In health care priority setting different criteria are used to reflect the relevant values that should guide decision-making. During recent years there has been a development of value frameworks implying the use of multiple criteria, a development that has not been accompanied by a structured conceptual and normative analysis of how different criteria relate to each other and to underlying normative considerations. Examples of such criteria are unmet need and severity. In this article these crucial criteria are conceptually clarified and (...) analyzed in relation to each other. We argue that disease-severity and condition-severity should be distinguished and we find the latter concept better reflects underlying normative values. We further argue that unmet need does not fulfil an independent and relevant role in relation to condition-severity except for in some limited situations when having to distinguish between conditions of equal severity. (shrink)

Volume 19, Issue 7, July 2019, Page 30-32.

With healthcare systems under pressure from scarcity of resources and ever‐increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient representatives in priority setting bodies at the policy level. We (...) find that the standard justifications for patient representation, such as to achieve patient‐relevant decisions, empowerment of patients, securing legitimacy of decisions, and the analogy with democracy, all fall short of supporting patient representation in this context. We conclude by briefly outlining an alternative proposal for patient participation that involves patient consultants. (shrink)

Childhood obesity is an increasing health problem. Prior empirical research suggests that, although discussing lifestyle behaviours with parents could help prevent childhood obesity and its health-related consequences, physicians are reluctant to address parental responsibility in the clinical setting. Therefore, this paper questions whether parents might be responsible for their children’s obesity, and if so, whether parental responsibility ought to be addressed in the physician–patient/parent encounter. We illustrate how different ideal-typical models of the physician–patient/parent interaction emphasise different understandings of patient autonomy (...) and parental responsibility and argue that these models advocate different responses to an appeal for discussing parents’ role in childhood obesity. We suggest that responsibility should be attributed to parents because of their parental roles in providing for their children’s welfare. We also argue that whether, and how, this responsibility gives rise to a requirement to act depends on the parents’ capacities. A deliberative-oriented physician–patient/parent interaction best captures the current ideals of antipaternalism, patient autonomy, and shared and evidence-informed decision-making, and might facilitate parental role development. We conclude that, while not discussing parental responsibility for childhood obesity in the clinical setting can be warranted in particular cases, this cannot be justified as a general rule. (shrink)

This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as “a field of study following specific and well-established methodological rules” bioethics is not a specific discipline as there are no explicit “well-established methodological rules.” The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological rules within subdisciplines or for specific tasks. As this does not appear to be the case, the article examines whether (...) bioethics’ adherence to specific quality criteria (instead of methodological rules) or pursuing of a common goal can make it qualify as a discipline. Unfortunately, the result is negative. Then, the article scrutinizes whether referring to bioethics institutions and professional qualifications can ascertain bioethics as a discipline. However, this makes the definition of bioethics circular. The article ends by admitting that bioethics can qualify as a discipline according to broader definitions of discipline, for example, as an “area of knowledge, research and education.” However, this would reduce bioethics’ potential for demarcation and identity-building. Thus, to consolidate the discipline of bioethics and increase its impact, we should explicate and elaborate on its methodology. (shrink)

In this article I respond to Björn Hofmann’s criticism of some elements in my theory of health. Hofmann’s main objective is to question “Nordenfelt’s basic premise that you can be ill without having negative first-person experiences, and to investigate the consequences of abandoning the premise.” One of Hofmann’s critical points is that my theory of health does not lend voice to the individual. My response is essentially conducted in four steps: (1) I question the aim of conceptual (...) analysis that Hofmann proposes for the analysis of the notion of health. (2) I maintain that my analysis, in spite of Hofmann’s contention, lends voice to the individual. It does so via my notion of subjective illness but also via my notion of vital goal. (3) I argue that conditions, such as coma, paralysis and mania are salient instances of ill health and that these may become neglected if the use of the terms “ill” and “illness” is restricted to instances where negative subjective experiences are present. (4) I rehearse my main arguments for selecting disability as the core element of ill health and respond to Hofmann’s contention that persons who are in great pain can sometimes nevertheless perform perfectly. (shrink)

