Against the background of the current debate in Germany, the paper explains and discusses ethical aspects of alternative consent systems for post-mortem organ donation. The focus is on opt-out and prompted choice solutions. The authors explain why libertarian paternalism might favour a prompted choice.

This article discusses the function, development and maintenance of meaning and the importance of meaning-making from different perspectives, as it is based on a collaboration between professionals from health science and psychology. The aim is to discuss how meaning-making processes can be employed in the health context to enhance individuals’ well-being. Starting point is a description of the common basis of the understanding of meaning-making. Afterwards brief examples from the different professional areas will show how meaning-making can improve health care (...) practice. We will focus on the processual nature of meaning-making, its existential layers, as well as the ways in which meaning-making is at play in everyday activities and limit situations, such as illness or suicidality. (shrink)

This article presents results from an empirical investigation of the role and importance of ethics in the daily work of Danish oncologyphysicians and Danish molecular biologists. The study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.We found that oncology physicians consider (...) ethical evaluation as part of their daily work. They discuss how to treat patients in groups and they have interdisciplinary seminars. In contrast, molecular biologists employed at the university do not think that basic research causes significant ethical problems, they do not talk about ethics in their daily work and they do not want to prioritise seminars on ethics. Molecular biologists employed in a private biopharmaceutical company do not think that basic research causes significant ethical problems, but the private company prioritises ethical evaluation. If the company behaves unethical, they will be punished by the consumers and by the investors in the last end. In general, oncology physicians working in the clinic experience a closer relationship between their daily work and ethical problems concerning human beings than molecular biologists conducting basic research. (shrink)

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? In (...) this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics. (shrink)

Within the caring science paradigm, variations of a method of interpretation inspired by the French philosopher Paul Ricoeur's theory of interpretation are used. This method consists of several levels of interpretation: a naïve reading, a structural analysis, and a critical analysis and discussion. Within this paradigm, the aim of this article is to present and discuss a means of creating distance in the interpretation and the text structure by using narration in a poetic language linked to the meaning of the (...) text. Ricoeur's ‘Hermeneutical function of distanciation’ will be introduced, and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a particular kind of mediation in the interpretation. That narration represents an interpreted understanding of the whole, which facilitates an appropriate and evocative presentation of the interpreted data. This way of objectifying the text through narration can contribute yet another perspective to Ricoeur's rich and varied theory of interpretation. (shrink)

BackgroundThis study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups.MethodThis study is based on 12 semi-structured interviews with (...) three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsIn this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice.ConclusionThis study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. (shrink)

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work.

It is commonly assumed that there are differences in physicians’ and caregivers’ ethical attitudes towards clinical situations. The assumption is that the difference is driven by different values, views and judgements in specific situations. At Aalborg University Hospital, Denmark, we aimed to investigate these assumptions by conducting a large quantitative study. The study design, based on the Factorial Survey Method, was a carefully constructed survey with 50 questions designed to test which factors influenced the respondents’ ethical reasoning. The factors were (...) clustered into three categories of ethical reasoning and values. The categories were formulated in terms of easily recognizable ethical positions: consequential ethics, deontological ethics and relational ethics. Based on 2129 respondents, we found significant support for the assumption of differences between physicians and caregivers. The group of caregivers favoured the relational ethics view in clinical ethical situations, and the group of ph... (shrink)

