Why do some people withdraw from biobank studies? To our knowledge, very few studies have been done on the reflections of biobank ex-participants. In this article, we report from such a study. 16 years ago, we did focus group interviews with biobank participants and ex-participants. We found that the two groups interestingly shared worries concerning the risks involved in possible novel uses of their biobank material, even though they drew opposite conclusions from their worries. Revisiting these interviews today reveals a (...) remarkable relevance to present concerns, since the possible developments that worried ex-participants and participants 16 years ago now are becoming realities. Drawing on conceptual distinctions by sociologist and philosopher Niklas Luhmann, we argue that while ex-participants express a loss of trust in the biobank institution to manage the use of their biobank material in a legitimate way, remaining participants expressed confidence in the management of the biobank institution to secure their interests. This analysis brings out important aspects of emerging trends in biobank research participation. (shrink)

Præsentation af Johannes Hohlenberg -- Udvalgte artikler af Johannes Hohlenberg i J.A.I.-Bladet 1935-1936 -- Johannes Hohlenberg i perspektiv.

For the purpose of contributing to a clarification of the term process, different kinds of musical processes are investigated: A rule-determined phase shifting process in Steve Reich's Piano Phase (1966), a model for an indeterminate composition process in John Cage's Variations II (1961), a number of evolution processes in György Ligeti's In zart fliessender Bewegung (1976), and a generative process of fractal nature in Per Nørgård's Second Symphony (1970). In conclusion I propose that six process categories should be included in (...) a typology of processes: Rule-determined, goal-directed and indeterminate transformation processes, and rule-determined, goal-directed and indeterminate generative processes. (shrink)

The issue of how to justify right and wrong is a recurring methodological problem in ethics. We can, somewhat simplified, distinguish between people who argue that right and wrong must be confirmed by our moral convictions and people who maintain that morality must be justified by principles independent from these convictions. The issue hinges on arriving at a standard or criterion for when something is right or wrong. The author discusses this issue in light of the distinction between perfect procedural (...) justice and pure procedural justice, drawing on the works of John Rawls and Peter Singer. One shortcoming affecting both these approaches is how they are unable to account for our basic beliefs. Using Ludwig Wittgenstein’s On Certainty as a point of departure, the author attempts to demonstrate that some of our basic beliefs cannot be formulated in propositions, but rather are expressed by our actions. The author concludes that we, in light of this, must distinguish between our ethical propositions and our basic beliefs. The former may be subject to doubt and may, consequently, be expressed in the form of propositions, whereas the latter is only expressed by what we say and what we do. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)