The discussion on ethical issues, it is said, should not be confined to experts but should be extended to patients and local communities, because of the real need to engage stakeholders and non‐stakeholders alike not only in carrying out any biomedical research project, but also in the drafting and legislation of bioethics instruments. Several local and inter‐country consultations have already been conducted in furtherance of this goal, but there is much left to be desired in them. The consultations may have (...) helped in articulating local principles, but not in making the instruments embody these principles. As such, instruments turn incompossible, i.e. the principles and actions they legitimate are not performable. In an ethnographic study conducted in the Philippines, for example, paragraphs 29 and 30 of the Declaration of Helsinki and CIOMS guidelines 8 and 15 are construed as not only contradictory to one another but also to local principles. This problem can be solved by taking deliberate steps to ensure that consultations are grounded in ethnographic data about local principles, which the instruments would embody. A steering committee can be of help in gathering ethnographic data, in conducting consultations at the local level, and in providing a venue for discourse on various bioethical issues. (shrink)

The question of how society should deal with social conflicts arising from cultural differences persists. Should we adopt an exclusivist approach by excluding reasons based on specific cultural traditions (culture-based reasons) from public debates about social policy, especially because these reasons do not appeal to the public at large? Or should we resort to an inclusivist approach by including reasons based on cultural traditions in public debate to give recognition to the diverse cultural identities of those who practice these traditions? (...) While these two approaches assign different roles to cultural traditions in public debate, both seem to welcome compromise between conflicting parties. This paper reviews contending normative approaches for dealing with conflicts in multicultural societies and explores the place of culture-based reasons in public debates designed to resolve conflicts. (shrink)

Rational justification of claims with empirical content calls for empirical and not only normative philosophical investigation. Empirical approaches to bioethics are epistemically valuable, i.e., such methods may be necessary in providing and verifying basic knowledge about cultural values and norms. Our assumptions in moral reasoning can be verified or corrected using these methods. Moral arguments can be initiated or adjudicated by data drawn from empirical investigation. One may argue that individualistic informed consent, for example, is not compatible with the Asian (...) communitarian orientation. But this normative claim uses an empirical assumption that may be contrary to the fact that some Asians do value and argue for informed consent. Is it necessary and factual to neatly characterize some cultures as individualistic and some as communitarian? Empirical investigation can provide a reasonable way to inform such generalizations. In a multi‐cultural context, such as in the Philippines, there is a need to investigate the nature of the local ethos before making any appeal to authenticity. Otherwise we may succumb to the same ethical imperialism we are trying hard to resist. Normative claims that involve empirical premises cannot be reasonably verified or evaluated without utilizing empirical methods along with philosophical reflection. The integration of empirical methods to the standard normative approach to moral reasoning should be reasonably guided by the epistemic demands of claims arising from cross‐cultural discourse in bioethics. (shrink)

Application of egalitarian and prioritarian accounts of health resource allocation in low‐income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that result from such allocation schemes. Insufficient health care and severe deprivation of health resources are difficult to accept even when justified by aggregative efficiency or legitimized by fair deliberative process in pursuing equality and priority oriented outcomes. I affirm the sufficientarian argument that, (...) given extreme scarcity of public health resources in low‐income countries, neither health status equality between populations nor priority for the worse off is normatively adequate. Nevertheless, the threshold norm alone need not be the sole consideration when a country's total health budget is extremely scarce. Threshold considerations are necessary in developing a theory of fair distribution of health resources that is sensitive to the lexically prior norm of sufficiency. Based on the intuition that shares must not be taken away from those who barely achieve a minimal level of health, I argue that assessments based on standards of minimal physical/mental health must be developed to evaluate the sufficiency of the total resources of health systems in low‐income countries prior to pursuing equality, priority, and efficiency based resource allocation. I also begin to examine how threshold sensitive health resource assessment could be used in the Philippines. (shrink)

