The aim of this study was to investigate the ethical dilemma of prioritising financial resources to expensive biological therapies. For this purpose, the four principles of biomedical ethics formulated by ethicists Tom Beauchamp and James Childress were used as a theoretical framework. Based on arguments of justice, Beauchamp and Childress advocate for a health care system organised in line with the Danish system. Notably, our study was carried out in a Danish setting.

The Danish healthcare system must meet the need for easy and equal access to healthcare for every citizen. However, investigations have shown unfair prioritization of cancer patients and unfair prioritization of resources for expensive medicines over care. What is needed are principles for proper prioritization. This article investigates whether American ethicists Tom Beauchamp and James Childress’s principle of justice may be helpful as a conceptual framework for reflections on prioritization of expensive biological therapies in the Danish healthcare system. We present (...) an empirical study exploring the principles for prioritizing new expensive biological therapies. This study includes qualitative interviews with key Danish stakeholders experienced in antibody therapy and prioritizing resources for expensive medicines. Beauchamp and Childress’s model only covers government-funded primary and acute healthcare. Based on the interviews, this study indicates that to be helpful in a Danish context this model should include equal access for citizens to government-funded primary and acute healthcare, costly medicine, and other scarce treatments. We conclude that slightly modified, Beauchamp and Childress’s principle of justice might be useful as a conceptual framework for reflections on the prioritization of expensive biological therapies in the Danish healthcare system. (shrink)

Plausibility models are Kripke models that agents use to reason about knowledge and belief, both of themselves and of each other. Such models are used to interpret the notions of conditional belief, degrees of belief, and safe belief. The logic of conditional belief contains that modality and also the knowledge modality, and similarly for the logic of degrees of belief and the logic of safe belief. With respect to these logics, plausibility models may contain too much information. A proper notion (...) of bisimulation is required that characterises them. We define that notion of bisimulation and prove the required characterisations: on the class of image-finite and preimage-finite models, two pointed Kripke models are modally equivalent in either of the three logics, if and only if they are bisimilar. As a result, the information content of such a model can be similarly expressed in the logic of conditional belief, or the logic of degrees of belief, or that of safe belief. This, we found a surprising result. Still, that does not mean that the logics are equally expressive: the logics of conditional and degrees of belief are incomparable, the logics of degrees of belief and safe belief are incomparable, while the logic of safe belief is more expressive than the logic of conditional belief. In view of the result on bisimulation characterisation, this is an equally surprising result. We hope our insights may contribute to the growing community of formal epistemology and on the relation between qualitative and quantitative modelling. (shrink)

A new concept of cognition also implies a novel approach to the study of metaphor. This insight is the starting point of this article presenting two innovations to comprehending and analyzing metaphor, one theoretical and one in terms of methodology. On a theoretical level we argue for a new orientation to metaphor and metaphoricity based on enactive cognition and distributed language and cognition. In recent years enactive and distributed cognition have been developing a new concept of cognition as an inter-bodily (...) and ecologically afforded achievement, and in light of this theoretical development we propose an approach to metaphor as a multi-body, multi-party, and multi-timescale phenomenon. On a methodological level we demonstrate a new way of analyzing metaphoricity in multimodal social interaction based on in-depth video analyses of two real life examples in which we introduce metaphorical identification criteria focusing on doubleness in meaning, affordances for co-action, co-ordination, and co-exper.. (shrink)

Plausibility models are Kripke models that agents use to reason about knowledge and belief, both of themselves and of each other. Such models are used to interpret the notions of conditional belief, degrees of belief, and safe belief. The logic of conditional belief contains that modality and also the knowledge modality, and similarly for the logic of degrees of belief and the logic of safe belief. With respect to these logics, plausibility models may contain too much information. A proper notion (...) of bisimulation is required that characterises them. We define that notion of bisimulation and prove the required characterisations: on the class of image-finite and preimage-finite models, two pointed Kripke models are modally equivalent in either of the three logics, if and only if they are bisimilar. As a result, the information content of such a model can be similarly expressed in the logic of conditional belief, or the logic of degrees of belief, or that of safe belief. This, we found a surprising result. Still, that does not mean that the logics are equally expressive: the logics of conditional and degrees of belief are incomparable, the logics of degrees of belief and safe belief are incomparable, while the logic of safe belief is more expressive than the logic of conditional belief. In view of the result on bisimulation characterisation, this is an equally surprising result. We hope our insights may contribute to the growing community of formal epistemology and on the relation between qualitative and quantitative modelling. (shrink)

