Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

Many bioethicists promote and defend the ‘bedside rationing paradigm’; a pertinent example is the recent publication by Morten Magelssen and colleagues, in which they attack my previous criticism in the field. The present response focuses on what I consider to be the main side-effects of the ‘bedside rationing paradigm’: the ignorance towards intentions and societal roles, the crumbling of political practice, and the fiduciary loss in the physician–patient relationship. Further, I claim that these side effects are related to certain underlying (...) presumptions, such as the conception of fairness as equivalent with distributive justice and the belief in the presence of universally valid, context-independent moral principles. These presumptions are characteristics of modernist ethics; thus, the ‘bedside rationing paradigm’ illustrates some fundamental shortcomings of this moral theory. I argue that an ethics of virtue is better suited to the practice of medicine as well as to the rationing dilemmas. (shrink)

Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug treatment. (...) Design: Eleven patients who had been informed about thrombolytic drug treatment and had been through the process of deciding whether or not to participate in a thrombolytic drug trial went through repeated qualitative, semistructured interviews. Results: Many patients showed a limited perception of the risks connected with thrombolytic drug treatment. Some perceived the risk as not relevant to them and were reluctant to accept that treatment could cause harm. Others seemed to be aware that treatment would mean exposure to risk. The patients’ willingness to take a risk also varied substantially. Several statements revealed ambiguity and confusion about being involved in a decision about treatment. The patients’ reasoning about risk was put into the context of their health-related experiences and life histories. Several patients wanted the doctor to be responsible for the decisions. Conclusion: Acute stroke patients’ difficulties in perceiving and processing information about risk may reduce their ability to be involved in clinical decisions where risks are involved. (shrink)

Ours is a literal world. We spend so many words arguing the fundamental truth of a few ancient metaphors that we finally close them to personal meaning. Or we commit our energies to washing every literary form and figure of speech cleanly away to protect our definitions of correctness and to make everyday thinking even safer. But the arguing gives us doctrines. And the purging denies us poetry. And when all the metaphors are gone, we find we've lost the richest (...) ways of knowing. We find we've even narrowed the possibility. Divina is a line of speculative, dimensional, and metaphorical books that will Challenge conventional wisdom, Offer alternative theories, Recreate noumenal experiences, Reach for poetry, and Promise other ways of knowing. The most rewarding reading addresses us personally and challenges what we believe. Divina will bring you books that do just that, chosen and published with the same dedication and editorial sensibility that have established our commitment t literary quality.An ambitious, open-minded inquiry revealing that science itself may be the language of the creator. (shrink)

The author scrutinizes the special application of arne naess's model for the semantical interpretation of texts which was made by laura grimm in her book, "definition in plato's meno". (staff).

Background Ethical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges. This paper explores how prehospital emergency personnel manage ethical challenges. The study is part of a larger action research project to develop and test an approach to clinical ethics support that is sensitive to the context of emergency medicine. Methods We (...) explored ethical challenges and management strategies in three focus groups, with 15 participants in total, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. Focus groups were audio-recorded and transcribed verbatim. The approach to data analysis was systematic text condensation approach. Results We stratified the management of ethical challenges into actions before, during, and after incidents. Before incidents, participants stressed the importance of mutual understandings, shared worldviews, and a supportive approach to managing emotions. During an incident, the participants employed moral perception, moral judgments, and moral actions. After an incident, the participants described sharing ethical challenges only to a limited extent as sharing was emotionally challenging, and not actively supported by workplace culture, or organisational procedures. The participants primarily managed ethical challenges informally, often using humour to cope. Conclusion Our analysis supports and clarifies that confidence, trust, and safety in relation to colleagues, management, and the wider organisation are essential for prehospital emergency personnel to share ethical challenges and preventing moral distress turning into burnout. (shrink)

A number of multinational enterprises have come under ethical scrutiny over the recent decades. In some cases, this may be due to a lack of maturity of corporate moral reasoning. The article is based on a framework developed by Lawrence Kohlberg. He suggested three main stages of moral development: They are (1) pre-conventional moral reasoning, (2) conventional and (3) post-conventional moral reasoning. The article places different approaches to business ethics into the framework developed by Kohlberg. It is argued that the (...) first two stages form an insufficient basis for ethical guidance for multinational organizations. Five post-conventional ethical perspectives are presented to assist MNC's in their analysis in order to uncover the possible dilemmas, to avoid harming others and also to avoid costly embarrassment at the hands of critics. (shrink)

This volume outlines a Deleuzian approach to analyzing science, culture and politics.

