Anna Smajdor

• Friedman, Yael & Smajdor, Anna (2026). Synthetic Medical Data vs. The Four Principles: Ethical Trade-Offs and Zombie Data | Health Care Analysis | Springer Nature Link. Health Care Analysis. ISSN 1065-3058. doi: 10.1007/s10728-026-00596-9. Fulltekst i vitenarkiv Vis sammendrag

  Rapid advances in AI for medical applications are accompanied by an increasing demand for vast datasets. Privacy constraints – legal restrictions such as GDPR, as well as more general ethical concerns – pose significant barriers to the acquisition and use of data. Synthetic medical data (SMD) is AI-generated data that mimics real patient information. SMD is being promoted as an ethical solution that preserves privacy while enabling scalable model training. However, as we will show, the use of SMD raises its own set of issues. SMD’s emphasis on privacy and scalability subtly embeds ethical and epistemic trade-offs that undermine the principles commonly regarded as being paramount in medical ethics. These trade-offs lack the kind of ethical justification one would expect in decisions that disrupt commonly accepted values and priorities, such as those captured by Beauchamp and Childress’ four principles. In the discourse on the ethical advantages of SMD, privacy tends to be treated as a value in its own right. We show that this is a problematic assumption. Transparency, privacy, scalability, and fidelity are all linked in complex ways with the principles of medical ethics. We map these relationships and show that when privacy is privileged over other values, it conflicts with autonomy and beneficence. Our aim here is not to establish that this privileging is wrong per se, but to show that it needs careful analysis before we can accept the idea that SMD is indeed ethically advantageous.

• Clausen, Hannah; Kutuzov, Andrey; Smajdor, Anna & Velldal, Erik (2026). Assessing Moral Judgment by Large Language Models – A Survey of Available Datasets. Northern European Journal of Language Technology (NEJLT). ISSN 2000-1533. 12(1), s. 88–116. doi: 10.3384/nejlt.2000-1533.2026.6366. Fulltekst i vitenarkiv Vis sammendrag

  Recent advances in language modeling have contributed to a growing emphasis on machine ethics, including researching and assessing moral judgments made by large language models (LLMs). This paper provides a critical survey of the existing datasets for exactly this assessment, with a special focus on the respective data sources. We address the current lack of theoretical grounding by providing an introduction to ethics and different frameworks from moral philosophy and moral psychology. Moreover, we identify four main data sources: webcrawled corpora, scholars, laypeople, and synthetic data generation. By discussing the strengths and weaknesses of these sources, we analyze their implications for the assessment of moral judgment. Importantly, systemizing the available datasets reveals an over-reliance on previous work, reinforcing existing shortcomings. Addressing the current limitations, we recommend adopting a consistent terminology and creating independently curated datasets based on interdisciplinary work. To ensure a clear delineation of normative approaches, we propose focusing on the assessment of moral consistency and certainty of LLMs as effective and well-defined indicators of their performance on moral judgment.

• Villalba, Adrian; Brassington, Iain; Smajdor, Anna & Cutas, Daniela (2025). Synthetic DNA and mitochondrial donation: no need for donor eggs? Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2024-110122. Fulltekst i vitenarkiv
• Villalba, Adrian; Smajdor, Anna; Brassington, Iain & Cutas, Daniela (2025). Non-viable embryos created with synthetic DNA. Trends in Biotechnology. ISSN 0167-7799. 43(9), s. 2093–2095. doi: 10.1016/j.tibtech.2025.02.021. Fulltekst i vitenarkiv
• Smajdor, Anna & Cutas, Daniela (2025). The Social Construction of Reproduction. Hypatia: A Journal of Feminist Philosophy. ISSN 0887-5367. doi: 10.1017/hyp.2025.9. Fulltekst i vitenarkiv Vis sammendrag

