This volume is a Norwegian/German collaboration lead by Trygve Wyller and Hans-Gunter Heimbrock.

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

Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the (...) fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications. (shrink)

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

The European Council called for a period of reflection in each of the member states of the European Union (EU) after the people of France and the Netherlands rejected the Constitutional Treaty in referendums in 2005. The present article offers a contribution to this process by reflecting on the prospects for institutional design and redesign in the EU, a topic that became even more relevant after the Irish ?no? to the Lisbon Treaty in June 2008. The discussions are based on (...) a historical perspective, and the article discusses what lessons can be drawn from Jean Monnet, viewed as an institutional designer on the European stage. The article argues that the successful establishment of the European Coal and Steel Community (ECSC) was a product of a robust deontological design in a constitutional moment for Europe, and that prospective designers in the EU can learn important lessons from how Monnet identified and exploited available spaces for institutional design. (shrink)

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

This article points out problems in current dynamic treatments of anaphora and provides a new account that solves these by grafting Muskens' Compositional Discourse Representation Theory onto a partial theory of types. Partiality is exploited to keep track of which discourse referents have been introduced in the text (thus avoiding the overwrite problem) and to account for cases of anaphoric failure. Another key assumption is that the set of discourse referents is well-ordered, so that we can keep track of the (...) order in which they have been introduced, allowing a semantic characterization of anaphoric accessibility across stretches of discourse. Unlike other dynamic approaches, the system defines semantic values for unresolved anaphors. This leads to a clear separation of monotonic and non-monotonic content (in this case anaphoric resolution) and arguably provides a sound basis for a non-monotonic theory of anaphoric resolution. (shrink)

No philistine, Thorstein Veblen thought humankind's innate impulse to imbue experience with aesthetic unity advanced all knowledge, and that the most beautiful objects, ideas, and actions met a standard of communal benefit reflecting humanity's naturally selected sociability. Though German idealism was an early influence, it clashed with Veblen's historicist critique of Western institutions, and it was William James's psychology that refined his ideas into a coherent aesthetics with ethical and political applications, by clarifying how instinct, habit, and environment could interact (...) to institutionalize standards of beauty subverting the native altruism of the aesthetic impulse. Over years of association with John Dewey, Veblen concluded that a redeemed and reflective will to behold and create beauty in and through selfless activity could advance a more efficient and egalitarian society, and that humans cooperatively shaping their environments for the common good could approximate the German tradition's ideal of harmonizing personal freedom and external reality. (shrink)

