Stethoscopes, x-rays and other medical technologies are two-edged swords. They make medical treatment and diagnosis more accurate and effective, but do at the same time reveal our perceptual inadequacy. By transcending our senses, these technologies reveal that we can be seriously diseased without experiencing any symptoms at all. This situation has changed our attitude towards our relations and ourselves. The situation can be analysed using Jürgen Habermas’ conception of systems colonisation of the lifeworld. Medical technologies colonise our life world. They (...) change the way we think and act. They make us all accept that we can become patients almost any minute, even if we feel perfectly healthy. Sense transcending technologies turn us all into proto-patient. (shrink)

In this article, I defend luck at the expense of risk. Or, more precisely, I try to make a distinction that gives both concepts fair treatment. I start by making it clear that luck stands in opposition to control and not to causation. Both luck and risk are related to causal uncertainty. But it is warranted to talk about risk only when the uncertainty involved is brought under control, as it is in some familiar forms of fair gambling such as (...) dicing and roulette. Life is however not a fair gamble. We rarely have the kind of control over the preconditions of life that we have over the preconditions of say dicing. Luck therefore has profound influence on our lives and our health. This means that the standard conception of responsibility - that is, that we stand responsible only for consequences that we control - breaks down far more often than what is usually acknowledged. I therefore end the article by arguing that the standard conception of responsibility ought to be supplemented with a different conception that I have called "responsibility because of social involvement.". (shrink)

Supported by Ian Hacking’s concept of “intervention,” and Charles Taylor’s concept of “intentionality,” this article argues that doubting is acting, and that doubting is therefore subject to the same demands of responsibility as any other action. The argument is developed by using medical practice as a test-case. The central suggestion is that the demand of acting responsibly limits doubt in medicine. The article focuses on two such limitations to doubt. Firstly, the article argues that it is irresponsible to doubt that (...) our actions can harm other people. Secondly, the article argues that it is irresponsible not to strive for coherence between our utterances of doubt and our other actions. Incoherence here can cause “cultural impoverishment.” In a larger context this article also argues that medicine can enrich our epistemology, because medical knowledge displays important traits of knowledge that are downplayed in traditional epistemology derived from mathematics and physics. In particular, medicine makes it possible to get the relation between ethics and epistemology into sharper focus. The endpoint in medical epistemology is “responsible action,” and not certainty in and of itself. (shrink)

In this article, tragedy and utopia are juxtaposed, and it is proposed that the problem of “medicalisation” is better understood in a framework of tragedy than in a utopian one. In utopia, it is presupposed that there is an error behind every setback and every side effect, whereas tragedy brings to light how side effects can be the result of irreconcilable conflicts. Medicalisation is to some extent the result of such a tragic conflict. We are given power by medical progress, (...) but are also confronted with our fallibility, thus provoking insecurity. This situation is illustrated by the sudden infant death syndrome . Recent epidemiological investigations have shown that infants sleeping in a prone position have a 15–20 times higher risk of dying from SIDS than infants sleeping in a supine position. A simple means of preventing infant death is suggested by this discovery, but insecurity is also created. What else has been overlooked? Perhaps a draught, or wet diapers, or clothes of wool are just as dangerous as sleeping prone? Further investigations and precautions will be needed, but medicalisation prevails. (shrink)

Journal Name: SATS Issue: Ahead of print.

This article takes its point of departure from the second (embodied) linguistic turn represented by the enactivist notion of humans as linguistic bodies, using resources from Hans Georg Gadamer in order to propose a view of the relation between art and everyday experience as one of symbolic transformation. Conceiving art as a form of linguistic phenomenon wherein one can engage in original situations of communication, this view rejects both autonomist and direct continuity views of the art-everyday relation. We start by (...) situating the idea of linguistic bodies within the enactive approach, spelling out relevant aspects concerning the significance of language for human life and perception (Sect. 2). Then we embark on a discussion of aspects of Shaun Gallagher’s and Alva Noë’s enactivist perspectives on art experience, highlighting places where their views align with and depart from ours (Sect. 3). The last two sections aim to lay out the transformative view in more detail, proposing a pluralistic understanding of art media and a view of art and art experience as modes of ideational, embodied thought (Sects. 4 and 5). (shrink)

Colin McGinn has argued that consciousness is a nonspatial phenomenon. McGinn’s arguments for the nonspatiality of consciousness are presented and then criticized. It is concluded that consciousness may be as spatial as electric charge and different kinds of abilities.