  In recent decades, ethicists have engaged with new developments in human reproductive technologies from a variety of angles. Yet there has been relatively little effort to problematize the concept of reproduction itself. In this paper, we examine the question of what reproduction is and its relationship with biology. We show that reproduction is commonly assumed to entail biological parenthood—an assumption that we term “the biological reproduction paradigm.” Drawing on Sally Haslanger’s analysis of the biological/social division between sex and gender, we suggest that the concept of reproduction is socially constructed, despite its apparently biological nature. In turn, we argue that the supposed necessity of the relationship between reproduction and biological parenthood leads to a situation in which access to a variety of medical, legal, and social goods is constrained on the basis of spurious, inconsistent, and undertheorized assumptions. Finally, we note that, given the socially constructed nature of reproduction, we cannot take it for granted that the term “reproduction” signifies the same thing among different interlocutors and in different contexts.

• Smajdor, Anna; Frigessi, Arnoldo & Zucknick, Manuela (2025). WHAT IS RIGHT FOR ‘THIS’ PATIENT? AUTONOMY, TRUST AND TRANSPARENCY IN THE ERA OF MEDICAL AI. Síntesis: Revista de Filosofia. ISSN 2452-4476. 52(164), s. 611–611. doi: 10.20911/21769389v52n164p611/2025. Fulltekst i vitenarkiv Vis sammendrag

  In this paper we compare the capabilities and limitations of AI algorithms and human doctors in the context of treatment recommendations. Ethical concerns have been raised in the literature about transparency, accountability, and interpretability in relation to AI algorithms in the medical context. Patients’ autonomy is not likely to be respected if treatment recommendations are opaque or incomprehensible. Medical AI algorithms are programmed to prioritise predefined goals that may not align with patients’ preferences, potentially undermining their autonomy without their awareness. Yet human doctors often face similar challenges, such as reliance on clinical trial data with endpoints that may not be fully understood by patients. We conclude that there are opportunities now to integrate patient autonomy considerations into AI algorithms at the design stage, and that these goals and any relevant weightings are made explicit to end users, including both doctors and patients. Keywords: Artificial intelligence. Autonomy Alignment. Medical ethics.

• Hens, Kristien; Moormann, Emma; Smajdor, Anna & Cutas, Daniela (2024). If Marc is Suzanne's father, does it follow that Suzanne is Marc's child? An experimental philosophy study in reproductive ethics. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2023-109808. Fulltekst i vitenarkiv Vis sammendrag

  In this paper, we report the results from an experimental reproductive ethics study exploring questions about reproduction and parenthood. The main finding in our study is that, while we may assume that everyone understands these concepts and their relationship in the same way, this assumption may be unwarranted. For example, we may assume that if ‘x is y’s father’, it follows that ‘y is x’s child’. However, the participants in our study did not necessarily agree that it does follow. This means, at the very least, that we need to make sure all parties in a debate have the same relationships in mind when talking about reproduction and parenthood. Moreover, it gives us reason to explore more carefully the conditions which support or undermine the connections between these concepts. This cannot come from purely theoretical reasoning, nor from empirical research alone, but from the alliance between the two.

• Cutas, Daniela & Smajdor, Anna (2024). Keeping it in the family: reproduction beyond genetic parenthood. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2023-109814. Fulltekst i vitenarkiv Vis sammendrag

  Recent decades have seen the facilitation of unconventional or even extraordinary reproductive endeavours. Sperm has been harvested from dying or deceased men at the request of their wives; reproductive tissue has been surgically removed from children at the request of their parents; deceased adults’ frozen embryos have been claimed by their parents, in order to create grandchildren; wombs have been transplanted from mothers to their daughters. What is needed for requests to be honoured by healthcare staff is that they align with widely shared expectations about what people’s reproductive potential ought to be, what marital relationships ought to result in, and which kinds of ties are desirable between parents and children. Costly and invasive technologies are not considered excessive when they are used to support the building of appropriate families. However, deviations from dominant reproductive norms, even if technologically simple and convenient to the participants, are unlikely to receive support. In this paper, we offer examples of such deviations and explore their implications. If reproduction is important as a way of creating genetic relationships, should reproductive material in storage be offered to genetic relatives other than the people from whom it originated? And if parents are allowed to have reproductive material collected from their offspring, or even to use it to create babies, should offspring likewise be allowed to use their parents’ reproductive material? We tackle these questions and suggest ways in which interests in genetic ties could be operationalised in a more coherent and less-invasive manner than they currently are.

