This study examined psychopathological correlates of implicit and explicit shame and guilt in 30 clinical and 129 non-clinical youths aged 8–17 years. Shame and guilt were measured explicitly via two self-reports and a parent report, and implicitly by means of an Implicit Association Test (IAT), while a wide range of psychopathological symptoms were assessed with questionnaires completed by children, parents, and teachers. The results showed no differences of implicit and explicit shame and guilt between the clinical and non-clinical group, implying (...) that dysregulation of these self-conscious emotions is not per definition associated with psychopathology. Correlational analyses indicated that self-reported explicit shame was positively associated with a broad range of internalizing psychopathology, while self-reported explicit guilt was associated with higher levels of anxiety and to some extent lower levels of externalizing psychopathology. Correlations with parent-rated shame and guilt revealed the same pattern of results but were in general weaker. Furthermore, implicit shame and guilt did not show significant correlations with the various measures of psychopathology. It can be concluded that the link between shame and guilt and psychopathology is complex, and partly dependent on the disorder under study and context-related factors defining the maladaptive nature of these self-conscious emotions. (shrink)

If our moral beliefs rest on a mistake, as moral error theorists claim, what should we do with them? According to Richard Joyce’s revolutionary moral fictionalism, error theorists should pretend to believe moral propositions in order to keep the benefits moral thinking has for their preference satisfaction. This, he claims, frees error theory from radical practical implications. In response, I argue that implementing fictionalism would not preserve our moral practices, but disrupt them. The change from moral belief to make-belief yields (...) an unintended second revolution: a revolution in the content of morality. I show that fictionalism necessarily relies on a similar justification of moral practices as David Gauthier’s contractarianism, and consequently has similar implications for moral content. Because fictionalists engage in moral thinking purely for its instrumental value, they should only accept moral obligations that are useful to them into their fiction. This restriction is important: the most useful moral fiction departs substantially from conventional moral views. Revolutionary moral fictionalism is therefore more radical than it is promised to be. (shrink)

Background:Since the adoption of the Universal Declaration of Human Rights by the United Nations in 1948, human rights as set out in government documents have gradually changed, with more and more power being transferred to individual.Objectives:The aim of this article is to analyze how the position of the patient in need of care is constructed in Norway’s renamed and revised Patients’ and Service Users’ Rights Act (originally Patients’ Rights Act, 1999) and published comments which accompanying this legislation from the Norwegian (...) Ministry of Health and Care Service.Research design:A constructivist design was used, and Fairclough’s critical discourse approach was adopted to analyze the text of the Patients’ and Service Users’ Rights Act and comments.Findings:The analysis identified three discourses: (a) political discourse, containing ethical discourses about priority and economy, in which patients are constructed as powerless individuals; (b) expert discourse, containing a theme about patients’ trust in the healthcare team and its knowledge, in which patients are constructed as helpless individuals lacking knowledge; and (c) patient participation and patient autonomy discourse, containing ethical discourses about decision-making, in which patients are constructed not only as individuals with needs and rights but also as “troublesome.”Conclusion:Dominant paternalistic discourses in the legal text validate the power of medicine, the healthcare system, and heath personnel over the needs, rights, participation, and autonomy of the patient. (shrink)

In this paper, we first classify different types of second opinions and evaluate the ethical and epistemological implications of providing those in a clinical context. Second, we discuss the issue of how artificial intelligent could replace the human cognitive labour of providing such second opinion and find that several AI reach the levels of accuracy and efficiency needed to clarify their use an urgent ethical issue. Third, we outline the normative conditions of how AI may be used as second opinion (...) in clinical processes, weighing the benefits of its efficiency against concerns of responsibility attribution. Fourth, we provide a ‘rule of disagreement’ that fulfils these conditions while retaining some of the benefits of expanding the use of AI-based decision support systems in clinical contexts. This is because the rule of disagreement proposes to use AI as much as possible, but retain the ability to use human second opinions to resolve disagreements between AI and physician-in-charge. Fifth, we discuss some counterarguments. (shrink)

