Background To characterize patients dying in a community hospital with or without attempting cardiopulmonary resuscitation and to describe patient involvement in, documentation of, and compliance with decisions on resuscitation. Methods All patients who died in Kalmar County Hospital during January 1, 2016 until December 31, 2016 were included. All information from the patients’ electronic chart was analysed. Results Of 660 patients female), 30 were pronounced dead in the emergency department after out-of-hospital CPR. Of the remaining 630 patients a DNAR order (...) had been documented in 558 patients. Seventy had no DNAR order and 2 an explicit order to do CPR. In 43 of these 70 patients CPR was unsuccessfully attempted while the remaining 27 patients died without attempting CPR. In 2 of 558 patients CPR was attempted despite a DNAR order in place. In 412 patients the DNAR order had not been discussed with neither patient nor family/friends. Moreover, in 75 cases neither patient nor family/friends were even informed about the decision on code status. Conclusions In general, a large percentage of patients in our study had a DNAR order in place. However, 27 patients died without CPR attempt or DNAR order. DNAR orders had not been discussed with the patient/surrogate in almost three fourths of the patients. Further work has to be done to elucidate the barriers to discussions of CPR decisions with the patient. (shrink)

BackgroundThe values and attitudes of healthcare professionals influence their handling of ‘do-not-attempt-resuscitation’ (DNAR) orders. The aim of this study was a) to describe attitudes, perceptions and practices among Swedish physicians and nurses towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and b) to investigate if the physicians and nurses were familiar with the national ethical guidelines for cardiopulmonary resuscitation.MethodsThis was a retrospective observational study based on a questionnaire and was conducted at 19 wards in two regional (...) hospitals and one county hospital.Results210 physicians and 312 nurses (n = 522) responded to the questionnaire. Every third (35%) professional had read the guidelines with a lower proportion of physicians (29%) compared to nurses (38%). Around 40% of patients had the opportunity or ability to participate in the DNAR discussion. The DNAR decision was discussed with 38% of patients and the prognosis with 46%. Of the patients who were considered to have the ability to participate in the discussion, 79% did so. The majority (81%) of physicians and nurses believed that patients should always be asked about their preferences before a DNAR decision was made.ConclusionsSwedish healthcare professionals take a patient’s autonomy into account regarding DNAR decisions. Nevertheless, as 50% of patients were considered unable to participate in the DNAR discussion, questions remain about the timing of patient participation and whether more discussions could have been conducted earlier. Given the uncertainty about timing, the majority of patients deemed competent participated in DNAR discussions. (shrink)

Berg, J. Buñuels dagdröm.--Bergström, L. Pessimismens konsekvenser.--Furberg, M. Möjliga teser hos Johannes Climacus.--Halldén, S. Teckenrelationen och språkreglernas juridik.--Hedenius, I. Ett argument mot den rättsfilosofiska domstolsrealismen.--Mates, B. Om Platons argument "den tredje människan."--Marc-Wogau, K. Kant om lögnen.--Næss, A. Om filosofiske projekter som forener empirisk semantikk og metafysisk spekulasjon.--Ofstad, H. Får nazister lettere magesår enn humanister?--Prawitz, D. Om moraliska och logiska satsers sanning.--Stenius, E. Om Descartes' psykofysiska modell.--Tranøy, K. E. Filosofenes etiske ansvar.--Wright, G. H. von. En filosof ser på filosofien.

This book provides an overview of different ethical views on animal experimentation. Special attention is given to the production and experimental use of genetically modified animals. It proposes a middle course between those positions that are very critical and those very positive. This middle course implies that animal experiments originating in vital human research interests are commonly justified, provided that animal welfare is taken seriously. Some animal experiments are not acceptable, since the expected human benefit is too low and the (...) animal suffering too severe. This position is supported by an argument from species care according to which we have special obligations to our children and other humans due to special relations. The book tries to bridge the gap between animal ethics and animal welfare science by discussing various conceptions of animal welfare: function-centered, feeling-based, and those focusing on natural living. The theoretical starting-point is “imaginative casuistry.” This approach stresses the role of moral imagination and metaphor in ethical deliberation, accepts a plurality of values, and recognizes the importance of case-by-case balancing. In the discussion of genetically modified animals, both intrinsic ethical concerns and animal welfare concerns are addressed. (shrink)

