Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Two ways of understanding the notion of autonomy are outlined and discussed in this article, in order to clarify how and if informed consent requirements in biotechnological research are to be justified by the promotion of personal autonomy: A proceduralist conception linking autonomy with authenticity, and a substantivist conception linking autonomy with control. The importance of distinguishing autonomy from liberty is emphasised, which opens for a possible conflict between respecting the freedom and the autonomy of research participants. It is argued (...) that this has implications for how consent requirements based on different criteria of specificity and understanding should be viewed and justified. (shrink)

What is privacy? What does privacy mean in relation to biobanking, in what way do the participants have an interest in privacy, (why) is there a right to privacy, and how should the privacy issue be regulated when it comes to biobank research? A relational view of privacy is argued for in this article, which takes as its basis a general discussion of several concepts of privacy and attempts at grounding privacy rights. In promoting and protecting the rights that participants (...) in biobank research might have to privacy, it is argued that their interests should be related to the specific context of the provision and reception of health care that participation in biobank research is connected with. Rather than just granting participants an exclusive right to or ownership of their health information, which must be waived in order to make biobank research possible, the privacy aspect of health information should be viewed in light of the moral rights and duties that accompany any involvement in a research based system of health services. (shrink)

Volume 19, Issue 6, June 2019, Page W5-W9.

Rosamond Rhodes and John Harris have both recently argued that we all have a general moral duty to participate in medical research. However, neither Rhodes' nor Harris' arguments in support of this obligation stand up to scrutiny, and severe and convincing criticism has been levelled against their case. Still, to refute their arguments is not to refute the conclusion. There seems to be some truth in the view that when people are asked to take part in medical research, their choice (...) is not completely morally neutral. In this article, we argue that the proper question to ask is when, rather than if, a certain moral duty to volunteer for medical research can be appealed to. To answer this question, we need a denser description of relevant research projects and their context rather than just describing medical research in general. Drawing on our study of participants in the Norwegian HUNT biobank, we use the normative implications of the Norwegian concept «dugnad» as an analogy to discuss the requirement of providing neutral information to potential biobank participants in order to promote their free and informed decision as to whether or not to take part. We suggest that normative recruitment is not just a question of principles and ethics. It is also a question of research design and the creation of the common good in the community where the research takes place. (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)

The worldwide decline in bees and other pollinating insects is a threat to biodiversity and food security, and urgent action must be taken to stop and then reverse this decline. An established cause of the insect decline is the use of harmful pesticides in agriculture. This case study focuses on the use of pesticides in Norwegian apple production and considers who among farmers, consumers and public authorities is most responsible for protecting bees against harmful pesticides. The extent to which these (...) three different groups consider themselves responsible and the degree to which they are trusted by each of the other groups are also studied. This empirical study involves both qualitative interviews with Norwegian apple farmers, consumers and public authorities and survey data from consumers and farmers. The results show that consumers consider public authorities and farmers equally responsible for protecting bees, while farmers are inclined to consider themselves more responsible. Farmers, consumers and public authorities do not consider consumers significantly responsible for protecting bees, and consumers have a high level of trust in both farmers and public authorities regarding this matter. This study also finds that a low level of consumer trust in farmers or public authorities increases consumers’ propensity to purchase organic food, suggesting that those who do not trust that enough action is adopted to protect the environment take on more individual responsibility. This paper adds to the existing literature concerning the allocation of responsibility for environmental outcomes, with empirical evidence focusing specifically on pesticides and bees. (shrink)

Volume 19, Issue 5, May 2019, Page 31-33.

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)

Respecting people’s consent choices for use of their material and data is a cornerstone of biobank ethics. Participation in biobanks is characteristically based on broad consent that presupposes an ongoing possibility of informing and interacting with participants over time. The death of a participant means the end of any interaction, but usually not the end of participation. Research on causes of death makes biobank material from deceased participants extremely valuable. But as new research questions and methods develop over time, the (...) question arises whether stored biobank material from deceased persons still can be used on the basis of their broad consent. In this paper, we discuss policies for postmortem use of biobank material, including consent options, proxy consent and criteria for limitation of types of use and duration of storage. We conclude that the interests of participants in biobank research are best served by asking at enrolment if and how the biobank material may be used after death. We state that the use of biobank material from deceased participants should be delimited both by their consent and by the prevailing broad consent choices of living participants.Biobanks also need to inform participants at enrolment about the duration of storage of biobank material or at minimum have procedures for deciding how long material will be stored for and for which purpose. For older collections, in the absence of such information or consent options, relevant authorities should decide. (shrink)

Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short- and long-term harms, and uncertainty turns provision of life support int...

