Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

Cognitive science has evolved since early disputes between radical empiricism and radical nativism. The authors are reacting to the revival of radical empiricism spurred by recent successes in deep neural network (NN) models. We agree that language-like mental representations (language-of-thoughts [LoTs]) are part of the best game in town, but they cannot be understood independent of the other players.

The aim of this study was to get a deeper understanding of student nurses’ experiences of personal caring ethics by reflection on caring encounters with patients in clinical practice, ethical caring ideals, ethical problems, and sources for inner strength that give courage to practice good caring. In all, 24 Scandinavian student nurses participated voluntarily in an interview study. The interviews were analyzed within a phenomenological–hermeneutical approach and revealed three themes. The students found themselves in two different states of vulnerability: one (...) in which they were overwhelmed by their vulnerability and began to suffer themselves and the other where their vulnerability became a source of development with focus on the patient. The students’ ethical caring ideals served as fixed reference points in their ethical development, but their ideals were at risk of decline. The students reflected on the barriers for performing ethical care and nurtured their ethical ideals by providing ethical care in secret. Caring in secret occurred also when student nurses did not experience a shared ethos. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

The term “globalization” was popularized by Marshall McLuhan in War and Peace in the Global Village. In the book, McLuhan described how the global media shaped current events surrounding the Vietnam War [1] and also predicted how modern information and communication technologies would accelerate world progress through trade and knowledge development. Globalization now refers to a broad range of issues regarding the movement of goods and services through trade liberalization, and the movement of people through migration. Much has also been (...) written on the global effects of environmental degradation, population growth, and economic disparities. In addition, the pace of scientific development has accelerated, with both negative and positive implications for global health. Concerns for national health transcend borders, with a need for shared human security and an enhanced role for international cooperation and development [2]. These issues have significant bioethical implications, and thus a renewed academic focus on the ethical dimensions of public health is needed. Future developments in science and health policy also require a firm grounding in bioethical principles. These core principles include beneficence; nonmaleficence ; respect for persons and human dignity ; and attention to equity and social justice. According to the World Health Organization [3], global ethical approaches should monitor and update ethical norms for research, as necessary; anticipate ethical implications of advances in science and technology for health; apply internationally accepted codes of ethics; ensure that agreed standards guide future work on the human genome; and ensure that quality in health systems and services is assessed and promoted. (shrink)

This is the first edited collection entirely dedicated to non-evidentialist epistemology or non-evidentialism—the controversial view that evidence is not required in order for doxastic attitudes to enjoy a positive epistemic status. Belief or acceptance can be epistemically justified, warranted, or rational without evidence. The volume is divided into three section: the first focuses on hinge epistemology, the second offers a critical reflection about evidentialist and non-evidentialist epistemologies, and the third explores extensions of non-evidentialism to the fields of social psychology, psychiatry, (...) and mathematics. Contributors: N. Ashton, A. Coliva, J. Kim, K. McCain, A. Meylan, L. Moretti, S. Moruzzi, J. Ohlorst, N. Pedersen, T. Piazza, L. Zanetti. (shrink)

This is the introduction to Moretti, Luca and Nikolaj Pedersen (eds), Non-Evidentialist Epistemology. Brill. Contributors: N. Ashton, A. Coliva, J. Kim, K. McCain, A. Meylan, L. Moretti, S. Moruzzi, J. Ohlorst, N. Pedersen, T. Piazza, L. Zanetti.

This article investigates how the Norwegian author Karl Ove Knausgård in My struggle uses his existential reading of 1914 and World War I to nuance our general understanding of the war. Knausgård wants to demonstrate that the collective enthusiasm, which took millions of men by storm, was existentially motivated. The war was able to give the soldiers a sense of meaning, a project and a community; feelings they needed in their civilian lives. Furthermore, Knausgård uses his reading of World War (...) I to make a connection between the soldier’s fight and his own struggle. On the basis of his existential reading of World War I, Knausgård is able to formulate a literary poetics and existential experience. Therefore, Knausgård is able to actualize World War I. (shrink)

We introduce a constructive model of selective belief revision in which it is possible to accept only a part of the input information. A selective revision operator ο is defined by the equality K ο α = K * f(α), where * is an AGM revision operator and f a function, typically with the property ⊢ α → f(α). Axiomatic characterizations are provided for three variants of selective revision.

