The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress (...) of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff. (shrink)

Since the 1970s, estrogen have sometimes been used in adolescent girls to reduce very tall adult expected height. Worries about long-term effects have led to a proposal to link treatment data with cancer registers. How should one deal with informed consent for such a study? We designed a qualitative study with semi-structured telephone interviews. From 1200 women who were to be followed-up in cancer registers, we randomly selected 22 women. Major themes were a wish to be involved and a positive (...) attitude to the proposed register research. The women did not express worry after reading the study protocol, but did convey considerable frustration that this research had not been initiated earlier. Active consent was not seen as crucial. We found strong interest in a high participation rate and a concern over missing data. The selection of information and consent or the decision to go ahead without consent in register follow-up is a delicate balancing act. Study participants wish to be contacted, but acknowledge the primary goal of answering important questions. Our study provides support for safeguarding privacy in epidemiological linkage studies and in follow-up of medical treatment without losing the scientific value by requesting for informed consent. (shrink)

Queen Christina of Sweden was unconventional in her time, leading to hypotheses on her gender and possible hermaphroditic nature. If genetic analysis can substantiate the latter claim, could this bring the queen into disrepute 300 years after her death? Joan C. Callahan has argued that if a reputation changes, this constitutes a change only in the group of people changing their views and not in the person whose reputation it is. Is this so? This paper analyses what constitutes change and (...) draws out the implications to the reputation of the dead. It is argued that a reputation is a relational property which can go through changes. The change is “real” for the group changing their views on Queen Christina and of a Cambridge kind for the long dead queen herself. Cambridge changes result in new properties being acquired, some of which can be of significance. (shrink)

With the advanced methods of analysing old biological material, it is pressing to discuss what should be allowed to be done with human remains, particularly for well documented historical individuals. We argue that Queen Christina of Sweden, who challenged the traditional gender roles, has an interest in maintaining her privacy when there are continued attempts to reveal her ‘true’ gender. In the long-running philosophical debate on posthumous wronging, the fundamental question is: Who is wronged? Our aim is to find this (...) ‘missing subject’ using narrative theory.Narrative identity emphasises the fact that no person is alone in knowing or telling their life story. People’s lives are entangled and parts of the life story of a deceased person can remain in the living realm. Since the narrative identity of a person does not necessarily end upon their death, and this narrative continues to relate directly to the person who once existed, it is the narrative subject that can continue to be posthumously wronged. Queen Christina can no longer maintain her own identity, but we maintain it by our research into her life. We propose three duties relevant for posthumous wronging: the duty of truthfulness, the duty of recognition and the duty to respect privacy. (shrink)

Multiple contraction (simultaneous contraction by several sentences) and iterated contraction are investigated in the framework of specified meet contraction (s.m.c.) that is extended for this purpose. Multiple contraction is axiomatized, and so is finitely multiple contraction (contraction by a finite set of sentences). Two ways to reduce finitely multiple contraction to contraction by single sentences are introduced. The reduced operations are axiomatically characterized and their properties are investigated. Furthermore, it is shown how iterated contraction can be reduced to single-step, single-sentence (...) contraction. However, in this framework the outcome of iterated contraction depends unavoidably on the order in which the inputs are received. This order-dependence makes it impossible to treat two inputs on an equal footing. Therefore it is often preferable to perform changes involving several pieces of information as multiple rather than iterated change. (shrink)

In the debate about human bio-sampling the interests of patients and other sample donors are believed to stand against the interests of scientists and of their freedom of research. Scientists want efficient access to and use of human biological samples. Patients and other donors of blood or tissue materials want protection of their integrity. This dichotomy is reflected in the Swedish law on biobanks, which came into effect 1 January 2003. In this article I argue that if the basic interest (...) of scientists using human biological samples is in increasing knowledge and developing better treatments, and if the concept ‘integrity’ is properly understood, then sample donors should also be interested in promotion of efficiency as well as in the protection of their integrity. The basic premise of this argument is that donors of samples have interests related to the donation and use of samples as well as to the use of the results of the research, that is, new medical products and treatments. They have a role both as donors or participants in research and as end users of the research. I conclude that if access to information acquired through biobank research is strictly limited to researchers, the information is protected by secrecy safeguards through coding and the procedures governing the research are open to public and democratic control, then most research using human biobanks may be carried out on the basis of making general information available when collecting biological samples, without further contact with participants. (shrink)