• Smajdor, Anna (2024). The End of Human Reproduction? Humana.Mente. 17(46), s. 1–23. Fulltekst i vitenarkiv
• Villalba, Adrian; Smajdor, Anna; Brassington, Iain & Cutas, Daniela (2024). The ethics of synthetic DNA. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2024-110124. Fulltekst i vitenarkiv
• Smajdor, Anna (2024). Facts and ideologies: race and moral equality. Inquiry (Oslo). ISSN 0020-174X. 67(8). doi: 10.1080/0020174X.2024.2320335. Fulltekst i vitenarkiv Vis sammendrag

  Appiah distinguishes between people who are racist because they are motivated by strong ideological convictions, and those who are racist because they believe certain facts to be true. I explore to what extent this distinction might apply to those who believe in racial equality. I show that it may be risky to ignore race-related factors in the health context, while acknowledging that what constitutes race may be open to question. I discuss the idea that there are no morally relevant differences between races, however construed. I show that to base one's belief in moral equality on empirical claims, is not only inherently problematic, but in most cases, is a false account of what really motivates such beliefs. Instead, I argue that we should embrace the ideological element of a belief in moral equality. Thus, instead of arguing about whether race exists, or whether there are morally relevant differences between races, (however construed), we may open a pathway to a more honest and challenging debate. That is, how can one moral ideology demonstrate its superiority over another?.

• Smajdor, Anna & Räsänen, Joona (2024). Is pregnancy a disease? A normative approach. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2023-109651. Fulltekst i vitenarkiv Vis sammendrag

  In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading the host’s body. Like a disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease.

• Räsänen, Joona & Smajdor, Anna (2024). Defending the disease view of pregnancy: A reply to our critics. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2024-110459. Fulltekst i vitenarkiv
• Smajdor, Anna (2023). Response to comments on my paper on whole body gestational donation. Theoretical Medicine and Bioethics. ISSN 1386-7415. 44(4), s. 393–399. doi: 10.1007/s11017-023-09646-y. Fulltekst i vitenarkiv
• Smajdor, Anna (2023). Assent and reification: a response to the commentators. Journal of Medical Ethics. ISSN 0306-6800. 49(7), s. 495–496. doi: 10.1136/jme-2023-109197. Fulltekst i vitenarkiv
• Smajdor, Anna (2023). Reification and assent in research involving those who lack capacity. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2022-108710. Fulltekst i vitenarkiv
• Smajdor, Anna & Villalba, Adrian (2023). The Ethics of Cellular Reprogramming. Cellular Reprogramming. ISSN 2152-4971. doi: 10.1089/cell.2023.0091. Fulltekst i vitenarkiv
• Smajdor, Anna & Räsänen, Joona (2022). Epigenetics, Harm, and Identity. American Journal of Bioethics. ISSN 1526-5161. doi: 10.1080/15265161.2022.2105424. Fulltekst i vitenarkiv
• Smajdor, Anna (2022). Whole body gestational donation. Theoretical Medicine and Bioethics. ISSN 1386-7415. doi: 10.1007/s11017-022-09599-8. Fulltekst i vitenarkiv Vis sammendrag

  Whole body gestational donation offers an alternative means of gestation for prospective parents who wish to have children but cannot, or prefer not to, gestate. It seems plausible that some people would be prepared to consider donating their whole bodies for gestational purposes just as some people donate parts of their bodies for organ donation. We already know that pregnancies can be successfully carried to term in brain-dead women. There is no obvious medical reason why initiating such pregnancies would not be possible. In this paper, I explore the ethics of whole-body gestational donation. I consider a number of potential counter-arguments, including the fact that such donations are not life-saving and that they may reify the female reproductive body. I suggest if we are happy to accept organ donation in general, the issues raised by whole-body gestational donation are differences of degree rather than substantive new concerns. In addition, I identify some intriguing possibilities, including the use of male bodies–perhaps thereby circumventing some potential feminist objections.