The postulate of recovery is commonly regarded to be the intuitively least compelling of the six basic Gärdenfors postulates for belief contraction. We replace recovery by the seemingly much weaker postulate of core-retainment, which ensures that if x is excluded from K when p is contracted, then x plays some role for the fact that K implies p. Surprisingly enough, core-retainment together with four of the other Gärdenfors postulates implies recovery for logically closed belief sets. Reasonable contraction operators without recovery (...) do not seem to be possible for such sets. Instead, however, they can be obtained for non-closed belief bases. Some results on partial meet contractions on belief bases are given, including an axiomatic characterization and a non-vacuous extension of the AGM closure condition. (shrink)

A descriptor is a set of sentences that are truth-functional combinations of expressions of the form \ , where \ is a metalinguistic belief predicate and p a sentence in the object language in which beliefs are expressed. Descriptor revision ) is an operation of belief change that takes us from a belief set K to a new belief set \ where \ is a descriptor representing the success condition. Previously studied operations of belief change are special cases of descriptor (...) revision, hence sentential revision can be represented as \ , contraction as \ , multiple contraction as \ , replacement as \ , etc. General models of descriptor revision are constructed and axiomatically characterized. The common selection mechanisms of AGM style belief change cannot be used, but they can be replaced by choice functions operating directly on the set of potential outcomes . The restrictions of this construction to sentential revision ) and sentential contraction give rise to operations with plausible properties that are also studied in some some detail. (shrink)

Blockage contraction is an operation of belief contraction that acts directly on the outcome set, i.e. the set of logically closed subsets of the original belief set K that are potential contraction outcomes. Blocking is represented by a binary relation on the outcome set. If a potential outcome X blocks another potential outcome Y, and X does not imply the sentence p to be contracted, then Y ≠ K ÷ p. The contraction outcome K ÷ p is equal to the (...) (unique) inclusion-maximal unblocked element of the outcome set that does not imply p. Conditions on the blocking relation are specified that ensure the existence of such a unique inclusion-maximal set for all sentences p. Blockage contraction is axiomatically characterized and its relations to AGM-style operations are investigated. In a finite-based framework, every transitively relational partial meet contraction is also a blockage contraction. (shrink)

Full meet contraction, that was devised by Carlos Alchourrón and David Makinson in the early 1980' s, has often been overlooked since it is not in itself a plausible contraction operator. However, it is a highly useful building-block in the construction of composite contraction operators. In particular, all plausible contraction operators can be reconstructed so that the outcome of contracting a belief set K by a sentence p is defined as K ∼ f, where ∼ is full meet contraction and (...) f a sentential selector, i.e. a function to and from sentences. This paper investigates the logic of full meet contraction. Seven properties of this operation are presented that contribute to making it useful as a building-block: Full meet contraction is a purely logical operation. It retains finitebasedness of the belief set. It is the inclusion-maximal contraction that removes all sentences that can contribute to implying the input sentence. It is the inclusion-maximal contraction that removes all non-tautologous consequences of the input sentence. Almost all contractions can be reconstructed as full meet contraction. Full meet contraction allows for recovery of the input sentence. Full meet contraction provides a unified account of multiple and singleton contraction. La llamada full meet contraction, creada por Carlos Alchourrón y David Makinson en los comienzos de los ' 80, ha sido a menudo desestimada puesto que ella no constituye un operador de contracción plausible. De todas formas ella es altamente útil en la construcción de operadores de contracción compuestos. En particular, todos los operadores de contracción plausibles pueden ser reconstruidos de forma tal que la contracción de un conjunto de creencias K por una sentencia p sea definida como K ∼ f, donde ∼ es una full meet contraction y f un selector de sentencias, i.e., una función de sentencias a sentencias. En este trabajo investigamos la lógica de la full meet contraction. Se presentan siete propiedades de esta operación que contribuyen a hacerla útil como building-block: Full meet contraction es una operación puramente lógica. Ella retiene la finit- basednes del conjunto de creencias. Ella es la máxima-inclusiva de las contracciones que elimina todas las sentencias que pueden contribuir a implicar la input-sentence. Es la contracción maximal inclusiva que elimina todas las consecuencias no tautológicas de la input-sentence. Casi todas las contracciones pueden ser reconstruidas como full-meet contractions. Full meet contraction permite la recuperación de la input-sentence. Full meet contracción da cuenta en forma unificada de las contracciones múltiples y singulares. (shrink)