_Vi gennemførte i 2016 et omfattende empirisk studie på Aalborg Universitetshospital med henblik på at afdække de forskellige sundhedsprofessioners etiske holdninger. Hensigten var at afdække eventuelle forskelle mellem professionerne samt at få begrebsliggjort de etiske tankemønstre, der er tilstede i den kliniske praksis. Vi fandt i den indledende dataanalyse, at vi med signifikans kunne vise, at plejegruppen i højere grad bruger nærhedsetiske og omsorgsetiske vurderinger, til forskel fra lægegruppen, der er mere pligtetisk funderet__. Undersøgelsen blev sat op ved brug af (...) vignetmetoden, der giver mulighed for at indsamle kvantitative data, der er velegnede til en statistisk analyse, men som samtidig også muliggør en kvalitativ undersøgelse ved en efterfølgende hermeneutisk analyse af udvalgte besvarelser. I denne artikel studerer vi undersøgelsens resultater inden for sygeplejegruppen alene med det formål at uddrage, hvad deres vurderinger kommer an på, og at diskutere, hvordan disse faktorer indbyrdes forholder sig til hinanden og skaber sammenhæng. Med udgangspunkt i dette finder vi frem til, hvordan sygeplejerskernes etiske holdninger som helhed formes af de særlige værdier, som den nærhedsetiske profil understøtter, men som videre også giver et mere fleksibelt og nuanceret billede af sygeplejeetikken._ _Nøgleord:_ sygeplejeetik, vignetmetoden, hermeneutik, patientperspektiv, klinisk praksis _ _ _English title: _Factors that influence nurses' attitude to "good clinical practice" - a qualitative analysis of data from an empirical study at Aalborg University Hospital In 2016, we conducted a comprehensive empirical study at Aalborg University Hospital in order to uncover the ethical attitudes of various health professions. The intention was to uncover any differences between professions as well as to conceptualize the ethical thought patterns present in clinical practice. We found in the preliminary data analysis that we could show with significance that the group of care givers uses relational ethics and care ethics assessments to a greater extent as opposed to the more duty ethics based group of physicians. The study was set up using the vignette method, which allows for the collection of quantitative data suitable for statistical analysis, but which also allows for a qualitative study by a subsequent hermeneutical analysis of selected answers. In this article we study the results of the study within the nursing group solely for the purpose of extracting what their assessments depend on and discussing how these factors relate to each other and create some form of moral coherence. Based on this we find how nurses' ethical attitudes are shaped by the particular values ​​that the relational ethical profile supports, but also how this profile is modified and flexible to the conditions of clinical settings and situations. In the end our interpretation provides us with a more nuanced picture of nursing ethics than a single theoretical perspective or a set of guidelines provide. _Keywords:_ nursing ethics, the vignette method, hermeneutics, patient perspective, clinical practice. (shrink)

This report documents the program and the outcomes of Dagstuhl Seminar 21381 "Conversational Agent as Trustworthy Autonomous System ". First, we present the abstracts of the talks delivered by the Seminar’s attendees. Then we report on the origin and process of our six breakout groups. For each group, we describe its contributors, goals and key questions, key insights, and future research. The themes of the groups were derived from a pre-Seminar survey, which also led to a list of suggested readings (...) for the topic of trust in conversational agents. The list is included in this report for references. (shrink)

BackgroundThe experiences of UK ethnic minority healthcare workers are crucial to ameliorating the disproportionate COVID-19 infection rate and outcomes in the UKEM community. We conducted a qualitative study on UKEM healthcare workers’ perspectives on COVID-19 vaccine hesitancy in the UKEM community.MethodsParticipants were 15 UKEM healthcare workers. Data were collected using individual and joint interviews, and a focus group, and analyzed using thematic analysis.ResultsWe generated three themes: heterogeneity, mistrust, and mitigating. Therein, participants distinguished CVH in the UKEM community in educational attainment (...) and ethnicity. They pointed to the role of mistrust in CVH in the UKEM community. They opined that the mistrust underlying CVH in the UKEM community is rooted in history and religion, conspiracy theories, the speedy development and novelty of the vaccines, post-vaccination complications/side effects, false positive test results, and social media and social support/influence. Participants recommended that interventions targeted at mitigating CVH in the UKEM community need to, in a non-judgmental way, tackle dis/misinformation and provide education, and incorporate UKEM healthcare worker endorsement. They also suggested such interventions be community-oriented, enhance the convenience of vaccination centers and the possibility of vaccine choice, and appreciate that overcoming CVH and accepting vaccination is a gradual process involving personal assessment of risks and benefits.ConclusionCVH in the UKEM community is a multifaceted phenomenon requiring multicomponent interventions. (shrink)

