Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates (...) of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease. (shrink)

Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates (...) of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease. (shrink)

When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.

In this essay, I argue for the rejection of Vihvelin's ‘Three-fold Classification’ , a nonstandard taxonomy of free-will compatibilism, incompatibilism, and impossibilism. Vihvelin is right that the standard taxonomy of these views is inadequate, and that a new taxonomy is needed to clarify the free-will debate. Significantly, Vihvelin notes that the standard formal definition of ‘incompatibilism’ does not capture the historically popular view that deterministic laws pose a threat to free will. Vihvelin's proposed solution is to redefine ‘incompatibilism.’ However, Vihvelin's (...) formal definition of ‘incompatibilism’ is flawed according to her own arguments. In addition, Vihvelin's characterization of ‘compatibilism’ is incomplete, and at least two important free-will views are missing from her proposed taxonomy. Given the problems with Vihvelin's arguments for 3-FC, her novel view of the dialectic between the major free-will views lacks support. (shrink)

Great hope has been placed on biobank research as a strategy to improve diagnostics, therapeutics and prevention. It seems to be a common opinion that these goals cannot be reached without the participation of commercial actors. However, commercial use of biobanks is considered morally problematic and the commercialisation of human biological materials is regulated internationally by policy documents, conventions and laws. For instance, the Council of Europe recommends that: “Biological materials should not, as such, give rise to financial gain”. Similarly, (...) Norwegian legislation reads: “Commercial exploitation of research participants, human biological material and personal health data in general is prohibited”. Both articles represent kinds of common moral intuitions. A problem, however, is that legislative documents are too vague and provide room for ample speculation. Through the use of focus group interviews with Norwegian biobank donors, we have tried to identify lay intuitions and morals regarding the commercial use of biobanks. Our findings indicate that the act of donation and the subsequent uses of the samples belong to two different spheres. While concerns around dignity and commodification were present in the first, injustice and unfairness were our informants’ major moral concerns in the latter. Although some opposition towards commercial actors was voiced, these intuitions show that it is possible to render commercial use of biobanks ethically acceptable based on frameworks and regulations which hinder commodification of the human body and promote communal benefit sharing. (shrink)

What is it to be a better ape? This is the question Victor Kumar and Richmond Campbell ask in their book on the evolution of the moral mind, an ambitious story that starts with the common ancestor of the modern apes—humans, chimpanzees, bonobos, gorillas, and orangutans. Of all of us, it’s the humans who remain in the running for being a better ape, because we’re the ones who have all the necessary ingredients: the binding emotions of sympathy and loyalty which (...) we share with our nonhuman cousins, but also the collaborative emotions of trust and respect and the reactive emotions of guilt and resentment. Importantly, only humans are thought to have norms, and to be biologically prepared to learn norms. For Kumar and Campbell, the co-evolution of emotions and norms is what set humans on this path so we can become a better ape. -/- The story they tell is artfully woven from major theories in psychology and anthropology, and those of us who have pre-existing opinions about these theories have points where we can quibble regarding the nature of the emotions–whether only humans imitate, what norms of fairness amount to, or whether any other species are generalists who can survive in a wide range of habitats. Rather than focusing on these, I want to turn to an exciting hypothesis Kumar and Campbell propose about the evolution and function of norms. While it is most common to think that norms helped our ancestors solve the collective action problems that emerged when larger groups of individuals started living together, Kumar and Campbell suggest a different, though complementary, function for norms. They propose that norms provide a more precise and flexible means for coordinating behavior in quickly changing societies. On their view, it isn’t the size of community that is the most significant variable, but rather the speed at which culture evolves. -/- That norms are a human universal is indubitable. Our contemporary human societies are rife with rules constraining our behaviors, governing aspects of our lives from birth to death, prescribing practices about what to wear, how to work, what to eat, when and how to sleep as well as rules about rare practices that are proscribed. However, Kumar and Campbell also presume that norms are human unique. Here I have more than a quibble, given the burgeoning empirical and theoretical literature on the question of animal normativity (Andrews 2020; Danón 2019; Fitzpatrick 2020; de Waal 2014; von Rohr et al. 2011; Rohr et al. 2015; Whiten et al. 2005; Westra et al., in prep)... (shrink)

