Biographical note: The author is associate professor in ethics and political philosophy, Department of Philosophy, NTNU Trond.

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased (...) tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. (shrink)

_This article presents an experiment in using Socratic dialogue as a methodological approach to Responsible Research and Innovation (RRI) in an interdisciplinary life sciences research project. The approach seeks to avoid imposing a set of predetermined substantive norms by engaging the researchers in knowledge-seeking group discussions. We adapted Svend Brinkmann’s method of epistemic interviewing, in order to facilitate reflection on normative issues concerning responsibility in research and innovation in two research group sessions. Two elements characterize this approach, relating it to (...) empirical ethics methodologies: (1) the aim is not to map and analyse opinions, but to develop knowledge based on the dialogue; and (2) the facilitators of the discussion are also active participants in the dialogue rather than mere “spectators”. Through a description of the approach and discussion of some key challenges, we __show the method’s potential as a supplement to the catalogue of RRI approaches and argue that it serves a dual purpose of contributing to knowledge production and reflexivity._ _Keywords_: Epistemic interviewing, bioethics, responsibility, reflexivity. (shrink)

Key to concerns about public involvement in technology governance is the concept of lay expertise, the idea that lay people possess some kind of special knowledge that neither trained experts in technology, ethics and social sciences nor professional politicians possess. There are at least four different meanings of "lay expert": (1) Lay people who are educated into quasi-experts on a particular issue or technology; (2) Lay people who turn themselves into experts in order to challenge scientific experts; (3) Lay people (...) with particular knowledge based on tradition and experience; (4) Lay people who represent an alternative perspective to expert views because they are non-experts. The challenge is that lay people are often ignorant in the relevant matters and wish to leave governance to experts. Still, there are normative reasons for lay engagement, either as stakeholders or as citizens in a deliberative democracy. According to the second approach, political decisions should be based on an inclusive open debate aimed at the better argument, providing lay people a crucial role in governance. In order to include lay people without making them hostage to experts, politicians or interest groups, we can engage them in focus group interviews which are analysed by social scientists and included in the interdisciplinary debate in journals and political forums. (shrink)

In the debate on conscientious objection in healthcare, proponents of conscience rights often point to the imperative to protect the health professional’s moral integrity. Their opponents hold that the moral integrity argument alone can at most justify accommodation of conscientious objectors as a “moral courtesy”, as the argument is insufficient to establish a general moral right to accommodation, let alone a legal right. This text draws on political philosophy in order to argue for a legal right to accommodation. The moral (...) integrity arguments should be supplemented by the requirement to protect minority rights in liberal democracies. Citizens have a right to live in accordance with their fundamental moral convictions, and a right to equal access to employment. However, this right should not be unconditional, as that would unduly infringe on the rights of other citizens. The right must be limited to cases where the moral basis is more fundamental in a sense that all reasonable citizens in a liberal democracy should accept, such as the constitutive role of the inviolability of human life in liberal democracies. There should be a legal, yet circumscribed, right to accommodation for conscientious objectors refusing to provide healthcare services that they reasonably consider to involve the intentional killing of a human being. (shrink)

Biotechnology proponents claim that the public has a duty to trust biotechnology due to its potential for handling significant future food security challenges. This article uses Kant’s moral and political philosophy as basis for constructing a framework for analyzing trust as a moral duty, both in personal relationships and in institutional settings. This includes trust in technology that is of societal significance. A discussion of key concepts of trust leads to an argument that there is a conditional duty of reflexive (...) trust in fundamental social institutions, including technology. However, reflexive trust in, for example, food biotechnology cannot be conceived of as an individual task. A duty of reflexive trust in technology can only be achieved within a publicly controlled institution of trust-building systematic distrust. This system should ideally clarify which instances and to what extent a technology is ethically justifiable and of benefit to society in general. (shrink)

