An introduction to the political philosophy of Kant, exploring how he developed his views in a context shaped by controversies following the French revolution. It provides new information on his followers and critics as they engaged in high stakes political debates on freedom's relation to the state at this key turning point in history.
Empathy is generally regarded as important and positive. However, descriptions of empathy are often inadequate and deceptive. Furthermore, there is a widespread lack of critical attention to such deficiencies. This critical review of the medical discourse of empathy shows that tendencies to evade and misrepresent the understanding subject are common. The understanding subject’s contributions to the empathic process are often neglected or described as something that can and should be avoided or controlled. Furthermore, the intrinsic and closely interwoven relationship between (...) medical understanding and empathy is generally not explored. Instead of challenging objectivistic and instrumental ideals, the medical discourse of empathy tends to accommodate to inadequate ideals of objectivity and instrumentalism. Thus, important aspects of physician’s rationality, understanding, and morality are neglected and important opportunities for reflection, dialogue, and critique are forfeited. Both the critical and constructive parts of this paper are heavily inspired by philosophical hermeneutic insights, e.g. that physician’s empathy is always historically situated and part of a moral commitment. At the end of this paper, an alternative description of empathy - i.e. appropriate understanding of another human being - is outlined to facilitate the inclusion of hermeneutic insights and accentuate the inherent relationship between empathy and morality. (shrink)
The paper addresses an understudied but highly relevant group of people within corporate organizations and society in general—the marginalized—as well as their narration, and criticism, of personal lived experiences of marginalization in business. They are conventionally perceived to lack traditional forms of power such as public influence, formal authority, education, money, and political positions; however, they still possess the resources to impact their situations, their circumstances, and the structures that determine their situations. Business ethics researchers seldom consider marginalized people’s voices (...) and experiences as resources to understand their lives, as demonstrated through a review of 7500 articles published in the Journal of Business Ethics and Business Ethics Quarterly. Only 78 studies included aspects of marginalized groups. 69 of those studies discussed the topic of marginalized groups of people, but without integrating their explicit voices into the text. Only 9 of the 78 articles featured marginalized people’s explicit voices about their marginalization experiences incorporated into the text as a source for exploration. None of the identified studies discussed the potential for theorizing based on such voices. This paper contributes to business ethics theory by developing four theoretical possibilities vis-à-vis the critical voices of marginalized people’s experiences in business: marginalized theory on critical agency and freedom of speech; the gatekeeping role of academia; primary sources; and a participative perspective. Discussing the theoretical potential of quoting the above voices can enrich business ethics research in terms of the theoretical understanding of marginalized groups in business. (shrink)
This article argues that Kant's republicanism provides a foundation for democratic procedures. The conclusion is reached through an investigation of Critique of the Power of Judgment, which allows us to interpret Kant's notion of the state as a self-determining organic community, and not merely an aggregate of individuals. The article rejects Isaiah Berlin's interpretation of Kant as an authoritarian thinker, and reveals a republican theory centered on liberal freedom expressed within a self-organizing political community.