This study investigates the interrelation of outer appearance and spatial configuration of modern Chinese court buildings with the party-state’s strategy of building regime legitimacy. The spatial element of this relation is explored in four different court buildings in Kunming, Chongqing, Shanghai and Xi’an. It is argued that court buildings contribute to the empowerment of individuals who appear as parties in trials. Courthouses also facilitate the courts’ function of exercising social control and the application of an instrumentalist approach to the principle (...) of public trials. Both the grounding of court buildings in the past and their compliance with international models of a modern independent judiciary are aspects of consolidating regime legitimacy. (shrink)

Sometimes it seems intuitively plausible to hold loosely structured sets of individuals morally responsible for failing to act collectively. Virginia Held, Larry May, and Torbj rn T nnsj have all drawn this conclusion from thought experiments concerning small groups, although they apply the conclusion to large-scale omissions as well. On the other hand it is commonly assumed that (collective) agency is a necessary condition for (collective) responsibility. If that is true, then how can we hold sets of people responsible for (...) not having acted collectively? This paper argues that that loosely structured inactive groups sometimes meet this requirement if we employ a weak (but nonetheless non-reductionist) notion of collective agency. This notion can be defended on independent grounds. The resulting position on distribution of responsibility is more restrictive than Held's, May's or T nnsj 's, and this consequence seems intuitively attractive. (shrink)

Defenses of the possibility of collective guilt feelings falls roughly into two categories: collectivistic positions that assign guilt feelings to groups as such but play down the experiential component in guilt feelings, and individualistic positions which understand collective guilt feelings in terms of individual experiences. The analogy between collective and individual guilt feelings is examined from two collectivistic viewpoints. It is argued that the functional states of collectives and individuals with respect to guilt are less analogous than collectivists assume. Instead, (...) an individualistic perspectival understanding of collective guilt feelings is proposed. Groups as such cannot feel guilty in the morally relevant sense, but guilt as felt by individuals can have a distinctively collective character, such that the feeling still may be an appropriate response to assignments of collective responsibility. (shrink)

In their Unfit for the Future, Ingmar Persson and Julian Savulescu argued that there is no moral right to privacy, which resulted in a string of papers. This paper addresses an argument in their most recent contribution, according to which there is no moral right to privacy because individuals cannot control their access to information. Here their argument is first denied after which their epistemic conception of a moral right to privacy is criticized.

Kairos has been a key concept in medicine for millennia and is frequently understood as “the right time” in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease) has resulted in too early diagnoses, i.e., overdiagnoses. Nonetheless, despite vast advances in science and (...) technology, diagnoses also come too late. Accordingly, timing diagnostics right is crucial. In this article we start with giving a brief overview of the etymology and general use of the concepts of kairos and diagnosis. Then we delimit kairos in diagnostics by analysing “too early” and “too late” diagnosis and by scrutinizing various phases of diagnostics. This leads us to define kairos of diagnostics as the time when there is potential for sufficient information for making a diagnosis that is most helpful for the person. It allows us to conclude that kairos is as important in diagnostics as in therapeutics. (shrink)

Fred Dretske’s account of mental causation, developed in Explaining Behavior and defended in numerous articles, is generally regarded as one of the most interesting and most ambitious approaches in the field. According to Dretske, meaning facts, construed historically as facts about the indicator functions of internal states, are the structuring causes of behavior. In this article, we argue that Dretske’s view is untenable: On closer examination, the real structuring causes of behavior turn out to be markedly different from Dretske’s meaning (...) facts. Our argument proceeds in three steps. First, we set forth the problem of meaning individuation: We argue that the proposal that meaning facts are structuring causes of behavior commits Dretske to a very fine-grained individuation of meanings that is deeply counterintuitive. In a second step, we show that even these finely individuated meaning facts cannot do the job that they are supposed to do, since information facts—which are constitutive of, but distinct from Dretske’s meaning facts—are better candidates for the role of structuring causes. Finally, we argue that it is not even information facts, but facts of co-instantiation which are the real structuring causes of behavior. In concluding, we briefly consider the options that are left for Dretske if our arguments succeed. (shrink)

Topics in Cognitive Science, Volume 14, Issue 2, Page 258-281, April 2022.