Background: Recent studies on public attitudes toward life extension technologies show a mix of ambivalence toward and support for extending the human lifespan. Attitudes toward genetic modification of organisms and technological enhancements may be used to categorize individuals according to political or ideological orientation such as technoprogressive or conservative and it could be easy to assume that these categories are related to more general categorizations related to culture, e.g. between Traditional and Secular-rational values in the World Values Survey. This paper (...) discusses how attitudes toward aspects of radical life extension may be related to cultural values as revealed in an online deliberative survey among university students conducted between January 2012 to January 2013. Survey results suggest that attitudes toward radical life extension tend to be mixed among groups categorized as Traditional, Secular-rational, Survivalist, and Self-expressionist. The study explored the relation between responses of 326 university students to 5 key questions on radical life extension and the cultural values they tend to favor as indicated by their response to 20 statements from the World Values Survey.Design and Method: The survey consisted of 3 stages: an online pre-discussion survey, face-to-face discussion, and post-discussion survey. After completing the 5 main survey questions in stage 1, participants were presented two additional questionnaires: one on cultural attitudes using 20 statements from the 2004-2008 World Values Survey and another on health attitudes with 12 statements from Dutta-Bergman’s 2004 study. In stage 2, participants were engaged in a face-to-face discussion in class focusing on their responses to the five key questions. After the discussion, they were invited to reconsider the choices and reasons they posted in stage 1 in the light of the face-to-face class discussion in stage 2.Results: Responses to the five survey questions showed that there tended to be more individuals across groups who disagreed with adopting technologies that radically extend the human lifespan beyond the current limit of 120 years. Attitudes toward radical life extension did not correspond to cultural attitudes indicated by responses to the WVS questions. The proportion of agreement/disagreement to statements presented in each of the five questions varied across cultural groups and there tended to be more individuals who disagreed with radical life extension in all groups. Changes in responses after the discussion stage were not significant and most respondents maintained their prior views.Discussion: Cultural attitudes associated with familiar technologies may not correspond with attitudes toward newer technologies since beliefs and values may need to be adapted to new imagined situations that the new technologies elicit. Moral understandings associated with familiar technological habits and beliefs are not necessarily carried over to new technologies. (shrink)

For this open issue of the _Etikk i Praksis: Nordic Journal of Applied Ethics_, we put together a broad mix of different articles tackling current important issues in the field.

This commentary explores “other” needed philosophical contributions to bioethics that is implied but not mentioned explicitly in the article by Blumentahal-Barby et al. (2022). That “other” role of...

This special issue of Etikk i Praksis – Nordic Journal of Applied Ethics features four articles that address a number of urgent ethical issues that arise in the COVID-19 pandemic.

The editorial introduces original articles, a commentary and book review.

It is urgent that we address the causes and harmful effects of racism in health care. We propose that building diversity competence in the way we deliver health care services is key to this effort....

Four papers are included in this November 2018 special issue Open Section. First is by Bjørn Hofmann and Siri Granum Carson titled _Filosofiens rolle i det offentlige ordskiftet: Hvordan har debatten om sorteringssamfunnet i 2017 påvirket forholdet mellom filosofi og samfunn? En innholdsanalyse_. Second, _Provokativ offentlig filosofi_ by Aksel Braanen Sterri. Third, Steinar Bøyum’s _The Democratic Duty to Educate Oneself._ And fourth, Jonas Jakobsen and Kjersti Fjørtoft’s _In defence of moderate Inclusivism: Revisiting Rawls and Habermas._.

As the year 2022 ends, we continue to face challenging issues and uncertainties about what should be the right approach to various ethical problems society face. In approaching these problems we reflect on our existing guiding values but also discover new ones. We then try to figure out how our actions and decisions could align with our well-considered judgments until we achieve some degree of reflective equilibrium.

White, Shelton, and Rivais (2018) identified a key development in the evolution of clinical ethics as a field and as a profession, namely, “identifying and instituting safeguards to assure professi...

The editors of Etikk i praksis are pleased to introduce six papers in this open-themed issue for the journal’s 10th year anniversary.

This open issue of the Nordic Journal of Applied Ethics consists of four papers that discuss the topics covering vaccination, sustainability, development ethics research and family ethics. It also includes a book review.

This issue provides readers the opportunity to broaden understanding of methods used in applied ethics. We hope you will be inspired to decide on which method, or a combination of different ones, to use towards achieving reflective balance that can enhance understanding of all considerations relevant to deciding what should be done. Like tools, methods are used because they are well suited to the task we seek to accomplish.

Ethical beliefs may vary across cultures but there are things that must be valued as preconditions to any cultural practice. Physical and mental abilities vital to believing, valuing and practising a culture are such preconditions and it is always important to protect them. If one is to practise a distinct culture, she must at least have these basic abilities. Access to basic healthcare is one way to ensure that vital abilities are protected. John Rawls argued that access to all-purpose primary (...) goods must be ensured. Amartya Sen and Martha Nussbaum claim that universal capabilities are what resources are meant to enable. Len Doyal and Ian Gough identify physical health and autonomy as basic needs of every person in every culture. When we disagree on what to prioritize, when resources to satisfy competing demands are scarce, our common needs can provide a point of normative convergence. Need-based rationing, however, has been criticized for being too indeterminate to give guidance for deciding which healthcare services to prioritize and for tending to create a bottomless-pit problem. But there is a difference between needing something (first-order need) and needing to have the ability to need (second-order need). Even if we disagree about which first-order need to prioritize, we must accept the importance of satisfying our second-order need to have the ability to value things. We all have a second-order need for basic healthcare as a means to protect our vital abilities even if we differ in what our cultures consider to be particular first-order needs. (shrink)

This open issue of the Nordic Journal of Applied Ethics consists of four papers that discuss topics covering fetal diagnostics ethics, value conflicts in the use of artificial intelligence, abortion and population ethics.