This paper offers a moral history of the industrialisation of seaweed harvesting in Norway. Industrialisation is often seen as degrading natural resources. Ironically, we argue, it is precisely the scale and scope of industrial utilisation that may enable non-instrumental valuations of natural resources. We use the history of the Norwegian seaweed industry to make this point. Seaweed became increasingly interesting to harvest as a fruit and then as a crop of the sea in the early twentieth century following biochemical applications (...) for alginates derived from seaweed. When harvesting was mechanised, however, attention turned to the environmental and aesthetic value of kelp forests. Further, the sale of the industry to the American FMC corporation flagged the national value of these plants. In sum epistemic, aesthetic and moral appreciations of natural resources are tangled up and co-evolve with their industrial utilisation, in an ecology of values. Our account uses interview and ethnographic material from key sites in Norway. (shrink)

Trust can be understood as a precondition for a well-functioning society or as a way to handle complexities of living in a risk society, but also as a fundamental aspect of human morality. Interactions on the Internet pose some new challenges to issues of trust, especially connected to disembodiedness. Mistrust may be an important obstacle to Internet use, which is problematic as the Internet becomes a significant arena for political, social and commercial activities necessary for full participation in a liberal (...) democracy. The Categorical Imperative lifts up trust as a fundamental component of human ethical virtues – first of all, because deception and coercion, the antitheses of trust, cannot be universalized. Mistrust is, according to Kant, a natural component of human nature, as we are social beings dependent on recognition by others but also prone to deceiving others. Only in true friendships can this tendency be overcome and give room for unconditional trust. Still we can argue that Kant must hold that trustworthy behaviour as well as trust in others is obligatory, as expressions of respect for humanity. The Kantian approach integrates political and ethical aspects of trust, showing that protecting the external activities of citizens is required in order to act morally. This means that security measures, combined with specific regulations are important preconditions for building online trust, providing an environment enabling people to act morally and for trust-based relationships. (shrink)

Public policy on the development and use of genetically modified organisms (GMOs) has mainly been concerned with defining proper strategies of risk management. However, surveys and focus group interviews show that although lay people are concerned with risks, they also emphasize that genetic modification is ethically questionable in itself. Many people feel that this technology “tampers with nature” in an unacceptable manner. This is often identified as an objection to the crossing of species borders in producing transgenic organisms. Most scientists (...) reject these opinions as based on insufficient knowledge about biotechnology, the concept of species, and nature in general. Some recent projects of genetic modification aim to accommodate the above mentioned concerns by altering the expression of endogenous genes rather than introducing genes from other species. There can be good scientific reasons for this approach, in addition to strategic reasons related to greater public acceptability. But are there also moral reasons for choosing intragenic rather than transgenic modification? I suggest three interrelated moral reasons for giving priority to intragenic modification. First, we should respect the opinions of lay people even when their view is contrary to scientific consensus; they express an alternative world-view, not scientific ignorance. Second, staying within species borders by strengthening endogenous traits reduces the risks and scientific uncertainty. Third, we should show respect for nature as a complex system of laws and interconnections that we cannot fully control. The main moral reason for intragenic modification, in our view, is the need to respect the “otherness” of nature. (shrink)

Jürgen Habermas has argued that religious views form a legitimate background for contributions to an open public debate, and that religion plays a particular role in formulating moral intuitions. Translating religious arguments into “generally accessible language” (Habermas, Eur J Philos 14(1):1–25, 2006) to enable them to play a role in political decisions is a common task for religious and non-religious citizens. The article discusses Habermas’ view, questioning the particular role of religion, but accepting the significance of including such counter-voices to (...) the predominant views. Furthermore it is pointed out that not only religious but also numerous secular views stand in need of translation to be able to bear on policy matters. Accepting Habermas’ general framework, I raise the question whether experts (such as clinicians working in relevant specialised areas of care) participating in political debates on biomedical issues have a duty to state their religious worldview, and to what extent the American government decision to restrict embryo stem cell research is an illegitimate transgression of the State-Church divide. (shrink)