IntroductionDrug-related deaths are a major public health challenge. Losing a child to a DRD can be a very stressful life event, which places parents at risk of mental and physical health problems. However, traumatic experiences like losing a child to DRD can paradoxically also lead to positive psychological changes. A mixed-method approach was used to understand the complexity of the phenomenon of post-traumatic growth experienced by parents following a DRD.MethodBy combining data from a survey and interviews, we explored positive (...) growth experiences among Norwegian parents. We conducted descriptive analyses of the sample’s demographic characteristics and mean scores for Post-traumatic Growth Inventory items. Hierarchical multiple regression was used to examine the influence of the ability to perform daily activities, self-efficacy, social support, and symptoms of prolonged grief on the outcome variable of post-traumatic growth. Reflexive thematic analysis was applied to analyze the qualitative data. Finally, we integrated the results of the survey and the interviews.ResultsFor items measuring post-traumatic growth, parents scored highest on the item “I discovered that I’m stronger than I thought I was” and lowest on the item “I am able to do better things with my life.” Self-efficacy and social support had a statistically significant relation with post-traumatic growth. Two themes were generated from the interviews: new perspectives on life and new paths in life. Even though the “New Possibilities” subscale had the lowest mean score for the PTGI-SF, new paths in life were important for many of the interviewed parents.DiscussionParents described traumatic stressors associated with having a child who uses narcotics and hence experienced positive changes even before losing their child. We argue that on an individual level, the consequences of spillover stigma, low self-efficacy, and intrusive rumination can hinder potential post-traumatic growth. On a group level, enhancing network support may increase post-traumatic growth experiences. Hence, parents who have experienced a DRD can benefit from help to activate their social networks and strengthen their self-efficacy. (shrink)

Many scientists, businessmen, and government regulators believe that the criteria for acceptable societal risk are too stringent. Those who subscribe to this belief often accept the view which I call the probability-threshold position. Proponents of this stance maintain that society ought to ignore very small risks, i.e., those causing an average annual probability of fatality of less than 10–6.After examining the three major views in the risk-evaluation debate, viz., the probability-threshold position, the zero-risk position, and the weighted-risk position, I (...) focus on the arguments for the first of these views, since it is the position which currently undergirds most public policy (especially in the U.S.) regarding acceptable risk. After analyzing Arrow's argument from decision theory, Comar's and Gibson's argument from ontology, and Starr's and Whipple's argument from epistemology, I conclude that these defenses of the probability-threshold position err in a variety of ways. Most commonly, they fail because they tacitly accept the assumption that magnitude of probability, alone, provides a sufficient condition for judging the acceptability of a given risk. In the light of these errors, I suggest that it might be more desirable for risk assessors, decision theorists, and policymakers to weight various risk-cost-benefit parameters according to alternative ethical criteria, rather than to evaluate risks solely in terms of mathematical considerations. (shrink)

Although we are likely unaware of it, in one troubling respect nearly all of us today wear the ring of Gyges. Because we are “invisible,” we use the ring to harm others with impunity. What is our ring of Gyges? It is our use/release of epigenetically toxic environmental pollutants (ETEP), such as endocrine disruptors, metals, and some pesticides. For developmentally/pre- and-postnatally-exposed children, ETEP often cause heritable gene-expression changes, developmental toxicity (DT) that increases later-life disease/dysfunction/death, including asthma/allergy, cancer, cardiovascular disease, depression, (...) diabetes, hypertension, immune/precocious autoimmune diseases, infertility, neuro-developmental/neuro-degenerative diseases, obesity, osteoporosis, puberty, and schizophrenia.Yet, like Gyges, we offenders are “invisible” in at least two senses: (i) invisible before the law, because current regulations do not prohibit ETEP exposures able to cause DT; (ii) invisible as perpetrators, because most child-DT harms appear later in life. This paper (1) uses ETEP and DT to explain how we cause severe, hidden, pollution harms to children and future generations, (2) argues that no major ethical theory can justify allowing avoidable ETEP, and (3) shows that we have justice-based duties to help stop avoidable ETEP exposures, because, to varying degrees, we help cause ETEP and profit from them. Finally, the paper (4) answers objections to (3). (shrink)

