We describe our clinical experience in treating patients with Tourette syndrome and other tic disorders using infra-low frequency neurofeedback, often in conjunction with cognitive behavior therapy. Following a narrative description of our approach, we present outcome data for 100 successive cases. Many of the children and adolescents that we have treated since 2005 did not derive sufficient benefit from standard treatment for Tourette syndrome and other tic disorders. In our clinical experience, based on extensive before- and after- testing and symptom (...) tracking, this patient group derived significant additive benefit from complementary neurofeedback treatment. The majority of trainees attained a higher level of functioning and were able to live up to their potential in a way they were not able to prior to neurofeedback treatment. (shrink)

Firms engage in social responsibility activities for diverse reasons. This study focuses on understanding firms' instrumental motivations for engaging in socially responsible activities. We suggest that the instrumental motivations underlying firms' corporate social responsibility engagement are associated with their market, learning, and risk-related behaviors; thus, we identify market orientation, learning orientation, and risk-taking attitudes as three constructs that influence firms' CSR engagement. This research was conducted in the Norwegian firewood sector, in which CSR expectations are high and in which we (...) expect CSR engagement to be encouraged by both instrumental and normative motivations. The firms in this study are micro-firms with fewer than 10 employees and represent an important but highly neglected segment of firms in CSR research. Data obtained from 230 firms were analyzed using structural equation modeling. Our results indicate that market orientation, learning orientation, and risk-taking attitudes affect social responsibility toward different stakeholder groups in different ways. In some cases, the size and age of firms also affect these relationships. (shrink)

In this paper, I make the case that the tradition of pragmatism may usefully inform aesthetic criticism. To that end, I contrast the anti-essentialist outlook and the ethico-political concerns of neo-pragmatist philosopher Richard Rorty with the epistemological underpinnings of analytic aesthetics. The aim is to outline an alternative meta-theoretical perspective that ‘overwrites’ long-standing concerns with exactitude and objectivity. Drawing on examples from my own area of expertise, film, and television studies, I seek to explicitly set up aesthetic criticism, especially evaluation, (...) as a means of social progress and human flourishing within the framework of liberal democracy. (shrink)

In a recent paper— The disvalue of death in the global burden of disease 1—we question the commensurability of the two components of the disability-adjusted life year — years lived with disability and years of life lost —and offer a tentative solution to this problem. In an exciting and constructive reply— Is consistency overrated? 2—philosopher S Andrew Schroeder argues that our concern about the DALY may be missing the mark by accepting the DALY as what he refers to as an (...) index reflecting nothing ‘beyond the importance we place in each ’. According to Schroeder, our consistency requirement is then made redundant. Recall our main argument: the DALY is the arithmetical sum of two components, YLDs and YLLs. The YLDs represents the individual disease burden that occurs while we are alive, while YLLs represents the individual disease burden resulting from our death. ‘Death’, in this context, is not the process of dying, which happens within life and which is captured by YLDs, but rather the incidence in which the life of a person has ended. Understood this way, the DALY is the aggregate of life and death, and we argue that these are incommensurables. Why are YLDs and YLLs incommensurables? In our article, we present several reasons for this. Briefly, YLDs measure disease burden that happens to an individual, whether it be painful experiences or loss of function. YLDs have a duration and are usually something we experience, such as pain. YLLs, on the other hand, are instantly generated when the life of that individual has expired. We do not experience YLLs, and they happen where we are not. When YLLs are generated, the life in question has already ended. On a secular account, death is the irreversible cessation of the mind and the senses, and …. (shrink)

This book is the first study to explore an ancient philosopher’s attitude towards the vast majority of society, who had no knowledge or affiliation with philosophy—namely laypeople. It reveals that Epictetus held a sophisticated viewpoint regarding laypeople and envisaged means for lay reform outside of philosophical study.

Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short- and long-term harms, and uncertainty turns provision of life support int...