A broad range of evidence regarding the functional organization of the vertebrate brain – spanning from comparative neurology to experimental psychology and neurophysiology to clinical data – is reviewed for its bearing on conceptions of the neural organization of consciousness. A novel principle relating target selection, action selection, and motivation to one another, as a means to optimize integration for action in real time, is introduced. With its help, the principal macrosystems of the vertebrate brain can be seen to form (...) a centralized functional design in which an upper brain stem system organized for conscious function performs a penultimate step in action control. This upper brain stem system retained a key role throughout the evolutionary process by which an expanding forebrain – culminating in the cerebral cortex of mammals – came to serve as a medium for the elaboration of conscious contents. This highly conserved upper brainstem system, which extends from the roof of the midbrain to the basal diencephalon, integrates the massively parallel and distributed information capacity of the cerebral hemispheres into the limited-capacity, sequential mode of operation required for coherent behavior. It maintains special connective relations with cortical territories implicated in attentional and conscious functions, but is not rendered nonfunctional in the absence of cortical input. This helps explain the purposive, goal-directed behavior exhibited by mammals after experimental decortication, as well as the evidence that children born without a cortex are conscious. Taken together these circumstances suggest that brainstem mechanisms are integral to the constitution of the conscious state, and that an adequate account of neural mechanisms of conscious function cannot be confined to the thalamocortical complex alone. (Published Online May 1 2007) Key Words: action selection; anencephaly; central decision making; consciousness; control architectures; hydranencephaly; macrosystems; motivation; target selection; zona incerta. (shrink)

This article proposes a way to zoom in on the concept of the social license to operate from the broader normative perspective of contractarianism. An SLO can be defined as a contractarian basis for the legitimacy of a company’s specific activity or project. “SLO”, as a fashionable expression, has its origins in business practice. From a normative viewpoint, the concept is closely related to social contract theory, and, as such, it has a political dimension. After outlining the contractarian normative background (...) to the SLO, we will show how academic concepts such as legitimacy and stakeholder management have a tendency to provide the intellectual underpinning for the business case for securing an SLO. While business case perspectives on the SLO may well be in line with the use of the term in business practice, we will highlight certain difficulties and ambiguities related to the instrumental use of the expression. In the final section, we briefly introduce the articles of this Special Issue to the reader and explain how they relate to the topic. (shrink)

In a seminal article in the Journal of Medical Ethics, Søren Holm and Tuja Takala analysed two protechnology arguments in bioethics: the hopeful principle and the automatic escalator. They showed how these arguments relate to problematic arguments such as the precautionary principle and the empirical slippery slope argument, and argued that they should be used with great caution. The present article investigates the recent debate on proton beam therapy, where the hopeful principle and the automatic escalator are identified. However, the (...) debate reveals a series of other arguments that deserve similar caution. An analysis of these arguments indicates that the roots of their fallacies are to be found in the ignorance of the uncertainties about risks and benefits and an overly optimistic attitude towards technology and progress. The point is not to argue against proton therapy, but rather to point out that flawed arguments for new technologies, such as proton therapy, can actually hamper their implementation instead of promoting it. Patients deserve the best technology available, not only on the basis of the best available evidence, but also on the basis of the best arguments. (shrink)