Theoria , the international Swedish philosophy journal, was founded in 1935. Its contributors in the first 75 years include the major Swedish philosophers from this period and in addition a long list of international philosophers, including A. J. Ayer, C. D. Broad, Ernst Cassirer, Hector Neri Castañeda, Arthur C. Danto, Donald Davidson, Nelson Goodman, R. M. Hare, Carl G. Hempel, Jaakko Hintikka, Saul Kripke, Henry E. Kyburg, Keith Lehrer, Isaac Levi, David Lewis, Gerald MacCallum, Richard Montague, Otto Neurath, Arthur N. (...) Prior, W. V. Quine, Nicholas Rescher, Ernest Sosa, Robert C. Stalnaker, P. F. Strawson, Patrick Suppes, Johan van Benthem, Georg Henrik von Wright and many others. Hempel's confirmation paradoxes, Ross's deontic paradox, Montague's universal grammar and Lindström's theorem are among the contributions to philosophy that were first published in Theoria. (shrink)

From an aging research and life-course perspective, the transition to retirement marks a significant life-event and provides a unique opportunity to study psychological health and coping during a period of substantial change in everyday life. The aim of the present paper is to: (a) outline the rationale of the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) study, (b) describe the study sample, and (c) to present some initial results from the two first waves regarding the association between retirement status (...) and psychological health. The HEARTS study is designed to annually study psychological health in the years before and following retirement, and to examine change and stability patterns related to the retirement event. Among a representative Swedish population-based sample of 14 990 individuals aged 60 to 66 years, 5 913 completed the baseline questionnaire in 2015. The majority of the participants (69%) completed a web-based survey, and the rest (31%) completed a paper version. The baseline HEARTS sample represents the general population well in terms of gender and age, but is more highly educated. Cross-sectional findings from the first wave showed that retired individuals demonstrated better psychological health compared to those who were still working. Longitudinal results from the first and second waves showed that individuals who retired between waves showed more positive changes in psychological health compared with those still working or previously retired. (shrink)

In the long-running debate on the interest of the dead, Joan C. Callahan argues against such interests and although Søren Holm for practical reasons is prepared to consider posthumous interests, he does not see any moral basis to support such interests. He argues that the whole question is irresolvable, yet finds privacy interests where Tutankhamen is concerned. Callahan argues that there can be reasons to hold on to the fiction that there are posthumous interests, namely if it is comforting for (...) the living and instrumental for society. Thus, despite arguing against the position that the dead have any interests or for any moral basis for such interests, these “interests” are still taken into consideration in the end. This shows the unsatisfactory basis of their positions and indicates the tenacity of the moral intuition that the dead can have moral claims on the living. One example of a posthumous interest is the interest in one’s good name. Here we argue that it is an interest of moral significance. This implies that if individuals restrict use of their sample when they are still alive, those restrictions apply after their death. Further, it implies that one should be concerned with the reputation of historic persons. Research that defeats these interests calls for justification. We have suggested two lines of thinking along which such a discussion could go: investigating the truth-value of the good name and the relevance of bringing it into possible disrepute. (shrink)

Wie werden in einzelnen Disziplinen Heureka-Effekte hervorgerufen? Wann leuchtet Wissenschaftlern in einem Fach ein Argument, ein Gedanke ein, wie werden sie davon überzeugt. Was sind die disziplinären Standards und wie sieht die Praxis im akademischen Alltag dazu aus? 15 Wissenschaftlerinnen und Wissenschaftler aus den Natur-, Geistes- und Sozialwissenschaften geben hierauf ihre Antworten in diesem Buch in einer Weise, dass alle, die das wissen wollen, sie auch verstehen.

