64 found
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  1. A Normative Approach to Artificial Moral Agency.Dorna Behdadi & Christian Munthe - 2020 - Minds and Machines 30 (2):195-218.
    This paper proposes a methodological redirection of the philosophical debate on artificial moral agency in view of increasingly pressing practical needs due to technological development. This “normative approach” suggests abandoning theoretical discussions about what conditions may hold for moral agency and to what extent these may be met by artificial entities such as AI systems and robots. Instead, the debate should focus on how and to what extent such entities should be included in human practices normally assuming moral agency and (...)
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  2.  41
    Sustainability principle for the ethics of healthcare resource allocation.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2021 - Journal of Medical Ethics 47 (2):90-97.
    We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...)
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  3.  50
    (1 other version)The Price of Precaution and the Ethics of Risk.Christian Munthe - 2011 - Springer.
    Since a couple of decades, the notion of a precautionary principle plays a central and increasingly influential role in international as well as national policy and regulation regarding the environment and the use of technology. Urging society to take action in the face of potential risks of human activities in these areas, the recent focus on climate change has further sharpened the importance of this idea. However, the idea of a precautionary principle has also been problematised and criticised by scientists, (...)
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  4. Shared Decision Making, Paternalism and Patient Choice.Lars Sandman & Christian Munthe - 2010 - Health Care Analysis 18 (1):60-84.
    In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM (...)
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  5.  48
    The Ethics of Screening in Health Care and Medicine: Serving Society Or Serving the Patient?Niklas Juth & Christian Munthe - 2011 - Springer Verlag.
    This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.
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  6. Shared decision-making and patient autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (...)
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  7.  24
    ‘Green’ bioethics widens the scope of eligible values and overrides patient demand: comment on Parker.Anders Herlitz, Erik Malmqvist & Christian Munthe - 2023 - Journal of Medical Ethics 49 (2):100-101.
    Parker’s article is a welcome attempt to address the importance of environmental sustainability in the realm of clinical ethics.1 We support the recent movement to seriously consider the environmental impact of healthcare institutions in bioethics.2 3 Still, we find two partly linked weaknesses of Parker’s analysis and guideline suggestion. These relate to a need in ‘green’ bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways of framing central (...)
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  8.  45
    Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management.Robert Ranisch, Niels Nijsingh, Angela Ballantyne, Anne van Bergen, Alena Buyx, Orsolya Friedrich, Tereza Hendl, Georg Marckmann, Christian Munthe & Verina Wild - 2020 - Ethics and Information Technology 23 (3):285-294.
    There is growing interest in contact tracing apps for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. (...)
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  9.  64
    A Virtue of Precaution Regarding the Moral Status of Animals with Uncertain Sentience.Simon Knutsson & Christian Munthe - 2017 - Journal of Agricultural and Environmental Ethics 30 (2):213-224.
    We address the moral importance of fish, invertebrates such as crustaceans, snails and insects, and other animals about which there is qualified scientific uncertainty about their sentience. We argue that, on a sentientist basis, one can at least say that how such animals fare make ethically significant claims on our character. It is a requirement of a morally decent (or virtuous) person that she at least pays attention to and is cautious regarding the possibly morally relevant aspects of such animals. (...)
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  10.  49
    A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal.Christian Munthe - 2014 - Bioethics 29 (1):36-45.
    A new landscape of prenatal testing is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development (...)
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  11. Adherence, shared decision-making and patient autonomy.Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe - 2012 - Medicine, Health Care and Philosophy 15 (2):115-127.
    In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What (...)
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  12. Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research.Christian Munthe, Lars Sandman & Daniela Cutas - 2012 - Health Care Analysis 20 (3):231-249.
    This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view (...)
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  13.  45
    Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?Leila El-Alti, Lars Sandman & Christian Munthe - 2019 - Health Care Analysis 27 (1):45-59.
    In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined (...)
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  14.  15
    What High-Income States Should Do to Address Industrial Antibiotic Pollution.Erik Malmqvist & Christian Munthe - 2020 - Public Health Ethics 13 (3):275-287.
    Antibiotic resistance is widely recognized as a major threat to public health and healthcare systems worldwide. Recent research suggests that pollution from antibiotics manufacturing is an important driver of resistance development. Using Sweden as an example, this article considers how industrial antibiotic pollution might be addressed by public actors who are in a position to influence the distribution and use of antibiotics in high-income countries with publicly funded health systems. We identify a number of opportunities for these actors to incentivize (...)
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  15.  85
    The goals of public health: An integrated, multidimensional model.Christian Munthe - 2008 - Public Health Ethics 1 (1):39-52.
    While promoting population health has been the classic goal of public health practice and policy, in recent decades, new objectives in terms of autonomy and equality have been introduced. These different goals are analysed, and it is demonstrated how they may conflict severly in several ways, leaving serious unclarities both regarding the normative issue of what goal should be pursued by public health, what that implies in practical terms, and the descriptive issue of what goal that actually is pursued in (...)
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  16.  59
    The Black Hole Challenge: Precaution, Existential Risks and the Problem of Knowledge Gaps.Christian Munthe - 2019 - Ethics, Policy and Environment 22 (1):49-60.
    So-called ‘existential risks’ present virtually unlimited reasons for probing them and responses to them further. The ensuing normative pull to respond to such risks thus seems to present us with r...
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  17.  16
    Cutting red tape to manage public health threats: An ethical dilemma of expediting antibiotic drug innovation.Christian Munthe & Niels Nijsingh - 2019 - Bioethics 33 (7):785-791.
    Antibiotic resistance, arising when bacteria develop defences against antibiotics, is creating a public health threat of massive proportions. This raises challenging questions for standard notions in bioethics when suitable policy is to be characterized and justified. We examine the particular proposal of expediting innovation of new antibiotics by cutting various forms of regulatory ‘red tape’ in the standard system for the clinical introduction of new drugs. We find strong principled reasons in favour of such a lowering of the ethical standards (...)
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  18.  33
    Price of precaution of human-pig chimeras for transplantation purposes.Christian Munthe - 2019 - Journal of Medical Ethics 45 (7):447-448.
    In response to Koplin and Wilkinson, I argue, first, that the uncertain clinical prospects of human-pig chimera based transplantation makes the reason to spend resources for clarifying whether such practice might imply serious ethical breach due to enhanced cognitive capacities of the chimeras rather weak. T he benefits of further pursuing this avenue of research is so uncertain, so that taking even very unclear risks of serious ethical breach (thus in need of clarification for justification of the research) is not (...)
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  19.  16
    Screening for multi-drug-resistant Gram-negative bacteria: what is effective and justifiable?Christina Åhrén, Anna Lindblom, Christian Munthe & Niels Nijsingh - 2020 - Monash Bioethics Review 38 (Suppl 1):72-90.
    Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria (MDRGN) from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus aureus (...)
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  20. The Return of Lombroso? Ethical Aspects of Preventive Forensic Screening.Christian Munthe & Susanna Radovic - 2015 - Public Health Ethics 8 (3):270-283.
    The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some (...)
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  21.  28
    Individual responsibility as ground for priority setting in shared decision-making.Lars Sandman, Erik Gustavsson & Christian Munthe - 2016 - Journal of Medical Ethics 42 (10):653-658.
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  22.  21
    Conscientious refusal in healthcare: the Swedish solution.Christian Munthe - 2017 - Journal of Medical Ethics 43 (4):257-259.
    The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination. Employee's requests to change work tasks are handled on (...)
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  23.  18
    Pharmaceutical Pollution from Human Use and the Polluter Pays Principle.Erik Malmqvist, Davide Fumagalli, Christian Munthe & D. G. Joakim Larsson - 2023 - Public Health Ethics 16 (2):152-164.
    Human consumption of pharmaceuticals often leads to environmental release of residues via urine and faeces, creating environmental and public health risks. Policy responses must consider the normative question how responsibilities for managing such risks, and costs and burdens associated with that management, should be distributed between actors. Recently, the Polluter Pays Principle (PPP) has been advanced as rationale for such distribution. While recognizing some advantages of PPP, we highlight important ethical and practical limitations with applying it in this context: PPP (...)
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  24.  68
    Divisibility and the Moral Status of Embryos.Christian Munthe - 2001 - Bioethics 15 (5-6):382-397.
    The phenomenon of twinning in early fetal development has become a popular source for doubt regarding the ascription of moral status to early embryos. In this paper, the possible moral basis for such a line of reasoning is critically analysed with sceptical results. Three different versions of the argument from twinning are considered, all of which are found to rest on confusions between the actual division of embryos involed in twinning and the property of early embryos to be divisible, be (...)
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  25. The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions.Anders Herlitz, Christian Munthe, Marianne Törner & Gun Forsander - 2016 - Health Communication 31 (8):964-973.
    This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...)
     