Blockage revision is a version of descriptor revision, i.e. belief change in which a belief set K is changed with inputs whose success conditions are metalinguistic expressions containing the belief predicate \. This is a highly general framework that allows a single revision operator \ to take inputs corresponding to sentential revision ), contraction ) as well as more complex and composite operations. In blockage revision, such an operation is based on a relation \ of blockage among the set of (...) potential outcomes. \ signifies that if X satisfies the success condition of a belief change, then Y cannot be its outcome. The properties of blockage revision are investigated, and conditions on the blocking relation are specified that characterize various properties of the resulting operation of change. (shrink)

"[L]ove is not merely a contributor - one among others - to meaningful life. In its own way it may underlie all other forms of meaning....by its very nature love is the principal means by which creatures like us seek affective relations to persons, things, or ideals that have value and importance for us. I. The Look of Love.

This collection of essays in honor of Prof. Stig Andur Pedersen's 60th Birthday spans over a broad scope of topics, ranging from mathematical modelling over realism in philosophy of science to an analysis of apology after medical mistakes. The unusually broad range is a fair but still inadequate reflection of the work of Stig Andur Pedersen, a philosopher and scientist whose range of interests, abilities and production is itself unusually broad.

Aus dem Inhalt: Views from the North: Hans Petter Graver: Law, Justice and the State: Nordic Perspectives u Jacob Dahl Rendtorff: The Danish Welfare State: Philosophical Ideals and Systemic Reality u Sigri!Dur *orgeirsdottir: Feminist Ethics and Feminist Politics u Kuellike Lengi: The Situation of Human Rights in Estonia u Einar Palsson: Pythagoras and Early Icelandic Law u Law, Discourse and Rationality: Mats Flodin: Internal and External Rationality of Legal Systems u Logi Gunnarsson: A Discourse About Discourse u Hjordi!s Hakonardottir: Legal (...) Language: A Tool of Justice u Ghita Holmstrom-Hintikka: On the Use of Expert Witness in Legal Reasoning and Inquiry u Law, State and Nation: Agust H. Ing*orsson: Democracy, Bureaucracy and Marginalization of the State u Aleksander Peczenik: Law-State, Legal Certainty and Legitimacy of Law u Ove K. Pedersen/Sverre Raffnsoe: Reorganizing Society u Juha Raikka: Mill on National Sentiment u Pall Skulason: Concepts of the State and Classes of Value u Problems of Law and Rights: Britt-Mari Blegvad: How to Cope With Uncertainty: Trust and Law u Jon Wetlesen: Animal Rights or Human Duties?. (shrink)

What is philosophy of mathematics and what is it about? The most popular answer, I suppose, to this question would be that philosophers should provide a justification for our presently most cherished mathematical theories and for the most important tool to develop such theories, namely logico-mathematical proof. In fact, it does cover a large part of the activity of philosophers that think about mathematics. Discussions about the merits and faults of classical logic versus one or other ‘deviant’ logics as the (...) logical basis for mathematical theories, ranging from intuitionist over modal logic to paraconsistent logic, typically belong to this area, as do debates about the natural-number concept, its ‘nature’, its properties, especially its uniqueness, and so on. No doubt sociologists of knowledge could explain why philosophers of mathematics came to select these particular problems and deal with them the way they do. What it does imply, however, is that the question is meaningful whether different kinds of philosophies of mathematics are possible, and—why not?—perhaps even desirable. To a certain extent, the answer is trivial: look at what, e.g., phenomenologists have to say about mathematics and you must notice it does not fit into the scheme sketched above.1 Rather, the question should be whether there are forms that, on the one hand, reinterpret the whole enterprise, and, on the other hand, somehow remain related to the work of ‘mainstream’ philosophers of mathematics today.The book under review here does precisely that. Let me be a bit more precise. The general proposal, present throughout all the contributions, is that even at a first, superficial, glance at what mathematicians do when they do mathematics, it is far more complex than ‘just thinking about and …. (shrink)