When is it morally acceptable to expose others to risk? Most moral philosophers have had very little to say in answer to that question, but here is a moral philosopher who puts it at the centre of his investigations.

Disposition ascription has been discussed a good deal over the last few decades, as has the revisionary metaphysical view of ordinary, persisting objects known as 'fourdimensionalism'. However, philosophers have not merged these topics and asked whether four-dimensional objects can be proper subjects of dispositional predicates. This paper seeks to remedy this oversight. It argues that, by and large, four-dimensional objects are not suited to take dispositional predicates.

In the first part of this paper, I clear the ground from frequent misconceptions of the relationship between fact and value by examining some uses of the adjective “natural” in ethical controversies. Such uses bear evidence to our “natural” tendency to regard nature as the source of ethical norms. I then try to account for the origins of this tendency by offering three related explanations, the most important of which is evolutionistic: if any behaviour that favours our equilibrium with the (...) environment is potentially adaptive, nothing can be more effective for this goal than developing an attitude toward the natural world that considers it as a dispenser of sacred norms that must be invariably respected. By referring to the Aristotelian notion of human flourishing illustrated in the first part of the paper, in the second I discuss as a case study some ethical problems raised by mini-chips implantable in our bodies. I conclude by defending their potential beneficial effects of such new technological instruments. (shrink)

In order to reduce the death toll of road traffic it is necessary to focus on how vehicles and roads can be improved. Like other dangerous machines, motor vehicles should be equipped with safety devices that prevent mistakes by the operator from leading to serious consequences. Speed limiters that prevent driving at illegal speeds would save many lives, and so would alcohol interlocks. Meshi Ori's proposal that most cars should be replaced by motorcycles would not lead to the moral improvement (...) that he hopes for. We need motor vehicles with better, not worse, protection of the driver and passengers than the cars presently in use. (shrink)

Trust among current and future patients is essential for the success of biobank research. The submission of an informed consent is an act of trust by a patient or a research subject, but a strict application of the rule of informed consent may not be sensitive to the multiplicity of patient interests at stake, and could thus be detrimental to trust. According to a recently proposed law on “genetic integrity” in Sweden, third parties will be prohibited from requesting or seeking (...) genetic information about an individual. Cumbersome restrictions on research may be lifted, thus creating a more favourable climate for medical research. (shrink)

This article is an attempt at a systematic account of decision making under greater uncertainty than what traditional, mathematically oriented decision theory can cope with. Four components of great uncertainty are distinguished: (1) the identity of the options is not well determined (uncertainty of demarcation) ; (2) the consequences of at least some option are unknown (uncertainty of consequences); (3) it is not clear whether information obtained from others, such as experts, can be relied on (uncertainty of reliance); and (4) (...) the values relevant for the decision are not determined with sufficient precision (uncertainty of values). Some possible strategy types are proposed for each of these components. Decisions related to environmental issues are used to illustrate the proposals. (shrink)

Clear-cut cases of decision-making under risk (known probabilities) are unusual in real life. The gambler’s decisions at the roulette table are as close as we can get to this type of decision-making. In contrast, decision-making under uncertainty (unknown probabilities) can be exemplified by a decision whether to enter a jungle that may contain unknown dangers. Life is usually more like an expedition into an unknown jungle than a visit to the casino. Nevertheless, it is common in decision-supporting disciplines to proceed (...) as if reasonably reliable probability estimates were available for all possible outcomes, i.e. as if the prevailing epistemic conditions were analogous to those of gambling at the roulette table. This mistake can be called the tuxedo fallacy. It is argued that traditional engineering practices such as safety factors and multiple safety barriers avoid this fallacy and that they therefore manage uncertainty better than probabilistic risk analysis (PRA). PRA is a useful tool, but it must be supplemented with other methods in order not to limit the analysis to dangers that can be assigned meaningful probability estimates. (shrink)