Objective: To evaluate whether ethics rounds stimulated ethical reflection. Methods: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to stimulate ethical reflection and promote mutual understanding between professions but not to offer solutions. Questionnaires directly before and after rounds were answered by 194 respondents. The analyses were primarily content analysis with Boyd’s framework but were also statistical in nature. Findings: Seventy-six per cent of the respondents reported a moderate (...) to high rating regarding new insights on ethical problem identification, but the ethics rounds did not seem to stimulate the ethical reflection that the respondents had expected (p<0.001). Dominant new insights did not seem to fit into traditional normative ethics but were instead interpreted as hermeneutic ethics. This was illustrated in the extended perspective on the patient and increased awareness of relations to other professions. Regarding insights into how to solve ethical problems, the request for further interprofessional dialogue dominated both before and after rounds. Conclusion: The findings show the need for interprofessional reflective ethical practice but a balance between ethical reflection and problem solving is suggested if known patients are discussed. Further research is needed to explore the most effective leadership for reflective ethical practice. (shrink)

Perceptual processes differ from cognitive, this paper argues, in functioning to be causally controlled by proximal stimuli, and being modular, at least in a modest sense that excludes their being isotropic in Jerry Fodor's sense. This claim agrees with such theorists as Jacob Beck and Ben Phillips that a function of stimulus-control is needed for perceptual status. In support of this necessity claim, I argue, inter alia, that E.J. Green's recent architectural account misclassifies processes deploying knowledge of grammar as perceptual. (...) _Pace_ Beck and Phillips, however, I argue a function of stimulus-control is insufficient for perceptual as opposed to cognitive status. One consideration in favour of such insufficiency, noted but (I argue) not convincingly rebutted by these theorists, concerns perpetually grounded demonstrative thought. Two other considerations trade on the fact that a function of stimulus-control can arise not from blind nature but intentional design or social institutions, where so-functioning processes may but need not be perceptual. I offer two cases where such processes are cognitive, viz. skilful play-by-play announcing of ongoing events, and voluntary visualizing of ongoing events under the guidance of apt play-by-play announcements, dubbed announcement-driven visualizing (ADV). The cognitive status of these three diverse phenomena cannot be explained by an absence of a perception-like representational format or content (for ADV has such) or by a presence of personal-level mental states causally mediating between stimuli and outputs (for perception has such). A bettter explanation invokes, I argue, the non-modular character of the generating process. (shrink)

It is often assumed that we are only blameworthy for that over which we have control. In recent years, however, several philosophers have argued that we can be blameworthy for occurrences that appear to be outside our control, such as attitudes, beliefs and omissions. This has prompted the question of why control should be a condition on blameworthiness. This paper aims at defending the control condition by developing a new conception of blameworthiness: To be blameworthy, I argue, is most fundamentally (...) to deserve to feel guilty. Being blamed by someone else is not necessarily harmful to the wrongdoer. The blame might not be expressed, or the wrongdoer might not care. But to blame oneself necessarily involves suffering. This conception of blameworthiness explains why the control condition should obtain: We are morally blameworthy for A only if A was under our control because to be blameworthy is to deserve to feel guilty, to feel guilty is to suffer, and one deserves to suffer for A only if A was under one’s control. (shrink)

This paper argues that accepting incommensurability can be a useful step for developing attractive hybrid theories to how to distribute scarce health-related resources. If one provides opportunity for distributive options to be incommensurable with respect to substantive criteria, one can hold on to substantive criteria while also providing room for decision processes to play a significant role. The paper also argues that the strategy of accepting incommensurability is preferable to the strategy of having substantive criteria establish sets of options that (...) are equally, explains why incommensurability gives us reason to go hybrid, and argues that reasons grounded in decision processes have properties that make them appropriate as “tiebreakers” in choice situations characterized by incommensurability. (shrink)

