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)

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)

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)

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)

This article presents and evaluates arguments supporting that an approval procedure for genome-edited organisms for food or feed should include a broad assessment of societal, ethical and environmental concerns; so-called non-safety assessment. The core of analysis is the requirement of the Norwegian Gene Technology Act that the sustainability, ethical and societal impacts of a genetically modified organism should be assessed prior to regulatory approval of the novel products. The article gives an overview how this requirement has been implemented in the (...) regulatory practice, demonstrating that such assessment is feasible and justified. Even in situations where genome-edited organisms are considered comparable to non-modified organisms in terms of risk, the technology may have—in addition to social benefits—negative impacts that warrant assessments of the kind required in the Act. The main reason is the disruptive character of the genome editing technologies due to their potential for novel, ground-breaking solutions in agriculture and aquaculture combined with the economic framework shaped by the patent system. Food is fundamental for a good life, biologically and culturally, which warrants stricter assessment procedures than what is required for other industries, at least in countries like Norway with a strong tradition for national control over agricultural markets and breeding programs. (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”: Lay people who are educated into quasi-experts on a particular issue or technology; Lay people who turn themselves into experts in order to challenge scientific experts; Lay people with particular knowledge (...) based on tradition and experience; 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 a world where issues of food safety and food security are increasingly important, the social responsibility of central actors in the food chain—producers and the main grocery chains—becomes more pressing. As a response, these actors move from implicitly assuming social responsibilities implied in laws, regulations and ethical customs, towards explicitly expressing social responsibilities. In this paper, we discuss the ethical values relevant for the social responsibility of central food producers and retailers in Norway, one of the most subsidized and (...) protected areas of food production in the world. How do the actors perceive and express their social responsibility, and—given their position in the local, national and global market—how should they handle these responsibilities? We analyze Tine and Nortura, two producers owned by farmer cooperatives with market regulator function, as well as Coop—a dominant grocery chain in Norway, with basis in the same public ownership model as the farmer-owned cooperative producers. While the complex roles of these key actors in the Norwegian food market have been criticized from several angles, we argue that these multifaceted roles put them in a good position to promote informed consumer choices in a globalized market. (shrink)

Den dominerende oppfatningen i den politiske og moralfilosofiske tenkningen de siste tiår har vært at religion ikke bør spille noen avgjørende politisk rolle i det moderne sekulariserte demokrati. Religion tilhører privatsfæren, og politiske avgjørelser må fattes på et felles grunnlag, uavhengig av livssyn. De mest sentrale tenkerne i vår tids politiske filosofi, John Rawls og Jürgen Habermas, har begge i tidlige arbeider gitt uttrykk for at dette er en oppfatning som vil få en allmenn, global tilslutning, for de ser modernisering (...) og sekularisering som to sider av samme sak. Det er nærmest to uunngåelige fenomen ettersom globalisering og modernisering vil føre til svekkelse av tradisjonelle kulturer og utbredelse av individualisme og demokratiske idealer. Bakgrunnen for dette temanummeret er at en rekke erfaringer fra de siste tiår har ledet til en gjenåpning av spørsmålet om religionens plass i sekulariserte samfunn. (shrink)

Velkommen til Etikk i praksis – Nordic Journal of Applied Ethics. Gjennom dette tidsskriftet ønsker vi å bidra til bedre kontakt mellom forskere innenfor anvendt etikk i Norden. Det finnes et økende antall forskere som arbeider med anvendte etiske problemstillinger, og anvendt etikk har blitt et tverrfaglig forskningsfelt i alle nordiske land. Etikk i praksis har som mål å gjøre den anvendte etikken i Norden sterkere og synligere.

Mat er så mangt, som David Kaplan påpeker i innledningen til The Philosophy of Food, blant annet næring, natur, kultur, et sosialt gode, åndelighet, begjærsgjenstand og estetisk objekt. Ikke minst er det et politisk tema på så mange måter. Derfor inviterte vi til et temanummer om matens etikk, for det er lite som berører våre liv så sterkt og fundamentalt som mat. Det er et område som til alle tider har hatt tydelige etiske regler, både hva man kan og ikke (...) kan spise, men også hvordan man skal behandle mat. I Første Mosebok står det: «Med svette i ansiktet skal du spise ditt brød». Vi gjør oss fortjent til å spise gjennom vårt arbeid. Til det er det også knyttet sterke tradisjoner rundt det å dele mat, takke for den, behandle den med respekt og ikke la noe gå til spille. Dette er tradisjoner som står stadig svakere ettersom vår kontakt med opphavet til mat i jordbruk, jakt og fiske blir svekket. Vi står ikke lenger i et direkte og intimt forhold til maten i vår del av verden, og det får betydning for matens etikk. (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)