Background: International developments suggest that providing clinical ethics services to help clinicians negotiate ethical issues that arise in clinical practice is beneficial and reflects best practice in promoting high ethical standards and patient-centered care. The aim of this study was to explore the needs and experiences of clinical staff members to inform the development of future clinical ethics support. Methods: Health professionals at a large regional health service completed an online survey containing questions about the frequency of ethical and legal (...) issues encountered in clinical practice, the type of situations that gave rise to the ethical and/or legal uncertainty or concern, how clinicians currently address these issues, and what support would be welcome. Results: The survey was completed by 369 staff members, including 61% with more than 10 years in the profession and 51% in nursing/midwifery. Two-thirds (66%) indicated they often considered ethical implications of their clinical decisions, and half (49%) often considered the legal implications. More than half (58%) were often/occasionally concerned about the ethically right thing to do. Patient requests for borderline treatment (47%), staff disagreements about patient care (48%), and patients declining recommended treatment (54%) were the most frequent reasons given for ethical or legal uncertainty. Sixty-nine percent of respondents indicated that the way their department addressed ethical issues could be improved and 85% agreed that there is a need for more discussion on ethical issues. The majority (82%) of respondents had encountered ethically challenging clinical situations where additional support would have helped. Common approaches to issues were discussion with colleagues/supervisor (91.1%), discussion at handover/group forums (50.8%), and consultation with guidelines/protocols (60.9%). Conclusions: A majority of clinical staff members surveyed have encountered ethically/legally challenging cases daily for which they have often sought additional advice. This study indicates that many clinical staff members would welcome some form of additional clinical ethics support including advice and education. (shrink)

The Nordic countries have been major contributors to peacekeeping, often seen as particularly well suited due to their lack of ties to colonialism and supposedly peaceful nature. The article critically addresses this idea in relation to how gender equality has been conceptualized in peacekeeping taking as an example Icelandic peacekeeping. Iceland’s recent engagement in peacekeeping has strongly emphasized gender issues but has lacked an engagement with issues of power and domination and thus reflects a particular idea of ‘Nordic exceptionalism’. (...) The authors emphasize in their discussion the need to maintain critical feminist perspectives that take diverse relations of power into account. (shrink)

Mark Twain said that, for people whose only tool is a hammer, everything looks like a nail. In Thinking about Technology, Joe Pitt's main tools appear to be those of the philosopher of science, so it is not surprising that he claims most problems of philosophy of technology are epistemic problems. As he puts it: 'The strategy here is straightforward. Philosophers of science have examined in detail a number of concepts integral to our understanding of what makes science what it (...) is. The bottom line is this: philosophical questions about technology are first and foremost questions about what we can know about a specific technology and its effects and in what that knowledge consists'. Although Pitt points out important disanalogies between scientific and technological knowledge, nevertheless he emphasizes that philosophy of technology is primarily epistemology. Pitt has stipulatively defined ethical and political analyses of technology as not part of philosophy and philosophy of technology. While claiming to assess the foundations of philosophy of technology, he has adopted a reductionist approach to his subject matter, one that ignores or denigrates the majority of work in philosophy of technology. Does Pitt's bold, reductionist move succeed? (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing (...) and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing (...) and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

In Feminist Phenomenology and Medicine, the editors have assembled a collection of papers on important topics that should be addressed in the modern phenomenology of medicine - topics which do not exclusively focus on illness, disability, bodily deterioration or pathologies, as seen for instance in prior work of the philosophers S Kay Toombs, Frederik Svenaeus, and Havi Carel. The contributors met at a congress on feminist phenomenology and medicine in Sweden in 2011, and come from a variety of relevant disciplines (...) including bioethics, philosophy of medicine, feminism and gender studies. All contributors are well-known, major players within their particular fields.Although it seems obvious that new developments in medicine, such as organ transplantation and plastic surgery, will push the boundaries of normality within the medical discourse, this volume is the first of its kind to offer a collection of essays exploring a variety of medical conditions that are situated within the gray zo .. (shrink)