We are subject to many different norms telling us how to act, from moral norms to etiquette rules and the law. While some norms may simply be ignored, we live under the impression that others matter for what we ought to do. How can we make sense of this normative authority some norms have? Does it fit into our naturalist worldview? Many philosophers claim it does not. Normativity is conceived to be distinct from ordinary natural properties, making it mysterious. The (...) mystery fuels a radical yet prominent scepticism about the existence of normative properties: if they are too strange to actually exist, there is nothing we ought to do. Some take this to mean, moreover, that nothing is morally right or wrong. We must critically examine the ideas behind these theories, which put both morality and normativity in general on the line. -/- The aim of this thesis is to unravel the mystery of normativity. It uncovers and objects to the influential non-natural conception of it, arguing that we can capture normativity with natural properties. In particular, it explores how the authority of norms can be explained by the commitments of the people subject to them. In connection to this, it challenges the conceptual claim behind the view that all moral judgements are mistaken. Finally, it reveals that treating morality as a mere fiction has revolutionary practical implications. This emphasises the importance of the overall conclusion: we need not conceive of either moral or normative properties as too mysterious to exist. (shrink)

The revised edition contains a new chapter which provides an elegant description of the semantics. The various classes of lambda calculus models are described in a uniform manner. Some didactical improvements have been made to this edition. An example of a simple model is given and then the general theory (of categorical models) is developed. Indications are given of those parts of the book which can be used to form a coherent course.

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and (...) informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

Natural language contains many expressions with underspecified emotive content. This paper proposes a way to resolve such underspecification. Nonmonotonic inference over a knowledge base is used to derive an expected interpretation for emotive expressions in a particular context. This ‘normal’ meaning is then taken to influence the hearer’s expectations about probable interpretations, and, because of these probable interpretations, the decisions of the speaker about when use of underspecified emotive terms is appropriate.

The aim of this article is to elucidate the processes that characterize natural language interpretation. The basic hypothesis is that natural language interpretation can be characterized as an optimization problem. This innovative view on interpretation is shown to account for the crucial role of contextual information while avoiding certain well-known problems associated with compositionality. This will become particularly clear in the context of incomplete expressions. Our approach takes as a point of departure total freedom of interpretation in combination with the (...) parallel application of soft constraints on possible interpretations. These constraints can be contextual, intonational or syntactic in nature. The integration of pragmatic and syntactic/semantic information in a system of ranked constraints is proposed to correctly derive the optimal interpretations in cases of nominal anaphorization, determiner quantification and elliptical comparatives. (shrink)

The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain this absence. I draw on (...) the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of ‘relational ontology’ originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients. (shrink)

Response-dependence theses are usually formulated in terms of a priori true biconditionals of roughly the form ‘something, x, falls under the concept ‘F’ ↔ x would elicit response R from subjects S under conditions C’. Such formulations are vulnerable to conditional fallacy problems; counterexamples threaten whenever the C-conditions’ coming to obtain might alter the object with respect to F. Crispin Wright has suggested that such problems can be avoided by placing the C-conditions in a proviso. This ensures that any changes (...) triggered by the C-conditions’ coming to obtain will be irrelevant to the truth of the biconditional. I argue that this move leaves the equations vulnerable to counterexamples of a slightly different kind : Cases where the change is triggered, not by the C-conditions’ coming to obtain, but by the response. I consider two ways to resist these counterexamples, and argue that both are insufficient. The upshot is a challenge that must be met if provisoed biconditionals are to serve their purpose. (shrink)

Response-dependence theses are usually formulated in terms of a priori true biconditionals of roughly the form 'something, x, falls under the concept 'F' ↔ x would elicit response R from subjects S under conditions C'. Such formulations are vulnerable to conditional fallacy problems; counterexamples threaten whenever the C-conditions' coming to obtain might alter the object with respect to F. Crispin Wright has suggested that such problems can be avoided by placing the C-conditions in a proviso. This ensures that any changes (...) triggered by the C-conditions' coming to obtain will be irrelevant to the truth of the biconditional. I argue that this move leaves the equations vulnerable to counterexamples of a slightly different kind: Cases where the change is triggered, not by the C-conditions' coming to obtain, but by the response. I consider two ways to resist these counterexamples, and argue that both are insufficient. The upshot is a challenge that must be met if provisoed biconditionals are to serve their purpose. (shrink)