I dette nummeret av Etikk i praksis ønsker vi å fokusere på et betent problemområde, nemlig etikken rundt teknologisk fravalg og tilvalg av fremtidige syke og funksjonshemmede barn. Det handler om abort, medisinsk teknologi og valg av barn. Det kan synes som om vi står overfor nye muligheter for fravalg og tilvalg som ikke bare setter en ny debatt, men som samtidig krever en tilbakevending og nyåpning av tidligere gjennomdiskuterte spørsmål og tema. Debattene rundt «valg av barn» berører dype, eksistensielle (...) dimensjoner ved menneskelivet. I tillegg berører det store samfunnsmessige temaer som inklusjon og menneskeverd, selvbestemmelse, abort, eugenikk og samfunnets forståelse av funksjonshemming. (shrink)

Idrettens etiske spørsmål oppleves særdeles engasjerende for svært mange mennesker. Enten man er topp- eller breddeidrettsutøver, TV-titter, foreldre til idrettsaktive barn eller man har en idrettsbarndom bak seg – hvilket til sammen utgjør en stor del av befolkningen – så oppleves idrettens etiske utfordringer så å si på kroppen. Juks og urettferdighet i idretten setter følelsene i kok.

BackgroundThe public’s attitudes to conscientious objection are likely to influence political decisions about CO and trust towards healthcare systems and providers. Few studies examine the pub...

Moderne samfunn synes mer sårbare enn vi synes å like og ta inn over oss. Flere tenkere som Ulrich Beck og Anthony Giddens har påpekt sammenhengen mellom teknologi, kompleksitet og risiko som et særtrekk ved det moderne samfunnet. De teknologier som bidrar til vår velstand og trygghet, er samtidig opphav til nye former for risiko. Vi utsettes dermed for risikoformer som er skapt av en utvikling vi alle har medansvar for, og som ingen enkeltpersoner eller grupper alene kan bære ansvaret (...) for. Det førmoderne livet var farefullt, og samfunnet ble utsatt for alvorlige kriser, men det var en type krise man i mindre grad kunne kalle menneskeskapt og som vi derfor ikke behøvde å laste oss selv og andre for. Noen av de mest alvorlige av vår tids kriser, derimot, er knyttet til våre egne, kollektive handlinger, og det stiller oss overfor spesifikt moderne etiske og politiske utfordringer. (shrink)

Dette nummeret av Etikk i praksis fokuserer på et av de største, om ikke det største, satsningsområdet vi har sett innenfor forskningsverdenen. Det handler om nanoteknologi, et felt som forventes å få betydelige positive samfunnsmessige konsekvenser i form av industriutvikling og forbedrede produkter for befolkningen. Nanoteknologien er et omfattende og uoversiktlig fagfelt, der det viktigste felles kjennetegnet er at en opererer med strukturer som er 100 nanometer eller mindre. Materialer i denne størrelsesorden har endrete egenskaper som innebærer en rekke nye (...) anvendelsesmuligheter innen medisin, elektronikk, fysikk og energiproduksjon. Artiklene i temadelen omhandler utfordringer og muligheter for utvikling av en etikk-komponent innenfor dette satsningsområdet. Når vi ser på hvor tidlig vi er i utvikling av nanoetikk som fagfelt, kan man spørre om det er for tidlig å ha et temanummer i et nordisk tidsskrift. Tross alt trenger en tid for å kunne si noe forskningsmessig interessant om et fagområde. Samtidig er det første internasjonale tidsskriftet for nanoetikk over ett år gammelt, og de nordiske land er generelt langt framme i teknologiutvikling, så det skulle være god grunn til å presentere feltet. I tillegg er de senere års studier av teknologiutvikling som en etisk og samfunnsmessig størrelse i økende grad opptatt av å være i forkant av utviklingen, og da er det rimelig å formidle tidlige resultat av denne oppstrømsforskningen. (shrink)