The argument in this essay is twofold. (1) Procedural justice requires,in particular cases, that we restrict property rights in natural resources, e.g., California agricultural land or Appalachian coal land. (2) Conditions imposed by Locke's political theory and by dense population require,in general, that we restrict property rights in finite or non-renewable natural resources such as land. If these arguments are correct, then we have a moral imperative to use land-use controls (such as taxation, planning, zoning, and acreage limitations) to restructure (...) land ownership and land use in a far more radical way than has ever been accomplished in the past. (shrink)

When Kangas suggested in 1986 that wildlife reserve designs could be much smaller than previously thought, community ecologists attacked his views on methodological grounds (island biogeographical theory is beset with uncertainties) and on conservation grounds (Kangas seemed to encourage deforestation and extinction). Kangas' defenders, like Simberloff, argued that in a situation of biological uncertainty (the degree/type of deforestation-induced extinction), scientists ought to follow the epistemologically conservative course and risk type-II error (the risk of not rejecting a null hypothesis that is (...) false), rather than type-I error. (This is the risk of rejecting a null hypothesis that is true). Kangas' opponents, like Noss, argued that, in a situation of scientific uncertainty, scientists ought to risk type-I, rather than type-II, error. This essay argues that there are different types of rationality appropriate to science and applied science and, therefore, in cases of applied science (like conservation biology), the more conservative course of action is for scientists to risk type-I error. The essay argues further that, on grounds of scientific rationality, Kangas, Simberloff, and others were correct in risking type-II error, but that, on grounds of decision-theoretic rationality, Noss, Waide, and others were correct in risking type-I error. (shrink)

Despite significant scientific uncertainties and strong public opposition, there appears to be an “iron triangle” of industry, government,and consultants/contractors promoting the siting of the world’s first permanent geological repository for high-level nuclear waste and spent fuel, proposed for Yucca Mountain, Nevada. Arguing that representatives of this iron triangle have ignored important epistemological and ethical difficulties with the proposed facility, I conclude that the business climate surrounding this triangle appears to leave little room for consideration of ethical issues related to public (...) safety, environmental welfare, and citizen consent to risk. If my analysis of the Yucca Mountain case is correct and typical, then some of themost pressing questions of business ethics may concern how to break the iron triangle or, at least, how to expand it into a quadrilateral that includes the public. (shrink)