In 2005 Japan completed its first census after the Personal Information Protection Law went into force in April 2005. The debate about the new law raised privacy concerns for the first time among the public. The news-media also provided several examples of possible lack of safeguards in the data collection of sensitive personal information required for the census. The result was the highest non-response rate ever for the Japanese census. Consequently, its accuracy and role as a source for the reliable (...) national statistics for health/welfare policy-making is now critically threatened. In this paper we argue the necessity to adopt specific safeguards to protect personal data in any future census if the trend of increasing non-response rates is to be reversed. We provide some suggestions for such safeguards, and criticize the Japanese government’s response of focusing exclusively on the mechanism of data collection as a means of meeting the privacy challenge. (shrink)
Before the Semitic fragments of 4QTobit were found at Qumran, the 4th-century Greek GI version of Tobit was thought to be original and was regarded as ‘a lesson on almsgiving and its redeeming powers’. In his presentation of the 4Q196–4Q199 and 4Q200 fragments of Tobit, Fitzmyer, in 1995, reconstructed and rendered the Semitic lexeme צדקה as ‘almsgiving’, as in Mishnaic Hebrew. He referred mainly to the 4th-century Common Era Greek and Old Latin versions. The hypothesis of this article is that (...) the Aramaic lexeme צדק may not yet have had the meaning of ‘almsgiving’ in the original composition; thus, the original authorial intention may be masked in Fitzmyer’s presentation. Therefore, the emphasis on almsgiving for ultimate personal gain found in the later copies of Tobit may be a secondary, reductionist application by subsequent scribes of the lexeme צדקה. To test this hypothesis, the relevant reconstructions and English translations as ‘almsgiving’ of the Semitic copies of Tobit found at Qumran are examined and reconsidered. In the beginning of the narrative, in 4Q196 the rather self-righteous Tobit is ‘accidentally’ blinded while performing an act of charity to his own kin, which he believed was the way to gain righteousness and thus be rewarded by God. In the end, when he has recovered his sight, Tobit redefines the way to achieve true righteousness: to bless God and extol his majesty to all nations with truthfulness in heart and soul.Contribution: The comparison of the Semitic fragments from Qumran with the Septuagint versions suggests that the first reconstructions and translations of 4QTobit may have been overly influenced by the long-standing Greek versions. Whereas the Greek versions tend to emphasise almsgiving as a means to gain righteousness, the older Aramaic versions tend to highlight righteousness and truthfulness as the primary value. (shrink)
The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified (i.e. experiencing moral dou...
This book provides a clear and concise introduction to the philosophy of Gilles Deleuze. It analyses his key theoretical concepts, such as difference and the body without organs, and covers all the different areas of his thought, including metaphysics, the history of philosophy, psychoanalysis, political theory, the philosophy of the social sciences and aesthetics. As the first book to offer a comprehensive analysis of Deleuze's writings, it reveals both the internal coherence of his philosophy and its development through a series (...) of distinct phases. Reidar Due offers an entirely new interpretation of Deleuze's philosophy, centred around the notion of thought as a capacity to form relations. These relations are embodied in nature, in language and in the unconscious; in art, science and social practice. With this concept of embodied thought, Deleuze challenges our most entrenched beliefs about the self and about signs whether linguistic or social. He develops an original theory of power and social systems and presents a method for understanding any signifying practice, from language and ritual to the unconscious, including cinema, literature and painting. Due analyses the different strands in this theoretical edifice and shows its implications for a wide range of human sciences, from history and psychology to political theory and cultural studies. (shrink)
The main idea of this article is to present various perspectives in order to analyze the recent crisis concerning the agriculture-based rural societies in the developed capitalist communities. In all of these countries there is a production crisis, resulting in too much food. But this is also an ideological crisis, because the consumer thinks that the food is produced at too high a price. And it is a political crisis as well because a major part of the voters think subsidies (...) and trade barriers are too high. The paper argues that beneath the present agricultural and rural policy crisis lies the failure of three great projects of our time: 1) The project of natural science; 2) The project of liberal capitalism; and 3) The project of scientific socialism. The failure of these three projects has to do with the breakdown of the positivist idea of modernization. Modernization theory was partly wrong because it overlooked the persistence of locally based life modes. Those life modes must be understood before a sustainable rural development is found. The article reviews some contemporary social science perspectives that have recently been developed to grasp the fundamental changes of today's rural societies. Based on those perspectives and primarily the life mode perspective, five key elements that are essential to analyze if we want to understand future development are isolated: food production, resources, space, social diversity, and culture. (shrink)
The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified is related to professionals’ normative attitudes regarding the use of coercion. This paper describes an explorative statistical analysis based on a cross-sectional survey across seven wards in three Norwegian mental health care institutions. Descriptive analyses showed that in general the 379 respondents a) were not so sure whether coercion should be seen as (...) offending, b) agreed with the viewpoint that coercion is needed for care and security, and c) slightly disagreed that coercion could be seen as treatment. Staff did not report high rates of moral doubt related to the use of coercion, although most of them agreed there will never be a single answer to the question ‘What is the right thing to do?’. Bivariate analyses showed that the more they experienced general moral doubt and relative doubt, the more one thought that coercion is offending. Especially psychologists were critical towards coercion. We found significant differences among ward types. Respondents with decisional responsibility for coercion and leadership responsibility saw coercion less as treatment. Frequent experience with coercion was related to seeing coercion more as care and security. This study showed that experiencing moral doubt is related to some one’s normative attitude towards coercion. Future research could investigate whether moral case deliberation increases professionals’ experience of moral doubt and whether this will evoke more critical thinking and increase staff’s curiosity for alternatives to coercion. (shrink)
To Kant, the French revolution's central events were the transfer of sovereignty to the people in 1789 and the trial and execution of the monarch in 1792-1793. Through a contextual study, this Element argues that while both events manifested the principle of popular sovereignty, the first did so in lawful ways, whereas the latter was a perversion of the principle. Kant was convinced that historical examples can help us understand political philosophy, and this Element seeks to show this in practice.