This article explores how paid domestic work is framed in state policies and discourses, drawing upon theoretical discussions on gender, welfare and global care chains. Based on a case study of the political debate on the `reconciliation of personal, family and work life' in Spain, the author argues that dominant policy frames relate gender inequality to women's unpaid domestic work and care, while domestic workers are essentially the invisible `other'. Empowering and disempowering frames are discussed; domestic workers are mainly constructed (...) as a solution to the care problem and only marginally as subjects and rights-holders. The overall aim is to examine how public policies legitimize and produce social inequalities related to gender, class and nationality. (shrink)

This paper considers the meaning and use of the English particle man. It is shown that the particle does quite different things when it appears in sentence-initial and sentence-final position; the first use involves expression of an emotional attitude as well as, on a particular intonation, intensification; this use is analyzed using a semantics for degree predicates along with a separate dimension for the expressive aspect. Further restrictions on modification with the sentence-initial particle involving monotonicity and evidence are introduced and (...) analyzed. The sentence-final use can be viewed as strengthening the action performed by the sentence. A formal semantics is given by making use of dynamic techniques and, in a sense, dynamically simulating the modification of certain speech acts. Some empirical and theoretical extensions of the analyses are proposed and some consequences discussed. (shrink)

Hendrik Lorenz presents a comprehensive study of Plato's and Aristotle's conceptions of non-rational desire. They see this as something that humans share with animals, and which aims primarily at the pleasures of food, drink, and sex. Lorenz explores the cognitive resources that both philosophers make available for the explanation of such desires, and what they take rationality to add to the motivational structure of human beings. In doing so, he finds conceptions of the mind that are coherent and deeply integrated (...) with both philosophers' views about such topics as the relation between body and soul, or the nature of the virtues. (shrink)

ABSTRACT:I argue that there are, according to Aristotle, two importantly different kinds of goals or ends in the domain of human agency and that one of these two kinds has been frequently, though not universally, overlooked. Apart from psychological goals, goals that agents adopt as their purposes, there are also, I submit, goals that actions have by being the kinds of actions they are and, in some cases, by occurring in the circumstances in which they do. These latter goals belong (...) to suitable actions whether or not agents adopt them as purposes and whether or not agents are aware of them. There is evidence both in Aristotle's ethical writings and in his discussion of chance and luck in Physics II.4–6 that he recognizes goals of this latter kind. (shrink)

This short essay argues that more attention should be paid to conventional norms in metaethics and metanormative theory.

Todas las reflexiones acerca del signo –convencionalismo-naturalismo, realismo- nominalismo, empirismo-racionalismo, concepción diádica-concepción triádica- se articulan en torno a las relaciones entre signo, pensamiento y realidad. Aunque todos coinciden en que un signo es "aliquid stat pro aliquo", esta antigua definición de carácter muy general adquiere implicaciones muy distintas según los presupuestos de cada autor y, todavía hoy, carecemos de un consenso en la definición de "signo".

With a specific example from Norway and inspiration from Sara Ahmed’s The Promise of Happiness, this article demonstrates how today’s educational rhetoric lacks the language and will to recognise a key pedagogical dimension in education: what happens when the normative ambitions of education and students meet. At best, teaching students life skills to mitigate their mental health issues is naive. Inspired by Ahmed, such an initiative might actually work against its purpose. At a time when educational outcomes are emphasised in (...) local and international political contexts, I argue that the task of philosophy of education should be 1) to reclaim the significance of the pedagogical dimension in education and 2) to philosophise on what negative emotions such as unhappiness require of education. (shrink)