This paper offers a moral history of the industrialisation of seaweed harvesting in Norway. Industrialisation is often seen as degrading natural resources. Ironically, we argue, it is precisely the scale and scope of industrial utilisation that may enable non-instrumental valuations of natural resources. We use the history of the Norwegian seaweed industry to make this point. Seaweed became increasingly interesting to harvest as a fruit and then as a crop of the sea in the early twentieth century following biochemical applications (...) for alginates derived from seaweed. When harvesting was mechanised, however, attention turned to the environmental and aesthetic value of kelp forests. Further, the sale of the industry to the American FMC corporation flagged the national value of these plants. In sum epistemic, aesthetic and moral appreciations of natural resources are tangled up and co-evolve with their industrial utilisation, in an ecology of values. Our account uses interview and ethnographic material from key sites in Norway. (shrink)

Nanoparticles have multifaceted advantages in drug administration as vaccine delivery and hence hold promises for improving protection of farmed fish against diseases caused by pathogens. However, there are concerns that the benefits associated with distribution of nanoparticles may also be accompanied with risks to the environment and health. The complexity of the natural and social systems involved implies that the information acquired in quantified risk assessments may be inadequate for evidence-based decisions. One controversial strategy for dealing with this kind of (...) uncertainty is the precautionary principle. A few years ago, an UNESCO expert group suggested a new approach for implementation of the principle. Here we compare the UNESCO principle with earlier versions and explore the advantages and disadvantages by employing the UNESCO version to the use of PLGA nanoparticles for delivery of vaccines in aquaculture. Finally, we discuss whether a combined scientific and ethical analysis that involves the concept of responsibility will enable approaches that can provide a supplement to the precautionary principle as basis for decision-making in areas of scientific uncertainty, such as the application of nanoparticles in the vaccination of farmed fish. (shrink)

Big data and artificial intelligence (“AI”) promise to transform virtually all aspects of biomedical research and health care (Matheny et al. 2019), through facilitation of drug development, diagno...

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption: early fetuses can elicit feelings of joy, love, indifference, or distress. If we start with the assumption that our attitudes toward fetuses reflect a real difference in their moral status, then we need an account of fetal moral status that can explain that difference. (...) I argue that we can have or lack relational obligations to early fetuses in light of our own activities or choices, independent of the fetus’s own features or properties. Those relational obligations make the early fetus morally considerable to the persons who stand in a moral relation to it. Pregnant persons (and other participants in the procreative process) can come to have relational obligations to an early fetus just in virtue of their own decision to create a person, either by intentionally getting pregnant or by deciding to continue a pregnancy. That decision not only makes it appropriate for them to care about the fetus, but it also generates obligations to the fetus that they didn’t have before that decision. (shrink)

Julie K. Ward examines Aristotle's thought regarding how language informs our views of what is real. First she places Aristotle's theory in its historical and philosophical contexts in relation to Plato and Speusippus. Ward then explores Aristotle's theory of language as it is deployed in several works, including Ethics, Topics, Physics, and Metaphysics, so as to consider its relation to dialectical practice and scientific explanation as Aristotle conceived it.

Die Beiträge dieses Buches untersuchen die Vielfalt der Herangehensweisen an die diversen Erscheinungsformen von Sprache, an das Wort und die Wortsemantik sowie an den Gebrauch von Sprache. Der Band enthält Arbeiten, die linguistische Fragestellungen zu sprachsystematischen Aspekten der Wort-, Satz-, Text- und Diskursebene behandeln sowie Perspektiven eröffnen, um diverse Aspekte von Sprache in einem über diese Domänen hinausgehenden Rahmen zu betrachten. Die Beiträger diskutieren Fragen der lexikalischen Semantik, Pragmalinguistik, Morphologie und der Lexikographie. Das Buch setzt seine Schwerpunkte neben der Wortsemantik (...) auf die Eingebundenheit lexikalischer Bedeutungen in registerspezifische Diskursmuster, öffentliche, interpersonelle und geschäftlich-beruflich orientierte Diskurse. (shrink)

A population policy, that assures the negative freedom of the individuals who are not forced to proceed on abortion, their well-being and their positive freedom of escaping from preventable mortality, of avoiding mortality during infancy and childhood, of being free from hunger and undernutrition, is possible in developing countries, if the developed states should realize that they overconsume and that they use nature as their own resource, at the expense of the rest of the world.By avoiding rich nations' overconsumption and (...) injustice towards the poor ones we are moving towards a restraint on resource depletion, environmental degradation, poverty and population explosion, on the destruction of a sustainable life in general. (shrink)

If a benevolent and all-powerful God exists, how can there be so much suffering? Could God have created a better world? Or is evil the price we pay for freedom of the will?