It is almost universally acknowledged that risks have to be weighed against benefits, but there are different ways to perform the weighing. In conventional risk analysis, collectivist risk-weighing is the standard. This means that an option is accepted if the sum of all individual benefits outweighs the sum of all individual risks. In practices originating in clinical medicine, such as ethical appraisals of clinical trials, individualist risk-weighing is the standard. This implies a much stricter criterion for risk acceptance, namely that (...) the risk to which each individual is exposed should be outweighed by benefits for that same individual. The different choices of risk-weighing methods in different policy areas seem to have emerged from traditional thought patterns and social relations, rather than from explicit deliberations on possible justifications for the alternative ways to weigh risks against benefits. It is not obvious how the prevalent differences in risk-weighing practices can be reconstructed in terms of consistent underlying principles of preventive health or social priority-setting. (shrink)

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal (...) identity, and cultural effects. (shrink)

The empirical basis for this article is threeyears of experience with ethical rounds atUppsala University Hospital. Three standardapproaches of ethical reasoning are examined aspotential explanations of what actually occursduring the ethical rounds. For reasons given,these are not found to be satisfyingexplanations. An approach called ``imaginativeethics'', is suggested as a more satisfactoryaccount of this kind of ethical reasoning. Theparticipants in the ethical rounds seem to drawon a kind of moral competence based on personallife experience and professional competence andexperience. By listening to (...) other perspectivesand other experiences related to one particularpatient story, the participants imaginealternative horizons of moral experience andexplore a multitude of values related toclinical practice that might be at stake. Inhis systematic treatment of aesthetics in theCritique of Judgement, Kant made use ofan operation of thought that, if applied toethics, will enable us to be more sensitive tothe particulars of each moral situation. Basedon this reading of Kant, an account ofimaginative ethics is developed in order tobring the ethical praxis of doctors and nursesinto sharper relief. The Hebraic and theHellenic traditions of imagination are used inorder to illuminate some of the experiences ofethical rounds. In conclusion, it is arguedthat imaginative ethics and principle-basedethics should be seen as complementary in orderto endow a moral discourse with ethicalauthority. Kantian ethics will do the job if itis remembered that Kant suggested only amodest, negative role of principle-baseddeliberation. (shrink)

The archive of the Nobel Assembly for Physiology or Medicine in Solna, Sweden, is a remarkable repository that contains reports and dossiers of the Nobel Prize nominations of senior and junior physicians from around the world. Although this archive has begun to be used more by scholars, it has been insufficiently examined by historians of surgery. No other German surgeon was nominated as often as Ferdinand Sauerbruch for the Nobel Prize for Physiology or Medicine in the first half of the (...) 20th century. This contribution reconstructs why and by whom Sauerbruch was nominated, and discusses the Nobel committee evaluations of his work. Political factors did not play an obvious role in the Nobel committee discussions, in spite of the fact that Adolf Hitler in 1937 had prohibited all German citizens to accept the Nobel Prize. The main reasons why Sauerbruch ultimately was not considered prize-worthy were that Sauerbruch’s achievements were marked by scientific priority disputes, and that his work was not seen as original enough. (shrink)

The relatively new discipline of risk analysis promises to provide objective guidance in some of the most controversial issues in modern high‐technology societies. Four conditions are discussed that must be satisfied for this promise to be fulfilled. Since none of these conditions is satisfied, risk analysis does not keep its promise. In its attempts to reduce genuinely political issues to technocratic calculations, it neglects many of the factors that should influence decisions on risk acceptance. A list of tentative guidelines is (...) given for numerical decision support that encourages democratic decision‐making instead of trying to evade it. (shrink)

