What is ethics? -- How the Bible guides Christian ethics -- Moral agent -- Sin -- Virtue -- Conscience -- Moral norms -- Biblical norms -- Moral consequences -- Ultimate ends.

When information on a coma patient’s expected outcome is uncertain, a moral dilemma arises in clinical practice: if life-sustaining treatment is continued, the patient may survive with unacceptably poor neurological prospects, but if withdrawn a patient who could have recovered may die. Continuous electroencephalogram-monitoring is expected to substantially improve neuroprognostication for patients in coma after cardiac arrest. This raises expectations that decisions whether or not to withdraw will become easier. This paper investigates that expectation, exploring cEEG’s impacts when it becomes (...) part of a socio-technical network in an Intensive Care Unit. Based on observations in two ICUs in the Netherlands and one in the USA that had cEEG implemented for research, we interviewed 25 family members, healthcare professionals, and surviving patients. The analysis focuses on the way patient outcomes are constructed, the kind of decision support these outcomes provide, and how cEEG affects communication between professionals and relatives. We argue that cEEG can take away or decrease the intensity of the dilemma in some cases, while increasing uncertainty for others. It also raises new concerns. Since its actual impacts furthermore hinge on how cEEG is designed and implemented, we end with recommendations for ensuring responsible development and implementation. (shrink)

Aim: To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America. Methods: A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for (...) dierences between countries. Results: In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37-54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p < 0.001) or the Netherlands (OR = 1.74, p < 0.001) and preferring to stay alive in a conscious state with severe physical and cognitive impairments more than respondents from Italy (OR = 3.76, p < 0.001), Germany (OR = 2.21, p < 0.001), or the Netherlands (OR = 2.39, p < 0.001). Conclusions: Over one-third of the respondents considered WLST unacceptable when there is any remaining prognostic uncertainty. Respondents had a more positive perspective on acceptable quality of life after coma than what is currently considered acceptable in medical literature. This indicates a need for a closer look at the practice of WLST based on prognostic information, to ensure responsible use of novel prognostic tests. (shrink)

This study is the first to examine the understandings that participants have of the consent process in a pharmacogenetic trial of anti-depressant medication.

Ve svém článku 'Hledání hyperintenzionality' se Bjorn Jespersen pokusil rekapitulovat a zdůvodnit způsob, jakým TIL vykládá pojem významu. Jakkoli si myslím, že se Jespersenovi (nikoli jenom v tomto článku) daří TIL předvádět způsobem srozumitelným i přitažlivým i pro outsidery..

The paper focuses on the relation of the so-called Transparent Intensional Logic and Aristotelian Essentialism. TIL is presented here as an antiessentialist system. I analyse the reasons of TIL´s anti-essentialism, and I see the main reasons in the very conception of possible worlds, which is preferred by TIL, as well as in the ontological status of properties and secondarily in the relation between individuals and properties, as TIL conceives it. I assert that even within the frame of TIL it is (...) possible to formulate a certain version of the Aristotelian Essentialism and I point out the intuitions that are connected with the concept of essence and preserved by the formulated conception, contrary to TIL and other systems of modern logic. (shrink)

Indledning til “Om spørgsmålet: Hvad er oplysning?” af Moses Mendelssohn.