One use of the noun ‘pain’ is exemplified in sentences like ‘There is a pain in my foot’. According to the Experiential Theory, ‘pain’ in this context refers to an experience located in the mind or brain. According to the Bodily Theory, it refers to an extra-cranial bodily occurrence located in a body part. In this paper, I defend the Bodily Theory. Specifically, I argue that pains are proximal activations of nociceptors that cause experiences of pain. This view is preferable (...) to the Experiential Theory, because it accords better with common sense and offers a better interpretation or semantics of ordinary pain reports. (shrink)

Few sports-related events have generated as much controversy as the steroid crisis in baseball. Both ardent fans and casual observers wonder why professional baseball players would choose to use such substances when their use was viewed as outside the bounds of fair play. This article attempts to answer that question by applying concepts from the area of organizational culture. Understanding the culture of baseball and the ways leaders embedded and strengthened that culture adds insight into the decisions by athletes to (...) engage in steroid use. In general, such use was consistent with the already-existing culture. In addition, key decisions and events likely created the conditions in which steroid use was more likely. (shrink)

It is common to characterise phenomenal consciousness as _what it is like_ to be in a mental state. This paper argues that the ‘what-it’s-like’-phrase in this context has a technical meaning, i.e. a meaning for which the association to the relevant expression is peculiar to a theoretical community. The relevant theoretical community is philosophy and some parts of cognitive science, so on this view, only philosophers and cognitive scientists use the ‘what-it’s-like’-phrase in the way that is characteristic in the literature (...) on phenomenal consciousness. This claim has important consequences. Firstly, I argue that the phrase says nothing informative about phenomenal consciousness. Secondly, I argue that the fact that non-philosophers use the phrase is not compelling evidence that they believe in phenomenal consciousness. These claims have further consequences for debates about phenomenal consciousness. (shrink)

In recent years substantial effort has been expended by scholars to better understand the nature of the ancient interest in divination. This study will argue that the Stoic philosopher Epictetus’ views of divination have been largely overlooked and mistakenly defined by his modern interpreters. While often portrayed as being opposed to the art, it is proposed that he envisages divination can be beneficially employed: namely in highlighting certain moral actions, and in motivating individuals to commence philosophical study.

In this article, we sketch up an action research process designed to give voice to those who traditionally have not had a voice in organizations. In particular, the research process was structured around “serious play” and designed as a talk show, where researchers played parts, including a talk show host, and where questions pertaining to organizational life were discussed in depth. The structure of the discussion was construed based on reflective teams, i.e., two actors performing a dialogue and a silent (...) group as listeners. The key research question concerns in what ways such an action research process is replicable? Applying a critical lens, we argue that even if strong claims of replicability are not met, as in being able to reproduce results and/or generalize them, this is outside the point. Rather, as we set out to apply a qualitative research design to achieve cogenerative learning effects, we advance an understanding of replicability-as-recoverability. This entails giving explicit grounds for our epistemic anchoring in critical realism and sketching out a research design which is sufficiently clear and transparent to undergo critical scrutiny. (shrink)

It is common in cognitive science to ascribe psychological predicates to the brain, i.e. to assert that the brain sees, feels, thinks, etc. This has prompted philosophical debate. According to the Nonsense View, the relevant locutions of cognitive scientists are nonsensical or false (Bennett and Hacker 2003, 2007). According to the Literal View, they are literal truths and report the psychological properties of brains (Dennett 2007; Crane 2015; Figdor 2018). In this paper, I propose the Synecdoche View, according to which (...) cognitive scientists’ locutions are figurative, with ‘brain’ referring to the human being, such that ‘the brain thinks’ reports the thinking of the human being, not the thinking of the brain. I compare this view to the dominant views in the literature and argue that it is a plausible alternative. One consequence of this is that there is no reason to believe that the locutions of cognitive scientists indicate empirical support for the claim that brains possess psychological properties. (shrink)