Healthcare depends increasingly on advanced medical technology. In addition, other forms of technology contribute to determine how our lives are influenced by disease and disability. The extent to which persons with impaired bodily functions are forced to live their lives differently than other people depends to a large part on a variety of technologies, from wheelchairs to computer interfaces, from hearing aids to garage doors. This wide-ranging influence of technology has important ethical aspects, but has seldom been discussed in bioethics, (...) the ethics of technology, or other branches of applied ethics. (shrink)

Extended antipaternalism means the use of antipaternalist arguments to defend activities that harm (consenting) others. As an example, a smoker’s right to smoke is often invoked in defence of the activities of tobacco companies. It can, however, be shown that antipaternalism in the proper sense does not imply such extended antipaternalism. We may therefore approve of Mill’s antipaternalist principle (namely, that the only reason to interfere with someone’s behaviour is to protect others from harm) without accepting activities that harm (consenting) (...) others. This has immediate consequences for the ethics of public health. An antipaternalist need not refrain from interfering with activities such as the marketing of tobacco or heroin, boxing promotion, driving with unbelted passengers, or buying sex from “voluntary” prostitutes. (shrink)

A representation theorem is obtained for contraction operators that are based on Levi's recent proposal that selection functions should be applied to the set of saturatable contractions, rather than to maximal subsets as in the AGM framework. Furthermore, it is shown that Levi's proposal to base the selection on a weakly monotonic measure of informational value guarantees the satisfaction of both of Gärdenfors' supplementary postulates for contraction. These results indicate that Levi has succeeded in constructing a well-behaved operation of contraction (...) that does not satisfy the postulate of recovery. (shrink)

The AGM theory of belief contraction is extended tomultiple contraction, i.e. to contraction by a set of sentences rather than by a single sentence. There are two major variants: Inpackage contraction all the sentences must be removed from the belief set, whereas inchoice contraction it is sufficient that at least one of them is removed. Constructions of both types of multiple contraction are offered and axiomatically characterized. Neither package nor choice contraction can in general be reduced to contractions by single (...) sentences; in the finite case choice contraction allows for reduction. (shrink)

Background:Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection.Aim:The aim of this study was to gain a deeper understanding of how the ethics rounds (...) were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff.Research design:An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews.Participants and research context:A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed.Ethical considerations:The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards.Findings:The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work.Discussion:A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care.Conclusion:By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. (shrink)

Despite Vision Zero’s moral appeal and its expansion throughout the world, it has been criticized on different grounds. This chapter is based on an extensive literature search for criticism of Vision Zero, using the bibliographic databases Philosopher’s Index, Web of Science, Science Direct, Scopus, Google Scholar, PubMed, and Phil Papers, and by following the references in the collected documents. Even if the primary emphasis was on Vision Zero in road traffic, our search also included documents criticizing Vision Zero policies in (...) other safety areas, such as public health, the construction and mining industries, and workplaces in general. Based on the findings, we identify and systematically characterize and classify the major arguments that have been put forward against Vision Zero. The most important arguments against Vision Zero can be divided into three major categories: moral arguments, arguments concerning the rationality of Vision Zero, and arguments aimed at the practical implementation of the goals. We also assess the arguments. Of the 13 identified main arguments, 6 were found to be useful for a constructive discussion on safety improvements. (shrink)

Due to modern biochemistry and, in particular, recent developments in genomics, proteomics, and bioinformatics, human samples have become the most important raw materials for advancement in the health sciences. Such material has been at the center of fundamental biomedical research for a long time. What is new is its increased usefulness in research with direct clinical relevance, such as the development of drugs. Because of the larger commercial involvement in such research, this has also led to greater economic interests in (...) human biological material and in the information that can be extracted from it. (shrink)