In this book, T. L. Short places the notorious difficulties of Peirce's important writings in a more productive light, arguing that he wrote philosophy as a scientist, by framing conjectures intended to be refined or superseded in the inquiries they initiate. He argues also that Peirce held that the methods and metaphysics of modern science are amended as inquiry progresses, making metaphysics a branch of empirical knowledge. Additionally, Short shows that Peirce's scientific work expanded empiricism on empirical grounds, grounding his (...) phenomenology and subverting the fact/value dichotomy, and that he understood statistical explanations in nineteenth-century science as reintroducing the idea of final causation, now made empirical. Those innovations underlie Peirce's late ideas of a normative science and of philosophy as a branch of science. Short's rich and original study shows us how to read Peirce's writings and why they are worth reading. (shrink)

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are (...) presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed. (shrink)

Artificial intelligence is rapidly entering our daily lives in the form of driverless cars, automated online assistants and virtual reality experiences. In so doing, AI has already substituted human employment in areas that were previously thought to be uncomputerizable. Based on current trends, the technological displacement of labor is predicted to be significant in the future – if left unchecked this will lead to catastrophic societal unemployment levels. This paper presents a means to mitigate future technological unemployment through the introduction (...) of a Basic Income scheme, accompanied by reforms in school curricula and retraining programs. Our proposal argues that such a scheme can be funded by a special tax on those industries that make use of robotic labour; it includes a practical roadmap that would see a government take this proposal from the conceptual phase and implement it nationwide in the span of one decade. (shrink)

Cet article comprend l’étude et l’édition du Versus de historia euangelica, un poème anonyme de 288 hexamètres léonins, qui relate l’histoire de la naissance du Christ, de son ministère et de sa crucifixion. En raison de la nature contradictoire et répétitive des récits évangéliques, le poète suit l’organisation du matériel biblique de l’ Historia scholastica de Pierre le Mangeur, dont l’achèvement en 1173 constitue le terminus post quem de la composition du poème. On peut appeler le style du Versus épigrammatique. (...) En fait, le poème dans son entier se lit comme une collection de brefs tituli indépendants qui pourraient être sortis de leur contexte et utilisés comme légendes pour des représentations figuratives appropriées. (shrink)

This article presents a study and a critical edition of the short anonymous treatise on the rainbow starting with the incipit Inter omnes impressiones. The text was known to Nicole Oresme who engages with it twice: in his Questiones in Meteorologica de prima lectura and in Le livre du ciel et du monde. This Tractatus de iride, previously unknown to scholars, is transmitted in three late thirteenth-century manuscripts. It uses Robert Grosseteste’s theories of the rainbow as caused by the refraction (...) of sunlight and of colour as light incorporated in aereal particles. However, contrary to Grosseteste, the Tractatus de iride adopts the idea of different degrees of incorporation of light, which is also found in the scientific writings by Adam of Exeter, a Franciscan scholar belonging to the same Oxonian circle as Grosseteste. Moreover, the Tractatus de iride develops original propositions in regard to the role of individual raindrops, the importance of the angle from which the rainbow is observed, and the idea of the spirituality of the colours in the medium, which were central also for Roger Bacon’s and Nicole Oresme’s own theories of the rainbow. (shrink)

Since the 1980s the concept of ANT has remained unsettled. ANT has continuously been critiqued and hailed, ridiculed and praised. It is still an open question whether ANT should be considered a theory or a method or whether ANT is better understood as entailing the dissolution of such modern ‘‘genres’’. In this paper the authors engage with some important reflections by John Law and Bruno Latour in order to analyze what it means to ‘‘do ANT,’’ and, doing so after ‘‘doing (...) ANT on ANT.’’ In particular the authors examine two post-ANT case studies by Annemarie Mol and Marilyn Strathern and outline the notions of complexity, multiplicity, and fractality. The purpose is to illustrate the analytical consequences of thinking with post-ANT. The analysis offers insights into how it is possible to ‘‘go beyond ANT,’’ without leaving it entirely behind. (shrink)