In a world where issues of food safety and food security are increasingly important, the social responsibility of central actors in the food chain—producers and the main grocery chains—becomes more pressing. As a response, these actors move from implicitly assuming social responsibilities implied in laws, regulations and ethical customs, towards explicitly expressing social responsibilities. In this paper, we discuss the ethical values relevant for the social responsibility of central food producers and retailers in Norway, one of the most subsidized and (...) protected areas of food production in the world. How do the actors perceive and express their social responsibility, and—given their position in the local, national and global market—how should they handle these responsibilities? We analyze Tine and Nortura, two producers owned by farmer cooperatives with market regulator function, as well as Coop—a dominant grocery chain in Norway, with basis in the same public ownership model as the farmer-owned cooperative producers. While the complex roles of these key actors in the Norwegian food market have been criticized from several angles, we argue that these multifaceted roles put them in a good position to promote informed consumer choices in a globalized market. (shrink)

A research biobank is a collection of personal health and lifestyle information, including genetic samples of yet unknown but possibly large information potential about the participant. For the participants, the risk of taking part is not bodily harm but infringements of their privacy and the harmful consequences such infringements might have. But what do we mean by privacy? Which harms are we talking about? To address such questions we need to get a grip on what privacy is all about and (...) aim for a fruitful perspective on the issues of property and privacy rights in the context of biobanking. This paper argues that the limits and handling of private matters is determined in specific social relations. The crucial point is thus to determine which information and activities are or are not the legitimate concern of others. Privacy and property rights should be seen as balanced by duties, that is as inherently relational interests extending into the public sphere, rather than to see these rights as the control of an object—for instance the participant’s biobank material. (shrink)

This special issue of Etikk i praksis features papers that articulate and discuss approaches and methodology that seek to make normative research activity and research output productive in contexts of ongoing societal and technological decision-making. The articles in various ways and to a varying degree exemplify and reflect on the methodology of the study of normativity in innovation.

Climate change is an existential risk reinforced by ordinary actions in afuent societies—often silently present in comfortable and enjoyable habits. This silence is sometimes broken, presenting itself as a nagging reminder of how our habits fuel a catastrophe. As a case in point, global warming has created a state of urgency among wine makers in Spain, as the alcohol level has risen to a point where it jeopardises wine quality and thereby Spanish viticulture. Eforts are currently being made to solve (...) this problem technologically by developing (non-GMO) strains of yeast that produce less alcohol. If successful, this could help save Spanish viticulture. This kind of technological solution is routinely criticised for ofering simplistic “techno-fx” solutions to solve complex societal problems. However, it is not clear what features are criticised by the notion of techno-fx and hence how to avoid this criticism. In our interpretation, the techno-fx notion is not exclusively used as a dismissive term. The notion points to a general virtue of engineering: to create technological solutions that work silently in the background. This asset of technological solutions might sometimes be problematic and sometimes not. Hence, it needs to be analysed case-by-case by paying attention to the moral relevance of the hidden implications of the technology and of the unrefective actions and habits that they facilitate. Such moral analysis will in turn inform strategies for foregrounding this technology to counteract silencing. We discuss what this means in the case of modifying yeast as a viticultural climate resilience strategy. (shrink)

Climate change is an existential risk reinforced by ordinary actions in affluent societies—often silently present in comfortable and enjoyable habits. This silence is sometimes broken, presenting itself as a nagging reminder of how our habits fuel a catastrophe. As a case in point, global warming has created a state of urgency among wine makers in Spain, as the alcohol level has risen to a point where it jeopardises wine quality and thereby Spanish viticulture. Efforts are currently being made to solve (...) this problem technologically by developing (non-GMO) strains of yeast that produce less alcohol. If successful, this could help save Spanish viticulture. This kind of technological solution is routinely criticised for offering simplistic “techno-fix” solutions to solve complex societal problems. However, it is not clear what features are criticised by the notion of techno-fix and hence how to avoid this criticism. In our interpretation, the techno-fix notion is not exclusively used as a dismissive term. The notion points to a general virtue of engineering: to create technological solutions that work silently in the background. This asset of technological solutions might sometimes be problematic and sometimes not. Hence, it needs to be analysed case-by-case by paying attention to the moral relevance of the hidden implications of the technology and of the unreflective actions and habits that they facilitate. Such moral analysis will in turn inform strategies for foregrounding this technology to counteract silencing. We discuss what this means in the case of modifying yeast as a viticultural climate resilience strategy. (shrink)