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  26.  55
    The morality of scientific openness.Christian Munthe & Stellan Welin - 1996 - Science and Engineering Ethics 2 (4):411-428.
    The ideal of scientific openness — i.e. the idea that scientific information should be freely accessible to interested parties — is strongly supported throughout the scientific community. At the same time, however, this ideal does not appear to be absolute in the everyday practice of science. In order to get the credit for new scientific advances, scientists often keep information to themselves. Also, it is common practice to withhold information obtained in commissioned research when the scientist has agreed with his (...)
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  27.  37
    Permissibility or Priority? Testing or Screening? Essential Distinctions in the Ethics of Prenatal Testing.Christian Munthe - 2017 - American Journal of Bioethics 17 (1):30-32.
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  28.  81
    Ethical issues in forensic psychiatric research on mentally disordered offenders.Christian Munthe, Susanna Radovic & Henrik Anckarsã„ter - 2009 - Bioethics 24 (1):35-44.
    This paper analyses ethical issues in forensic psychiatric research on mentally disordered offenders, especially those detained in the psychiatric treatment system. The idea of a 'dual role' dilemma afflicting forensic psychiatry is more complicated than acknowledged. Our suggestion acknowledges the good of criminal law and crime prevention as a part that should be balanced against familiar research ethical considerations. Research aiming at improvements of criminal justice and treatment is a societal priority, and the total benefit of studies has to be (...)
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  29.  27
    Health‐related Research Ethics and Social Value: Antibiotic Resistance Intervention Research and Pragmatic Risks.Christian Munthe, Niels Nijsingh, Karl Fine Licht & D. G. Joakim Larsson - 2019 - Bioethics 33 (3):335-342.
    We consider the implications for the ethical evaluation of research programs of two fundamental changes in the revised research ethical guideline of the Council for International Organizations of Medical Sciences. The first is the extension of scope that follows from exchanging “biomedical” for “health‐related” research, and the second is the new evaluative basis of “social value,” which implies new ethical requirements of research. We use the example of antibiotic resistance interventions to explore the need to consider the instances of what (...)
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  30.  21
    Error trawling and fringe decision competence: Ethical hazards in monitoring and address patient decision capacity in clinical practice.Thomas Hartvigsson, Christian Munthe & Gun Forsander - 2018 - Clinical Ethics 13 (3):126-136.
    This article addresses how health professionals should monitor and safeguard their patients’ ability to participate in making clinical decisions and making subsequent decisions regarding the implementation of their treatment plan. Patient participation in clinical decision-making is essential, e.g. in self-care, where patients are responsible for most ongoing care. We argue that one common, fact-oriented patient education strategy may in practice easily tend to take a destructive form that we call error trawling. Illustrating with empirical findings from a video study of (...)
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  31.  43
    The Legal Ethical Backbone of Conscientious Refusal.Christian Munthe & Morten Ebbe Juul Nielsen - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (1):59-68.
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  32.  29
    The Ethics of Antibiotic Resistance: Towards an Agenda for Feasible and Justified Global Health Policy.Christian Munthe, Niels Nijsingh, Karl de Fine Licht & D. G. Joakim Larsson - 2019 - Bioethics 33 (7):731-733.
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  33. The Best Interest of Children and the Basis of Family Policy: The Issue of Reproductive Caring Units.Christian Munthe & Thomas Hartvigsson - 2012 - In Daniela Cutas & Sarah Chan (eds.), Families – Beyond the Nuclear Ideal. Bloomsbury Academic.
    The notion of the best interest of children figures prominently in family and reproductive policy discussions and there is a considerable body of empirical research attempting to connect the interests of children to how families and society interact. Most of this research regards the effects of societal responses to perceived problems in families, thus underlying policy on interventions such as adoption, foster care and temporary assumption of custodianship, but also support structures that help families cope with various challenges. However, reference (...)
     