In 1986-1987, a number of ecologists were involved in a dispute over design of wildlife reserves and species losses resulting from deforestation. The battle was played out largely in the pages of the Ecological Society of America Bulletin. The most focused aspect of the controversy began in August 1986 when P. C. Kangas gave a paper at the meetings of the Fourth International Congress of Ecology, held in Syracuse, New York.Using data on trees in Costa Rica and the “objective approach” (...) of species-area curves, Kangas argued that extinction rates due to deforestation in the tropics are actually much lower than most other researchers have alleged (Kangas 1986, p. 194). Ecologists in the audience disagreed with Kangas’ claim that extinction rates were indeed lower, complained that his questionable results would be used to justify more rapid and widespread deforestation, and claimed to have “sharply trounced his [Kangas’] arguments” (Noss 1986, pp. 278-279). (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)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Women Philosophers in the Long Nineteenth Century: The German Tradition ed. by Kristin Gjesdal and Dalia NassarAlison StoneKristin Gjesdal and Dalia Nassar, editors. Women Philosophers in the Long Nineteenth Century: The German Tradition. Oxford: Oxford University Press, 2021. Pp. 336. Hardback, $99.00."How plausible, [Dalia Nassar and I] kept asking, is it that women published philosophy in the early modern period and then simply ceased to think and (...) publish philosophy in the nineteenth century?" remarked Kristin Gjesdal recently (interview with Richard Marshall, 3:16am [blog], https://www.3-16am.co.uk/articles/gadamer-herder-and-the-womenphilosophers-of-the-long-nineteen-cent ury?c=end-times-series). Not plausible at all—yet this is what historians of women in philosophy often seem to have assumed, judging by the remarkably small amount of scholarship on nineteenth-century women philosophers compared with those of the early modern period or the twentieth century. Eileen O'Neill, for instance, claims that it was "not a particularly friendly century for women philosophers" (1). In fact, as Gjesdal and Nassar observe, women were "significant contributors" to the "thriving intellectual cultures in German-speaking countries" at this time (1). Gjesdal and Nassar contrast Germanic countries to France and Britain in this regard, yet I would add that nineteenth-century Britain too had a vibrant print and periodical culture that created openings for women philosophers such as Harriet Martineau, Anna Jameson, Frances Power Cobbe, and many others. The broader point remains: the nineteenth century has only seemed empty of women philosophers because we have not yet investigated the women thinkers of this period or challenged the canons and narratives from which they have been excluded.Recognizing German women philosophers is particularly important because the vast majority of scholarship on the nineteenth century focuses on the German tradition. Consequently, unless we recover the work of German-speaking women, we will never change the narrative about this period. This makes the present anthology invaluable for both teaching and research. Edited by Gjesdal and Nassar, it contains new translations, nearly all by Anna Ezekiel, of texts by historical German-speaking women philosophers.Regarding teaching, many courses on post-Kantian European philosophy include no women until Beauvoir or Arendt. Such courses typically cover Fichte, Hegel, Marx, Schopenhauer, Nietzsche, Husserl, and Heidegger. The editors have clearly designed this volume to enable instructors easily to bring women into such courses, by providing extracts—of suitable lengths for teaching—from women affiliated respectively with German idealism and Romanticism (Germaine de Staël, Karoline von Günderrode, and Bettina von Arnim), Marxism (Clara Zetkin, Rosa Luxemburg), Nietzscheanism (Hedwig Dohm, Lou Salomé), and phenomenology (Edith Stein, Gerda Walther). Some of these women are already well-known as political activists, as with Luxemburg and Zetkin, or under the elastic heading of "writers," as with Staël and von Arnim. But this collection presents these women's writings in a new light, showcasing their philosophical side. After all, we have learned to read Marx and Nietzsche philosophically: why not extend the same courtesy to Staël or Luxemburg?For researchers, this collection will likewise be invaluable. Post-Kantian European philosophy has been slow to respond to the wider questioning and broadening of the traditional philosophical canon. It remains sadly common for narratives of nineteenth-century German philosophy to discuss men only—a position that this book makes untenable. [End Page 336] Hopefully it will galvanize philosophers to integrate these women into the historiography of the post-Kantian tradition at last.In the introduction, the editors helpfully contextualize the selected writings, arguing that these women's exclusion from academic institutions led them to philosophize in ways that spoke to general audiences, connected with lived experience, and addressed practical and political concerns. In short, these women did a type of philosophy that was not purified but socially engaged, and can be a model for us today. Thereafter the book consists of sections on nine women philosophers, ordered chronologically. Each section begins with an editorial introduction to the philosopher and her interests, ideas, writings, and interlocutors.The writings included from Staël—whose work spans the period from the French Revolution into Romanticism—are "On Women Writers" from... (shrink)

The objective of Working Group 4 of the COST Action NET4Age-Friendly is to examine existing policies, advocacy, and funding opportunities and to build up relations with policy makers and funding organisations. Also, to synthesize and improve existing knowledge and models to develop from effective business and evaluation models, as well as to guarantee quality and education, proper dissemination and ensure the future of the Action. The Working Group further aims to enable capacity building to improve interdisciplinary participation, to promote knowledge (...) exchange and to foster a cross-European interdisciplinary research capacity, to improve cooperation and co-creation with cross-sectors stakeholders and to introduce and educate students SHAFE implementation and sustainability. To enable the achievement of the objectives of Working Group 4, the Leader of the Working Group, the Chair and Vice-Chair, in close cooperation with the Science Communication Coordinator, developed a template to map the current state of SHAFE policies, funding opportunities and networking in the COST member countries of the Action. On invitation, the Working Group lead received contributions from 37 countries, in a total of 85 Action members. The contributions provide an overview of the diversity of SHAFE policies and opportunities in Europe and beyond. These were not edited or revised and are a result of the main areas of expertise and knowledge of the contributors; thus, gaps in areas or content are possible and these shall be further explored in the following works and reports of this WG. But this preliminary mapping is of huge importance to proceed with the WG activities. In the following chapters, an introduction on the need of SHAFE policies is presented, followed by a summary of the main approaches to be pursued for the next period of work. The deliverable finishes with the opportunities of capacity building, networking and funding that will be relevant to undertake within the frame of Working Group 4 and the total COST Action. The total of country contributions is presented in the annex of this deliverable. (shrink)