• Räsänen, Joona & Smajdor, Anna (2021). The complex case of Ellie Anderson. Journal of Medical Ethics. ISSN 0306-6800. s. 1–5. doi: 10.1136/medethics-2020-106998. Fulltekst i vitenarkiv
• Smajdor, Anna (2021). Why bother the public? A critique of Leslie Cannold’s empirical research on ectogenesis. Theoretical Medicine and Bioethics. ISSN 1386-7415. s. 155–168. doi: 10.1007/s11017-021-09549-w. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper ‘Women, Ectogenesis and Ethical Theory’, which investigates the ways in which women reason about abortion and ectogenesis (the gestation of foetuses in artificial wombs). In her study, Cannold interviewed female non-philosophers. She divided her participants into separate ‘pro-life’ and ‘pro-choice’ groups and asked them to consider whether the availability of ectogenesis would change their views about the morality of dealing with an unwanted pregnancy. The women in Cannold’s study gave responses that did not map onto the dominant tropes in the philosophical literature. Yet Cannold did not attempt to reason with her participants, and her engagement with the philosophical literature is oddly limited, focussing only on the pro-choice perspective. In this paper, I explore the question of whether Cannold is correct that philosophers’ reasoning about abortion is lacking in some way. I suggest that there are alternative conclusions to be drawn from the data she gathered and that a critical approach is necessary when attempting to undertake philosophy informed by empirical data.

• Smajdor, Anna Colette (2019). An alternative to sexual reproduction: Artificial gametes and their implications for society. British Medical Bulletin. ISSN 0007-1420. 129(1), s. 79–89. doi: 10.1093/bmb/ldz001. Fulltekst i vitenarkiv
• Filbee-Dexter, Karen & Smajdor, Anna (2019). Ethics of Assisted Evolution in Marine Conservation. Frontiers in Marine Science. 6. doi: 10.3389/fmars.2019.00020. Fulltekst i vitenarkiv Vis sammendrag

  Climate change is outpacing existing rates of evolution and adaptation for many marine organisms. Human societies are pushing hard to find new solutions to save and protect marine ecosystems, generating research on manipulating genetics of wild organisms for the goal of conservation. This – “assisted evolution” – raises challenging ethical questions because the intention is not to revert to a previous status quo, but to modify a community so that it survives better in the conditions we have created. In so doing, our role changes toward “designers” of nature, which requires a rethinking of what is natural, and whether altering or influencing genetics of wild organisms changes the way we conceptualize nature. Assisted evolution could also perpetuate damaging habits and dispositions, such as commodification and technological intervention, which have caused the harm in the first place. Even if we feel morally obliged to repair ecosystems, we still risk further havoc if our attempts to fix our damage are affected by ignorance. Still, from an ethical point of view, we offer cautious support for research on assisted evolution tools. However, we must be clear that we are using these approaches for our own benefit, and should only proceed when they are adequately understood and other options are exhausted. In many cases, we should instead focus our efforts on protecting what we can, minimizing future damage, and understanding future changes. Either way, we need stronger ethical regulations on applying assisted evolution techniques in marine conservation so that there is sufficient deliberation before we use these tools.

• Smajdor, Anna Colette; Cutas, Daniela & Takala, Tuija (2018). Artificial gametes, the unnatural and the artefactual. Journal of Medical Ethics. ISSN 0306-6800. 44(6), s. 404–408. doi: 10.1136/medethics-2017-104351. Fulltekst i vitenarkiv
• Smajdor, Anna Colette & Cutas, Daniela (2018). Reproductive technologies and the family in the twenty-first century. I Giordano, Simona; Harris, John & Piccirillo, Lucio (Red.), The freedom of scientific research. Manchester University Press. ISSN 9781526127686. s. 57–70. doi: 10.7765/9781526127686.00014. Fulltekst i vitenarkiv
• Smajdor, Anna Colette (2018). Your sperm is mine! Do artificial gametes change the ethics of posthumous sperm retrieval and conception? Etica & Politica / Ethics & Politics. 20(3), s. 53–72. doi: 10.13137/1825-5167/22585. Fulltekst i vitenarkiv Vis sammendrag