This paper clarifies Wittgenstein’s critique of Moore in _On Certainty,_ and argues that this critique is largely misunderstood, for two reasons. Firstly, Wittgenstein partly misrepresents Moore. Secondly, Wittgenstein is wrongly taken to be an internalist regarding justification for knowledge. Once we realize these two points, we can understand Wittgenstein’s critique properly as a grammatical argument in that Moore fails to see how the concepts of knowledge and certainty relate to those of justification and evidence. On this reading, we can also (...) understand that Moore and Wittgenstein were in more agreement than many people have thought, even though Moore was not able to exploit and express his philosophical insights properly. (shrink)

BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic (...) fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

Rosamond Rhodes and John Harris have both recently argued that we all have a general moral duty to participate in medical research. However, neither Rhodes' nor Harris' arguments in support of this obligation stand up to scrutiny, and severe and convincing criticism has been levelled against their case. Still, to refute their arguments is not to refute the conclusion. There seems to be some truth in the view that when people are asked to take part in medical research, their choice (...) is not completely morally neutral. In this article, we argue that the proper question to ask is when, rather than if, a certain moral duty to volunteer for medical research can be appealed to. To answer this question, we need a denser description of relevant research projects and their context rather than just describing medical research in general. Drawing on our study of participants in the Norwegian HUNT biobank, we use the normative implications of the Norwegian concept «dugnad» as an analogy to discuss the requirement of providing neutral information to potential biobank participants in order to promote their free and informed decision as to whether or not to take part. We suggest that normative recruitment is not just a question of principles and ethics. It is also a question of research design and the creation of the common good in the community where the research takes place. (shrink)

In the Global Burden of Disease study, disease burden is measured as disability-adjusted life years (DALYs). The paramount assumption of the DALY is that it makes sense to aggregate years lived with disability (YLDs) and years of life lost (YLLs). However, this is not smooth sailing. Whereas morbidity (YLD) is something thathappens toan individual, loss of life itself (YLL) occurs when that individual’s life has ended. YLLs quantify something that involves no experience and does not take place among living individuals. (...) This casts doubt on whether the YLL is an individual burden at all. If not, then YLDs and YLLs are incommensurable. There are at least three responses to this problem, only one of which is tenable: a counterfactual account of harm. Taking this strategy necessitates a re-examination of how we count YLLs, particularly at the beginning of life. (shrink)

In recent years, it has become commonplace among the Global Burden of Disease study authors to regard the disability-adjusted life year primarily as a descriptive health metric. During the first phase of the GBD, it was widely acknowledged that the DALY had built-in evaluative assumptions. However, from the publication of the 2010 GBD and onwards, two central evaluative practices—time discounting and age-weighting—have been omitted from the DALY model. After this substantial revision, the emerging view now appears to be that the (...) DALY is primarily a descriptive measure. Our aim in this article is to argue that the DALY, despite changes, remains largely evaluative. Our analysis focuses on the understanding of the DALY by comparing the DALY as a measure of disease burden in the two most significant phases of GBD publications, from their beginning to the most recent releases. We identify numerous assumptions underlying the DALY and group them as descriptive or evaluative. We conclude that while the DALY model arguably has become more descriptive, it remains, by necessity, largely evaluative. (shrink)

The aim of this article is to study the relationship between Epicureanism and pandemic priority-setting and to explore whether Epicurus's philosophy is compliant with the later developed utilitarianism. We find this aim interesting because Epicurus had a different way of valuing death than our modern society does: Epicureanism holds that death—understood as the incident of death—cannot be bad (or good) for those who die (self-regarding effects). However, this account is still consistent with the view that a particular death can be (...) bad for everyone else but those who die, such as family, friends, and society (other-regarding effects). During the pandemic, the focus has been on the number of deaths more than on the suffering and reduced well-being of those infected and the rest of society. However, since the pandemic requires prioritization, it is, on a utilitarian account, important to consider priorities that do the most good overall. In this article, we approach the harm of death from an Epicurean point of view, seeking to flesh out potential implications for pandemic priority-setting, and healthcare in general, using a case study of COVID-19 priority-setting. We also explore whether this would conflict with utilitarianism. We conclude that an Epicurean pandemic priority-setting approach would be different but, surprisingly, not radically different from many of the actual priority-setting decisions we saw under the COVID-19 pandemic. (shrink)