Objective: To inquire into the subjective experience of treatment by persons diagnosed with avoidant personality disorder. Methods: Persons with avoidant personality disorder (N = 15) were interviewed twice, using semi-structured in-depth interviews, analyzed by and the responses subject to interpretative-phenomenological analysis. Persons with firsthand experience of avoidant personality disorder were included in the research process. Results: The superordinate theme emerging from the interviews, “searching for courage to be” encompassed three main themes: “seeking trust, strength, and freedom,” “being managed,” and “discovering (...) the possibility for change and development.” The main theme, “being managed,” included the subthemes: “getting a diagnosis,” “receiving medication,” and “attending therapy.” Conclusion: Although this may not be specific to avoidant personality disorder, Ttheese findings highlight the importance, importance of being met intersubjectively as a person with intentionality and agency, even when one does not feel like one.as an agentive intentional being, even when one does not feel like one, of being met intersubjectively by a therapist. The importance of establishing an emotional bond and emergent trust for open therapeutic communication, collaboration, learning, and becoming able to build courage to begin to approach that which one fears, is emphasized. (shrink)

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed (...) with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved. (shrink)

Voluntary actions and their distal effects are intimately related in conscious awareness. When an expected effect follows a voluntary action, the experience of the interval between these events is compressed in time, a phenomenon known as ‘intentional binding’ . Current accounts of IB suggest that it serves to reinforce associations between our goals and our intention to attain these goals via action, and that IB only occurs for self-generated actions. We used a novel approach to study IB in the context (...) of shared intentions and actions. Pairs of participants judged the time of occurrence of actions and events attributed either to oneself or to another agent. We found that IB and subjective agency are not mutually predictive when an action can be attributed to only one of two ‘co-intending’ agents. Our results pose a complication for the prevailing view that IB and subjective agency reflect a common mechanism. (shrink)

In this essay, I suggest that Spinoza acknowledges a distinction between formal reality that is infinite and timelessly eternal and formal reality that is non-infinite (i. e., finite or indefinite) and non-eternal (i. e., enduring). I also argue that if, in Spinoza’s system, only intelligible causation is genuine causation, then infinite, timelessly eternal formal reality cannot cause non-infinite, non-eternal formal reality. A denial of eternal-durational causation generates a puzzle, however: if no enduring thing – not even the sempiternal, indefinite individual (...) composed of all finite, enduring things – is caused by the infinite, eternal substance, then how can Spinoza consistently hold that the one infinite, eternal substance is the cause of all things and that all things are modes of that substance? At the end of this essay, I sketch how Spinoza could deny eternal-durational causation while still holding that an infinite, eternal God is the cause of all things and that all things are modes. I develop the interpretation more in the companion essay.1 1 In “Spinoza’s Monism II,” in the next issue of this journal. (shrink)

My two principal aims in this essay are interconnected. One aim is to provide a new interpretation of the ‘infinite modes’ in Spinoza’s Ethics. I argue that for Spinoza, God, conceived as the one infinite and eternal substance, is not to be understood as causing two kinds of modes, some infinite and eternal and the rest finite and non-eternal. That there cannot be such a bifurcation of divine effects is what I take the ‘infinite mode’ propositions, E1p21–23, to establish; E1p21–23 (...) show that each and every one of the immanent effects of an infinite and eternal God is an infinite and eternal mode. The other aim is to show that these propositions can be understood as part of an extended critical response to Descartes’s infamous doctrine that God creates eternal truths and true and immutable natures. If we have the correct (Spinozan) conceptions of what God is and how God works, we see that an eternal and infinite God can only be understood to cause ‘eternal truths,’ and that these eternal truths are infinite and eternal modes of God. (shrink)