  A number of cases have arisen over recent decades in which sperm has been extracted from dead and dying men without their prior consent. These extractions are undertaken in order to allow the man's partner to become a mother, or his parents, to become grandparents. Currently, the techniques used to perform such extractions are highly invasive, requiring either the use of an electric probe inserted in the anus to stimulate ejaculation, or surgical removal of all or part of the testicles. However, the development of artificial gametes may make it possible to produce sperm from skin cells, in which case the interventions required are far less invasive. In this paper I consider whether artificial gametes would offer a morally preferable way of producing sperm from dead or dying men without their consent. I evaluate the role played by bodily integrity, and reproductive autonomy in such cases. I suggest that artificial gametes would be less problematic than current techniques. And I argue that concern for reproductive autonomy does not ground a right not to become a parent. Nevertheless, I show that, whatever technique is used in order to derive sperm from dead or dying men, it is rooted in a morally problematic tendency to reify such men. That is, their bodies become the means to achieving the reproductive ends of some third party. Thus, even if sperm could be obtained through minimally invasive techniques, we should still regard such interventions as being a cause for moral concern.

• Smajdor, Anna Colette (2018). Means, ends, and the fetal patient. I Schmitz, Dagmar; Clarke, Angus & Dondorp, Wybo (Red.), The Fetus as a Patient. Routledge. ISSN 9781351692786. Fulltekst i vitenarkiv
• Smajdor, Anna Colette; Frith, Lucy; Hooper, Carwyn; Camporesi, Silvia; Douglas, Thomas A. & Nottingham, Emma [Vis alle 9 forfattere av denne artikkelen] (2018). Institute of Medical Ethics Guidelines for confirmation of appointment, promotion and recognition of UK bioethics and medical ethics researchers. Journal of Medical Ethics. ISSN 0306-6800. 44(5), s. 289–291. doi: 10.1136/medethics-2018-104816. Fulltekst i vitenarkiv
• Cutas, Daniela & Smajdor, Anna Colette (2017). The moral status of the (nuclear) family. Etikk i praksis. ISSN 1890-3991. 11(1), s. 5–15. doi: 10.5324/eip.v11i1.2250. Fulltekst i vitenarkiv
• Smajdor, Anna Colette & Stockl, Andrea (2017). PMDs and the Moral Specialness of Medicine: An Analysis of the ‘Keepsake Ultrasound’. I Farrington, Conor & Lynch, Rebecca (Red.), Quantified Lives and Vital Data - Exploring Health and Technology through Personal Medical Devices. Palgrave Macmillan. ISSN 9781349952342. s. 155–178. doi: 10.1057/978-1-349-95235-9_7. Fulltekst i vitenarkiv
• Smajdor, Anna Colette & Cutas, Daniela (2016). “I am Your Mother and Your Father!” In Vitro Derived Gametes and the Ethics of Solo Reproduction. Health Care Analysis. ISSN 1065-3058. doi: 10.1007/s10728-016-0321-7. Fulltekst i vitenarkiv Vis sammendrag

  In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people to reproduce in this way, and the implications that solo reproduction might have for ethics and policy. We suggest that such an innovation is unlikely to revolutionise reproduction and parenting. Indeed, in some respects it is less revolutionary than in vitro fertilisation as a whole. Furthermore, we show that solo reproduction with in vitro created gametes is not necessarily any more ethically problematic than gamete donation—and probably less so. Where appropriate, we draw parallels with the debate surrounding reproductive cloning. We note that solo reproduction may serve to perpetuate reductive geneticised accounts of reproduction, and that this may indeed be ethically questionable. However, in this it is not unique among other technologies of assisted reproduction, many of which focus on genetic transmission. It is for this reason that a ban on solo reproduction might be inconsistent with continuing to permit other kinds of reproduction that also bear the potential to strengthen attachment to a geneticised account of reproduction. Our claim is that there are at least as good reasons to pursue research towards enabling solo reproduction, and eventually to introduce solo reproduction as an option for fertility treatment, as there are to do so for other infertility related purposes.