Most proposals for new international agreements aim to address important global challenges. If the goal is to solve problems, then the value of these agreements depends on their ability to influence the world — to shape norms, constrain behavior, facilitate cooperation, and mobilize action. A recent review of empirical studies has suggested that many international agreements fail to achieve their aspirations. The review indicates that the form in which states make commitments to each other — through an international legal agreement (...) or through other means — may not be as important as commonly thought. It is the content of the commitments and how these are supported by mechanisms to encourage implementation that matter the most. When developing proposals for new international agreements, like the one that has recently been proposed to address antibiotic resistance, attention to implementation mechanisms should therefore be equal to if not greater than the attention paid to its form. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:William James’s Ethical RepublicTrygve ThrontveitFor William James (1842–1910), all philosophical problems were ultimately ethical. In Pragmatism (1907), James invoked the logical theory of his friend Charles Peirce to argue that the “meaning” of any belief consisted solely in “what conduct it is fitted to produce.” There was “no difference in abstract truth,” he elaborated, “that doesn’t express itself in a difference in concrete fact and in conduct consequent upon (...) that fact, imposed on somebody, somehow, somewhere, and somewhen.” Indeed, James concluded that truth was not just reflected in the consequences of conduct but shaped by them: “Truth is made,” he wrote, “just as health, wealth, and strength are made, in the course of experience.”1 This major thesis of Pragmatism distilled a career spent describing an unfinished world, in which human thoughts and actions made differences for which thinkers and actors were responsible. As early as 1878, James insisted that beliefs imply action to advance goals, creating effects valued in light of those goals. The mind, he reiterated in his 1890 masterpiece The Principles of Psychology, is a “fighter for ends,” and thinking, a “moral act.” Later, in “The Will to Believe” (1896), James argued that when evidence is inconclusive, belief might create conditions in which hypotheses could be verified and potential goods realized—or lost. That frank (if often overlooked) assessment of the moral risks as well as rewards of intellectual life echoed James’s most explicitly ethical work, “The Moral Philosopher and the Moral Life” [End Page 255] (1891), where he asserted that when choosing what to believe, it is “simply our total character and personal genius that are on trial; and if we invoke any so-called philosophy, our choice and use of that also are but revelations of our personal aptitude or incapacity for moral life.”2In short, James, as John Dewey elegized in 1910, “was everywhere and always the moralist.”3 Yet for much of the twentieth century critics deemed James’s philosophy ethically vacuous, a warrant for moral solipsism. In 1909, Bertrand Russell criticized James for privileging belief over suspension of judgment, and thus encouraging people to live in private moral universes rather than seek objective grounding for common values. Today, some intellectual historians continue to echo Russell and likeminded contemporaries, judging ethical pragmatism tantamount to moral relativism, even moral apathy.4 Others, acknowledging James’s impassioned pronouncements on lynching, industrial conflict, imperialist expansion, and other public moral issues, have interpreted them as expressing a particularly cosmopolitan but otherwise unremarkable American liberalism, rather than a coherent moral philosophy.5These criticisms are unfounded, but understandable. They reflect a general [End Page 256] antipathy toward James’s broader conceptions of knowledge, truth, and experience, and frustration with his unorthodox mode of philosophizing. In Pragmatism, James followed Peirce in arguing that beliefs are not copies of reality, but “rules for action” resembling the probabilistic predictions guiding scientific inquiry. James, however, extended Peirce’s argument, claiming there is no static reality that beliefs can once-for-all describe. A self-proclaimed “radical empiricist,” James held that the universe is pluralistic, and the only reality accessible to human minds is constantly changing—not least through the ceaseless flux of human consciousness, a fact as natural and consequential as any other.6 This blurring of subject-object distinctions scandalized contemporaries. It also underpinned James’s equally scandalous claim that ideas not only demonstrate their meaning through conduct, but derive both meaning and value from their origins and verification in human activity. To ask what is true in such a world was to ask which ideas, moral or otherwise, allow people to navigate it successfully—which “carry us prosperously from any one part of our experience to any other part”—and which do not.7 Because of these commitments James never made hard distinctions between ethics and other branches of inquiry, or defined his ethics as a separable component of his philosophy easily analyzed on its own terms. Meanwhile, his further refusal to dislodge theory from practice has frustrated those conceiving ethics as a logically and temporally consistent program of conduct. Instead, James insisted that ethical principles emerge organically from individuals’ collective experience in... (shrink)

Much is known about the phenomenon of dignity, yet there is still a need for implementing this understanding in clinical practice. The main purpose of this study was to find out how persons suffering from multiple sclerosis experience and understand dignity and violation in the context of a rehabilitation ward. A phenomenological-hermeneutic approach was used to extract the meaningful content of narratives from 14 patients with multiple sclerosis. Data were collected by personal research interviews. The findings revealed three main themes: (...) (1) ‘invisibly captured in fatigue’; (2) ‘fighters’ law: one who does not ask will not receive’; and (3) ‘dignity is humanity’. The essence of the findings in this study is that dignity is humanity. According to the participants, dignity requires time and is experienced only in a context of empathy and mutual confidence. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

In this essay I respond to critical readers of my book, William James and the Quest for an Ethical Republic. I argue that James’s ultimate preoccupations are ethical, and that his ethical and moral writings constitute a rich resource for pluralistic societies seeking democratic tools for negotiating deep ideological, cultural, and religious differences, and for building a thriving commons.

Few remember Thorstein Veblen (1857-1929) as a connoisseur of beauty or champion of beauty’s importance to an institutionally modern and technologically sophisticated society. Similarly few credit Veblen with any constructive theory of politics. Yet Veblen’s conception of the beautiful, his account of its role in human cultural evolution, and his critique of its perversion in the industrialized societies of the nineteenth and early twentieth centuries are invaluable to contemporary social-aesthetic aims of political and economic reconstruction. In contrast to the Veblen (...) of memory, the real Veblen devoted significant intellectual energy to building a theory of what political thinkers today call public work: creative, negotiated, open-ended production of shared goods by individuals alert both to self-interest and collective needs. Partaking of the rich tradition of philosophical pragmatism, Veblen's social aesthetics also points to that tradition's continuing value for contemporary aesthetic, social, and political theory. Indeed, further augmented by recent advances in cultural evolutionary theory, Veblen’s pragmatist, public-work aesthetics suggests a vision of democratic citizenship defined by cooperative imagination, production, critique, and re-creation of a moral and material commonwealth. The so-called “bard of savagery,” therefore, is better understood as a “bard of democracy,” narrating the travails and affirming the ideals of a culture aspiring to self-government. His is a vision that might lend the fragmented field of social aesthetics a common, compelling narrative of its own. (shrink)

The ethical origins of James's pragmatism -- Religion and the refinement of James's pragmatism -- The ethical republic -- Citizen James -- Legacies and prospects.