The assertion “he could have done otherwise” represents a notorious problem in the science of penal law and in moral philosophy. Some philosophers have assumed that this statement is to be analysed as “he would have done otherwise if he had so chosen” (analysis view), thus believing to have found an interpretation which is compatible with determinism. It has been argued, however, that these two statements are not equivalent. The following article attempts to show that this objection is not far-reaching (...) enough. At the same time the analysis view is considered to be of little help, as it presupposes the solution of the problems it claims to solve. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Excerpt from Empfindung und Vorstellung: Ein Beitrag zur Klarung Psychologischer Grundbegriffe Vor kurzem erschien eine Abhandlung von Carl Stumpf uber Empfindung und Vorstellung, welche auf Grund feinfuhliger Selbstbeobachtungen und unter Berucksichtigung der grossen einschlagigen Literatur in die vielen Winkel und Dunkelheiten dieses Problems der deskriptiven Psychologie hineinleuchtet. Unter sorgfaltiger Analyse der von den verschiedenen Beobachtern gegebenen Beschreibungen und scharfsinniger Untersuchung der logischen Durchfuhrbarkeit jeder einzelnen der bisher ausgesprochenen Auffassungen versucht diese Abhandlung die Frage zu klaren, worin der wesentliche Unterschied beider (...) Erlebnisarten besteht. Als Ergebnis gelangt Stumpf in der Hauptsache zu einer Rechtfertigung der altuberlieferten Auffassung, nach der ein "spezifischer" Unterschied zwischen Empfindung und Vorstellung nicht vorliegt, sich die Vorstellungen vielmehr vor allem durch ihre geringere Intensitat von den Empfindungen unter-scheiden. Ausser an Intensitat fehlt es den Vorstellungen im Gegensatz zu den Empfindungen an Fulle und Bestandigkeit, ferner sind sie dadurch charakterisiert, dass sie willkurlich leichter modifizierbar sind, dass ihnen gegenuber der Glaube an die Realitat fur das erlebende Bewusstsein einer Rechtfertigung bedarf, und dass sie durchschnittlich schwachere Gefuhlswirkungen mit sich fuhren. Vorstellungen stellen sich so den Empfindungen gegenuber als "Erscheinungen zweiter Ordnung" dar: in dem Inhalt der Erlebnisse, nicht in den Akten des Erlebens, ist ihre Verschiedenheit zu suchen. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.". (shrink)

The essays in Powerful Arguments reconstruct the standards of validity underlying argumentative practices in a wide array of late imperial Chinese discourses, from the Song through the Qing dynasties. The fourteen case studies analyze concrete arguments defended or contested in areas ranging from historiography, philosophy, law, and religion to natural studies, literature, and the civil examination system. By examining uses of evidence, habits of inference, and the criteria by which some arguments were judged to be more persuasive than others, the (...) contributions recreate distinct cultures of reasoning. Together, they lay the foundations for a history of argumentative practice in one of the richest scholarly traditions outside of Europe and add a chapter to the as yet elusive global history of rationality. (shrink)

In April 2017, scientists took to the streets in a historically unprecedented Global March for Science. The event was seen as symbolic of a crisis in the relationship of science and society. This book considers the Global March for Science from a postcolonial perspective to inquire into the toolkit that the academic field of Science & Technology Studies (STS) has to offer. It argues that new concepts and analytical approaches are necessary to investigate current global dynamics in science, technology and (...) society, so as to deliver insights that the recent expansion of STS scholars beyond Western Europe and North America alone is unlikely to provide. The book presents a Programme in Science Studies Elsewhere (SSE) to demonstrate the urgent need to carry postcolonial issues right into the centre of STS's intellectual programme. (shrink)