Se alle arbeider i NVA

• Robert, Wheeler; Jon, Herring & Smajdor, Anna (2022). Oxford Handbook of Medical Ethics and Law. Oxford University Press. ISBN 9780199659425. 384 s. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Friedman, Yael & Smajdor, Anna (2026). Synthetic Medical Data. Fulltekst i vitenarkiv
• Friedman, Yael & Smajdor, Anna (2026). Synthetic medical data: ethical panacea or invasion of the zombies…? Fulltekst i vitenarkiv
• Friedman, Yael & Smajdor, Anna (2026). On synthetic medical data: Values hierarchies, reification, and zombies. Fulltekst i vitenarkiv Vis sammendrag

  Synthetic medical data (SMD) has been introduced to address data-acquisition challenges. It has been described as a “magical” solution that enables model training without compromising patients’ privacy and is therefore considered ethically desirable (Bellovin et al. 2019; Savage, 2023). However, as we will show in this article, synthetic data is not value-neutral, and it poses both epistemic and ethical trade-offs that cumulatively affect the medical realm. We focus on three primary methodologies: two key deep learning approaches, namely generative models without privacy guarantees and differential privacy (DP) models. In addition, we will use vine copula models as our primary example to demonstrate the statistical approach. We show that prioritizing privacy over transparency undermines explainability, which in turn hinders trust and fairness, pushing these values down the ladder. We also show that prioritizing scalability over fidelity moves medicine away from personalized, participatory, and patient-centered approaches and toward a naturalistic, mechanistic understanding. The collapse of context and experiential knowledge into “zombie data” yields a narrow conception of utility in medicine that ignores the patient as a person. The absence of a direct real-world reference (combined with the use of this data to train algorithms) is where SMD makes a step forward in the reification process relative to “regular” medical data. The data collected to represent reality may gradually subsume the very thing it is intended to represent. As such, SMD also introduces a new degree of reification in medicine, promoting fungibility, which offers clear advantages for data-intensive enterprises, over patients and minorities.

• Friedman, Yael & Smajdor, Anna (2026). DATA, Synthetic DATA, and the spectrum of reification. Fulltekst i vitenarkiv Vis sammendrag

  With rapid advances in AI technology, there is an increasing demand for data to train AI models. These models are used in medicine and health care for clinical research, diagnosis, drug development, and prevention. However, while significant amounts of health-related data are generated, large datasets may not be available due to privacy concerns and regulatory frameworks (e.g., GDPR). To obtain patients’ data, informed consent is required, therefore creating a high threshold for data sharing. In addition, for rare diseases or cases of “no diagnosis”, large data sets are not available. Synthetic medical data (SMD) has been introduced to address data-acquisition challenges; It has been described as a solution that enables model training without compromising patients’ privacy and is therefore considered "ethically desirable" (Bellovin et al. 2019, Savage, 2023). In this talk, we will introduce three main models of SMD: Generative models, Differential Privacy (DP) models, and the C-vine copula-based synthetic data generator. As we will show, these models are not value-neutral, and they pose both epistemic and ethical trade-offs. We will illustrate how SMD use creates new value hierarchies: Privacy over transparency: SMD can obscure the specific characteristics and nuances of real patient populations, which can create explanation gaps that undermine clinicians’ ability to interpret model outputs, erode trust, hinder bias mitigation (Susser et al., 2024), and knowledge development, and risk long-term de-skilling. These risks are especially relevant in the case of rare diseases, where small original datasets and oversimplified synthetic approaches can lose critical dependencies and idiosyncratic features, leading to misleading clinical insights. Scalability over fidelity: developers of SMD aim for low individual fidelity (to protect privacy) but high distributional fidelity, yet, as we will show, noise and selective-distortion methods can break crucial dependencies or entrench biased dependencies from the original data (ibid.), perpetuating the “garbage in, garbage out” paradox (in the process of keeping what seems as important dependencies in C vein copula models), or even introduce new biases (when adding noise in DP models). The preference for scalable, quantified data over individual experience holds risks of alienating patients, erasing contextual and minority experiences (creating what we call “zombie data”), expanding diagnostic disparities, and institutionalizing these trade-offs as a new normal. We will discuss how this prioritization fosters fungibility in medical practice, which we conceptualize as an advanced stage of the medical reification process. We will distinguish between the stage of “datafication”, which is characterize by decontextualization and translation of messy human experiences into transportable data points that creates a partial, curated technical form of objectivity (Leonelli,2016; Nguyen,2024), and SMD, which goes a step further, generating “zombie data” that deepens reification by stripping lived experience, context and agency from those experiences. Finally, we will argue that this new level of reification is a step forward in the process of commodification and, hence, in capitalism. References Bellovin, S. M., Dutta, P. K., & Reitinger, N. (2019). Privacy and synthetic datasets. Stan. Tech. L. Rev., 22, 1. Leonelli, S. (2019). Data-centric biology: A philosophical study. University of Chicago Press. Nguyen, C. T. (2024). Value capture. J. Ethics & Soc. Phil., 27, 469. Savage, N. (2023). Synthetic data could be better than real data. Susser, D., Schiff, D. S., Gerke, S., Cabrera, L. Y., Cohen, I. G., Doerr, M., ... & Wagner, J. K. (2024). Synthetic health data: real ethical promise and peril. Hastings Center Report, 54(5), 8-13.