This paper proposes an analytical framework for the analysis of organizational cognition that borrows from distributed and ecological cognition. In so doing, we take a case study featuring a decision on the topic of agreeing on a set point in the agenda of a meeting. It is through the analysis of a few minutes of video-recording used in the case that enables us to demonstrate the power of applying distributed and ecological cognition to organizing processes. Cognitive mechanism, resources, and processes (...) are identified within this combined framework. Mechanisms are described as “socio-material” —where “people” and “artifacts” are the related cognitive resources—and as “conceptual” —with “group” identity, “topic” understanding, meaning of “procedures,” and perception of “time” as resources. Processes are defined as “coupling,” “de-coupling,” and “un-coupled” depending on the type of relation in place. Finally, the paper presents an agent-based computational simulation to demonstrate the potentials of operationalizing this approach. (shrink)

This paper investigates an unexplored indexical dimension inherent in the mapping structure of metaphor. The empirical focus is on the metaphor of stain but the scope of indexicality in relation to...

This book moves toward building a new and more comprehensive theory of literature, philosophy, psychology, and art. The extremely popular work of Ken Wilber, unites the best of both western and eastern thought and affirms that the stages of consciousness, more refined than that of the reasoning mind, do exist.

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students’ perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories (...) and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be “in” medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training. (shrink)

The contact hypothesis has dominated work on prejudice reduction and is often described as one of the most successful theories within social psychology. The hypothesis has nevertheless been criticized for not being applicable in real life situations due to unobtainable conditions for direct contact. Several indirect contact suggestions have been developed to solve this “application challenge.” Here, we suggest a hybrid strategy of both direct and indirect contact. Based on the second-person method developed in social psychology and cognition, we suggest (...) working with an engagement strategy as a hybrid hypothesis. We expand on this suggestion through an engagement-based intervention, where we implement the strategy in a theater performance and investigate the effects on prejudicial attitudes toward people with physical disabilities. Based on the results we reformulate our initial engagement strategy into the Enact hypothesis. To deal with the application challenge, this hybrid hypothesis posits two necessary conditions for prejudice reduction. Interventions should: work with engagement to reduce prejudice, and focus on the second-order level of attitudes formation. Here the aim of the prejudice reduction is not attitude correction, but instead the nuancing of attitudes. (shrink)

Thomas Nagel recognizes that it is commonly believed that people can neither be held morally responsible nor morally assessed for what is beyond their control. Yet he is convinced that although such a belief may be intuitively plausible, upon reflection we find that we do make moral assessments of persons in a large number of cases in which such assessments depend on factors not under their control. Of such factors he says: (p. 26).

We investigated whether memories are selected for the life story based on event characteristics. Sixty-one students completed weekly diaries over their first term at university. They described, dated and rated two events each week. Three months after the end of the term they completed an unexpected memory test. They recalled three memories from the diary period that were important to their life story. Three randomly selected events scoring low on importance to the life story functioned as control memories. Life story (...) memories were rated higher on goal relevance, emotional intensity, importance and rehearsal in the diary and maintained their higher ratings at the test session, while ratings for control memories dropped off. Life story memories’ content was less consistent over time but they were more accurately dated than control memories. The results suggest that event characteristics play an important role for the selection of life story memories. (shrink)

In this collection of interviews, Derrick Jensen discusses the destructive dominant culture with ten people who have devoted their lives to undermining it. Whether it is Carolyn Raffensperger and her radical approach to public health, or Thomas Berry on perceiving the sacred; be it Kathleen Dean Moore reminding us that our bodies are made of mountains, rivers, and sunlight; or Vine Deloria asserting that our dreams tell us more about the world than science ever can, the activists and (...) philosophers interviewed in How Shall I Live My Life? each bravely present a few of the endless forms that resistance can and must take. (shrink)