The reliability of clinical practice guidelines has been disputed because guideline panel members are often burdened with financial conflicts of interest. Current recommendations for COI regulation advise not only detailed declaration but also active management of conflicts. To continuously assess COI declaration and management in German guidelines we established the public database LeitlinienWatch. We analyzed all German guidelines at the highest methodological level that included recommendations for pharmacological therapy according to five criteria: declaration and assessment of COI, composition of the (...) guideline development group, independence of the coordinators and lead authors, imposed abstentions because of COI and public external review. Each criterion was assessed using predefined outcome categories. Most guidelines contained a detailed declaration of COI. However, none of the guidelines provided full transparency of COI assessment results. The guideline group was composed of a majority of participants with COI in 55% of the guidelines, no guideline was free of participants with COI. Only 9% of guidelines had coordinators and lead authors without any financial COI. Most guidelines did not provide a rule for abstentions for participants with COI. In 21% of guidelines there was a rule, but abstentions were either not practiced or not documented, whereas in 7% partial abstentions and in 2% complete abstentions were documented. Two thirds of the guideline drafts were not externally reviewed via a public website. COI are usually documented in detail in German guidelines of the highest methodological level. However, considerable improvement is needed regarding active management of COI, including recruitment of independent experts for guideline projects, abstention from voting for participants with COI and external review of the guideline draft. We assume that the publicly available ratings on GuidelineWatch will improve the handling of conflicts of interest in guideline development. (shrink)

As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)

Swedish beef and dairy farmers are currently facing a challenging financial situation. Simultaneously, beef farming contributes significant environmental impacts. To support farmers, actors from the whole value chain are now promoting Swedish beef as particularly ‘sustainable’. The paper draws on critical discourse analysis of interviews with and documents from the largest Swedish supermarket chain ICA, Swedish farmer organisations and farmers to study how ICA and farmers articulate sustainability and their responsibility for the same. Articulations are subsequently discussed in the light (...) of actual environmental impacts of beef production and the distribution of power in the beef value chain. The findings suggest that negative environmental impacts and farmers’ struggles are largely hidden in the dominant articulation of sustainability. Furthermore, ICA does not use the power it has to steer consumers toward reduced beef consumption. We conclude with suggesting more open deliberation about current levels of beef sales and consumption and about what compromises to make when striving for ‘sustainable’ beef consumption. (shrink)

We review evidence regarding Tomasello et al.'s proposal that individuals with autism understand intentions but fail socially because of a lack of motivation to share intentions. We argue that they are often motivated to understand others but fail because they lack the perceptual integration skills that are needed to apply their basically intact theory of mind skills in complex social situations.

To avoid post-neurosurgical language deficits, intraoperative mapping of the language function in the brain can be complemented with preoperative mapping with functional magnetic resonance imaging. The validity of an fMRI “language localizer” paradigm crucially depends on the choice of an optimal language task and baseline condition. This study presents a new fMRI “language localizer” in Russian using overt sentence completion, a task that comprehensively engages the language function by involving both production and comprehension at the word and sentence level. The (...) paradigm was validated in 18 neurologically healthy volunteers who participated in two scanning sessions, for estimating test–retest reliability. For the first time, two baseline conditions for the sentence completion task were compared. At the group level, the paradigm significantly activated both anterior and posterior language-related regions. Individual-level analysis showed that activation was elicited most consistently in the inferior frontal regions, followed by posterior temporal regions and the angular gyrus. Test–retest reliability of activation location, as measured by Dice coefficients, was moderate and thus comparable to previous studies. Test–retest reliability was higher in the frontal than temporo-parietal region and with the most liberal statistical thresholding compared to two more conservative thresholding methods. Lateralization indices were expectedly left-hemispheric, with greater lateralization in the frontal than temporo-parietal region, and showed moderate test-retest reliability. Finally, the pseudoword baseline elicited more extensive and more reliable activation, although the syllable baseline appears more feasible for future clinical use. Overall, the study demonstrated the validity and reliability of the sentence completion task for mapping the language function in the brain. The paradigm needs further validation in a clinical sample of neurosurgical patients. Additionally, the study contributes to general evidence on test–retest reliability of fMRI. (shrink)

This paper examines the support for diversity from a moral perspective. Combining business ethics theory with a lens of critical discourse analysis, it reconstructs the debates on the ethicality of three disability inclusion practices—positive discrimination, job adaptations, and voluntary disclosure—drawn from multi-stakeholder interviews in disability-friendly organizations. Discursive resistance to disability inclusion practices, otherwise known to work, arises out of moral beliefs characteristic of an ethic of justice, whereas support is more often informed by an ethic of care. This study contributes (...) to the literature by laying bare how ethics fuel ‘resistance to’ rather than ‘support for’ diversity and inclusion. Like prior studies, it links such resistance to the myth of individual merit, noting that some re-appropriation of an ethic of justice becomes possible when legal awareness around issues of disability is raised in the context of work. In addition, it identifies an ethic of care as holding the greatest potential for fostering workplace inclusion yet cautions for two adverse side effects that may arise when promoting corporate care: the potential of paternalism and the inclination to individualise inherent to wellbeing initiatives. (shrink)

As noninvasive prenatal testing is being implemented as a first-trimester prenatal screening modality in healthcare systems around the world, it raises ethical concerns. In theory, NIPT allo...