This article criticizes recent suggestions that the current ELSI research field should accommodate a new direction towards a ‘post-ELSI’ agenda. Post-ELSI research seeks to avoid the modernist division of responsibility for technical and social issues said to characterize ELSI research. Collaboration and integration are consequently the key terms of post-ELSI strategies that are to distinguish it from ELSI strategies. We argue that this call for a new direction relies on an inadequate generalized analysis of ELSI research as modern that will (...) affect the construal of post-ELSI strategies. We are concerned that the call for post-ELSI shift will exclude imaginative proposals and intellectual freedom by narrowing down the scope and methodologies of ELSI and thereby missing opportunities to play a critical and constructive normative role. Instead of framing current trends in ELSI research as a radical and progressive shift from ELSI to post-ELSI, we suggest an alternative story of expansion and diversification described in terms of a drift from ELSA 1 to ELSA 2, pertaining to acronyms in use in Europe. ELSI research has never been modern. It has been experimenting from the very start on ways to mesh the works of humanist, social and natural scientist in order to bridge and build alignments of emerging scientific and societal goals and matters of concern. The development from ELSA 1 to ELSA 2 expands in our account the range of intellectual and methodological capacities of analysis and engagement of complex and dynamic science-society relationships. We present three areas of ELSA expertise to illustrate that the expertise within the field builds on scholarly achievements within the humanities, social sciences as well as the natural sciences. The plurality of disciplinary background of ELSA researchers represents a valuable diversity that enables mutual criticism and formulations of complementary approaches that together constitute a viable ELSA field. (shrink)

Dette nummeret av Etikk i praksis er i utgangspunktet ikke et temanummer. Profesjonsetiske utfordringer synes likevel å utgjøre et gjennomgangstema i de fleste av artiklene som utgis i dette nummeret. Det er en påminnelse om at en aldri blir ferdig med etiske problemstillinger innenfor et fagfelt, siden fagfeltene og profesjonelle oppgaver samt forventninger til profesjonen forandres hele tiden.

WHO IS THE LIBERATOR? IDEALISM AND REALISM - PERSPECTIVES ON PLATO'S ALLEGORY OF THE CAVE IN LØGSTRUP AND HEIDEGGERWhen Danish theologian and philosopher K E. Løgstrup followed Heidegger’s lectures On theEssence of Truth in 1933-34, he encountered an interpretation of Plato’s Allegory of the Cave that influenced his view on the dangers of idealism, thus shaping what became a central theme in his works, the importance of realism and to focus on what is concrete. This article explores two main areas: (...) Løgstrup’s concept of understanding and its relation to disclosure and revelation, and Heidegger’s interpretation of Plato’s Allegory of the Cave – as found in Løgstrup’s own notes in his posthumous manuscripts – and this interpretation’s link to Nazism. To Løgstrup, philosophy and theology must concern itself with life inside the cave, the reality of our human existence, because doctrines concerning life outside the cave lead to the dangers of idealism. (shrink)

Da dette tidsskriftet ble etablert for seks år siden, var det ut fra tanken om at det finnes noen felles problemstillinger innen etikk og politikk som får en spesiell karakter i nordiske land. Den velferdsmodellen vi har utviklet innenfor rammene av et deltakende demokrati, gir vilkår for debatten som vi ikke deler fullt ut med de fleste andre demokrati i verden. Mange av de artiklene vi har trykket i disse årene, har vist betydningen av denne nordiske konteksten. Det gjelder også (...) noen av bidragene i dette nummeret. (shrink)

We prove that superhigh sets can be jump traceable, answering a question of Cole and Simpson. On the other hand, we show that such sets cannot be weakly 2-random. We also study the class $superhigh^\diamond$ and show that it contains some, but not all, of the noncomputable K-trivial sets.

Dieser Beitrag bietet eine umfassende Diskussion des Textes “Humanismus und Christentum” des dänischen Philosophen und Theologen Knud E. Løgstrup. Er verortet den Text in seinem geistesgeschichtlichen Kontext und analysiert seine wichtigsten Argumente wie auch seine zentrale These, der zufolge Humanismus und Christentum einen entscheidenden Grundsatz teilen, insofern beide die Ethik als “stumm“ oder “unausgesprochen“ verstehen. Darüber hinaus wird dargelegt, wie Løgstrups Text zentrale Überlegungen in dessen späteren Publikationen, besonders in dem Hauptwerk Die ethische Forderung, vorwegnimmt.