This article contains an implicit comparison of the institutions and thought of the Italian city republics in the period from about 1150 to 1350 with medieval and early-modern monarchies and oligarchical republics, the latter being exemplified here by a passage from Bartolo of Sassoferrato. The grammarians, notaries, and jurists treated here are representative of the secular or lay professionalism that first emerged on a large scale in these republics. To these have been added occasional clerks who show the influence of (...) these legal and secular traditions, including Ptolemy of Lucca , whose On Princely Government continued a work by the far more famous Dominican Thomas Aquinas and hence enjoyed wide circulation and great influence. His work shows evidence of the influence of the translation of Aristotle's Politics done c. 1260; the only other author treated here who absorbed part of that tradition is the civilian jurist Bartolo of Sassoferrato. Most of the lawyers and other professionals derived their ideas from Roman law and, to a lesser extent, from Seneca and even Cicero. Readers may be surprised to observe that Marsiglio of Padua, surely Italy's premier political thinker, is not seen here at all or, rather, only once mentioned in passing. A reason for this is that he is much discussed in today's scholarly literature of political theory. A main intention of this author, however, has to do with him. It is to help explain the world he came from. If exaggerated, A. J. Carlyle's observation remains sound. Marsiglio, he said, “is not … setting out some new and revolutionary democratic doctrine, but is rather expressing, even if in rather drastic and unqualified terms, the normal judgement and practice of the [Italian] Middle Ages. (shrink)

*Tackles the Thomistic debate surrounding the inherent good and evil of human actions*.

Contemporary commentators on the history of ethics have devoted little attention to the ethical theory of Thomas Reid. The main reason for this neglect concerns the perspective from which they are very likely to view his theory. Roughly, this perspective is as follows. Eighteenth century ethics tends to be viewed as consisting mainly in the prolonged dispute concerning the nature of the moral faculty. In identifying Reid’s part in this dispute it should be noted that his Essays on the (...) Active Powers of the Human Mind, his major work on ethics, was published in 1788. It was therefore preceded by the works of such early rational intuitionists as Cudworth, Clarke, Balguy, and Wollaston and by the criticisms directed against them by such defenders of the moral sense position as Shaftesbury, Hutcheson, and Hume. Moreover, it was preceded by the intuitionistic counterattack directed against the latter by Richard Price, a near contemporary of Reid, who has often been described as the greatest of the intuitionists and whose prominence is such that his ethical theory has tended to eclipse that of Reid. The result is that there are in Reid a large number of pages devoted to restatements of an intuitionistic position which a contemporary reader has already encountered in earlier writers and which he is therefore likely to find rather boring. Even those who have maintained correctly that Reid is the founder of the Scottish school of common sense and that his ethical theory is to be seen in the context of his defense of common sense have added little to this perspective, since, generally speaking, they have found no significant differences between his ethical theory as seen in this context and intuitionism. Viewed from this perspective, Reid’s ethics might well be deserving of neglect and of the comment made by Alasdair MacIntyre that “the successors of Hume and Adam Smith in Scottish philosophy have little to say to us. Thomas Reid was a rationalist in the spirit of Price.”. (shrink)

This paper explores the continuing relevance of Karl Rahner’s work on development of doctrine to a church within a world marked by an emerging postmodern consciousness. It focuses primarily on three elements of development as Rahner understands it, theological discussion, the influence of the Spirit and the role of church authority. The discussion of a possible definition of Mary as co-redemptrix and the controversy over the ordination of women are cited as concrete examples of issues of development facing the church (...) today. Rahner’s increasing awareness of the context of irreducible plurality that marks the world-church of today and tomorrow led him to the increasing conviction in the later works that the Spirit is leading the church to a deepening understanding of the central mysteries of faith rather than to a further proliferation of defined dogmas. In the later works especially, he encouraged an attitude of open discussion that reflects the confidence that the Spirit is with the whole church as it struggles to express its faith in ever changing contexts. The paper concludes that Rahner’s understanding of the complex balance of elements involved in authentic doctrinal development continues to offer valuable insight to today’s discussions. (shrink)

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

Since the 1980s the concept of ANT has remained unsettled. ANT has continuously been critiqued and hailed, ridiculed and praised. It is still an open question whether ANT should be considered a theory or a method or whether ANT is better understood as entailing the dissolution of such modern ‘‘genres’’. In this paper the authors engage with some important reflections by John Law and Bruno Latour in order to analyze what it means to ‘‘do ANT,’’ and, doing so after ‘‘doing (...) ANT on ANT.’’ In particular the authors examine two post-ANT case studies by Annemarie Mol and Marilyn Strathern and outline the notions of complexity, multiplicity, and fractality. The purpose is to illustrate the analytical consequences of thinking with post-ANT. The analysis offers insights into how it is possible to ‘‘go beyond ANT,’’ without leaving it entirely behind. (shrink)