This paper describes the significance of key empirical findings from the recent and landmark study Caring and Aging with Pride: The National Health, Aging and Sexuality Study (with Karen I. Fredriksen‐Goldsen as the principal investigator), on lesbian, gay, bisexual, and transgender aging and health disparities. We will illustrate these findings with select quotations from study participants and show how nonconscious bias (i.e., activation of negative stereotypes outside conscious awareness) in the clinical encounter and health care setting can threaten shared (...) decision‐making and perpetuate health disparities among LGBT older adults. We recognize that clinical ethicists are not immune from nonconscious bias but maintain that they are well situated to recognize bias and resulting injustice by virtue of their training. Further, we discuss how clinical ethicists can influence the organization's ethical culture and environment to improve the quality and acceptability of health care for LGBT older adults. (shrink)

Objectives: No systematic review or meta-analysis concerning the prevalence of shift work disorder has been conducted so far. The aim was thus to review prevalence studies of SWD, to calculate an overall prevalence by a random effects meta-analysis approach and investigate correlates of SWD prevalence using a random-effects meta-regression.Methods: Systematic searches were conducted in ISI Web of Science, PsycNET, PubMed, and Google Scholar using the search terms “shift work disorder” and “shift work sleep disorder.” No restrictions in terms of time (...) frame were used. Included studies had to present original data on the prevalence of SWD in an occupational sample published in English. A total of 349 unique hits were made. In all, 29 studies were finally included from which two authors independently extracted data using predefined data fields. The meta-regression included four predictors.Results: The overall prevalence of SWD was 26.5%. Cochran Q was 1,845.4, and the I2 was 98.5%, indicating very high heterogeneity across the observed prevalence estimates. Diagnostic criteria and sample size were inversely related to SWD prevalence.Conclusions: The prevalence of SWD was high across the included studies. The between-study disparity was large and was partly explained by diagnostic criteria and sample size. In order to facilitate comparative research on SWD, there is a need for validation and standardization of assessment methodology as well as agreement in terms of sample restrictions. (shrink)

In this book, award-winning historian of religion Paula Fredriksen tells the surprising story of early Christian concepts of sin, exploring the ways that sin came to shape ideas about God no less than about humanity.

A questionnaire relating to attitudes towards setting economic priorities within the health care system was sent to all 151 general practitioners in Northern Norway. Of these, 109 (72 per cent) responded. Ninety-six per cent of the respondents agreed or partly agreed that the setting of economic priorities within the health care system was necessary. Ninety-three per cent had experienced a conflict between their responsibility towards the individual patient and the requirement for them to manage the health budget. The responses suggest (...) that doctors act more in the interests of their patient than the interests of society. However, 68 per cent reported having refrained from giving the best treatment to patients because it was too expensive. As many as 60 per cent of the respondents wanted more public guidelines. Only 10 per cent wanted doctors to have more influence in difficult questions arising from setting priorities. (shrink)

This article takes issue with the formalism problem arguably pertaining to Habermas's conception of communicative rationality and discursive justification. Beginning with the Hegelian premises of Habermas's theory of mutual understanding and communicative rationality, the article proceeds to make Kant's doctrine of reflective judgement fruitful for a critique of Habermas's restriction of reasons to discursively articulated endorsements, the 'force of the better reasons'. The argument consists in showing that discursive justification must rely upon endorsements of particulars exhibited in right judgements, and (...) that such endorsements must be expressed or articulated to yield public manifestations of discursive orientations and commitments, constituting what is referred to as 'communicative experience'. On the account presented here, the rational significance of particulars is revealed in the expressive attitude that allows or admits non-discursive constraints to the conception of rational justification. The promise of such an account - as premised upon Kant's insights in his third Critique - consists in its capability to avoid the one-sided formalism of discursive rationality, incorporating ethical, expressive and aesthetic dimensions to our rational self-conception. Key Words: aesthetic experience • communicative experience • concrete other • discourse-ethics • ethical life • feminism • Habermas • Hegel • Kant • morality • rational justification • reflective judgement • world-disclosure. (shrink)

Adorno's conception of conceptually articulated experience can be defended and made fruitful for a critical philosophy after the so-called linguistic turn. The aim is both to answer the criticisms raised by Jürgen Habermas and others that Adorno's philosophy remains bound by the premises of a subject-centred philosophy, and to criticize social-pragmatism from the vantage-point of Adorno's philosophy of language. It is shown that Adorno is committed to a picture of experience very much in line with the recent views of John (...) McDowell, which extends the space of reasons beyond the space of concepts. Further, it is shown that non-inferential justification can be combined with an expressivist picture of judgment. Finally, it is argued that what is called the extended space of reasons is ultimately social; that representation, the aboutness of thought, serves expressive roles in a socially articulated space of reason-giving. The advantage of Adorno's position vis-à-vis a one-sided social-pragmatism consists in his defence of what is called subjective-material proprieties of judgment. Adorno's idea that the extended space of reasons implies the acknowledgement of what he refers to as the non-identical within conceptually articulated experience is thus reconstructed and defended. Such non-identity, it is claimed, is exhibited in successful art-works which thereby ought to be counted as forms of reasoning. On this basis, Adorno's philosophy acquires critical and normative significance after the linguistic turn. (shrink)