PurposeSocial media has increased as a marketing channel, and Facebook is the biggest social media company globally. Facebook contains both positive and negative information about companies; therefore, it is important for companies to manage their Facebook page to best serve their own interests. Although most users are familiar with business and marketing activities on Facebook, they use it primarily for fun and personal purposes. The most effective methods for companies to use Facebook have not been clear. The personal nature of (...) Facebook presents unique challenges for companies by raising ethical and social responsibility issues that are important to users. The purpose of this paper is to discover how companies can optimize their use of Facebook as a marketing channel.Design/methodology/approachA survey was conducted. The respondents were 158 users of Facebook in Sweden; complete answers were provided by all respondents. In a series of specific questions and comments, the respondents were asked to describe an optimal marketing solution on Facebook for companies. They rated different functions, which were illustrated with pictures, to help in the cognitive process and to avoid misunderstandings.FindingsMost users who have an opinion on the issue accept marketing on Facebook, but only in the right amount. There are basically two groups: those who think that companies have no place on Facebook and those who want companies to be active on Facebook. The latter group emphasizes the importance of meaningful posts without unsolicited sales messages, and would prefer to search for the companies themselves rather than being bombarded by company messages. By far, status updates and pictures/images were found to be the most important functions to respondents.Research limitations/implicationsThe sample consisted of only Swedish users. Another limitation was that, since many Facebook users do not normally think about the implications of being exposed to marketing on Facebook, they have difficulty taking a position on many issues related to the service.Practical implicationsThe results give companies a clear idea of how to effectively use Facebook in their marketing efforts.Originality/valueA large number of companies are currently asking themselves, “How can we use Facebook in an optimal way?” The results in this study answer this question and lead directly to saving time and resources for these companies. (shrink)

ObjectiveTo explore how clients in clinical settings experience the process of opening up and sharing their inner experiences in the initial phase of therapy.MethodsTwo psychotherapy sessions of clients were videotaped and followed by interviews. Interpersonal process recall was used to obtain in-depth descriptions of clients’ immediate experiences in session. A follow-up interview was conducted 3 months later. The interviews were analyzed using thematic analysis.ResultsThe data revealed how and why clients distanced themselves from inner experiences in the initial phase of therapy. (...) The overarching theme was “Holding back and struggling to open up,” which included four subthemes: fearing the intensity and consequences of negative emotions; experiences of being incapable and bodily stuck; being insecure about one’s worthiness and right to share inner experiences with the therapist; and struggling with feeling disloyal to loved ones.ConclusionThe participants held back because they feared different consequences of opening up. A range of concerns led participants to distance themselves from their inner experiences and/or to refrain from openly talking about them to the therapist. Concerns related to appropriate interpersonal conduct as client were especially important. This knowledge is highly relevant to clinicians when building safety for psychotherapeutic work. (shrink)

Volume 19, Issue 5, May 2019, Page 31-33.