Medicalization is frequently defined as a process by which some non-medical aspects of human life become to be considered as medical problems. Overdiagnosis, on the other hand, is most often defined as diagnosing a biomedical condition that in the absence of testing would not cause symptoms or death in the person’s lifetime. Medicalization and overdiagnosis are related concepts as both expand the extension of the concept of disease. They are both often used normatively to critique unwarranted or contested expansion of (...) medicine and to address health services that are considered to be unnecessary, futile, or even harmful. However, there are important differences between the concepts, as not all cases of overdiagnosis are medicalizations and not all cases of medicalizations are overdiagnosis. The objective of this article is to clarify the differences between medicalization and overdiagnosis. It will demonstrate how the subject matter of medicalization traditionally has been non-medical phenomena, while the subject matter of overdiagnosis has been biological or biomolecular conditions or processes acknowledged being potentially harmful. They also refer to different types of uncertainty: medicalization is concerned with indeterminacy, while overdiagnosis is concerned with lack of prognostic knowledge. Medicalization is dealing with sickness while overdiagnosis with disease. Despite these differences, medicalization and overdiagnosis are becoming more alike. Medicalization is expanding, encompassing the more “technical” aspects of overdiagnosis, while overdiagnosis is becoming more ideologized. Moreover, with new trends in modern medicine, such as P4 medicine, medicalization will become all-encompassing, while overdiagnosis more or less may dissolve. In the end they may converge in some total “iatrogenization.” In doing so, the concepts may lose their precision and critical sting. (shrink)

We demonstrate how to validly quantify into hyperintensional contexts involving non-propositional attitudes like seeking, solving, calculating, worshipping, and wanting to become. We describe and apply a typed extensional logic of hyperintensions that preserves compositionality of meaning, referential transparency and substitutivity of identicals also in hyperintensional attitude contexts. We specify and prove rules for quantifying into hyperintensional contexts. These rules presuppose a rigorous method for substituting variables into hyperintensional contexts, and the method will be described. We prove the following. First, it (...) is always valid to quantify into hyperintensional attitude contexts and over hyperintensional entities. Second, factive empirical attitudes validate, furthermore, quantifying over intensions and extensions, and so do non-factive attitudes, both empirical and non-empirical , provided the entity to be quantified over exists. We focus mainly on mathematical attitudes, because they are uncontroversially hyperintensional. (shrink)

In this article we discuss what we call the deliberative division of epistemic labor. We present evidence that the human tendency to engage in motivated reasoning in defense of our beliefs can facilitate the occurrence of divisions of epistemic labor in deliberations among people who disagree. We further present evidence that these divisions of epistemic labor tend to promote beliefs that are better supported by the evidence. We show that promotion of these epistemic benefits stands in tension with what extant (...) theories in epistemology take rationality to require in cases of disagreement. We argue that the epistemic benefits that result from the deliberative division of epistemic labor can provide epistemic reason to maintain confidence in cases of disagreement. We then show that the deliberative division of epistemic labor constitutes a distinct kind of epistemic dependence. (shrink)

Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease. (...) Then it investigates how definitions of disease address various challenges of overdiagnosis. The article specifically investigates recent attempts to clarify the relationship between the concepts of disease and overdiagnosis. Several shortcomings are identified and lead to a closer analysis of overdiagnosis in the diagnostic process. Contrary to recent contributions to the field, it is argued that cases of overdiagnosis are not cases of disease. They are non-verified labelling of disease. It is revealed how overdiagnosis establishes an unwarranted link between indicative phenomena, such as polyps or cell changes, and harm, and thereby generates a link to disease. One implication of this study is that we should stop attributing disease language to indicative phenomena. That is, we should stop calling it “cancer screening” when we are actually searching for polyps. Another implications is that we should strive for scientific progress in differentiating phenomena that are of negative value to us from those that are not. In overdiagnosis we diagnose something that is not disease: it is over-diagnosis. (shrink)

The degree of doxastic revision required in response to evidence of disagreement is typically thought to be a function of our beliefs about (1) our interlocutor’s familiarity with the relevant evidence and arguments, and their intellectual capacities and virtues, relative to our own, or (2) the expected probability of our interlocutor being correct, conditional on our disagreeing. While these two factors are typically used interchangeably, I show that they have an inverse correlation in cases of disagreement about politically divisive propositions. (...) This presents us with a puzzle about the epistemic impact of disagreement in these cases. The most significant disagreements on (1) are the least significant disagreements on (2), and vice versa. I show that assessing the epistemic status of an interlocutor by reference to either (1) or (2) has uncomfortable consequences in these cases. I then argue that this puzzle cannot be escaped by claiming that we usually have dispute-independent reason to reject the significance of politically charged disagreement altogether. (shrink)