Background: People with progressive cancer experience that their bodies change due to disease and/or treatment. The body is integral to the unity of the human being, a unity that must be perceived as whole if dignity shall be experienced. Relatives are in touch with the suffering bodies of their dear ones, physically, socially, mentally, and existentially, and thus the relatives’ experiences of the bodies of their dear ones might yield insight into the concept of dignity. Aim: The aim of this (...) study is to explore relatives’ experiences of the patients’ bodily changes from a perspective of dignity. Research design and method: A total of 12 relatives from a hospice in Norway were interviewed. Gadamer’s ontological hermeneutics inspired the interpretation. Ethical considerations: The principles of voluntariness, confidentiality, withdrawal, and anonymity were respected during the whole research process. The Norwegian Social Science Data Services approved the study. Results and conclusion: The conversations about the body were conversations about ambivalent or paradoxical matters that shed light on the concept of dignity. The results show that the relatives got in touch with elements that otherwise would have remained tacit and unspoken, and which gave glimpses of a deeper truth, which might reveal the core of dignity. Furthermore, the relatives’ confirmation of the ambivalence might be understood as a strong ethical obligation to treat the other with dignity. The confirmation may also reveal the relatives’ unselfish love of the other, which can be understood as the core of ethics and ethos. Finally, the results reveal the relatives’ limited insight into their dear ones’ bodily changes, and we discuss the challenges of truly seeing the other. Body knowledge and the relationship between body and dignity as phenomena cannot be ignored and needs more attention and articulation in clinical nursing practice and in nursing research. (shrink)

An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of (...) 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services. (shrink)

What is the strength of anthropological fieldwork when we want to understand human technologies? In this article we argue that anthropological fieldwork can be understood as a process of gaining insight into different contextualisations in practiced places that will open up new understandings of technologies in use, e.g., technologies as multistable ontologies. The argument builds on an empirical study of robots at a Danish rehabilitation centre. Ethnographic methods combined with anthropological learning processes open up new way for exploring how robots (...) enter into professional practices and change values, social relations and materialities. Though substantial funding has been invested in developing health service robots, few studies have been undertaken that explore human-robot interactions as they play out in everyday practice. We argue that the complex learning processes involve not only so-called end-users but also staff, management, doings and discourse in a complex amalgamation of materials and values. (shrink)

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue—young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in (...) dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants’ thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants’ justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers’ thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking. (shrink)

Introduction -- The history of written codes of ethics -- Contemporary codes -- Media councils in the Western Hemisphere -- Journalists' responsibility for the destiny of peace -- Towards an international code of ethics -- Journalistic ethics in Latin America -- The international ethics of journalists.

Can God create an unliftable stone? Beall & Cotnoir propose that ‘God can create an unliftable stone’ is a truth-value gap (neither true nor false). However, this yields a revenge paradox on whether God can eschew gaps. Can God avoid gappy ascriptions of power? Either way, God’s power seems to have limits. In response, it may be said that ascribing God the power to avoid gaps is itself gappy—it concerns a power that God neither has nor lacks. Yet this ends (...) up being inconsistent, for it implies that God definitely lacks that power. Following Aquinas, perhaps Beall & Cotnoir could accept this lack and still uphold omnipotence, suggesting that the power to avoid gaps is impossible for God. Yet the Aquinian stratagem is enough to block the original paradox, which saps the motivation to proffer truth-value gaps in addition. I conclude that the gappy solution is either inadequate or insufficiently motivated. (shrink)

During the past decade, several governmental reports have discussed how information technology can transform Danish society. Most important among these reports is Digital Denmark from 1999.In this article, the authors examine how to analyze Digital Denmark by considering two strategies for engaging reports. The first aims at uncovering and making explicit hidden assumptions or ideologies in the text. This approach is called “reading against the text.” The second approach—inspired by science, technology, and society studies—considers where a text goes and what (...) it does rather than how to critically interpret it. Texts may be read as material-semiotic actors, having effects on their environment that exceed or bypass discussions of content or motivation. This approach is called “reading with the text,” and the authors argue that traveling with Digital Denmark makes visible the limitations of critical analyses, while adding agency to the report as it moves in between practices. (shrink)