• Smajdor, Anna & Friedman, Yael (2025). Epistemological and Ethical Dimensions of Synthetic Data for trustworthy AI. Fulltekst i vitenarkiv Vis sammendrag

  The development of AI systems relies on vast quantities of data, much of which is acquired without meaningful consent from the individuals whose information is harvested. Synthetic data – artificially generated through statistical modelling, generative AI, or data augmentation – has emerged as a proposed solution to both the logistical challenges of data acquisition and the ethical dilemmas of using personal data. However, as we will show, synthetic data does not necessarily offer an ethically superior pathway towards the development of trustworthy AI, and it raises a number of epistemological as well as ethical concerns in its own right. The risks related to AI’s reliance on mass scale data-harvesting are well recognised. They tend to be characterised in three ways: privacy, property and plagiarism. Using people’s data may result in private information being leaked into domains where it cannot easily be controlled or removed. There is also a worry that in using people’s data, AI developers may be regarded as in some senses stealing another person’s property. And in terms of generative AI, it has been suggested that the use of a person’s data to feed the generative model can be viewed as a form of plagiarism. Synthetic data seems to offer a perfect solution to these three problems, in effectively divorcing data-originators from the data itself. Synthetic data is artificially generated using a variety of methods, including rule based systems, statistical modelling based on probabilities, generative machine learning, where the AI learns patterns from real data and then generates its own simulations, and data augmentation, where a ‘real’ dataset is infiltrated with ‘noise’ – random variations in the data – in order to make it harder to trace back data to its original source. (Importantly, it should be noted here that synthetic data still depends on ‘real’ data to begin with; synthetic data cannot be generated out of thin air – it might thus be argued that the challenges of provenance remain, but become harder to identify and track.) In epistemic terms, the push for synthetic data tends to prioritize scalability over fidelity, introducing significant reliability risks. For example, generating synthetic patient records (e.g., for rare diseases where real data is limited) to train diagnostic AI models without exposing real patient data raise an epistemological issue: can synthetic medical data accurately capture the complexity of biological processes, or does it introduce epistemic risks by oversimplifying pathologies? While we want to have more data on rare diseases, generating synthetic data put us at risk of generating misleading clinical insights if this data lacks fidelity. Rare diseases often involve idiosyncratic symptom presentations, genetic variations, and comorbidities that may not be fully captured in small original datasets. Synthetic data can lead to epistemic injustice by abstracting lived realities into quantifiable inputs, privileging dominant frameworks over contextual or subjugated knowledge. Take for example the privilege of genetic information over environmental information or phenomenological inputs. When data originators—particularly marginalized underrepresented groups—are excluded from shaping synthetic datasets, their realities are reduced to raw material for extraction, fostering epistemic alienation. The generalization of synthetic data sets creates a movement away from ideas of knowledge co-creation, solidarity and benefit sharing. Instead, it presents a sanitised product for companies to use as they see fit. In addition, while synthetic datasets can address privacy concerns by severing ties to real individuals, thus circumventing some legal and ethical problems they also reinforce the ‘garbage in, garbage out’ paradox: if the original data reflects biases or underrepresentation of marginalized communities (e.g., representation of mostly white Europeans males), the synthetic output will amplify these flaws under the veneer of neutrality. AI models may then fail to recognize symptoms in marginalized groups, worsening diagnostic disparities. Synthetic data will reproduce and amplify these gaps, leading to AI models that underdiagnose women and non-white patients. In short, rather than repairing knowledge gaps and injustices (e.g., testimonial injustice of minorities in health care), synthetic data can codify them as statistical inevitabilities; data that replicates existing biases naturalizes disparities as inevitable rather than contestable power structures. The generation of synthetic data can be viewed as part of a broader ongoing push towards datafication, and hence, reification. At its core, datafication is the rendering of human experiences, relationships, and biological processes, into fungible units of data. This transformation is neither epistemically nor ethically neutral. The individual is not treated as a subject with agency, but as a means through which valuable goods can be obtained. The term ‘harvesting’ is apt here. The data then becomes as a tool to serve ends that may have no connection with the data originator. In a further step towards reification, the data that is collected in order to represent reality, may gradually subsume the thing it is intended to represent. The attempt to abstract data away from real people facilitates the consumption and commodification of data, without adequately addressing the ethical and epistemological issues that this raises. We conclude our paper by arguing that benefit sharing approaches, which maintain and make explicit the links between data originators and the data they produce, are a better way of approaching these challenges.