The relative merits and demerits of historically prominent views such as the correspondence theory, coherentism, pragmatism, verificationism, and instrumentalism have been subject to much attention in the truth literature and have fueled the long-lived debate over which of these views is the most plausible one. While diverging in their specific philosophical commitments, adherents of these historically prominent views agree in at least one fundamental respect. They are all alethic monists. They all endorse the thesis that there is only one property (...) in virtue of which propositions can be true, and so, in this sense, take truth to be one. The truth pluralist, on the other hand, rejects this idea. There are several properties in virtue of which propositions can be true. The literature on truth pluralism has been growing steadily for the past twenty years. This volume, however, is the first of its kind—the first collection of papers focused specifically on pluralism about truth. Part I is dedicated to the development, investigation, and critical discussion of different forms of pluralism. An additional reason to look at truth pluralism with interest is the significant connections it bears to other debates in the truth literature—the debates concerning traditional theories of truth and the deflationism/inflationism divide being cases in hand. Parts II and III of the volume connect truth pluralism to these two debates. (shrink)

The book is an introductory exposition of the development of the physical and astronomical notions of the universe. It covers the period from Greek antiquity to the Copernican revolution and the Renaissance, half of the text being devoted to medieval science within both the Aristotelian and the Archimedean traditions. The book is intended for a general audience interested in intellectual and scientific developments, but should also be useful as a guide to further studies. Thus it has an extensive bibliography classifying (...) much of the secondary literature on the subject, and also a sixty page 'dictionary' of all the scientists and philosophers mentioned in the text. This contains references to printed editions of the sources and to a selection of books and periodicals. (shrink)

Here is a well-known thought about truth: Truth consists in correspondence with reality. A sentence is true just in case what it says corresponds with how the world is. Theories of truth that incorporate this thought are naturally regarded as robust or “heavyweight”. Truth is to be understood in a realist fashion. The world decides what is true and what is not. A recent incarnation of the correspondence view is found in truth-maker theories, whose adherents maintain that truths are true (...) in virtue of there being something – a truth-maker – in the world that makes them so.2. (shrink)

This article is an attempt at a systematic account of decision making under greater uncertainty than what traditional, mathematically oriented decision theory can cope with. Four components of great uncertainty are distinguished: (1) the identity of the options is not well determined (uncertainty of demarcation) ; (2) the consequences of at least some option are unknown (uncertainty of consequences); (3) it is not clear whether information obtained from others, such as experts, can be relied on (uncertainty of reliance); and (4) (...) the values relevant for the decision are not determined with sufficient precision (uncertainty of values). Some possible strategy types are proposed for each of these components. Decisions related to environmental issues are used to illustrate the proposals. (shrink)

Sustainability challenges typically occur across sectoral boundaries, calling the state, market, and civil society to action. Although consensus exists on the merits of cross-sector collaboration, our understanding of whether and how it can create value for various, collaborating stakeholders is still limited. This special issue focuses on how new combined knowledge on cross-sector collaboration and business models for sustainability can inform the academic and practitioner debates about sustainability challenges and solutions. We discuss how cross-sector collaboration can play an important role (...) for the transition to new and potentially sustainability-driven business models given that value creation, delivery, and capture of organizations are intimately related to the collaborative ties with their stakeholders. Sustainable alternatives to conventional business models tend to adopt a more holistic perspective of business by broadening the spectrum of solutions and stakeholders and, when aligned with cross-sector collaboration, can contribute new ways of addressing the wicked sustainability problems humanity faces. (shrink)

In this critical comment, we argue that nondemocratic, but decent regimes fail to constitute legitimate governance under Applbaum’s free group agency account. To make this case, we first introduce the three principles of liberty, equality and agency that Applbaum takes to flow directly from his free agency conception of legitimacy. Against this backdrop, we discuss Applbaum’s claim that a nondemocratic regime along the lines of a Rawlsian decent consultation hierarchy could meet the threshold of legitimacy. Contrary to this suggestion, we (...) argue that nondemocratic, but decent regimes cannot claim legitimacy under Applbaum’s account because they are constitutively inegalitarian, thus failing to adequately grant citizens the equal normative power without which legitimacy is unattainable under the free group agency account. (shrink)