The Scandinavian welfare states have public health care systems which have universal coverage and traditionally low influence of private insurance and private provision. Due to raises in costs, elaborate public control of health care, and a significant technological development in health care, priority setting came on the public agenda comparatively early in the Scandinavian countries. The development of health care priority setting has been partly homogeneous and appears to follow certain phases. This can be of broader interest as it may (...) shed light on alternative models and strategies in health care priority setting. Some general trends have been identified: from principles to procedures, from closed to open processes, and from experts to participation. Five general approaches have been recognized: The moral principles and values based approach, the moral principles and economic assessment approach, the procedural approach, the expert based practice defining approach, and the participatory practice defining approach. There are pros and cons with all of these approaches. For the time being the fifth approach appears attractive, but its lack of true participation and the lack of clear success criteria may pose significant challenges in the future. (shrink)

This paper addresses the mereological problem of the unity of structured propositions. The problem is how to make multiple parts interact such that they form a whole that is ultimately related to truth and falsity. The solution I propose is based on a Platonist variant of procedural semantics. I think of procedures as abstract entities that detail a logical path from input to output. Procedures are modeled on a function/argument logic, but are not functions. Instead they are higher-order, fine-grained structures. (...) I identify propositions with particular kinds of molecular procedures containing multiple sub-procedures as parts. Procedures are among the basic entities of my ontology, while propositions are derived entities. The core of a structured proposition is the procedure of predication, which is an instance of the procedure of functional application. The main thesis I defend is that procedurally conceived propositions are their own unifiers detailing how their parts interact so as to form a unit. They are not unified by one of their constituents, e.g., a relation or a sub-procedure, on pain of regress. The relevant procedural semantics is Transparent Intensional Logic, a hyperintensional, typed λ-calculus, whose λ-terms express four different kinds of procedures. While demonstrating how the theory works, I place my solution in a wider historical and systematic context. (shrink)

Theories of structured meanings are designed to generate fine-grained meanings, but they are also liable to overgenerate structures, thus drawing structural distinctions without a semantic difference. I recommend the proliferation of very fine-grained structures, so that we are able to draw any semantic distinctions we think we might need. But, in order to contain overgeneration, I argue we should insert some degree of individuation between logical equivalence and structural identity based on structural isomorphism. The idea amounts to forming an equivalence (...) class of different structures according to one or more formal criteria and designating a privileged element as a representative of all the elements, i.e., a first among equals. The proposed method helps us to a cluster of notions of co-hyperintensionality. As a test case, I consider a recent objection levelled against the act theory of structured propositions. I also respond to an objection against my methodology. (shrink)

Fairness, the notion that people deserve or have rights to certain resources or kinds of treatment, is a fundamental dimension of moral cognition. Drawing on recent evidence from economics, psychology, and neuroscience, we ask whether self-interest is always intuitive, requiring self-control to override with reasoning-based fairness concerns, or whether fairness itself can be intuitive. While we find strong support for rejecting the notion that self-interest is always intuitive, the literature has reached conflicting conclusions about the neurocognitive systems underpinning fairness. We (...) propose that this disagreement can largely be resolved in light of an extended Social Heuristics Hypothesis. Divergent findings may be attributed to the interpretation of behavioral effects of ego depletion or neurostimulation, reverse inference from brain activity to the underlying psychological process, and insensitivity to social context and inter-individual differences. To better dissect the neurobiological basis of fairness, we outline how future research should embrace cross-disciplinary methods that combine psychological manipulations with neuroimaging, and that can probe inter-individual, and cultural heterogeneities. (shrink)

New emerging biotechnologies, such as gene editing, vastly extend our ability to alter the human being. This comes together with strong aspirations to improve humans not only physically, but also mentally, morally, and socially. These conjoined ambitions aggregate to what can be labelled “the gene editing of super-ego.” This article investigates a general way used to argue for new biotechnologies, such as gene-editing: if it is safe and efficacious to implement technology X for the purpose of a common good Y, (...) why should we not do so? This is a rhetorical question with a conditional, and may be dismissed as such. Moreover, investigating the question transformed into a formal argument reveals that the argument does not hold either. Nonetheless, the compelling force of the question calls for closer scrutiny, revealing that this way of arguing for biotechnology is based on five assumptions. Analysis of these assumptions shows their significant axiological, empirical, and philosophical challenges. This makes it reasonable to claim that these kinds of question based promotions of specific biotechnologies fail. Hence, the aspirations to make a super-man with a super-ego appear fundamentally flawed. As these types of moral bioenhancement arguments become more prevalent, a revealing hype test is suggested: What is special with this technology, compared to existing methods, that makes it successful in improving human social characteristics in order to make the world a better place for all? Valid answers to this question will provide good reasons to pursue such technologies. Hence, the aim is not to bar the development of modern biotechnology, but rather to ensure good developments and applications of highly potent technologies. So far, we still have a long way to go to make persons with goodness gene. (shrink)