The influence of conscience on nurses in terms of guilt has frequently been described but its impact on care has received less attention. The aim of this study was to describe nurses' conceptions of the influence of conscience on the provision of inpatient care. The study employed a phenomenographic approach and analysis method. Fifteen nurses from three hospitals in western Sweden were interviewed. The results showed that these nurses considered conscience to be an important factor in the exercise of their (...) profession, as revealed by the descriptive categories: conscience as a driving force; conscience as a restricting factor; and conscience as a source of sensitivity. They perceived that conscience played a role in nursing actions involving patients and next of kin, and was an asset that guided them in their efforts to provide high quality care. (shrink)

This article argues for the value of working with conflicts in social practice as resources for collaboration, learning and development. The interest in conflicts in social practice is rooted in a preoccupation with social power relations and how to understand and analyse power relations from a subject-science perspective. Following this interest, a methodological framework, best described as a kind of ‘mobile ethnography’, is discussed and exemplified through an empirical example. A preliminary conceptual framework for understanding power as a capacity for (...) action is presented. The overarching ambition of the article is to consider what democratic collaboration and coexistence entails and how it might be supported conceptually and analytically by the notion of conflicts as heuristics for social inquiry and by the notion of power as a capacity for action and social participation. (shrink)

Over the past few years, there has been a proliferation of artificial intelligence strategies, released by governments around the world, that seek to maximise the benefits of AI and minimise potential harms. This article provides a comparative analysis of the European Union and the United States’ AI strategies and considers the visions of a ‘Good AI Society’ that are forwarded in key policy documents and their opportunity costs, the extent to which the implementation of each vision is living up to (...) stated aims and the consequences that these differing visions of a ‘Good AI Society’ have for transatlantic cooperation. The article concludes by comparing the ethical desirability of each vision and identifies areas where the EU, and especially the US, need to improve in order to achieve ethical outcomes and deepen cooperation. (shrink)

Ethical decision making is of concern to researchers across all fields. However, researchers typically focus on the biases that may act to undermine ethical decision making. Taking a new approach, this study focused on identifying the most common compensatory strategies that counteract those biases. These strategies were identified using a series of interviews with university researchers in a variety of areas, including biological, physical, social, and health as well as scholarship and the performing arts. Interview transcripts were assessed with two (...) scoring procedures, an expert rating system and computer-assisted qualitative analysis. Although the expert rating system identified Understanding Guidelines, Recognition of Insufficient Information, and Recognizing Boundaries as the most frequently used compensatory strategies across fields, other strategies, Striving for Transparency, Value/norm Assessment, and Following Appropriate Role Models, were identified as most common by the computer-assisted qualitative analyses. Potential reasons for these findings and implications for training and practice are identified and discussed. (shrink)

A number of researchers have begun to demonstrate that the widely discussed ?Knobe effect? (wherein participants are more likely to think that actions with bad side-effects are brought about intentionally than actions with good or neutral side-effects) can be found in theory of mind judgments that do not involve the concept of intentional action. In this article we report experimental results that show that attributions of knowledge can be influenced by the kinds of (non-epistemic) concerns that drive the Knobe effect. (...) Our findings suggest there is good reason to think that the epistemic version of the Knobe effect is a theoretically significant and robust effect, and that the goodness or badness of side-effects can often have greater influence on participant knowledge attributions than explicit information about objective probabilities. Thus, our work sheds light on important ways in which participant assessments of actions can affect the epistemic assessments participants make of agents? beliefs. (shrink)

The increasing interconnectedness of academic research and external industry has left research vulnerable to conflicts of interest. These conflicts have the potential to undermine the integrity of scientific research as well as to threaten public trust in scientific findings. The present effort sought to identify themes in the perspectives of faculty researchers regarding conflicts of interest. Think-aloud interview responses were qualitatively analyzed in an effort to provide insights with regard to appropriate ways to address the threat of conflicts of interest (...) in research. Themes in participant responses included disclosure of conflicts of interest, self-removal from situations where conflict exists, accommodation of conflict, denial of the existence of conflict, and recognition of complexity of situations involving conflicts of interest. Moral disengagement operations are suggested to explain the appearance of each identified theme. In addition, suggestions for best practices regarding addressing conflicts of interest given these themes in faculty perspectives are provided. (shrink)