This article considers the treatment of intersubjectivity as the core of Husserl's transcendental phenomenology. From this standpoint it identifies the problematic of Husserl's theory of the "experience of the Other", which Husserl exposes in his commentaries on Descartes V Meditation. The paper draws a parallel between Husserl and Kant in order to clarify the Husserlian notions, and finally shows the difficulties of Husserl's approach due to his assumption of the premises of the "Subjektsphilosophie".

The administration of pro re nata medications is the responsibility of the nurse. However, ethical uncertainties often happen due to the inability of incapacitated patients to collaborate with the nurse in the process of decision making for pro re nata medication administration. There is a lack of integrative knowledge and insufficient understanding regarding ethical considerations surrounding the administration of pro re nata medications to incapacitated patients. Therefore, they have been discussed in this paper and practical strategies to avoid unethical practices (...) have been suggested. The complicated caring situation surrounding the administration of pro re nata medications is intertwined with ethical issues affecting the consideration of the patient's wishes and interventions that override them. The patient's right of autonomy and treatment refusal, surrogacy role, paternalism, and coercion are the main ethos of ethical pro re nata medication administration. Education and training can help nurses avoid legal and ethical issues in pro re nata medicines management and improve the quality and safety of healthcare. Empirical research is needed to improve our understanding of this phenomenon in the multidisciplinary environment of medicines management. (shrink)

This study investigated the relationship between supervisor personality and subordinate reports of exposure to bullying and harassment at work. Three research questions were examined: (a) Is there a direct relationship between supervisor personality and reports of workplace bullying? (b) Is there an interaction between supervisor personality and supervisors' perceived stress as predictors of workplace bullying? (c) Will subordinates who experience bullying at their workplace rate their supervisor's personality more negatively (negative halo effect)? The sample consisted of 207 supervisors and employees (...) within 70 Norwegian restaurants. Supervisors low on conscientiousness, high on neuroticism and portraying high levels of exposure to stress were the subject of significantly more reports from subordinates of exposure to workplace bullying. An interaction between agreeableness and stress was found showing that agreeableness is related to bullying under low levels of stress. In addition, subordinates who perceived their supervisor as being low on agreeableness and high on introversion reported significantly more workplace bullying, supporting a negative halo effect hypothesis. (shrink)

This study investigated the relationship between supervisor personality and subordinate reports of exposure to bullying and harassment at work. Three research questions were examined: Is there a direct relationship between supervisor personality and reports of workplace bullying? Is there an interaction between supervisor personality and supervisors’ perceived stress as predictors of workplace bullying? Will subordinates who experience bullying at their workplace rate their supervisor’s personality more negatively? The sample consisted of 207 supervisors and employees within 70 Norwegian restaurants. Supervisors low (...) on conscientiousness, high on neuroticism and portraying high levels of exposure to stress were the subject of significantly more reports from subordinates of exposure to workplace bullying. An interaction between agreeableness and stress was found showing that agreeableness is related to bullying under low levels of stress. In addition, subordinates who perceived their supervisor as being low on agreeableness and high on introversion reported significantly more workplace bullying, supporting a negative halo effect hypothesis. (shrink)

The diversity of nanotechnologies and of the governance challenges that their applications raise calls for exploration and learning across different cases. We present an Upstream Oversight Assessment (UOA) of expected benefits and potential harms of nanoparticles made of a synthetic polymer (PLGA) to improve vaccines for farmed salmon. Suggested by Jennifer Kuzma and colleagues, an UOA may help identify and prioritise research needs, and it may support evaluations of the adequacy of relevant existing regulatory frameworks. In this work, the UOA (...) approach is modified and supported with elements from the uncertainty analysis framework developed by Warren Walker and colleagues. Empirically, we draw on relevant available published literature and insights generated in an ongoing nanoparticle salmon vaccine project, in which one of the authors participates. Nanotechnologies have not previously been encountered in the regulatory context of fish vaccines, which in part raises unique challenges due to prospective large scale vaccine use in semi-open aquatic systems. Strengthened through cooperation between ELSA and technology researchers we found the UOA useful for an early mapping of benefits and concerns, and for identifying areas in need of further research prior to a nanoparticle based salmon vaccine is developed and taken into use. We consider our approach to represent one among several complementing initiatives that seek to contribute to early stage evaluations of possible negative side effects, broadly conceived, in order to facilitate a more robust nanotechnology development. (shrink)