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  34.  21
    Precaution, bioethics and normative justificaton.Christian Munthe - 2015 - Monash Bioethics Review 33 (2-3):219-225.
    Daniel Steel’s new book on the precautionary principle illustrates the need to work ahead to fuse perspectives of epistemology and philosophy of science with those of ethics to accomplish progress in the debate on the proper role of precaution in a broad selection of bioethical areas. Steel advances the territory greatly with regard to conceptual clarity and epistemology, but from a bioethics standpoint he is mistaken in discounting the need for ethical underpinnings of a sound theory of the precautionary principle.
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  35. The Morality of Interference.Christian Munthe - 1999 - Theoria 65 (1):55-69.
    This paper is about the idea of a moral distinction between doing harm and allowing harm to occurr. It discusses, and developes a general argument against, the version of the distinction often described as counterfactual, which I characterize in terms of making a moral difference between different ways of causing harm (in contrast to, e.g., the version famously discussed by Jonathan Bennett). The gist of the argument is that all variants of this version of the doing-allowing idea would have to (...)
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  36. Abortion: From ethics to politics.Christian Munthe - manuscript
    This article is not about abortion, but rather about how one can reflect on abortion - in particular its moral and political status. My aim, however, is not to defend any particular position regarding such status, rather, I will try to say something comprehensible about how one can (and cannot) reason one's way from a stand regarding the morality of abortion to a stand on the issue of abortion policy.
     