Death is something we mourn or fear as the worst thing that could happen―whether the deaths of close ones, the deaths of strangers in reported accidents or tragedies, or our own. And yet, being dead is something that no one can experience and live to describe. This simple truth raises a host of difficult philosophical questions about the negativity surrounding our sense of death, and how and for whom exactly it is harmful. The question of whether death is bad has (...) occupied philosophers for centuries, and the debate emerging in philosophical literature is referred to as the "badness of death." Are deaths primarily negative for the survivors, or does death also affect the deceased? What are the differences between death in fetal life, just after birth, or in adolescence? In order to properly evaluate deaths in global health, we must find answers to these questions. -/- In this volume, leading philosophers, medical doctors, and economists discuss different views on how to evaluate death and its relevance for health policy. This includes theories about the harm of death and its connections to population-level bioethics. For example, one of the standard views in global health is that newborn deaths are among the worst types of death, yet stillbirths are neglected. This raises difficult questions about why birth is so significant, and several of the book's authors challenge this standard view. -/- This is the first volume to connect philosophical discussions on the harm of death with discussions on population health, adjusting the ways in which death is evaluated. Changing these evaluations has consequences for how we prioritize different health programs that affect individuals at different ages, as well as how we understand inequality in health. (shrink)

The legalization of physician-assisted suicide (PAS) in various U.S. states draws into question the interpretation of the cardinal virtues of medicine, including beneficence, non-maleficence, auton...

Published in 1721 by the prominent Puritan clergyman Cotton Mather, The Christian Philosopher was the first comprehensive book on science to be written by an American. Building on natural theology, Mather demonstrated the harmony between religion and the new science associated with Sir Isaac Newton. His survey of all the known sciences from astronomy and physics to human anatomy presented evidence that both celestial and terrestrial phenomema imply an intelligent designer. Winton Solberg's introduction places Mather's treatise in its widest (...) historical context. In addition to tracing the origins and sources of Mather's work, Solberg analyzes the book's contents, its reception, and its significance in American intellectual and cultural history. This edition affirms Mather's importance to American thought as a deeply religious intellectual who introduced the Enlightenment to America. (shrink)

Minkoff et al. (2024) discuss the potential deprivation of medical liberties against pregnant persons following Dobbs v. Jackson Women’s Health. Another consideration is how Dobbs may impact physic...

Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults (response rate 8.5%). A majority of respondents supports increased access to prenatal screening with ultrasound (...) (60%) and/or full genome sequencing of fetal DNA (55%) available for all pregnant women. Significant minorities indicate, however, that a public offer of prenatal screening for all pregnant women would signal that people with Down syndrome are unwanted (46%) or could be criticized for contributing to a ‘sorting society’ (48%). Results indicate deeper ambivalences and a cultural sensitivity to the ethical challenges of prenatal screening and subsequent abortions. The specific diagnosis of Down syndrome and the fear of becoming a ‘sorting society’ which sorts human life due to diagnoses, appear to play prominent roles in citizen deliberations. The low response rate means that a non-response bias cannot be excluded, yet reasons why results are still likely to be of value are discussed. (shrink)

Det er muligens ikke lenger et spørsmål om, men når mennesker med Downs syndrom ikke lenger finnes blant oss. Moderne medisinsk teknologi brukt i masseundersøkelser av gravide, tilsier at det nesten ikke behøver å bli født mennesker med Downs syndrom i fremtiden. I den politiske debatten i flere av de nordiske landene er dette kontroversielt. Det handler om et samfunn der det er plass til alle, hevdes det. På samme tid tas moderne genteknologi i bruk for bl.a. å forhindre at (...) mennesker disponert for Huntingtons sykdom eller arvelig brystkreft blir født. Om noen generasjoner kan slike sykdommer være utryddet. Dette påkaller imidlertid ikke henvisninger til «sortering» og «seleksjon». I denne artikkelen undersøkes de viktigste forutsetningene for hvorfor fosterdiagnostikk på noen indikasjoner vekker etisk debatt, mens det ikke skjer i andre tilfeller. Det argumenteres for at den medisinske forståelsen av alvorlighetsgrad ved en sykdom/funksjonshemming ikke gir oss nøkkelen til å forstå den etiske bekymringen rundt seleksjon. Identitets- og anerkjennelsesproblematikk, hevdes det, er kjernen i kontroversene rundt fosterdiagnostikk i Norden. Derfor står det noe vesentlig på spill i fosterdiagnostikkdebatten. Men bare for noen grupper. (shrink)

