Purpose: To survey the attitudes of the general public in Sweden to biobank research and to discuss the findings in the light of some well-known ethical principles.Methods: A questionnaire was used to survey the opinions of the general public in Sweden, and an ethical analysis (using the principles of autonomy, non-maleficence, beneficence and justice) was performed to discuss the possible conditions of such research.Findings: Between 3 and 9% answered that they did not want their samples to be collected and stored (...) in a biobank. Many respondents required information about the purpose of the research and wanted to be able to consent or refuse. About one third of the respondents said they would have answered differently if financial gain was involved and those who commented indicated a more negative attitude. The principle of autonomy maintains that the right to self-determination should be respected, and the principles of non-maleficence and beneficence that the probable harms and benefits resulting from a particular project by using samples from a biobank should be balanced. The general public disagree about how these principles are to be balanced. Interpretation: In the light of the findings different interpretations of the situation as well as possible alternatives are discussed in this paper. (shrink)

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks (...) makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

The aim of this paper is to investigate whether or not ethical conflicts can be identified, analysed and solved using ethical principles. The relation between the physician and the patient with ischemic heart disease (IHD) as life style changes are recommended in a secondary prevention program is used as an example. The principal persons affected (the patient and his or her spouse) and the ethical principles (respect for autonomy, non-maleficence, beneficence and justice) are combined in a two dimensional model. The (...) most important person affected by the recommendations is the patient. His or her autonomy is challenged by the suggested life style changes, the purpose of which is to promote the future wellbeing and health of the patient. The spouse is indirectly involved in and affected by the process. He or she often feels neglected by caregivers. Ethical conflicts can both be identified and analysed using ethical principles, but often no solution is implied. Most (if not all) physicians would strongly encourage life style changes, but surprisingly there is no uncontroversial justification for this conclusion using principles. (shrink)

Human dignity is grounded in basic human attributes such as life and self-respect. When people cannot stand up for themselves they may lose their dignity towards themselves and others. The aim of this study was to elucidate if dignity remains intact for family members during care procedures in a children’s hospital. A qualitative approach was adopted, using open non-participation observation. The findings indicate that dignity remains intact in family-centred care where all concerned parties encourage each other in a collaborative relationship. (...) Dignity is shattered when practitioners care from their own perspective without seeing the individual in front of them. When there is a break in care, family members can restore their dignity because the interruption helps them to master their emotions. Family members’ dignity is shattered and remains damaged when they are emotionally overwhelmed; they surrender themselves to practitioners’ care, losing their self-esteem and self-respect. (shrink)

Since the 1990s, numerous studies on the relationship between parents and their children have been reported on in the literature and implemented as a philosophy of care in most paediatric units. The purpose of this article is to understand the process of nurses' care for children in a paediatric setting by using Noddings's caring ethics theory. Noddings's theory is in part described from a theoretical perspective outlining the basic idea of the theory followed by a critique of her work. Important (...) conceptions in her theory are natural caring (reception, relation, engrossment, motivational displacement, reciprocity) and ethical caring (physical self, ethical self, and ethical ideal). As a nurse one holds a duty of care to patients and, in exercising this duty, the nurse must be able to develop a relationship with the patient including giving the patient total authenticity in a 'feeling with' the patient. Noddings's theory is analysed and described in three examples from the paediatrics. In the first example, the nurse cared for the patient in natural caring while in the second situation, the nurse strived for the ethical caring of the patient. In the third example, the nurse rejected the impulse to care and deliberately turned her back to ethics and abandoned her ethical caring. According to the Noddings's theory, caring for the patient enables the nurse to obtain ethical insights from the specific type of nursing care which forms an important contribution to an overall increase of an ethical consciousness in the nurse. (shrink)

We respond to the comments provided on our paper `Principles help to analyse but often give no solution-secondary prevention after a cardiac event’ by Simon Waltho, and highlight points of clarification.

