初期建立社会时体现它的价值，在社会发展期与持续期，这种价值将沦落为一把砍向自己，也砍向别人的刀；这时候，文明以一种迫切的姿态展现，对于统治阶层，它体现于法律秩序的建立、人文文化的持续与继承等等。换句话说，就是什么是公德？个人理解，公德应该是适用于各种阶层、各种年龄、各种肤色与种族的人们的道德体系。而对于个体，什么是私德？个人在社会中生存下去的，一种在生存背景与社会发展下自发的道德觉醒，或者说自觉遵守社会准则，并自发维护社会秩序，自愿服务于社会体系，并体现个人在社会中的价值。

        人无完人，掠夺是人类最原始的本性，也可以说是欲望的一种，而道德正是约束人类欲望无限发展与膨胀失控的最佳方式，它需要统治阶层与社会基础的共同努力与维系。由此依法治国，建立一个共同的法律体系是根本。而道德在个体发展中，也是至关重要的。

P158

In 1973, at the age of twenty-five, Dax suffered severe burns over much of his body as a result of a propane gas explosion. In spite of his persistent and repeated protests and a psychiatrist‘s finding that he was competent, Dax was forced to undergo extremely painful burn treatments. He survived, but he was blind and badly scarred, he lost the use of his arms, and his fingers had to be amputated. Ultimately, Dax was satisfied with his quality of life. However, he remained angry that his wishes were not respected, and he became an advocate for patient rights, in particular the right to refuse medical treatment.

 

暂记如此。

想起童年那个高中班上的被烧伤的姐姐，因为点着蜡烛在蚊帐中看书，弟弟被烧死了，而她成为幸存者。一九八几年的中国，沿海地区还比较保守，即使是夏天，她也会将自己捂得严严实实，只是脸与头是无法遮掩的，因为我们要呼吸空气。她的大半个头皮，祼露着，长不出头发，半边脸上布满了深红色的疤，一只眼睛被疤痕牵扯着，会现出几分狰狞，嘴角也有一处被疤痕拉扯着，她的整个面孔让人感觉害怕。这个姐姐很少笑，至令也想不起她的名字，只知道她以面孔丑陋而在校闻名，不懂事的一些学生会说：“不要去看她，晚上会做恶梦的。“

外人看到她尚有不适之处，而做为她本人，有谁能理解她以多大的毅力在活？十多年以后，阿康钓鱼时，被高压电打了，他也成了幸存者。他在当地的以治烧伤闻名的医院治疗电击伤时，他为自己能成为有手有脚，而没有造成任何严重性伤残感到庆幸。在中国，有多少个高压电线杆下有醒目标识？又有多少个高压杆矗立在民居与农田四周，而没有设制一定的安全距离?又有多少个中国人能知道或被教育知道高压有害，远离高压？而不是为盗取那些铜线去换取买面包的钱？而又有哪条法律制定了在此方面，政府应承担的责任与赔偿？

一场灾祸的发生，不仅仅是私德的问题，也是公德的问题!!!

从另一方面也反映了，作为工程师或设计师，如果身怀责任感，而不是追求短暂的经济利益，那么对一个城市的规划，比如下水道的设计，交通枢纽的设计等等，应该是跨时代的整体布局，而不仅仅是眼前的利益。

一些统治者高高在上，掠夺着民生，却忘了在塔尖上的人只占着世界人口的百分之一或千万分之一，而建立金字塔的人占着另外的百分之九十九。没有了塔底，哪来的塔尖？

而社会的蛀虫们的生存，本是社会制度给了他们生存的土壤，与他人无关。怎么可能为了一只蛀虫而祸害他人？玩起了封建社会，株连九族的连带责任。每个人都以个体存于社会，相互依附。公德的建立，正是王了犯法，与民同罪。所以法律面前，人人都是平等的，这也真正体现了社会的公德与价值。

P72

The Principle of Sufficient Reason (PSR)

P158

治与被治（生命的质量与生命的长度，哪个更重要？）

Why, it might be asked, is Dax angry and resentful? After all, he admits that he is enjoying life, and but for the medical paternalism of his doctors, he would be dead. In a documentary about him entitled Dax’s case, he offers two reasons. First, he believes that the means (the excruciating pain and extreme suffering associated with the burn treatments that he endured for months) did not justify the end (preventing his death). Accordingly, Dax says that even if he knew the outcome would refuse treatment. Second, he says he values freedom and the ability to choose for himself. Accordingly, he is angry that others (his mother and physicians) decided for him.

Dax’s first reason helps to expose a fallacy in the notion that a brilliant clinician such as House knows what is best for patients. Due to their medical training and expertise, physicians may know best how to keep their patients alive. However, keeping a patient alive will not necessarily promote the patient’s good or best interests. When there are treatment options (non-treatment is always one option), determining which is best for a particular patient (evaluating the potential benefits and harms) depends on that patient’s distinctive preferences and values. As a popular saying puts it, “Different strokes for different folks.” (人上一百，形形色色。)For Dax, but not necessarily for all patients in a similar situation, avoiding the pain and suffering associated with burn treatments was more important than preventing death. Accordingly, even though the outcome in his case was good, it cannot be said that treating him against his wishes promoted his best interests better than forgoing treatment would have.