There is a tendency in the business ethics literature to think of ethics in restrictive terms: what one should not do, and how to control this. Drawing on Lawrence Kohlberg''s theory of moral development, the paper focuses on, and draws attention to, another more positive aspect of ethics: the capacity of ethics to inspire and empower individuals, as well as groups. To understand and facilitate such empowerment, it is argued that it is necessary to move beyond Kohlberg''s justice reasoning so (...) as to appreciate the value and importance of feeling and care. Accordingly, we draw upon case study material to review the meaning of Kohlberg''s higher stages — 5, 6 and 7 — to question the meaning of ethical reasoning. With such deeper understanding of particular ethical codes or practices, it is thought that members of organisations may come closer to thespirit, as opposed to the letter, of ethical conduct in organisations. This, we argue, is consistent with the degree of trust and integrity demanded by leaner, post-bureaucratic ways of organizing and conducting business as well as being personally beneficial to the people involved. (shrink)

Helsevesenet har blitt en sentral samfunnsaktør og medisinen dets førende fag. Hvorfor har det blitt slik? En grunn er at medisinen fører sammen sfærer som ellers har vært adskilt: det sanne, det gode og det skjønne. Medisinen som fag og helsevesenet som institusjon, har blitt et fascinerende skjæringspunkt nettopp mellom evidens, etikk og estetikk. Her kobles kunnskap til det som er vondt og skjønnhet til det som er friskt. Kunnskapsproduksjonen dirigeres ut fra ønsket om å gjøre det gode ved å (...) unngå det vonde. Samtidig styres helsevesenets normer også av estetikkens normer. Koblingene mellom evidens, estetikk og etikk gir noen grunnleggende utfordringer, som det er viktig å være oppmerksom på. Riktig håndtert gjør de helsevesenet generelt og medisinen spesielt til et fascinerende og fruktbart skjæringspunkt mellom det sanne, det gode og det skjønne. Nøkkelord: Evidens, etikk, estetikk, sannhete, godhet, skjønnhet English Title: Evidence, ethics and aesthetics: Medicine at the intersection of the true, the good and the beautiful: While Western history of ideas has tried to differentiate truth, goodness, and beauty, medicine is a fascinating meeting place precisely between evidence, ethics, and aesthetics. In medicine, knowledge is connected to pain and suffering and beauty to health. The production of knowledge is directed towards doing good by avoiding bad. At the same time, medicine is also governed by aesthetics. A range of challenges follow from the connection between the three spheres, but if we are attentive to the interconnectedness medicine becomes a fascinating and fruitful rendezvous of truth, goodness, and beauty. Keywords: Evidence, ethics, aesthetics, truth, goodness, beauty. (shrink)

Logical semantics includes once again structured meanings in its repertoire. The leading idea is that semantic and syntactic structure are more or less isomorphic. A key motive for reintroducing sensitivity to semantic structure is to obtain fine‐grained meanings, which are individuated more finely than in possible‐world semantics, namely up to necessary equivalence. Just getting the truth‐conditions right is deemed insufficient for a full semantic analysis of sentences. This paper surveys some of the most recent contributions to the program of structured (...) meaning, while providing historical background. I suggest that to make substantial advances the program needs to solve the problem of propositional unity and develop an intensional mereology of abstract objects. (shrink)

Aim of the paper is to present a new logic of technical malfunction. The need for this logic is motivated by a simple-sounding philosophical question: Is a malfunctioning corkscrew, which fails to uncork bottles, nonetheless a corkscrew? Or in general terms, is a malfunctioning F, which fails to do what Fs do, nonetheless an F? We argue that ‘malfunctioning’ denotes the modifier Malfunctioning rather than a property, and that the answer depends on whether Malfunctioning is subsective or privative. If subsective, (...) a malfunctioning F is an F; if privative, a malfunctioning F is not an F. An intensional logic is required to raise and answer the question, because modifiers operate directly on properties and not on sets or individuals. This new logic provides the formal tools to reason about technical malfunction by means of a logical analysis of the sentence “a is a malfunctioning F”. (shrink)