The aim of this article is to contribute to responsible innovation by developing a conceptual framework for the processes of creativity and innovation. The hypothesis is that creative and innovative processes are similar in that both are affective in nature. I develop this conceptual framework through an interpretation of the insights of Henri Poincaré’s notion of the ‘four stages’ in the creative process and Joseph Schumpeter’s notion of the entrepreneur. Building on this framework, I analyze the creative and innovative practices (...) of the film director Lars von Trier and the entrepreneur Steve Jobs. The interpretation and analysis suggest that the processes of creativity and innovation are similar in nature in that both are based on the moods of disturbance and enthusiasm; but that they differ in that creativity is based on the feelings of interest and irritation, whereas innovation is based on the feelings of desire and anger. In the conclusion I discuss the implications of this for responsible innovation with regard to the social aspect of resistance towards innovation and the ethical aspects of anger in entrepreneurial leadership. (shrink)

Neo-Fregean logicism seeks to base mathematics on abstraction principles. But the acceptable abstraction principles are surrounded by unacceptable ones. This is the "bad company problem." In this introduction I first provide a brief historical overview of the problem. Then I outline the main responses that are currently being debated. In the course of doing so I provide summaries of the contributions to this special issue.

Definition of the problem The umbrella term “explicability” refers to the reduction of opacity of artificial intelligence (AI) systems. These efforts are challenging for medical AI applications because higher accuracy often comes at the cost of increased opacity. This entails ethical tensions because physicians and patients desire to trace how results are produced without compromising the performance of AI systems. The centrality of explicability within the informed consent process for medical AI systems compels an ethical reflection on the trade-offs. Which (...) levels of explicability are needed to obtain informed consent when utilizing medical AI? Arguments We proceed in five steps: First, we map the terms commonly associated with explicability as described in the ethics and computer science literature, i.e., disclosure, intelligibility, interpretability, and explainability. Second, we conduct a conceptual analysis of the ethical requirements for explicability when it comes to informed consent. Third, we distinguish hurdles for explicability in terms of epistemic and explanatory opacity. Fourth, this then allows to conclude the level of explicability physicians must reach and what patients can expect. In a final step, we show how the identified levels of explicability can technically be met from the perspective of computer science. Throughout our work, we take diagnostic AI systems in radiology as an example. Conclusion We determined four levels of explicability that need to be distinguished for ethically defensible informed consent processes and showed how developers of medical AI can technically meet these requirements. (shrink)

A brief review of Øystein Linnebo's Thin Objects. The review ends with a brief discussion of cardinal number and metaphysical ground.

Using Riemann’s Rearrangement Theorem, Øystein Linnebo (2020) argues that, if it were possible to apply an infinite positive weight and an infinite negative weight to a working scale, the resulting net weight could end up being any real number, depending on the procedure by which these weights are applied. Appealing to the First Postulate of Archimedes’ treatise on balance, I argue instead that the scale would always read 0 kg. Along the way, we stop to consider an infinitely jittery flea, (...) an infinitely protracted border conflict, and an infinitely electric glass rod. (shrink)

We analyze the precise modal commitments of several natural varieties of set-theoretic potentialism, using tools we develop for a general model-theoretic account of potentialism, building on those of Hamkins, Leibman and Löwe [14], including the use of buttons, switches, dials and ratchets. Among the potentialist conceptions we consider are: rank potentialism, Grothendieck–Zermelo potentialism, transitive-set potentialism, forcing potentialism, countable-transitive-model potentialism, countable-model potentialism, and others. In each case, we identify lower bounds for the modal validities, which are generally either S4.2 or S4.3, (...) and an upper bound of S5, proving in each case that these bounds are optimal. The validity of S5 in a world is a potentialist maximality principle, an interesting set-theoretic principle of its own. The results can be viewed as providing an analysis of the modal commitments of the various set-theoretic multiverse conceptions corresponding to each potentialist account. (shrink)