Responsibility as accountability is normally taken to have stricter control conditions than responsibility as attributability. A common way to argue for this claim is to point to differences in the harmfulness of blame involved in these different kinds of responsibility. This paper argues that this explanation does not work once we shift our focus from other-directed blame to self-blame. To blame oneself in the accountability sense is to feel guilt and feeling guilty is to suffer. To blame oneself in the (...) attributability sense, it will be argued, is to feel shame and feeling shame is also to suffer. The different control conditions cannot be explained by a difference in the harm of blame. Instead, this paper argues that accountability and attributability are governed by different kinds of appropriateness: an agent S is accountability blameworthy for X only if S deserves to feel guilty; an agent S is attributability blameworthy for X only if it is fitting that S feels shame for X. (shrink)

In _Plato on Democracy and Political technē_ Anders Dahl Sørensen offers an in-depth investigation of Plato’s discussions of democracy’s ‘epistemic potential’, arguing that this question is far more central to his political thought than is usually assumed.

Although we find the idea of representation by similarities attractive as such, we have two main objections to the specific proposal of Edelman. First, he does not consider complexity issues in terms of storage and speed of recall for recognition. Related to this, the appearance of objects depends on far more factors than just shape, illumination, and pose. This requires an intermediate shape abstraction process that extracts category-specific shape properties from the mixed appearance of images.

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient’s self-determination, the patient’s best interest, the carer’s professional ideals, the carer’s professional (...) role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context. (shrink)

According to Kantian ethics, immoral actions convey disrespect. This negative attitude makes injuries inflicted by other persons worse than injuries caused by nature, ceteris paribus. As Strawson would later put it, the perpetrator’s attitude of disregard prompts in the victim the reactive attitude of resentment. But, I point out, we harbour and display plenty of other negative attitudes toward people aside from disrespect. What, if any, reactive attitudes are natural and appropriate in response to these? In unrequited love, for example, (...) the beloved denies the lover a certain kind of recognition that she desires. I claim that this often prompts resentment in the lover, despite the fact that she has suffered no moral wrongdoing—that her injury is, as I term it, ‘tragic’. If this is so, we must reconceive the meaning of resentment, distinguishing it sharply from indignation. After offering such a reinterpretation of resentment and indignation, I show how ‘tragic resentment’ might be warranted despite lacking a moral claim. If the beloved bears a deep responsibility for not reciprocating the love, then he is subject to negative reactive attitudes for it, despite the fact that he cannot choose whom to love and has no obligation to love. (shrink)

The article briefly introduces an academic debate between two different responses to the predicament of the human in the ecological crisis, namely the object-oriented ontology and the vitalist response to that approach. Based on that introduction, it argues for the need of a complementing analytical tool and sketches the contours of such a tool by suggesting an epistemological tactic for a decolonizing human distinctiveness. The article suggests an analytical maneuver to be used by scholars who aim at decolonizing nature from (...) human oppression, a tool that enables illumination and critical scrutiny of the epistemological role of the human as one stage toward destabilizing the notion of human distinctiveness. The article, thus, introduces an approach where human distinctiveness is not understood as a factual distinctiveness—not an essential difference between the human and the nonhuman world—but where human distinctiveness is critically viewed as a discursive role in theoretical work, a role that can be temporarily put to use by the scholar as a decolonizing epistemological tactic. In other words, human distinctiveness is here tactically used as a tool to critically scrutinize the idea of human distinctiveness rather than to safeguard it. (shrink)

According to the Strawsonian tradition, a person is responsible for an action just in case it is appropriate to hold them responsible for that action. One important way of holding people responsible for wrongdoing is by experiencing and expressing blaming emotions. This raises the questions of what blaming emotions are and in what sense they can be appropriate. In this chapter I will provide an overview of different answers to both these questions. A common thread in the chapter will be (...) a challenge for the Strawsonian tradition. Given that this tradition understands moral responsibility in terms of the appropriateness of blaming emotions, it must provide a realistic picture of these emotions and the practices in which they take part. On the other hand, it also aims to develop a normatively plausible account of the conditions of responsibility. I will try to show that it is often difficult to strike a satisfactory balance between these two aspirations. (shrink)