The founder of the eponymous engineering firm, which continues to realize seminal projects around the world, Ove Arup is widely acknowledged as one of the most significant engineers of his time. Generated over the course of his illustrious career, these lectures, essays, and interviews broadlyshare several themes: insight into Arup's thinking on the nature of good design, quality and value in the built environment, and the growing need for better collaboration between engineers, architects, and contractors in order to exploit technological (...) advances in materials and methods, while at the same time reducing the environmental impact of building. These chronologically arranged essays span five decades, and many of the themes they address are as relevant today as they were when first produced. Illustrating wisdom, practical problem solving, and Arup's philosophical approach, this book is a necessary and long-overdue addition to the library of anyone who has a passion for, and an interest in, the principles of great design. (shrink)

In this article, I critically assess Hélène Landemore's new model of Open Democracy, asking whether it requires of citizens to blindly defer to the decisions of the mini-public. To address this question, I, first, discuss three institutional mechanisms in Open Democracy, all of which can be read to grant citizens democratic control. I argue that neither the capacity to authorize the selection mechanism (random sortition), nor the lottocratic conception of political equality, nor the self-selection mechanisms of Landemore's model deliver the (...) form of control that would insulate Open Democracy from the charge of blind deference. I then discuss the direct democracy mechanisms that Landemore incorporates into her model. Although these devices grant citizens control and, by extension, offer the resources for repudiating the charge of blind deference, they also, I argue, subvert the logic of Landemore's lottocratic model, rendering Open Democracy predictably unstable. Given the deliberative asymmetries between the mini-public and the citizenry, a high frequency of bottom-up challenges is to be expected that would throw the whole system into jeopardy. Thus, the challenge for lottocrats is to show how democratic control can be achieved in a lottocratic system without undermining the benefits of the legislature by lot. (shrink)

Vann McGee claims that open-ended schemas are more innocuous than ordinary second-order quantification, particularly in terms of ontological commitment. We argue that this is not the case.

This article examines Swedish, Danish and Norwegian governments’ participation in the European Return Platform for Unaccompanied Minors project and its failed attempts to deport unaccompanied minors to Afghanistan. It argues that ERPUM is an interesting and urgent case of a “deportation corridor”, and suggests that this framework can benefit from analysis through normative and applied ethics and in particular discussions of feasibility constraints. It therefore identifies and critically assesses two nationalistic arguments for deportation common in Nordic politics, based on appeals (...) credibility and humanitarianism. Considering the growth of nationalistic immigration policies in Nordic states, the article turns the usual discussions of feasibility on its head by showing that not only cosmopolitan, but also nationalistic ethics must face up to charges of lacking realism. More specifically, it argues that the case of ERPUM illustrates how nationalistic deportation ethics can rely on inconsistent normative and erroneous empirical assumptions, which can be criticized for their arbitrariness, ideological grounding and lacking feasibility. (shrink)

Including empirical examples and theoretical clarifications on many of the analytical issues raised in his recently published Down to Earth, this conversation with Bruno Latour and his collaborator, Danish sociologist Nikolaj Schultz, offers key insights into Latour’s recent and ongoing work. Revolving around questions on political ecology and social theory in our ‘New Climatic Regime’, Latour argues that in order to have politics you need a land and you need a people. This interview present reflections on such politics, such land (...) and such people, and it ends with a call for a sociology that takes up the task of connecting the three by investigating what he and Schultz call ‘geo-social classes’. The interview was conducted by Jakob Stein in Paris in November 2018. (shrink)

We study finite ℓ‐colourable structures with an underlying pregeometry. The probability measure that is used corresponds to a process of generating such structures by which colours are first randomly assigned to all 1‐dimensional subspaces and then relationships are assigned in such a way that the colouring conditions are satisfied but apart from this in a random way. We can then ask what the probability is that the resulting structure, where we now forget the specific colouring of the generating process, has (...) a given property. With this measure we get the following results: (1) A zero‐one law. (2) The set of sentences with asymptotic probability 1 has an explicit axiomatisation which is presented. (3) There is a formula (not directly speaking about colours) such that, with asymptotic probability 1, the relation “there is an ℓ‐colouring which assigns the same colour to x and y” is defined by. (4) With asymptotic probability 1, an ℓ‐colourable structure has a unique ℓ‐colouring (up to permutation of the colours). (shrink)