During the recent debates on whether to prioritize health care workers for COVID-19 vaccines, two main lines of arguments emerged: one centered on maximizing health and one centered on reciprocity. In this article, we scrutinize the argument from reciprocity. The notions of fittingness and proportionality are fundamental for the act of reciprocating. We consider the importance of these notions for various arguments from reciprocity, showing that the arguments are problematic. If there is a plausible argument for reciprocity during the pandemic, (...) this is most likely one that centers on the risk that health care workers take on while working. We argue that the scope of this argument is not plausibly extended only to health care workers. Other essential workers at risk are in the position to make the same arguments. We also argue that there is no compelling argument from reciprocity that makes reciprocating with vaccines, rather than by other means, necessary. Furthermore, allocating vaccines based on reciprocity will conflict with utility-maximizing. Given the weak state of the arguments, overriding concerns for utility seem unreasonable. (shrink)

This book surveys various sciences from astronomy and physics to human anatomy to present evidence that both celestial and terrestrial phenomena imply an intelligent designer.

The welfare of the child is the prevailing principle and concern regarding access to assisted reproduction in Western countries today, and there is a wish to avoid harm to future children. New research fields have developed in order to provide scientific evidence on the welfare of children living with different “types” of parents. Assisted reproductive technologies (ART) seems to be heading in a responsible direction where the care and concern for future children is vital. However, the claim of this article (...) is that the principle of the welfare of the child confuses the ethical framing of ART. Several philosophers in the past have argued that potential people must be regarded as outside the moral domain, and therefore cannot be harmed or benefitted. This message has not reached the policymakers, probably because the welfare of the child principle seems to fit so elegantly with common sense. In this article a different ethical framing of ART is proposed. The author argues that “futile care” and not “the welfare of the child” should be the guiding principle for eventually rejecting access to ART. The desired goal of ART treatment should be understood to be the production of functional families. Assisted reproduction is primarily about us, actual people in an actual society, and how potential children may affect us. (shrink)

Criminologists have long acknowledged the link between a number of cognitive deficits, including low intelligence and impulsivity, and crime. A new wave of research has demonstrated that pharmacological intervention can restore or improve cognitive function, particularly executive function, and restore neural plasticity. Such restoration and improvement can allow for easier acquisition of new skills and as a result, presents significant possibilities for the criminal justice system. For example, studies have shown that supplements of Omega-3, a fatty acid commonly found in (...) food such as tuna, can decrease frequency of violent incidents in an incarcerated population. Research has also begun to explore the use of selective serotonin reuptake inhibitors to reduce impulsivity in some violent offenders. However, there are significant legal and ethical implications when moving from dietary supplements to prescription pharmaceuticals and medical devices for cognitive intervention. This paper will explore the legal and ethical issues surrounding the use of pharmacological intervention on prisoners as an effort to reduce crime and recidivism. (shrink)

The business case for social responsibility is one of the most widely studied topics in the business and society literature that focuses on large firms. This attention is understandable because large firms have an obligation to shareholders who, as commonly assumed, seek to maximize returns on their investments, in turn, pressing corporate managers to show that firms’ expenditures in social engagement would pay off. Small firms, on the other hand, rarely face such pressures, yet the BCSR logic is increasingly applied (...) to small firms as well. Our primary objective in this paper is to examine whether and how much do small firm owners’ perceptions of BCSR affect the firm’s social engagement. In finding a fine-grained answer to those questions, we consider BCSR as a two-dimensional construct consisting of tangible and intangible benefits, and also integrate the BCSR perspective with the slack resource perspective to offer a motivation-capacity lens to examine firm’s social engagement. Drawing on a multi-industry sample of 478 small firms in the US, we find that while small firm owners’ perceptions about potential tangible benefits of social engagement are not related to the firm’s social engagement, perceptions about potential intangible are positively related. Firm's financial performance is also positively related to its social engagement, but there is no interaction between potential benefits and financial performance. This study contributes to an improved understanding about small firms’ social engagement, which still remains an understudied area. Our results are in line with studies which argue that firms’ social engagement is a response to institutional factors. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...) Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