How should national societies build legitimate and inclusive collective identities amidst prolific multiculturalism and linguistic diversity? We argue that cultural ownership of particular ways of framing ethics should be part of this collective identity building process. We should avoid unfair domination of minority cultural identities, but how do we do this when ethical discourses themselves tend to be shaped by particular dominant identities? We look into the case of the challenges that a particular multicultural society, the Philippines, faces in its (...) ongoing collective identity building project on three levels: ethnic and linguistic differences, the historical layers of foreign culture that have each influenced these distinct cultural identities in different degrees, and the apparent domination of Tagalog linguistic culture over others. Our answer to the question of legitimate and inclusive collective identity comes from an inter-linguistic dialogue that can be effected between cultures by harnessing similarities of ethical concepts, without compromising cultural differences. We present three different possible approaches under the following headings: Pilipino ethics, Filipino ethics and Philippine ethics, each representing a particular stance to the dominant Tagalog linguistic culture. We argue for the third option, which is the most inclusive because of how it equalizes the status of all participating cultures in the dialogue. We also draw from the possibilities afforded by the phenomena of Scandinavian semicommunication and what this practice offers in making collective identity building more inclusive. (shrink)

This article discusses clinical ethics consultation (CEC), and thereby ethics support services in the Canadian context. Commonalities and differences between the three models of ethics support and CEC shared in this article are identified, set within the broader context of the Canadian healthcare system, accreditation, and professionalization of practicing healthcare ethicists.

Dette nummeret av tidsskriftet er et åpent nummer. Der fire av fem bidrag handler om profesjonsetikk. Ett av disse drøfter profesjonsetikk mer generelt, mens de andre tre fokuserer på bestemte profesjoner. Det ene bidraget drøfter spionvirksomhet, mens de andre to ser på toppfotball og global helseetikk. I tillegg har vi et bidrag som sammenlikner etikk og identitetsbygging innenfor ulike nasjonale kontekster.

This open themed issue of Etikk i praksis compiles five diverse papers that overlap at key conceptual intersections around trust, care and responsibilities across national boundaries. Our globalized social environments have become more and more complex, and the information needed to understand society and our moral responsibilities have grown ever more challenging. The ‘fake news’ buzzword, used by various societal actors to cast doubt on political rivals, is shaking the trust needed to be confident about institutional sources of information. The (...) caring attitude that serves to cement social groups and communities seems to be weakening in certain contexts, resulting in individual acts of unimaginable violence that shock us to the core. On the other hand, we are inspired when the same caring attitude mobilizes groups and individuals to reach across national boundaries and aid those who are suffering. In sorting through the generalizations and attempts to categorize the many highly complex social phenomena that occur in our interconnected global realities, we apply careful analysis of both facts and values that facilitate ethical reflection, helping us to make ethical decisions. (shrink)

_Taking issue with sustainable governance involves careful consideration of social, economic, and environmental dimensions of sustainability, and the interplay of those dimensions in political processes and decision-making. The current issue of Etikk i Praksis contributes to this task by offering analysis of central concepts in the discourse of sustainability, as well as examinations of political and moral issues raised by pressing environmental challenges such as climate change._.

This special issue of Etikk i praksis features papers that articulate and discuss approaches and methodology that seek to make normative research activity and research output productive in contexts of ongoing societal and technological decision-making. The articles in various ways and to a varying degree exemplify and reflect on the methodology of the study of normativity in innovation.

In this paper, I appeal to two aspects of Immanuel Kant’s philosophy – his metaphysics and ethics – in defense of abortion rights. Many Kantian pro-life philosophers argue that Kant’s second principle formulation of the categorical imperative, which proscribes treating persons as mere means, applies to human embryos and fetuses. Kant is clear, however, that he means his imperatives to apply to persons, individuals of a rational nature. It is important to determine, therefore, whether there is anything in Kant’s philosophy (...) that permits regarding embryos and fetuses as persons, since they lack the capacity for sentience (at least until mid-gestation), let alone rational thought. In the first part of the paper, I will illustrate why there are difficulties maintaining, from a Kantian perspective, that conception marks the genesis of a new person. Even granting that embryos and fetuses are persons, however, this alone would not entail the moral impermissibility of abortion rights, mainly because prohibiting abortion, and compelling women to gestate, violates the formula of humanity against them. Developing this thesis encompasses the second part of my essay. Finally, although I argue that Kant’s philosophy lends strong support to abortion rights, this does not thereby entail that it allows for the complete dehumanization of the human fetus. By appealing to the writings of Kantian scholar Allen Wood, I will argue that a fetus’ status as a potential person does render it worthy of some degree of respect and moral value. (shrink)