• Clausen, Hannah; Kutuzov, Andrey; Smajdor, Anna & Velldal, Erik (2025). Assessing Morality in Large Language Models - A Survey. Fulltekst i vitenarkiv Vis sammendrag

  Poster Presentation of the current state of research presenting datasets, approaches and theories used to evaluate moral judgment by large language models

• Zucknick, Manuela; Frigessi, Arnoldo & Smajdor, Anna (2024). Autonomy and decision-making in the era of medical AI: the red pill or the blue? Fulltekst i vitenarkiv
• Frigessi, Arnoldo; Smajdor, Anna & Zucknick, Manuela (2023). The Importance of Reward Functions in Machine Learning Algorithms and Why These Should be Regulated. Fulltekst i vitenarkiv Vis sammendrag

  Session III: AI in Practice Presentation: The Importance of Reward Functions in Machine Learning Algorithms and Why These Should be Regulated presented by Frigessi

• Räsänen, Joona & Smajdor, Anna Colette (2020). The Ethics of Ectogenesis. Bioethics. ISSN 0269-9702. 34(4), s. 328–330. doi: 10.1111/bioe.12745. Fulltekst i vitenarkiv
• Bøhn, Einar Duenger; Smajdor, Anna Colette & Jensenius, Alexander Refsum (2018). Humaniora og teknologi. Fulltekst i vitenarkiv
• Smajdor, Anna Colette & Stockl, Andrea (2017). The MMR debate in the United Kingdom: vaccine scares, statesmanship and the media. I Holmberg, Christine; Blume, Stuart & Greenough, Paul (Red.), The politics of vaccination A global history. Manchester University Press. ISSN 9781526110930. Fulltekst i vitenarkiv
• Smajdor, Anna Colette; Cutas, Daniela & Hens, Kristien (2017). Procreative Procrastination: The Ethics of Postponed Parenthood. I Stoop, Dominic (Red.), Preventing Age Related Fertility Loss. Springer. ISSN 9783319148571. Fulltekst i vitenarkiv

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