Formålet med nærværende oversigtsartikel er at undersøge den stigende digitalisering og deling af personlige informationer i sundhedsvæsenet, samt hvilke etiske udfordringer denne udvikling har for den enkelte borger. Mere præcis vil vi rammesætte denne diskussion i en dansk kontekst eksemplificeret ved Det Fælles Medicinkort. Det Fælles Medicinkort er en obligatorisk database for danske borgere indeholdende informationer om patienters medicinske historie to år tilbage. Denne database kan tilgås af en bred vifte af sundhedsprofessionelle i Danmark.På trods af lovede sundhedsmæssige fordele, såsom (...) en højere grad af sikkerhed i forbindelse med medicinering, en øget effektivisering af sundhedsvæsenet og dermed besparelser på de offentlige budgetter, plæderer vi i artiklen for, at implementeringen af Det Fælles Medicinkort kompromitterer den enkeltes privathed. Den enkelte borger er ikke i tilstrækkelig grad informeret om brugen af Det Fælles Medicinkort. Ydermere finder vi ikke, at borgerens autonomi i forhold til indholdet af personlige oplysninger i Det Fælles Medicinkort er opretholdt på en tilfredsstillende måde.Artiklens primære perspektiv er deontologisk, men for at nuancere vores diskussion inddrages lejlighedsvist også utilitaristiske argumenter. Endvidere inddrages i artiklen Helen Nissenbaum, Tom L. Beauchamp og James F. Childress samt John Rawls. I artiklen vil tre konkrete problemstillinger blive diskuteret i relation til Det Fælles Medicinkort: Deler vi relevante og passende data? Er distributionen af disse data til en så bred vifte af sundhedsprofessionelle på sin plads? Og slutteligt: Er den enkelte borgers beslutningsdygtighed, og dermed mulighed for autonomi i forhold til personrelaterede informationer, tilstrækkelig.Nøgleord: digitalisering, privathed, Danmark, sundhedsvæsen, Det Fælles MedicinkortEnglish summary: The right to privacy in Danish healthcareThe scope of this paper is to assess the growing digitalization of personal information in healthcare and the ethical challenges this development poses to the citizen. Specifically the paper discusses the right to privacy in a Danish context, namely in relation to the use of The Shared Medical Record. The Shared Medical Record is a default digital health record consisting of every patient’s medical history for the previous two years, accessible to a broad range of health professionals in Denmark.In this paper we discuss three aspects of The Shared Medical Record, primarily from a normative point of view: 1) Are the personal data shared by The Shared Medical Record relevant and appropriate? 2) Is the distribution of this information to the current array of health professionals appropriate? And 3) Does The Shared Medical Record adequately support and account for the quorum and autonomy of the individual citizen with regards to personal information?We argue that, advantages such as heightened security, efficiency and convenience aside, the citizens’ right to privacy is to some extent compromised by the terms and use of this record. The citizen is not extensively informed on the use of the record, and does not hold a sufficient degree of autonomy over the content and distribution of their personal data. The primary ethical perspective of the paper is deontological, but in order to properly nuance our stance we have chosen to include traditionally utilitarian points of view throughout our discussions.In the paper we introduce Helen Nissenbaum’s notion of contextual integrity in order to thoroughly assess the service’s ethical implications for Danish citizens and their future privacy, as well as points from John Rawls, Tom L. Beauchamp and James F. Childress. (shrink)

Couples need to make their wishes explicit if we are to allow postmortem gamete donation.

Tekster til Buddhismen. Selected and translated by Frede Möller-Kristensen. Gyldendal, Copenhagen 1980. 104 pp. Illustrated. D.Kr.68.50.

I november 2020 stod statsminister Mette Frederiksen på en gård i Jylland og kneb en tåre foran den forsamlede presse. Hun havde netop besøgt to generationer af minkfarmere, far og søn, hvis levebrød hun selv lige havde besluttet at slå ned. Var det kynisme eller reelle følelser, der var på spil? Tog statsministeren personligt ansvar for sin egen, svære beslutning, eller var hun en hykler? I denne videnskabeligt funderede debatbog sætter Silas F. Harrebye vores allesammens hykleri under lup. Han skelner (...) mellem forskellige former for hykleri og undersøger, hvad det gør ved demokratiet, at vi ofte er mere optagede af at anklage end at forstå hinanden. Bogen viser, hvorfor vi har brug for flere nuancer i debatten, hvis der skal være plads til politiske visioner og personlig udvikling. Bogen indeholder dybdegående interviews med 8 kendte politikere og meningsdannere som selv har været igennem deciderede shitstorms og anklager om hykleri: Lars Løkke Rasmussen, Pelle Dragsted, Carolina Magdalene Maier, Morten Messerschmidt, Tim Whyte, Rasmus Willig, Anders Gadegaard og Lea Korsgaard. De bliver alle udfordret til at reflektere over både eget og andres hykleri. Derudover præsenterer bogen resultaterne fra en omfattende befolkningsundersøgelse lavet i forbindelse med bogen. Ved hjælp af overraskende teoretiske vinkler og fortolkninger formulerer Silas F. Harrebye et forsvar for hykleriet, som han mener er uundgåeligt og ligefrem kan være politisk produktivt. Som han skriver:?hellere hyklerisk idealist end konsekvent kyniker.? Bogen er skrevet til borgere og fagfolk, der interesserer sig for demokrati, politik og samfund. Den rummer en masse inspiration til at reflektere over de svære valg i livet og blive det, forfatteren kalder?den gode hykler?. Bogen kan oplagt bruges som supplerende litteratur på universiteter og højskoler inden for fx samfundsfag, filosofi og medievidenskab. (shrink)