Dax’s case also challenges the recurrent notion in the series that medical paternalism is justified because House and his team provide patients what they need. What do patients need? House’s answer is health and longevity. But, as Dax illustrates, patients can have various goals and values other than health or longevity. Dax valued freedom and the absence of pain, and he assigned higher priority to both than to health and longevity. As House himself illustrates in “Three Stories,” patients can value bodily integrity more than life, as shown by the fact that they are willing to bear an increased risk of death in order to keep a limb or breast or in order to reduce the risk of incontinence, sterility, or impotence. …… Clearly, then, although patients may need certain medical interventions to stay alive, it does not follow that they need those interventions to promote their good (the goals that matter most to them).

后面故事太长，暂以达克斯案为例。

简    译：

达克斯对自己不能选择治疗的方案是愤怒和憎恨的。虽然母亲与医生对他的治疗做了决定与计划，但达克斯本人却在治疗的过程中忍受着巨大的痛苦与心理的创伤，这种痛苦不仅是肉体上的，还有精神与心灵的深层次的，并不被外人所能理解与看到，比如大小便失禁、生育能力的丧失或者性能力的丧失等等。就像在古时候，“凌迟”对于生命的痛苦远远大于“咔嚓一声的砍头”。医生尝试的各种各样的对病人的医疗手段，从某种意义上来说，也是一种“凌迟”，只是目标不一样而已。

作为医生，豪斯认为医生的职责是救死扶伤，尽量让病人健康与长寿是医生应该去做的。而对于达克斯，面对着每次治疗方案的不同，需要忍受的肉体与精神的双重痛苦，并且是长期的，这不是他所感兴趣的。他更注重于他的自由选择的权力与做一些他心里真正想做的事，这些东西优先于他的“健康与长寿”，说白了，让生活真正的快乐起来，做自己喜欢的事并能做自己喜欢的事，才是他内心里真正的选择。即使医疗技术可以不断的改进，但并不意味着医生们的选择与建议真正有助于他的生活质量的提高，治疗方案也许会因人而异，产生差别，最终的结果有可能出乎于所有人的期望与目标。其实对于一些让肉体产生具大伤痛与伤害的疾病，“不治疗”也是一种选择。一些病人更愿意自己的生命具有质量，而不是“苟活下去”的生命的长度。

如何考虑病人内在的需求？如何对决定对病人进行最好的治疗手段？这是一把双刃剑，它考量着社会的伦理与道德。东西方都有这种观念的冲突，什么是社会价值与个人价值？如何尊重与体现？这是个有趣的论题。西方更注重于个人的自由与价值，而中国人认为身体受之于父母，好死不如赖活着，这是为什么有些晚期癌症病人或长期瘫痪的病人拖垮了一家人，像是因为一个病人，全家都生病了，全家都失去了生活的质量与乐趣、人生目标。如何让病人理解自己真实的病况？医生如何根据病人的真实情况，给予其必要的治疗手段，这也是对良心的一种考量。毕竟在生命的面前，大家都是平等的。

科学是有禁区的。

爱因斯坦在回答日本中小学生提问科学家是否对原子弹的毁灭性灾难负有责任时是否定 的，认为那只是政治家的事。但爱因斯坦去世前几个朋在回复一位朋友的信中却承认，科学家应当对原子弱这样的大杀伤性武器负有责任。科学家在任何研究之前都要考虑其研究成果到底是给人类带来灾难还是幸福。

思考：爱因斯坦在晚年皈依了宗教，思其原因有二种可能，一是对原子弹造成的杀伤性灾难的罪赎；二是对自己的科学试验结果的灾难性的预见不足的反悔性思考。

由此引起另一个问题：政治家是否要为战争负责？如何做出决策，才能成为有远见而英明的政治家？

归根到底，科学与政治都应遵循的四条原则：行善，自主，不伤害，公正。

更简单的一句话就是：以人为本。

人工林与原生林的区别：

原生林具有自然渖化，自我更新的能力，具备适合地貌与气候的生态系统，对正常的自然灾害有自适应和恢复能力，还有在自然进化的过程中产生的宝贵的动植物基因库。

人工林，没有一个由乔、灌、草、藤兼备的植物体系，维护与对抗天灾需要耗费大量的人工与经济成本。（2003年6月4日《中国经济时报》）

人工智能与人脑的区别：
最显著的区别：情感的不同

人工智能，是按照设计者的思路与思维进行创造与设计，而设计者本身逃脱不了对事物认知的有限与社会大背景的局限性。最大的优点：贮存量巨大，速度快。

人脑，最大的优点具有情感思维，在处理问题时，会根据当时的处境对事物进行灵活性处理。依外在与内在的环境不同，而、做出处理意见。