Silence is reserved for what cannot be verbally expressed. The well-known Wittgensteinian quote summarizes an established understanding of the relationship between language and silence: because language is not enough to account for reality and thinking, it must be transcended by other means of expression, like music or silence. But what if the opposite is the case and silence is not the extension but the precondition of language, the ultimate source of meaning? This paper explores how this is the phenomenological and (...) Derridean philosophical framework of Coetzee’s novels, a literary universe created from the will to signify and build singular meanings. (shrink)

In this book, Newell makes the case for unified theories by setting forth a candidate.

Recopilació dels textos de les reflexions que van tenir lloc en l'encontre inter nacional "Noves fronteres de la ciència, l'art i el pensament. Física de l'estèt ica", celebrat els dies 6 i 7 de setembre de 2005 a l'Auditori Caixa Catalunya-l a Pedrera de Barcelona. En la trobada es plantejaren preguntes universals relati ves als límits de la nostra percepció, al disseny de la matèria o a la narrativa de la complexitat circumdant. Va comptar amb la col·laboración de personalitats d'àmbits (...) no científics que, des de la seva perspectiva, contribuiren a destil·l ar l'estètica emanada de les tendències contemporànies d'aquesta disciplina cien tífica. (shrink)

Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

This masterful work on Kant's Religion within the Boundaries of Mere Reason explores Kant's treatment of the Idea of God, his views concerning evil, and the moral grounds for faith in God. Kant and Religion works to deepen our understanding of religion's place and meaning within the history of human culture, touching on Kant's philosophical stance regarding theoretical, moral, political, and religious matters. Wood's breadth of knowledge of Kant's corpus, philosophical sharpness, and depth of reflection sheds light not only on (...) Kant, but also on the fate of religion and its relation to philosophy in the modern world. (shrink)

Aesthetics and the Environment presents fresh and fascinating insights into our interpretation of the environment. Traditional aesthetics is often associated with the appreciation of art, but Allen Carlson shows how much of our aesthetic experience does not encompass art but nature--in our response to sunsets, mountains or horizons or more mundane surroundings, like gardens or the view from our window. Carlson argues that knowledge of what it is we are appreciating is essential to having an appropriate aesthetic experience and (...) that a scientific understanding of nature can enhance our appreciation of it, rather than denigrate it. (shrink)

Higher education institutions worldwide have begun to embrace sustainability issues and engage their campuses and communities in such efforts, which have led to the development of integrity and ethical values in these organizations and their relationships with stakeholders. This study provides a literary review of the concept of University Social Responsibility (USR) and sustainability programs worldwide, grouped into eight research streams: conceptual framework, strategic planning and USR, educating on USR, spreading USR, reporting and USR, evaluation of USR, barriers and accelerators (...) and case studies. The aforementioned research streams served as a context to explore best practices in sustainability on a global basis. (shrink)

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

This paper explores the idea that many “simple minded” invertebrates are “natural zombies” in that they utilize their senses in intelligent ways, but without phenomenal awareness. The discussion considers how “first-order” representationalist theories of consciousness meet the explanatory challenge posed by blindsight. It would be an advantage of first-order representationalism, over higher-order versions, if it does not rule out consciousness in most non-human animals. However, it is argued that a first-order representationalism which adequately accounts for blindsight also implies that most (...) non-mammals are not conscious. The example of the honey bee is used to illuminate these claims. Although there is some reason to think that bees have simple beliefs and desires, nevertheless, their visually-mediated cognizing is comparable to that of an animal with blindsight. There is also reason to think that the study of blindsight can also help determine how consciousness is distributed in the animal world. (shrink)

This volume provides a guide to the discussion among biologists and philosophersabout the role of concepts such as function and design in an evolutionary understanding oflife.

Epistemic akrasia arises when one holds a belief even though one judges it to be irrational or unjustified. While there is some debate about whether epistemic akrasia is possible, this paper will assume for the sake of argument that it is in order to consider whether it can be rational. The paper will show that it can. More precisely, cases can arise in which both the belief one judges to be irrational and one’s judgment of it are epistemically rational in (...) the sense that both are supported by sufficient evidence. (shrink)