Dominant food systems, based on industrial methods and corporate control, are in a state of flux. To enable the transition towards more sustainable and just food systems, food movements are claiming new roles in governance. These movements, and the initiatives they spearhead, are associated with a range of labels (e.g., food sovereignty, food justice, and community food security) and use a variety of strategies to enact change. In this paper, we use the concept of relational fields to conduct a post-hoc (...) analysis of nine cases, examining how social movement organizations and other actors actively create new deliberative governance spaces. We argue that successes are related to the “power to convene,” a process-oriented approach that increases movements’ capacity to mobilize; leverage different types of power; and integrate, coordinate, and build a systems-oriented vision. The power to convene and create deliberative spaces is demonstrated in a variety of contexts and often results in outcomes that further movement aims, including policy change and repositioning food movement actors vis-à-vis others in the field. Our findings suggest that success is not only measured as policy outcomes, but as an advantageous repositioning of social movement actors that enables them to be part of governance processes beyond simple policy advocacy. (shrink)

Pediatric palliative care is specialized medical care for children who live with serious and life-limiting illnesses, with the central goal to improve quality of life for both children and their families. Presently, a majority of pediatric palliative care referrals are based on the traditional consultative model, in which primary providers serve as the gatekeepers to palliative care access. It is well-known that racial and ethnic healthcare disparities exist across the continuum of care, fraught with healthcare providers’ biases that impact the (...) care delivered. This includes the referral practices, allocation and utilization of palliative care services, and leaving vulnerable children and families with potentially unmet palliative care needs. We make the moral argument that the establishment of standard referral criteria for pediatric palliative care services is one simple step that must be taken to begin to address and hopefully ameliorate the impact of providers’ biases and disparities that exist within pediatric palliative care. (shrink)

Bad jokes are not simply non-humorous texts. They are texts that are humorous for someone––their author at least––but not for their audience. Bad jokes thus involve a contextual––pragmatic––dimension that is neglected in the semantic theories of humor. In this paper, we propose an approach to humor based on the Aristotelian notion of surprising enthymemes. Jokes are analyzed as kinds of arguments, whose tacit dimension can be retrieved and justified by considering the “logic” on which it is based. However, jokes are (...) based on specific pragmatic conditions: they are regarded as arguments grounded on a generalization that is at the same time uncommon, retrievable, and acceptable or plausible for the audience. This perspective integrates the “local logic” of jokes within a broader rhetorical theory that ultimately rests on the communicative notion of common ground. (shrink)

Do we need justification in order to know God exists? Must we infer God exists, if we are to know that he is there? How might religious experience ground belief in God?

Ibn al-'Arabī (d. 1240) was one of the towering figures of Islamic intellectual history, and among Sufis still bears the title of al-shaykh al-akbar, or "the greatest master." Ibn al-'Arabī and Islamic Intellectual Culturetraces the history of the concept of "oneness of being" (wahdat al-wujūd) in the school of Ibn al- 'Arabī, in order to explore the relationship between mysticism and philosophy in Islamic intellectual life. It examines how the conceptual language used by early mystical writers became increasingly engaged over (...) time with the broader Islamic intellectual culture, eventually becoming integrated with the latter's common philosophical and theological vocabulary. It focuses on four successive generations of thinkers (Sadr al-Dīn al-Qūnawī, Mu'ayyad al-Dīn al-Jandī, 'Abd al-Razzāq al-Kāshānī, and Dāwūd al-Qaysarī), and examines how these "philosopher-mystics" refined and developed the ideas of Ibn al-'Arabī. Through a close analysis of texts, the book clearly traces the crystallization of an influential school of thought in Islamic history and its place in the broader intellectual culture. Offering an exploration of the development of Sufi expression and thought, this book will be a valuable resource for students and scholars of Islamic thought, philosophy, and mysticism. (shrink)