Background:In recent years, operating theatre nurse students’ education focused on ethics, basic values and protecting and promoting the patients' dignity in perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery.Objective:The objective of this study was to present what operating theatre nursing students perceived and interpreted as undignified caring in perioperative practice.Research design:The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan’s critical incident technique.Participants and research context:Operating (...) theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation.Ethical considerations:The study was approved by the Karlstad University's Research Ethics Committee.Findings:The findings show careless behaviour and humiliating actions among health professionals. Health professionals commit careless acts by rendering the patient invisible, ignoring the patient’s worry and pain and treating the patient as an object. They also humiliate the patient when speaking in negative terms about the patient’s body, and certain health professionals blame the patients for the situation they are in. Health professionals lack the willingness and courage to protect the patient’s dignity in perioperative practice.Discussion:In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act.Conclusion:The findings reveal that patients were exposed to unnecessary suffering; furthermore, the operating theatre nurse students suffered an inner ethical conflict due to the undignified caring situations they had witnessed. (shrink)

This article explores how female graduate engineers construct femininities in male-dominated organizations. By applying a dynamic relational understanding of gender it is argued that different versions of femininities are constructed through associations to sameness and difference. The graduate engineering profession is closely connected to hegemonic masculinity, not least by the strong representation of technology and a management system itself heavily connected to current hegemonic masculinity. The female engineers stand in a position which can be described as `the dilemma of difference' (...) that arises when women choose to construct themselves as more or less different from men, or more or less visible as women. They negotiate whether the meaning of gender should mean sameness or difference from men, and they negotiate how to relate to hegemonic masculinity. This inuences the different strategies they choose. (shrink)

This chapter considers the semantics and pragmatics of expressive content. It begins by exemplifying the class of expressives, in the process introducing the tests that have been proposed for expressivity, focusing on the expressive adjectives fucking and damn, and on pejorative terms. The chapter then turns to specific analyses of these and other expressive items, also discussing facts related to how the particular content of some expressives can be derived from context. The chapter concludes with a discussion and overview of (...) various approaches to semantic composition with expressives. (shrink)

Västvärldens åldrande befolkning anses ofta ställa krav på nya former av vård och omsorg. Olika typer av informations- och kommunikationstekniskt baserat vårdstöd framhålls ofta som en lösning. Tekniken medger en rad olika fördelar, exempelvis tätare tillsyn, kontinuerliga mätningar av vitala funktioner, med möjlighet att kontinuerligt ställa diagnos, och snabb respons på larm, men de tekniska lösningarna får också etiska implikationer. I den här artikeln beskrivs och exemplifieras IKT-baserad vård och omsorg och teknikens påverkan på centrala värden som personlig integritet, autonomi, (...) frivillighet och informerat samtycke diskuteras. Interaktiv etisk teknikvärdering föreslås för att bättre inkorporera alla berörda parters behov av och synpunkter på den här typen av vårdstöd.Nyckelord: autonomi, etik, frivillighet, informerat samtycke, interaktiv etisk teknikvärdering, IKT-baserat vårdstöd, hemvård, personlig integritet, robotteknik, sensorteknik, säkerhet, trygghet, valfrihetEnglish summary: When health care moves in – the ethics of mobile health careAn ageing population in the Western world is typically taken to require novel forms of health care. Different types of Information and Communication based services and functions are presented as a solution. Even if such technology imply benefits in terms of more frequent attendance, continuous monitoring and diagnoses of vital signs and quick response to alarms, the technology also gives raise to ethical concerns. This article describes and exemplifies ICT-based health care and discusses implications on central values like privacy, autonomy, freedom of choice and informed consent. Interactive ethical technology assessment is suggested as a means to better incorporate the needs of all concerned parties and their perspectives on this type of support. (shrink)