Almost all articles on education in medical ethics present proposals for or describe experiences of teaching students in different health professions. Since experienced staff also need such education, the purpose of this paper is to exemplify and discuss educational approaches that may be used after graduation. As an example we describe the experiences with a five-day European residential course on ethics for neonatal intensive care personnel. In this multidisciplinary course, using a case-based approach, the aim was to enhance the participants' (...) understanding of ethical principles and their relevance to clinical and research activities. Our conclusion is that working with realistic cases encourages practising nurses and physicians to apply their previous knowledge and new concepts learnt in the course, thus helping them to bridge the gap between theory and practice. (shrink)

This chapter draws on Ayn Rand's esthetic discourse, especially her essay collection The Romantic Manifesto: A Philosophy of Literature and her lecture course on fiction‐writing, edited and published as The Art of Fiction: A Guide for Writers and Readers. First, it looks briefly at Romanticism in its historical context. Next, the chapter discusses how plot enables a writer to show the events of a story as following logically from the values and premises of the characters, and how this method implies (...) a specific approach to characterization. Then, the chapter looks at plot in relation to a story's theme; to the author's projection of his/her own unique values and personality; and to the distinctive use of imagination typical of Romantic art. Finally, it addresses the question of how Rand's advocacy of plot relates to her concept of objectivity. (shrink)

Artificial intelligence receives attention in media as well as in academe and business. In media coverage and reporting, AI is predominantly described in contrasted terms, either as the ultimate solution to all human problems or the ultimate threat to all human existence. In academe, the focus of computer scientists is on developing systems that function, whereas philosophy scholars theorize about the implications of this functionality for human life. In the interface between technology and philosophy there is, however, one imperative aspect (...) of AI yet to be articulated: how do intelligent systems make inferences? We use the overarching concept “Artificial Intelligent Behaviour” which would include both cognition/processing and judgment/behaviour. We argue that due to the complexity and opacity of artificial inference, one needs to initiate systematic empirical studies of artificial intelligent behavior similar to what has previously been done to study human cognition, judgment and decision making. This will provide valid knowledge, outside of what current computer science methods can offer, about the judgments and decisions made by intelligent systems. Moreover, outside academe—in the public as well as the private sector—expertise in epistemology, critical thinking and reasoning are crucial to ensure human oversight of the artificial intelligent judgments and decisions that are made, because only competent human insight into AI-inference processes will ensure accountability. Such insights require systematic studies of AI-behaviour founded on the natural sciences and philosophy, as well as the employment of methodologies from the cognitive and behavioral sciences. (shrink)

‘Scientific dishonesty’ implies the fabrication, falsification or plagiarism in proposing, performing or reviewing research or in reporting research results. A questionnaire was given to postgraduate students at the medical faculties in Sweden who attended a course in research ethics during the academic year 2008/2009 and 58% answered (range 29%–100%). Less than one-third of the respondents wrote that they had heard about scientific dishonesty in the previous 12 months. Pressure, concerning in what order the author should be mentioned, was reported by (...) about 1 in 10 students. We suggest that all departments conducting research should have a written policy about acceptable research behaviour and that all doctoral students should be informed of the content of this policy. Participants in the research groups concerned should also be required to analyse published articles about scientific dishonesty and critically discuss what could be done about unethical conduct. (shrink)

This article discusses fundamental problems in "rational choice theory," as outlined by Jon Elster. Elster's discussion of why institutions may not be said to act shows his fundamental presupposition that only "monolithic," unitary entities are capable of action. This is, for him, a reason why only individual human beings may be said to act. Furthermore, human beings may be said to act only insofar as they "maximize" (their "utility") on the basis of a unitary, complete, consistent "preference structure." All action (...) that is not maximization in this sense is for Elster not really human action, but rather instances of "pure causality." Elster distinguishes between the "real," intentional person, who "maximizes," and "purely causal forces" within the person. This article tries to show that this radical, sharp dichotomy between "intentionality," in this narrow sense, and "pure causality" is inadequate as a basis for understanding human action. This radical dichotomy is central to important arguments made by Elster more generally. (shrink)