Inference has long been a concern in epistemology, as an essential means by which we extend our knowledge and test our beliefs. Inference is also a key notion in influential psychological or philosophical accounts of mental capacities, from perception via utterance comprehension to problem-solving. Consciousness, on the other hand, has arguably been the defining interest of philosophy of mind over recent decades. Comparatively little attention, however, has been devoted to the significance of consciousness for the proper understanding of the nature (...) and role of inference. It is commonly suggested that inference may be either conscious or unconscious. Yet how unified are these various supposed instances of inference? Does either enjoy explanatory priority in relation to the other? In what ways or senses, can an inference be conscious, or fail to be conscious, and how does this matter? This book brings together original essays from established scholars and emerging theorists that illustrate how several current debates in epistemology, philosophy of psychology, and philosophy of mind can benefit from reflections on these and related questions about the significance of consciousness for inference. Contributors include: Kirk Ludwig and Wade Munroe; Michael Rescorla; Federico Bongiorno and Lisa Bortolotti; Berit Brogaard; Nicholas Allott; Jake Quilty-Dunn and Eric Mandelbaum; Corine Besson; Anders Nes; David Henderson, Terry Horgan, and Matjaž Potrč; Elijah Chudnoff; and Ram Neta. (shrink)

This book is a joint effort of like-minded researchers to define the concept of process within a psychological setting. Although minor differences exist as regards choice of background theory, their common focus is on personality in a broad psychodynamic context. Their definition of personality rests on a series of test instruments that have been validated during decades of thorough and vigorous empirical work. These were originally designed to open up micro-processes underlying the adaptation to or construction of reality, and have (...) subsequently proven diagnostically efficient. Coming from both sides of the Atlantic, the contributors have their background in psychological as well as medical institutions. The contributions in the book are examples of a vital source sustaining our efforts to get a more profound understanding of the vicissitudes of the human mind. (shrink)

Victor Eremita proposes that the reader understand parts I and II of Either/Or as parties in a dialogue; most readers in fact view II as a devastating reply to I. I suggest that part I be read as a reaction or follow-up to Kierkegaard’s dissertation. Much of part I presents reflective characters who are aware of their freedom but reluctant or unable to adopt the ethical life. The modern Antigone and the Silhouettes are sisters of Alcibiades—failed students of Socrates. I (...) articulate and defend their modes of loving, which are significantly different from Don Giovanni’s and Johannes the Seducer’s purely aesthetic approaches to love. Such feminine love, I argue, dwells in the disputed territory between passion and action, substance and freedom, the aesthetic and the ethical. Antigone’s love is a passion she both suffers and tries to appropriate. The Silhouettes’ devotion to their beloved makes them dependent on him. I defend this dependence even though it is undoubtedly a form of despair. By appealing to Sartre’s account of love, I argue moreover that this love involves a recognition and appraisal of the beloved absent in the love exemplified by Fear and Trembling’s knight of infinite resignation. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

I argue against the intellectualist view of love according to which we (must) love for reasons so that love is rational. Engaging primarily with the quality appraisal view of love, I concede that qualities can cause love but insist that it is misguided to think of love as having reasons. A number of features of human psychology complicate the issue of how lover relates to beloved's qualities. (a) The lover may be attracted to a quality without appraising that quality reflectively. (...) (b) Personal qualities are not perceived in isolation; rather, our assessment of one quality will affect how we perceive another. In fact, we tend to posit essences in persons, and these guide our interpretation of their other qualities. (c) We do not see persons as bundles of qualities but as unique wholes. This is due to our capacity to fetishize particulars, and it dispels the problem of fungibility. (d) We have a tendency to see meaning in things retrospectively—philosophers have mistaken this sense of meaning for rationality. The philosophical movement to incorporate love into rationality fails to recognize that there is a folk metaphysics built deep into our psyches that does not correspond to the worldview of contemporary philosophers. (shrink)

Thesis (doctoral)--Göteborgs universitet, 2001.