This paper challenges a conception of philosophy that is seldom clearly expressed, yet appears to be prevalent in contemporary academic philosophy. On the website of the American Philosophical Quarterly, some sentences appear that articulate well the essentials of that assumption. This article discusses those sentences and assumes that they may be symptomatic of a widespread blindness to a fundamental aspect of the nature of philosophical study. The first part of the article consists of an analysis and criticism of the sentences (...) in question. The second part investigates some possible defences of the sentences and the conception of philosophy they express. (shrink)

This paper challenges a conception of philosophy that is seldom clearly expressed, yet appears to be prevalent in contemporary academic philosophy. On the website of the American Philosophical Quarterly, some sentences appear that articulate well the essentials of that assumption. This article discusses those sentences and assumes that they may be symptomatic of a widespread blindness to a fundamental aspect of the nature of philosophical study. The first part of the article consists of an analysis and criticism of the sentences (...) in question. The second part investigates some possible defences of the sentences and the conception of philosophy they express. (shrink)

In this article, I respond to David McIvor’s and Lars Rensmann’s discussion of my recent book, The Politics of Repressed Guilt: The Tragedy of Austrian Silence (2018, Edinburgh University Press). Both invited me to clarify my use of Arendt in my conception of embodied reflective judgment. I argue for a stronger connection between judgment and emotions than Arendt because one can effectively shut down critical thinking if one uses defense mechanisms to repress feelings of guilt. In response to McIvor, (...) I discuss the idea of the “subject-in-outline” and “embodied reflective spaces” to overcome the guilt/defense complex to engender a reparative politics of justice. Finally, in response to Rensmann, I point out that the lingering culture of repressed guilt helps us explain the general conditions that contributed to the rise of the far and extremist right in Austria, which I develop further in my new book Analyzing the Far Right. (shrink)

Kit Fine has since the 1970s been one of the leading contributors to work at the intersection of logic and metaphysics. This is his eagerly-awaited first book in the area. It draws together a series of essays, three of them previously unpublished, on possibility, necessity, and tense. These puzzling aspects of the way the world is have been the focus of considerable philosophical attention in recent decades. A helpful introduction orients the reader and offers a way into some of the (...) most original work in contemporary philosophy. (shrink)

This paper presents and evaluates a methodological approach aiming at analysing some of the complex interaction between patients and different health care practitioners working together in teams. Qualitative health care research describes the values, perceptions and conceptions of patients and practitioners. In modern clinical work patients and professional practitioners often work together on complex cases involving different kinds of knowledge and values, each of them representing different perspectives. We need studies designed to capture this complexity. The methodological approach presented here (...) is exemplified with a study in rehabilitation medicine. In this part of the health care system the clinical work is organized in multi-professional clinical teams including patients, handling complex rehabilitation processes. In the presented approach data are collected in individual in-depth interviews to have thorough descriptions of each individual perspective. The interaction in the teams is analysed by comparing different descriptions of the same situations from the involved individuals. We may then discuss how these perceptions relate to each other and how the individuals in the team interact. Two examples from an empirical study are presented and discussed, illustrating how communication, differences in evaluations and the interpretation of incidents, arguments, emotions and interpersonal relations may be discussed. It is argued that this approach may give information which can supplement the methods commonly applied in qualitative health care research today. (shrink)

According to Weyl, “‘inexhaustibility’ is essential to the infinite”. However, he distinguishes two kinds of inexhaustible, or merely potential, domains: those that are “extensionally determinate” and those that are not. This article clarifies Weyl's distinction and explains its enduring logical and philosophical significance. The distinction sheds lights on the contemporary debate about potentialism, which in turn affords a deeper understanding of Weyl.

In interprofessional clinical teams, the patients have interpersonal relationships with several practitioners. The aim of this study was to explore patients’ and practitioners’ perceptions of how such relationships may contribute to promote the whole team’s respect for the patient’s autonomy, as interpersonal patient–provider relationships may contribute to enhance patient autonomy. Sixteen qualitative in-depth interviews were conducted with 12 informants, including patients, nurses, physiotherapists, and physicians from three rehabilitation teams. Data were analysed according to Grounded Theory procedures. The informants discussed interpersonal (...) relationships as an integral and significant part of the team work. The practitioners tried to adjust their professional approach to the patients’ genuine opinions and let patients decide the teams’ goals. Close relationships with patients could be important to accomplish this, particularly described by nurses and physiotherapists, who could facilitate the communication with the rest of the team. (shrink)