When Kant in 1793 rejected a right of revolution, he was immediately criticized by a group of radical followers who argued that he had betrayed his own principles of justice. Jakob, Erhard, Fichte, Bergk and Schlegel proceeded to defend a right of resistance and revolution based on what they took to be his true principles. I argue that we must understand Kant's Metaphysics of Morals, which came in 1797, partly as a response to these radical democratic writings. Exploring this forgotten (...) controversy reveals that Kant did not betray his own principles when he denied a right of revolution, because he did not mean that persons have an unconditional duty to obey. This becomes clear when we read the final developments of Kant's thinking on individual liberty and republican government in light of the radical critique. (shrink)
BackgroundNorway has extensive and detailed legal requirements and guidelines concerning involvement of next of kin during involuntary hospital treatment of seriously mentally ill patients. However, we have little knowledge about what happens in practice. This study explores NOK’s views and experiences of involvement during involuntary hospitalisation in Norway.MethodsWe performed qualitative interviews-focus groups and individual-with 36 adult NOK to adults and adolescents who had been involuntarily admitted once or several times. The semi-structured interview guide included questions on experiences with and views (...) on involvement during serious mental illness and coercion.ResultsMost of the NOK were heavily involved in the patient’s life and illness. Their conceptions of involvement during mental illness and coercion, included many important aspects adding to the traditional focus on substitute decision-making. The overall impression was, with a few exceptions, that the NOK had experienced lack of involvement or had negative experiences as NOK in their encounters with the health services. Not being seen and acknowledged as important caregivers and co sufferers were experienced as offensive and could add to their feelings of guilt. Lack of involvement had as a consequence that vital patient information which the NOK possessed was not shared with the patient’s therapists.ConclusionsDespite public initiatives to improve the involvement of NOK, the NOK in our study felt neglected, unappreciated and dismissed. The paper discusses possible reasons for the gap between public policies and practice which deserve more attention: 1. A strong and not always correct focus on legal matters. 2. Little emphasis on the role of NOK in professional ethics. 3. The organisation of health services and resource constraints. 4. A conservative culture regarding the role of next of kin in mental health care. Acknowledging these reasons may be helpful to understand deficient involvement of the NOK in voluntary mental health services. (shrink)
China has become a global player in the field of biosamples research and analysis of genetic data. The Beijing Genomics Institute is a genetics factory where enormous amounts of biosamples/data from all over the world are being analyzed. Most of the global bioethics discussions focused on research conducted by scientists from industrialized countries with subjects from poorer countries. Today, however, samples from industrialized nations are being analyzed in China on an unprecedented scale. This means that one should not just focus (...) on bioethics developments in western countries, but also should pay attention to the situation in China. Under this era of rapid advancement in genomics, reassessing the conventionally accepted bioethical principles is strongly needed. (shrink)
This essay raises some questions concerning the method and conceptual structure of Sartre's Being and Nothingness. Three substantially different types of interpretation of this text have been put forward. One of the main issues separating the three interpretative strategies is the relationship that they each establish between Sartre's three fundamental concepts: consciousness, nothingness and freedom—each of which can be seen to play the fundamental role in the argument. It therefore seems crucial for any interpretation of Being and Nothingness to determine (...) the exact relationship between these terms. However, Being and Nothingness presents a hybrid argument that interweaves metaphysical deduction, phenomenological description and moral-existential argument in a way that makes it almost impossible to decide which of the strands of the argument should be seen to dominate the others. It is therefore perhaps equally difficult to ascertain which of its principal concepts has the most central place in the system. One could therefore argue that a reading of Being and Nothingness should aim to account for (rather than dismiss) the hybridity of the argument and then seek to assign relative functions to its different strands. The following remarks are intended as a step in that direction. (shrink)