We offer a summary of the WHO Report "Making Fair Choices on the Path to Universal Health Coverage".

We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.

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

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...) tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

I defend what I take to be a genuinely Kantian view on temporal extension: time is not an object but a human horizon of concrete particulars. As such, time depends on the existence of embodied human subjects. It does not, however, depend on those subjects determined as spatial objects. Starting with a realist notion of “apperception” as applied to indexical space, I proceed with the need for external criteria of temporal duration. In accordance with Kant’s Second Analogy of Experience, these (...) criteria are found in concepts and laws of motion and change. I then see what follows from this for a reasonable notion of transcendental idealism. Finally, in support of my Kantian conclusions, I argue for the transcendentally subjective nature of particular temporal extension. (shrink)

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

BackgroundIn precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed.MethodsWe distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a forced-choice (...) conjoint analysis pairs of hypothetical patients were presented, and we calculated the average marginal component effect of seven individual patient characteristics, to estimate how each of them influence doctors’ priority-setting decisions.ResultsA positive biomarker status increased the probability of being allocated the new drug, while older age, severe comorbidity and reduced physical function reduced the probability. Importantly, sex, education level and smoking status had no significant influence on the decision.ConclusionBiomarker status is perceived as relevant for priority setting decisions, alongside more well-known patient characteristics like age, physical function and comorbidity. Based on our results, we discuss a framework that can help clarify whether biomarker status should be seen as an ethically acceptable factor for providing unequal treatment to patients with the same disease. (shrink)

In his ‘pains and Places’ (Philosophy 78, 2003), John Hyman is right that pains are not located in their causes or effects but in the hurting limbs. However, his position may be consonant with Wittgensteinian expressivism or the view that consciousness is the locus of pain: In producing its own parts, a living organism ‘autopoietically’ sustains itself as an activity functionally present in its limbs. It thus supplies the biological basis for pain consciousness as something wholly present in organs that (...) hurt. (Published Online October 13 2005). (shrink)

‚Erfahrung ist eine verstandene Wahrnehmung‘ Die hier vorgeschlagene Kant-Interpretation stellt eine nicht-repräsentationalistische Version seiner Theorie der raumzeitlichen Erkenntnis dar. So befindet sie sich nicht nur im Gegensatz zu herkömmlichen Lesarten deutlich mentalistischer Prägung, sondern opponiert im allgemeinen gegen repräsentationalistische Auslegungen des Verhältnisses zwischen Wahrnehmung und Wissen. Wie sehr man sich dabei auf ein interpretatorisches Minenfeld hinaus bewegen kann – davon zeugt das folgende Schlusswort einer Lexikon-Eintragung zu Kantischen und anderen Varianten des Idealismus: „In the end, the only argument for idealism (...) of any form is to be found in the representative theory of perception, and that theory is false“. Formulierungen wie diese sind in verschiedenen Traditionen der Interpretation tief verwurzelt und können nicht ohne weiteres als extreme Einzeläusserungen abgetan werden – um so weniger, als repräsentationalistische oder auch mentalistische Lesarten der theoretischen Philosophie Kants immer noch einen wichtigen Trend darstellen. (shrink)

Of what does the size of spatially and temporally extended phenomena consist? The particular, non-conceptual magnitude of a spatial thing is a determinate, world-defining unit size. Correspondingly, natural objects have a definite size in relation to embodied human subjectivity as a global ‘measure of worlds’. As displayed by the occurrence of global models in human life, this relation has an irreducibly indexical character. The particular temporal extension of events is intrinsic to human experience as well – albeit in a different (...) way. As displayed in local models only, it is a conceivable object of practical but not of propositional knowledge. In its role as a global spatial measure, somehow the human body is more than one among the many possible objects of descriptive knowledge. This role is supplied by rational agency – which is then a condition of the world. (shrink)

Gegen von Wright und andere Anhänger nicht-kausaler Handlungserklärungen hat Davidson argumentiert, daß Handlungen nicht nur als sinnvolles Verhalten konzeptuell verstanden, sondern auch durch singulare Ursachen als ihre „wahren” Motive erklärt werden. Dem entspricht auch der von Perry und anderen nachgewiesene indexikalische Charakter eines jeden Handlungsbewußtseins. Da jedoch ein singuläres Handlungsbewußtsein auch zukunfisgerichtet ist, hat das entsprechende, indexikalische Motiv keine von der erst zu realisierenden Handlung unabhängige Existenz. Die Handlung wird eher als eine „Wirkung von der Zukunft” verstanden, und so haben (...) die Anti-Kausalisten recht, daß bei Handlungserklärungen nicht auf Humesche Ursachen hingewiesen wird. (shrink)