The overarching aim of this article is to scrutinize how severity can work as a qualifier for the moral impetus of malady. While there is agreement that malady is of negative value, there is disagreement about precisely how this is so. Nevertheless, alleviating disease, injury, and associated suffering is almost universally considered good. Furthermore, the strength of a diseased person’s moral claims for our attention and efforts will inevitably vary. This article starts by reflecting on what kind of moral impetus (...) malady incites. We then analyze how severity may qualify this impetus. We do so by discussing the relationship between severity and need, well-being and disvalue, death, urgency, rule of rescue, and distributive justice. We then summarize our thoughts about severity as a moral qualifier. We conclude that severity is, and should continue to be seen, as a morally significant concept that deserves continued attention in the future. (shrink)

Adopting the methods of Ethnomethodology and Conversation Analysis, this article aims to add to our knowledge of the dynamics and resistance in professional-client encounters. It does this by examining the argumentative function of second-hand assessments in the setting of vocational rehabilitation. In the situated negotiation of appropriate work-targeted initiatives, the practice of reporting second-hand assessments functions either as ‘opposing’ the professional’s investigations, or, when used in initiating turns, as ‘promoting’ the client’s case. Regarding the first, second-hand assessments provide opportunities to (...) oppose and redirect the institutional agenda. That is, the issue introduced by the professional is fended off more or less openly through second-hand accounts, which provide a presumptive better grasp on the matter at hand. (shrink)

A rapidly growing proportion of health research uses ‘secondary data’: data used for purposes other than those for which it was originally collected. Do researchers using secondary data have an obligation to disclose individual research findings to participants? While the importance of this question has been duly recognised in the context of primary research, it remains largely unexamined in the context of research using secondary data. In this paper, we critically examine the arguments for a moral obligation to disclose individual (...) research findings in the context of primary research, to determine if they can be applied to secondary research. We conclude that they cannot. We then propose that the nature of the relationship between researchers and participants is what gives rise to particular moral obligations, including the obligation to disclose individual results. We argue that the relationship between researchers and participants in secondary research does not generate an obligation to disclose. However, we also argue that the biobanks or data archives which collect and provide access to secondary data may have such an obligation, depending on the nature of the relationship they establish with participants. (shrink)

Asks what sorts and sources of knowing we should consider compelling as we seek to live morally responsible lives. Contends that Martin Luther's theology of the cross provides a solid theological and ethical basis for a surprisingly congenial conversation with feminist thought and scholarship on these issues.

In welfare encounters, clients may from time to time report about other peoples’ doings in ways that are heard as more or less downgrading. This article examines how these reports are brought off in Norwegian vocational rehabilitation encounters, and especially, how the professional party aligns. Do such practices represent what Levinson calls ‘allowable contributions’ in the vocational rehabilitation meeting or are they treated as matter out of place? The analysis of five data extracts suggests that it is very important for (...) the reception that the report is well contextualized and attuned to the institutional agenda. The counsellors displayed a neutral but cooperative alignment to reports integrated neatly in the business-at-hand in a top-down fashion. Here, the reports served as a tool to inform the recipient about the client’s own character and/or her experience of the rehabilitation process. However, in the two latter cases, where the client had a more initiating role, the reports appeared to have a more humorous or entertaining function. In response, the counsellors did not display alignment but searched for institutional relevance before re-contextualizing the report into a proper context. This suggests that out-of-frame reports about other people delivered on a humorous footing do not straightforwardly fall into the category of ‘allowable contributions’ in this setting. (shrink)