Gilles Deleuze famously expressed distaste for the philosophy of Ludwig Wittgenstein and his followers. The two thinkers are here seen as irreconcilable. The critique of false problems and the refutation of scepticism found in Wittgenstein have no resonance in Deleuze, who was a systematic metaphysical philosopher in the tradition of pre-Kantian rationalism. Pragmatic-sceptical self-limitation of thought's capabilities on the grounds of existing practice flies in the face of aesthetic experience. Moreover Deleuze explicitly upholds modern literature as a locus of philosophical (...) innovation. The comparison between Deleuze and Wittgenstein is pursued in an examination of the questions of ‘rule following’, literary practice and semiotics. Deleuze was hostile to ‘pragmatism’, whereas Wittgenstein and his followers could often be described as pragmatists. (shrink)
The WHO Consultative Group on Equity and Universal Health Coverage published a comprehensive report titled “Making Fair Choices on the Path to Universal Health Coverage” detailing strategies that countries should adopt when moving towards providing healthcare coverage to the entire population. The report provides detailed guidelines on how to expand coverage to more people, what services should be covered, and how to prioritize these healthcare resources in achieving universal healthcare coverage. The main goal of this WHO report is to ensure (...) fair and equitable access for all population groups within a country during the implementation of UHC. In principle, the group’s approach is sound and fair, but we argue that each country must take into account its own unique situations in designing a pathway towards UHC. China has achieved near UHC but did so by an approach that would have been deemed completely unacceptable based on this group’s recommendations. In this article, we provide a brief review of the Chinese healthcare system and argue that the implementation of the recommendations in the report is not always feasible. We argue that there are alternate pathways towards achieving UHC and there are good reasons for China’s departure from the approach outlined by the WHO report. Nevertheless, we acknowledge substantial inequities still exist for various segments of the population and among the diverse areas of China in accessing healthcare services and make suggestions on how to reduce such inequities within the system. (shrink)
I disagree with what Reidar Lie has presented here, not because his presentation is deficient, but because the philosophy of the relationship between physician and patient is too narrow. First of all he paints a one-sided and distorted picture of American formulations and descriptions of the concept of autonomy, especially one aspect of it: informed consent. He concludes that autonomy is not an adequate basis for understanding the medical relationship. And then he ends his paper in a vacuum: a (...) proposal to actively explore and experiment with new ways of seeing and modelling this relationship without a program or a script, based on Foucault’s description of the relationship between knowledge and power. That statement causes some suspicion, because it is this relationship that was part of the abuse of patients and research subjects in the first place. (shrink)
ABSTRACTCan there be a legal or a moral right to resist the government? Scholarly interest in the right of resistance has rarely focused on German philosophy, which has often been considered unusually committed to authority. Yet, during the Enlightenment German philosophers regularly attempted to justify not just conscientious refusal but also revolution. This essay explores the two dominant justifications, which were based in Wolffian perfectionism and Kantian relational theory. It argues that we can best understand the complexity of these theories (...) of resistance by exploring their contrasting views on the state’s purpose: providing material and spiritual welfare, or establishing freedom as independence. (shrink)
This article explores the writings of Ludwig Heinrich Jakob and Johann Benjamin Erhard, two young Kantians who produced original defences of resistance and revolution during the 1790's. Comparing these two neglected philosophers reveals a crucial divergence in the liberal theory of revolution between a perspective that emphasises resistance by the individual and another that emphasises revolution by the nation. The article seeks to contribute to a more nuanced view of the political theory of the German Enlightenment, which has often been (...) presented as excessively obedient to authority.The historian Charles Ingrao repeated a common perception when, in an article on enlightened absolutism, he speculated that, ‘the German's greater acceptance of authority both then and now may be rooted in their own distinctive national culture’. This idea of the obedient German has been promoted especially by those who seek cultural explanations for the authoritarian bent of German society in the 20thcentury. But the idea has a longer history. Herder described Germany as the land of obedience, and Kant wrote that, ‘in keeping with their penchant for law and order, they [the Germans] will rather submit to despotic treatment than venture on innovations ’. By ‘wilful reforms of government’ Kant meant revolution. Madame de Staël later observed that Germans ‘join the greatest boldness of thought to the most obedient character’. As Frederick Beiser has shown, this view, which was repeated by Heine and Marx, came to dominate the historiography. (shrink)