Evidential Decision Theory is flawed, but its flaws are not fully understood. David Lewis (1981) famously charged that EDT recommends an irrational policy of managing the news and “commends the ostrich as rational”. Lewis was right, but the case he appealed to—Newcomb’s Problem—does not demonstrate his conclusion. Indeed, decision theories other than EDT, such as Committal Decision Theory and Functional Decision Theory, agree with EDT's verdicts in Newcomb’s Problem, but their flaws, whatever they may be, do not stem from any (...) ostrich-like recommendations. We offer a new case which shows that EDT mismanages the news, thus vindicating Lewis’s original charge. We argue that this case reveals a flaw in the “Why ain’cha rich?” defense of EDT. We argue further that this case is an advance on extant putative counterexamples to EDT. (shrink)

Kierkegaard's preoccupation with a separation between the ‘inner’ and the ‘outer’ runs through his work and is widely thought to belong to his rejection of Hegel's idealist monism. Focusing on The Concept of Irony and Either/Or, I argue that although Kierkegaard believes in various metaphysical distinctions between inside and outside, he nonetheless understands the task of the philosopher as that of making outside and inside converge in a representation. Drawing on Hegel's philosophy of art, I show that Kierkegaard's project in (...) both of these books is the aesthetic project of revealing the inner essence of something in its outward appearance. Kierkegaard's portrait of Socrates in The Concept of Irony is a phenomenology of the spirit of irony. My interpretation adds a new dimension to our understanding of Kierkegaard's aesthetics and his relation to Hegel; it presents him as a follower of Plato, whom he is usually thought to have dismissed; and it uncovers a deep connection between Kierkegaard's first two books, which are never read in conjunction. (shrink)

The aim of this article is to present re-enactment interviewing and to propose that it can be used to reveal tacit caring knowledge. This approach generates knowledge not readily attainable by other research methods, which we demonstrate by analysing the epistemological and methodological underpinnings of re-enactment interviewing. We also give examples from a study where re-enactment was used. As tacit knowledge is often characteristic of care, re-enactment interviewing has the potential to engage the informant in a holistic mode and thereby (...) reveal wisdom of the body. When the care provider recalls an event, the details are articulated, which contributes to in-depth data, which subsequently serves as a basis for trustworthy analysis. (shrink)

In this paper, I argue that sufficientarian principles are indispensable in the set of principles that have bearing on issues in distributive ethics. I provide two arguments in favor of this claim. First, I argue that sufficientarianism is the only framework that allows us to appropriately analyze what sort of obligations we have toward individuals who are badly off due to their own faults and choices. Second, I argue that sufficientarianism is the only theory that provides an adequate framework for (...) thinking about the desperately badly off. (shrink)

A wide range of gene knockout experiments shows that functional stability is an important feature of biological systems. On this backdrop, we present an argument for higher‐level causation based on counterfactual dependence. Furthermore, we sketch a metaphysical picture providing resources to explain the metaphysical nature of functional stability, higher‐level causation, and the relevant notion of levels. Our account aims to clarify the role empirical results and philosophical assumptions should play in debates about reductionism and higher‐level causation. It thereby contributes to (...) the development of a philosophical foundation for systems biology. †To contact the authors, please write to: CSMN/IFIKK, University of Oslo, Box 1020 Blindern, N‐0315, Oslo, Norway; e‐mail: anders[email protected] , [email protected]. (shrink)

According to perceptualism, fluent comprehension of speech is a perceptual achievement, in as much as it is akin to such high-level perceptual states as the perception of objects as cups or trees, or of people as happy or sad. According to liberalism, grasp of meaning is partially constitutive of the phenomenology of fluent comprehension. I here defend an influential line of argument for liberal perceptualism, resting on phenomenal contrasts in our comprehension of speech, due to Susanna Siegel and Tim Bayne, (...) against objections from Casey O'Callaghan and Indrek Reiland. I concentrate on the contrast between the putative immediacy of meaning-assignment in fluent comprehension, as compared with other, less ordinary, perhaps translation-based ways of getting at the meaning of speech. I argue this putative immediacy is difficult to capture on a non-perceptual view (whether liberal or non-liberal), and that the immediacy in question has much in common with that which applies in other, less controversial cases of high-level perception. (shrink)