In this paper a close look is taken at van Fraassen's use of the concept of truth. It is shown that the rather deflationist understanding of the term in his more recent publications differs considerably from the one referred to in his earlier writings, where the truth of a scientific theory is construed as its correspondence to the world. As will be argued, his more recent remarks call for a reevaluation of the difference between scientific realism and constructive empiricism and (...) force him - for the sake of consistency - to give up his realist commitments regarding the world and the observable. (shrink)

As the frequent use of metaphors like friendship or relationship in academic and colloquial discourse on serial television suggests, long-term narratives seem to add something to the spectator's engagement with fictional characters that is not fully captured by terms such as empathy and sympathy. Drawing on philosophical accounts of friendship and psychological theories on the formation of close relationships, this article clarifies in what respect the friendship metaphor is warranted. The article proposes several hypotheses that will enhance cognitive theories of (...) character engagement. Spectators tend to like what they have been exposed to more, and the feeling of familiarity is pleasurable. Familiar characters are powerful tools to get the spectator hooked. Furthermore, by generating an impression of a shared history, television series activate mental mechanisms similar to those activated by friendship in real life. These factors, and several others, create a bond with characters in television series that tends to be described in everyday language as a sort of friendship. (shrink)

The antihero prevails in recent American drama television series. Characters such as mobster kingpin Tony Soprano, meth cook and gangster-in-the-making Walter White and serial killer Dexter Morgan are not morally good, so how do these television series make us engage in these morally bad main characters? And what does this tell us about our moral psychological make-up, and more specifically, about the moral psychology of fiction? Vaage argues that the fictional status of these series deactivates rational, deliberate moral evaluation, making (...) the spectator rely on moral emotions and intuitions that are relatively easy to manipulate with narrative strategies. Nevertheless, she also argues that these series regularly encourage reactivation of deliberate, moral evaluation. In so doing, these fictional series can teach us something about ourselves as moral beings—what our moral intuitions and emotions are, and how these might differ from deliberate, moral evaluation. (shrink)

This paper begins with a problem stemming from Hume regarding credences about credences. Suppose one has a credence of .95 in p, and suppose one assesses the credence to be such. But suppose one’s second-order credence in this assessment is less than 1. Then, by a standard conditionalization rule, one’s credence in p becomes less than .95. Moreover, such “erosion” can iterate by considering one’s, third-, fourth-, fifth-order credences, etc. (In light of this, some have rejected higher-order credences; however, it (...) is argued that Lewis’ “Principal Principle” forbids this.) The paper then offers a partial solution by describing circumstances under which a person has reason to assign credence 1 to a first-order credence. The solution takes the form of a “transparency” view of self-knowledge from Parent (2017, chapter 8). Briefly, it is argued that when one “reflex-like” utters a sentence “The probability of p is n”, then as a matter of psychological law, the utterance is an expression of one’s own judgment. The Principal Principle then necessitates that one’s credence in p is n, assuming one is being rational. Thus, upon perceiving such an utterance, one can thereby have a reason to assign a second-order credence of 1. (shrink)

This contribution to the second installment of the Common Knowledge symposium “Whatever Happened to Richard Rorty?” argues that the field of science studies should be understood as a way of inheriting, rather than fundamentally breaking with, Rorty's antifoundationalism and postepistemology. Taken together, the work of Bruno Latour, Isabelle Stengers, and Donna Haraway has been less about rebalancing the relative and the objective, and more about redrawing the checkerboard of knowledge into “in-disciplinary” styles of empirical philosophy. These styles rely on doubly (...) held commitments to radical empirical curiosity about, on the one hand, events of science and culture, and, on the other hand, promises of conceptual speculation for collective learning. This work is highly important for the novel perplexities of the Anthropocene, but not quite in the way that Gaskill proposed. (shrink)