Cheyne and Girard characterize felt presence during sleep paralysis attacks as a pre-hallucinatory expression of a threat-activated vigilance system. While their results may be consistent with this interpretation, they are nonetheless correlational and do not address a parsimonious alternative explanation. This alternative stipulates that FP is a purely spatial, hallucinatory form of a common cognitive phenomenon—social imagery—that is often, but not necessarily, linked with threat and fear and that may induce distress among susceptible individuals. The occurrence of both fearful and (...) non-fearful FPs in a multiplicity of situations other than sleep paralysis attacks supports the notion that FPs are hallucinatory variants of social imagery and that they are not necessarily bound to threat-activated vigilance. Evidence linking FPs with anxiety disorders supports the notion that the distress they evoke may be mediated by a more general affective distress personality factor. To illustrate the predominantly spatial character of FP hallucinations, similarities between FP and phantom limbs are summarized and the possibility that these two phenomena are parallel expressions of a mirror neuron system is considered. (shrink)

This introduction describes the background and reasons why the Mercator-Hondius atlas analysed in this issue became part of the library collection of the Donner Institute.

This paper presents a range of new triviality proofs pertaining to naïve truth theory formulated in paraconsistent relevant logics. It is shown that excluded middle together with various permutation principles such as A → (B → C)⊩B → (A → C) trivialize naïve truth theory. The paper also provides some new triviality proofs which utilize the axioms ((A → B)∧ (B → C)) → (A → C) and (A → ¬A) → ¬A, the fusion connective and the Ackermann constant. An (...) overview over various ways to formulate Leibniz’s law in non-classical logics and two new triviality proofs for naïve set theory are also provided. (shrink)

This paper argues against Jon Elster's contention that there is a fundamentalincompatibility between, on one hand, autonomy and rationality and, on theother hand, adaptation to conditions of one's existence in the sense that one'sdesires or preferences are adjusted to what it is possible to achieve. While thefirst part of the paper more narrowly concentrated on Elster's discussion ofthese ideas, this second part goes on to a more general discussion of the conceptof rationality. On the basis of this discussion, it is (...) claimed that Elster's conclusionsconcerning autonomy and adaptation are premised on a defective conceptionof human experience and rationality. Moreover, the claim is made that thesedefects are also characteristic of "rational choice theory" more generally. (shrink)

This article argues against Jon Elster’s contention that there is a fundamental incompatibility between, on the one hand, autonomy and rationality, and, on the other hand, adaptation to the conditions of one’s existence in the sense that one’s desires or preferences are adjusted to what it is possible to achieve. It is claimed that Elster’s conclusions are premised on a defective conception of human faculties and powers, including a defective conception of human experience and rationality. Moreover, the claim is made (...) that these defects are also characteristic of “rational choice theory” more generally. (shrink)

In recent years, semantical partiality has emerged as an important explanatory concept in philosophical logic as well as in the study of natural language semantics. Despite the many applications, however, a number of mathematically intriguing questions associated with this concept have received only very limited attention. ;The present dissertation aims to present a systematic study of certain types of partiality in the area of basic model theory. Two types of issues are given special attention: Introducing partially defined models, there are (...) many ways to generalize the classical truth definition for sentences of a simple first order language relative to standard, complete models. Different interpretations of the formal framework motivate conflicting truth definitions between language and partial models: A partial model can be taken to represent a part of the world, or a partial information set. The truth of a sentence can be supported directly by a part of the world, but can also follow indirectly from an information set. These notions are related, and the relation motivates a comparison between various weaker and stronger alternative truth definitions. Results are obtained about the extent to which these truth definitions differ, and a number of characterization results are deduced. ;Among other conditions that are not expressible in the framework of standard, complete model theory, a condition of monotonicity or persistence of truth relative to partial models is argued to follow under both the given interpretations of the formal framework. The final chapter investigates the relation between such conditions and expressibility properties in general. These discussions culminate with a combined Lindstrom and persistence characterization theorem. (shrink)

Relevant logics have traditionally been viewed as paraconsistent. This paper shows that this view of relevant logics is wrong. It does so by showing forth a logic which extends classical logic, yet satisfies the Entailment Theorem as well as the variable sharing property. In addition it has the same S4-type modal feature as the original relevant logic E as well as the same enthymematical deduction theorem. The variable sharing property was only ever regarded as a necessary property for a logic (...) to have in order for it to not validate the so-called paradoxes of implication. The Entailment Theorem on the other hand was regarded as both necessary and sufficient. This paper shows that the latter theorem also holds for classical logic, and so cannot be regarded as a sufficient property for blocking the paradoxes. The concept of suppression is taken up, but shown to be properly weaker than that of variable sharing. (shrink)