In this article I will describe the main elements of the Norwegian presss moral confrontation with the Government Pension Funds ethical investment management when it was in an introductory phase in early 2005, with special emphasis on one newspaper, Stavanger Aftenblad. The press criticized the funds fresh investment profile and intended exclusionary practice before it had really started in earnest. Then I will focus on how the presss unilateral criticism of the funds investment practice at the time overshadowed a discussion (...) of any defects in the ethical principles for investment. And I will focus on the presss lack of distinguishing between information and sensation. In conclusion I point out that in 2006 the press has abandoned its critical stance from 2005 and has now a tendency to idealize the funds exclusionary practice and the underlying principles. (shrink)
An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of (...) 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services. (shrink)
Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient’s best interest, assessment of capacity to consent, and on the patient’s own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. Using a questionnaire, we studied the (...) decision-making process for 299 nursing home patients who were treated for dehydration using intravenous fluids, or for bacterial infections using intravenous antibiotics. We compared the 215 patients treated in nursing homes to the 84 nursing home patients treated in the hospital. The patients’ capacity to consent was considered prior to treatment in 197 of the patients treated in nursing homes and 56 of the patients treated in hospitals. The answers indicate that capacity to consent can be difficult to assess. Patients that were considered capable to consent, were more often involved in the decision-making in nursing homes than in hospital. Next of kin and other health personnel were also more rarely involved when the nursing home patient was treated in hospital. Whether advance care planning had been carried out, was more often unknown in the hospital. Hospital doctors expressed more doubt about the decision to admit the patient to the hospital than about the treatment itself. This study indicates a potential for improvement in decision-making processes in general, and in particular when nursing home patients are treated in a hospital ward. The findings corroborate that nursing home patients should be treated locally if adequate health care and treatment is available. The communication between the different levels of health care when hospitalization is necessary, must be better. ClinicalTrials. gov NCT01023763 [The registration was delayed one month after study onset due to practical reasons]. (shrink)
BackgroundEthically challenging critical events and decisions are common in nursing homes. This paper presents nursing home doctors’ descriptions of how they include the patient and next of kin in end-of-life decisions.MethodsWe performed ten focus groups with 30 nursing home doctors. Advance care planning; aspects of decisions on life-prolonging treatment, and conflict with next of kin were subject to in-depth analysis and condensation.ResultsThe doctors described large variations in attitudes and practices in all aspects of end-of-life decisions. In conflict situations, many doctors (...) were more concerned about the opinion of next of kin than ensuring the patient’s best interest.ConclusionsMany end-of-life decisions appear arbitrary or influenced by factors independent of the individual patient’s values and interests and are not based on systematic ethical reflections. To protect patient autonomy in nursing homes, stronger emphasis on legal and ethical knowledge among nursing home doctors is needed. (shrink)
The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)
In this issue, Alex London and Kevin Zollman provide an analysis of an influential approach to the ethics of international research, known as the “fair benefits” approach. According to them, the fair benefits approach suffers from a fatal flaw: it is either too vague to be useful, or worse, is internally inconsistent. The fair benefits approach was developed based on a presentation I gave at a workshop organized in Malawi in March 2001 by the National Institutes of Health Clinical Center’s (...) Department of Bioethics. In this presentation, I made what I still think is a valid point, which was accepted by the diverse group of participants and formed the basis of the subsequent publications: One should not .. (shrink)