The article sets out to explore the international legal dimension in Jürgen Habermas' latest publications on philosophy of law. It is our view that Habermas deals with the examination of just relations beyond the nation-state first and foremost from a legal perspective, and that the key to a Habermasian reading of international justice is not through an application of discourse-theoretical models of communicative or moral action as such, but primarily through proper legal institutionalisation of the rule of law. In asserting (...) this view, we will look closer at the Kantian influence in Habermas' legal construct at the international level, and show why this institutional approach is to be sharply distinguished from and preferred to any exclusively non-institutional approach to international justice. (shrink)

It is widely thought that the acceptability of an abstraction principle is a feature of the cardinalities at which it is satisfiable. This view is called into question by a recent observation by Richard Heck. We show that a fix proposed by Heck fails but we analyze the interesting idea on which it is based, namely that an acceptable abstraction has to “generate” the objects that it requires. We also correct and complete the classification of proposed criteria for acceptable abstraction.

La matematica viene generalmente considerata uno degli ambiti più affidabili dell’intera impresa scientifica. Il suo successo e la sua solidità sono testimoniati, ad esempio, dall’uso imprescindibile che ne fanno le scienze empiriche e dall’accordo pressoché unanime con cui la comunità dei matematici delibera sulla validità di un nuovo risultato. Tuttavia, dal punto di vista filosofico la matematica rappresenta un puzzle tanto intrigante quanto intricato. Philosophy of Mathematics di Ø. Linnebo si propone di presentare e discutere le concezioni filosofiche della matematica (...) che hanno dominato la scena da Frege ai giorni nostri. (shrink)

Can groups really be agents or is group agency just a fiction? Christian List and Philip Pettit argue influentially for group-agent realism by showing how certain groups form and act on attitudes in ways they take to be unexplainable at the level of the individual agents constituting them. Group agency is therefore considered not a fiction or a metaphor but a reality we must account for in explanations of certain social phenomena. In this paper, I challenge this defence of group-agent (...) realism by showing how it is undermined by individual-level analysis of how individuals interact within groups. While group agency can be a useful fiction, real agents are at the individual level, not the collective level. (shrink)

Questions about the relation between identity and discernibility are important both in philosophy and in model theory. We show how a philosophical question about identity and dis- cernibility can be ‘factorized’ into a philosophical question about the adequacy of a formal language to the description of the world, and a mathematical question about discernibility in this language. We provide formal definitions of various notions of discernibility and offer a complete classification of their logical relations. Some new and surprising facts are (...) proved; for instance, that weak dis- cernibility corresponds to discernibility in a language with constants for every object, and that weak discernibility is the most discerning nontrivial discernibility relation. (shrink)

The so-called “empirical turn” in bioethics gave rise to extensive theoretical and methodological debates and has significantly shaped the research landscape from two decades ago until the present day. Attentive observers of the evolution of the bioethical research field now notice a new trend towards the inclusion of data science methods for the treatment of ethical research questions. This new research domain of “digital bioethics” encompasses both studies replacing (or complementing) socio-empirical research on bioethical topics (“empirical digital bioethics”) and argumentative (...) approaches towards normative questions in the healthcare domain (“argumentative digital bioethics”). This article draws on insights taken from the debate on the “empirical turn” for sounding out perspectives for the newly developing field of “digital bioethics.” We particularly discuss the disciplinary boundaries, chances and challenges, and potentially undesirable developments of the research field. The article closes with concrete suggestions on which debates need to be initiated and which measures need to be taken so that the path forward of “digital bioethics” will be a scientific success. (shrink)

Recent years have witnessed intensive efforts to specify which requirements ethical artificial intelligence (AI) must meet. General guidelines for ethical AI consider a varying number of principles important. A frequent novel element in these guidelines, that we have bundled together under the term explicability, aims to reduce the black-box character of machine learning algorithms. The centrality of this element invites reflection on the conceptual relation between explicability and the four bioethical principles. This is important because the application of general ethical (...) frameworks to clinical decision-making entails conceptual questions: Is explicability a free-standing principle? Is it already covered by the well-established four bioethical principles? Or is it an independent value that needs to be recognized as such in medical practice? We discuss these questions in a conceptual-ethical analysis, which builds upon the findings of an empirical document analysis. On the example of the medical specialty of radiology, we analyze the position of radiological associations on the ethical use of medical AI. We address three questions: Are there references to explicability or a similar concept? What are the reasons for such inclusion? Which ethical concepts are referred to? (shrink)