Many studies of bribery acknowledge the important role of bribe-givers, but their true motives remain unclear. We propose that the likelihood of bribery depends on the willingness of an organization to affiliate with local parties or to be successful in a host country, or to have power over local parties. We further argue that different opportunities, either pervasive or arbitrary, facilitate different types of motives that affect the likelihood of bribery. In addition, we investigate the effect of perceived fairness on (...) the likelihood of bribery. We employ a 3 (motives: affiliation vs. achievement vs. power) × 2 (opportunities: pervasiveness vs. arbitrariness) × 2 (perceived fairness: high vs. low) factorial design in experimental settings among Executive MBA students in southern Taiwan. Our findings indicate that, when companies perceive a higher level of distributive fairness, high-achieving organizations are more likely to offer a bribe when the condition is pervasive. When they have a powerful motive, arbitrariness engenders a higher likelihood of bribery. When they perceive less distributive fairness, there are no significant differences between motive and opportunity. (shrink)

Three of the bioethical issues recently discussed in Sweden appear to be particularly interesting also to an international audience. A new law allowing restrictive use of preimplantation genetic diagnosis /human leukocyte antigen () has been implemented, a new recommendation for the cessation of life-sustaining treatment has been issued, and the scope of individual responsibility for medical mistakes has been rather thoroughly discussed.

Sweden is probably one of the most secularized nations in the world. Therefore religious arguments tend to play a smaller role in the public bioethical debate than in most other countries. Issues such as abortion, stem-cell research, and therapeutic cloning have been far less controversial in Sweden than elsewhere. Instead, other issues have dominated recent bioethical debates in Sweden, in particular those concerning privacy and the control over biological information about individuals.

Modern belief revision theory is based to a large extent on partial meet contraction that was introduced in the seminal article by Carlos Alchourrón, Peter Gärdenfors, and David Makinson that appeared in 1985. In the same year, Alchourrón and Makinson published a significantly different approach to the same problem, called safe contraction. Since then, safe contraction has received much less attention than partial meet contraction. The present paper summarizes the current state of knowledge on safe contraction, provides some new results (...) and offers a list of unsolved problems that are in need of investigation. (shrink)

This study explores the interaction effects of game outcomes and status instability and the moderating role of implicit team identification on spectators’ status-seeking behavior. The current study seeks to contribute to the existing consumer behavior and spectatorship literature by examining the counterintuitive outcomes of winner–loser effects through the application of the biosocial theory of status. In an online experiment, NFL fans’ retrospective spectating experiences were captured and manipulated. This experiment used a 2 × 2 × 2 between-subjects design. The findings (...) indicated that decisive victories and close losses positively influenced spectators’ future attendance as well as their intention to purchase luxury suites and merchandise featuring images of the team mascot. Conversely, decisive losses and close victories had a negative influence. Additionally, the more spectators implicitly identified with a particular team, the more they exhibited status-seeking behavior; even close victories positively influenced the outcomes. By applying a nascent theoretical approach in the field of consumer behavior, our results provide fresh insight into explaining spectators’ status-seeking behavior. Also, the findings identify specific conditions in which spectators’ status-seeking behavior is enhanced, thus suggesting ways for managers to strategically allocate their resources. (shrink)

This volume presents the ethical implications of risk information as related to genetics and other health data for policy decisions at clinical, research and societal levels. Ethical, Social and Psychological Impacts of Genomic Risk Communication examines the introduction of new types of health risk information based on faster, cheaper and larger sets of genetic or genomic analysis. Synthesising the results of a five-year interdisciplinary project, it explores the unsolved ethical and social questions around the sharing of this data, such as: (...) What is best practice in risk communication? What are the normative presumptions and ethical consequences of an increased individual responsibility for ones' health? And how does one deal with the gap between the knowledge of risk and the lack of therapeutic options which often exist for complex diseases, such as dementia or some types of cancer? Drawing on contributions from over twenty experts in the field, this collection examines these questions from a liberal bioethics' perspective, advocating for contextual and cultural-sensitive ethical discussions. This book will be of great interest to students and scholars of theoretical and clinical medical ethics, medical sociology, risk communication and ethics of risk, as well as professionals in clinical genetics. (shrink)