This paper gives an account of Anderson and Belnap’s selection criteria for an adequate theory of entailment. The criteria are grouped into three categories: criteria pertaining to modality, those pertaining to relevance, and those related to expressive strength. The leitmotif of both this paper and its prequel is the relevant legitimacy of disjunctive syllogism. Relevant logics are commonly held to be paraconsistent logics. It is shown in this paper, however, that both E and R can be extended to explosive logics (...) which satisfy all of Anderson and Belnap’s selection criteria, provided the truth-constant known as the Ackermann constant is available. One of the selection criteria related to expressive strength is having an “enthymematic” conditional for which a deduction theorem holds. I argue that this allows for a new interpretation of Anderson and Belnap’s take on logical consequence, namely as committing them to pluralism about logical consequence. (shrink)

It is known that many relevant logics can be conservatively extended by the truth constant known as the Ackermann constant. It is also known that many relevant logics can be conservatively extended by Boolean negation. This essay, however, shows that a range of relevant logics with the Ackermann constant cannot be conservatively extended by a Boolean negation.

This article provides a normative framework for evaluating the moral permissibility of various defences of European Union (EU) values against their violation in EU member states. This requires, first, a coherent interpretation of EU values as the values of liberal democracy; second, a clear notion of when they are violated; third, a theory of how liberal democracy can be defended with measures that are consistent with the values of liberal democracy themselves; and, finally, a discussion of what the EU’s role (...) is in this defence. The article argues that it would be permissible for the EU to combine a number of political, cultural, socio-economic and legal responses in a concentric defence of liberal democracy as long as they respect the separation of powers doctrine and do not rely on problematic notions of collective responsibility. (shrink)

Lautemann et al. (1995) gave a descriptive characterisation of the class of context-free languages, showing that a language is context-free iff it is definable as the set of words satisfying some sentence of a particular logic (fragment) over words. The present notes discuss how to specialise this result to the class of linear languages. Somewhat surprisingly, what would seem the most straightforward specialisation actually fails, due to the fact that linear grammars fail to admit a Greibach normal form. We identify (...) an alternative specialisation, based on an alternative characterisation of context-free languages, also noted by Lautemann et al. (1995). (shrink)

En el mundo actual, en el que se está reduciendo la abundancia y la inalterabilidad de la diversidad cultural, nuestras barreras culturales se pueden salvar —aunque no adulterar— si todo el mundo en todas partes se acoge a los derechos humanos. En el presente artículo intento defender la idea de que, para conseguirlo, tenemos que elaborar una pluralidad de aprobaciones de los derechos humanos universalmente aplicables que sea diversa pero bien cimentada culturalmente; en resumidas cuentas, deberíamos adoptar una justificación plural (...) de los derechos humanos. (shrink)

Many relevant logics can be conservatively extended by Boolean negation. Mares showed, however, that E is a notable exception. Mares’ proof is by and large a rather involved model-theoretic one. This paper presents a much easier proof-theoretic proof which not only covers E but also generalizes so as to also cover relevant logics with a primitive modal operator added. It is shown that from even very weak relevant logics augmented by a weak K-ish modal operator, and up to the strong (...) relevant logic R with a S5 modal operator, all fail to be conservatively extended by Boolean negation. The proof, therefore, also covers Meyer and Mares’ proof that NR—R with a primitive S4-modality added—also fails to be conservatively extended by Boolean negation. (shrink)

Many relevant logics are conservatively extended by Boolean negation. Not all, however. This paper shows an acute form of non-conservativeness, namely that the Boolean-free fragment of the Boolean extension of a relevant logic need not always satisfy the variable-sharing property. In fact, it is shown that such an extension can in fact yield classical logic. For a vast range of relevant logic, however, it is shown that the variable-sharing property, restricted to the Boolean-free fragment, still holds for the Boolean extended (...) logic. (shrink)