This book is the first monograph that takes a comprehensive approach to Jacques Derrida as a philosopher of technology. It refines and complements his mainstream image as a philosopher of language and deconstructionist of classical literary and philosophical texts. This volume outlines the key features of Derrida’s alternative philosophy of technology, a philosophy which Sjöstrand argues, avoids the problems associated with, on the one hand, a Heideggerian orientation, which completely separates thinking and technology and, on the other, an empirically oriented (...) ”post-phenomenology” that can be said to be hegemonic within the field today. Based on a sustained interpretation of Derrida, and a robust, coherent philosophy of technology, a phenomenology of technology is developed that, in a radical way, extends the concept of technology to cover the entire field of phenomenology. This places the technological not in opposition to humanity, but rather always already in close proximity to man and, consequently, to life, ethics, politics, democracy and religion. Strikingly, this important aspect of Derrida’s thinking is only rarely analyzed or discussed by his many exegetes. This text appeals to graduates and researchers working on Derrida, phenomenology, and the philosophy of technology. (shrink)

Giulio Tononi's integrated information theory (IIT) proposes explaining consciousness by directly identifying it with integrated information. We examine the construct validity of IIT's measure of consciousness,phi(Φ), by analyzing its formal properties, its relation to key aspects of consciousness, and its co-variation with relevant empirical circumstances. Our analysis shows that IIT's identification of consciousness with the causal efficacy with which differentiated networks accomplish global information transfer (which is what Φ in fact measures) is mistaken. This misidentification has the consequence of requiring (...) the attribution of consciousness to a range of natural systems and artifacts that include, but are not limited to, large-scale electrical power grids, gene-regulation networks, some electronic circuit boards, and social networks. Instead of treating this consequence of the theory as a disconfirmation, IIT embraces it. By regarding these systems as bearers of consciousnessex hypothesi, IIT is led toward the orbit of panpsychist ideation. This departure from science as we know it can be avoided by recognizing the functional misattribution at the heart of IIT's identity claim. We show, for example, what function is actually performed, at least in the human case, by the cortical combination of differentiation with integration that IIT identifies with consciousness. Finally, we examine what lessons may be drawn from IIT's failure to provide a credible account of consciousness for progress in the very active field of research concerned with exploring the phenomenon from formal and neural points of view. (shrink)

The objective of this article is to analyse the value-ladenness of technology in the context of medicine. To address this issue several characteristics of technology are investigated: i) its interventive capacity, ii) its expansiveness and iii) its influence on the concept of disease, iv) its generalising character, v) its independence of the subjective experience of the patient. By this analysis I hope to unveil the double face of technology: Technology has a Janus-face in modern medicine, and the opposite of its (...) factual face is evaluative. (shrink)

The ‘Guiding Principles on Business and Human Rights’ (Principles) that provide guidance for the implementation of the United Nations’ ‘Protect, Respect and Remedy’ framework (Framework) will probably succeed in making human rights matters more customary in corporate management procedures. They are likely to contribute to higher levels of accountability and awareness within corporations in respect of the negative impact of business activities on human rights. However, we identify tensions between the idea that the respect of human rights is a perfect (...) moral duty for corporations and the Principle’s ‘human rights due diligence’ requirement. We argue that the effectiveness of the ‘human rights due diligence’ is in many respects dependent upon the moral commitment of corporations. The Principles leave room for an instrumental or strategic implementation of due diligence, which in some cases could result in a depreciation of the fundamental norms they seek to promote. We reveal some limits of pragmatic approaches to coping with business-related human rights abuses. As these limits become more apparent, not only does the case for further progress in international and extraterritorial human rights law become more compelling, but so too does the argument for a more forceful discussion on the moral foundations of human rights duties for corporations. (shrink)

Human actions have diverse consequences. Some consequences are intended, others are considered side effects, although they too, such as climate-damaging CO2 emissions, can be ethically relevant. Ethically speaking, considering consequences in a differentiated way is therefore clearly unavoidable. After discussing the influential concepts of utilitarianism and moral theology, the author presents his own approach to considering consequences.

According to a classical causal account of perception, to perceive that object x is F is to fulfill the following conditions: (i) one has an experience as of x's being F, (ii) x is F, and (iii) one's experience of x's being F depends causally on x's being F. This is the core of Grice's causal theory of perception, and it is initially quite plausible (Grice 1961).