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  37. David B. Resnik. Environmental Health Ethics.Christian Munthe - 2013 - Public Health Ethics (3):pht016.
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  38.  15
    Handlingsfrihet och straff.Christian Munthe - 1989 - Filosofisk Tidskrift 9 (4):21-24.
  39.  42
    Sustainable healthcare resource allocation, grounding theories and operational principles: response to our commentators.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2022 - Journal of Medical Ethics 48 (1):38-38.
    We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.
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  40.  56
    Part I: Introduction to the Philosophy of Hate Crime.David Brax & Christian Munthe - 2013 - In David Brax & Christian Munthe (eds.), The Philosophy of Hate Crime Anthology. University of Gothenburg.
  41. The Philosophy of Hate Crime Anthology.David Brax & Christian Munthe - 2013 - University of Gothenburg.
    Introductory anthology to the philosophy of hate crime, written in the EU project "When Law and Hate Collide".
     
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  42. Are unwanted risks ethically worse than wanted ones?Christian Munthe - manuscript
    Societal decisions regarding the possible granting of permission for industrial and power plants, waste disposals, traffic routes and other facilities implementing modern science and technology (here simply called technology-decisions) often provoke debates regarding the risks involved. A main theme in these debates concerns the magnitudes of these risks and whether or not they are worth taking to reach some aim. This is also a main theme in traditional risk-analysis and critical discussions of risk-management. However, sometimes the fact that some people (...)
     
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  43. Challenges for Empirical Study of Patient Autonomy, Self-determination and Co-Decision Making.Christian Munthe - forthcoming - Thinking Ahead: Bioethics for the Future, the Future of Bioethics–Challenges, Changes, Concepts. 11th World Congress of the International Association of Bioethics. Rotterdam, June 26-29, 2012.
     
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  44.  13
    Controlled Medical Research or Routine Medical Procedure? The Ethics and Politics of Drawing a Line.Christian Munthe - unknown
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  45. Ethical aspects of controlling genetic doping.Christian Munthe - manuscript
    The IOC and WADA have announced their ambition to develop control program in order to detect athletes' illegitimate use of genetic technology for enhancing performance. Although it is far from clear what such uses should be counted as illegitimate, as well as to what extent the idea of control programs for such things is a feasible idea, I will assume that such programs will concern so-called somatic genetic modifications that aims at altering the athlete's initial bodily biochemistry in a way (...)
     
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  46.  31
    Editorial: New Media and Risky Behavior of Children and Young People: Ethics and Policy Implications. Introducing the Themes and Pushing for More.Christian Munthe & Karl Persson - 2014 - Public Health Ethics 7 (1):1-4.
    Guest editorial to a special symposium on New Media and Risky Behavior of Children and Young People: Ethics and Policy Implications.
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  47. Ethical problems of precautionarity.Christian Munthe - manuscript
    In recent years a principle for responsible risk-taking called "The Precautionarity Principle" (PP) has been put forward in several policy documents regarding risk-management of technological and environmental issues. PP involves two claims: 1. An ethical claim according to which it is irresponsible to, for example, use new technologies, regdless of how large benefits these are known to bring, unless it has been proven that they will not give rise to unacceptable long term risks. 2. An administrative/political claim according to which (...)
     
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  48. Genetic treatment and preselection. Ethical differences and similarities.Christian Munthe - manuscript
    Medical genetic interventions can be performed in two ways. First, genetic defects may be repaired (gene therapy). Secondly, a possible future individual (an embryo or a possible combination of gametes) may be preselected because of its favourable genetic make-up (by using genetic diagnostic methods and procedures from reproductive medicine so called Preimplantation Genetic Diagnosis). The first kind of intervention means that someone gets medical treatment in the normal sense, however, the second kind does not. Rather, in that case, the potential (...)
     
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  49. Informed consent and quality of available information.Christian Munthe - manuscript
    Standard versions of the requirement of informed consent state that patients who are offered to enter a clinical trial of a medical procedure should be informed about risks and possible benefits of this procedure (compared to available alternatives) in order to facilitate a rational decision whether or not to participate. However, in many real cases where new medical procedures are to be clinically tested for the first time the information available for such communication to prospective patients is very scarce, vague (...)
     
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  50. Klinik och vetenskap.Christian Munthe - manuscript
    ❙❙ Under den senare hälften av 1900-talet ökade möjligheterna att diagnostisera sjukdomar redan under fosterlivet. Ultra- SAMMANFATTAT ljudsdiagnostiken som började tillämpas på 1960-talet har förfinats alltmer. Idag genomgår nästan varje gravid kvinna..
     
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