The goal of this paper is to show that a particular view of emotion sharing and a specific hypothesis on infant social perception strengthen each other. The view of emotion sharing is called “the straightforward view.” The hypothesis on infant social perception is called “the pairing account.” The straightforward view suggests that participants in emotion sharing undergo one and the same overarching emotion. The pairing account posits that infants perceive others’ embodied experiences as belonging to someone other than the self (...) through a process of assimilation to, and accommodation of, their own embodied experience. The connection between the two theories lies in the domain-general process of association by similarity, which functions both in the individuation of a unitary emotion and in the interpretation of the sensory stimulus. By elaborating on this connection, the straightforward view becomes more solid from the cognitive-developmental standpoint and the pairing account expands its explanatory power. Since the straightforward view requires minimal forms of self- and other-awareness, the paper provides a characterization of the developmental origin of the sense of us, i.e., the experience of self and other as co-subjects of a shared emotional state. (shrink)

In a previous paper, we argued that death's badness consists in the deprivation of pleasurable experiences which one would have had, had one died later rather than at the time of one's actual death. Thus, we argued that death can be a bad thing for the individual who dies, even if it is an experiential blank. But there is a pressing objection to this view, for if the view is correct, then it seems that it should also be the case (...) that it is a bad thing for a person that he is born when he actually is born, rather than earlier. That is, if the deprivation account is the correct account of death's badness, then it appears that one should have symmetric attitudes to prenatal and posthumous nonexistence. But clearly we do not in general have symmetric attitudes toward the period before our birth and the period after our death; in general, we do not think of our late births as a bad thing, but we can indeed consider our early deaths as bad for us. Thus, it appears that there is a problem for the deprivation account of death's badness. (shrink)

In ‘Dilemma for Appeals to the Moral Significance of Birth’, we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her (...) decision is wrong as well as deny the underlying normative principle that killing a viable fetus requires good reason, and not wanting to care for the child when the child could be easily placed for adoption is not a good enough reason to abort. If they reject the moral permissibility of the late-term abortion, they need to explain why her decision is wrong. Doing so, however, will undermine their own project of denying infanticide by appeal to birth. Walter Veit argues that the dilemma relies too much on intuition and does not live up to biological continuity. We explain why his criticisms are unconvincing. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

This article critically considers Castoriadis’ central concept of creation ex nihilo. It does so in two ways. It first draws on recent research to suggest that the historical inauguration of the project of autonomy in ancient Greece - in both its political and philosophical aspects - was more complex and contextually anchored than Castoriadis acknowledges: it did not surge forth out of nothing. Second, it considers the idea of creation from a theoretical perspective. Here the idea of creation as contextual (...) rather than absolute is offered. Within this suggested qualification, two lines of discussion - drawn from the hermeneutical and phenomenological traditions - are broached. (shrink)

Traces the development of Nietzsche's ideas on Jesus, St. Paul, and early Christianity.

Bobier and Omelianchuk argue that the Birth Strategy for addressing analogies between abortion and infanticide is saddled with a dilemma. It must be accepted that non-therapeutic late-term abortions are either, impermissible, or they are not. If accepted, then the Birth Strategy is undermined. If not, then the highly unintuitive claim that non-therapeutic late-term abortions are permissible must be accepted. I argue that the moral principle employed to defend the claim that non-therapeutic late-term abortions are morally impermissible fails to (...) do so. Furthermore, the principle that people have a right to bodily autonomy can be used as an argument for the conclusion that non-therapeutic late-term abortions are permissible and is intuitively stronger than the intuition for the opposite of this conclusion. This is because people having a right to bodily autonomy explains the impermissibility of rape and sexual assault. Consequently, the posited dilemma is defused and does not undermine the Birth Strategy. (shrink)

This paper examines Hannah Arendt’s contribution to recent debate concerning the urgency of Martin Heidegger’s original ethics. To this end, I turn to Arendt’s existential interpretation of birth as this takes shape in her discourse on the miracle. Though recent commentators have criticized Arendt’s emphasis on the miracle, I argue that she deepens a conversation about birth that Dennis Schmidt, following Jacques Derrida, has set in motion in his efforts to contribute to a more original ethics. Whereas Schmidt (...) prioritizes the helplessness of the newborn, Arendt’s interpretation of the miracle suggests that birth reminds us not simply of our responsibility to help the helpless, but also of our responsibility to prepare the world for the incalculable possibilities of the newcomer. In this, I argue that Arendt brings into focus the ground of our responsibility to make space in the world for what cannot be reduced and decided on in advance by calculative procedure, thereby opening new paths to thinking the task of original ethics. (shrink)

This paper examines how to best be with women during birth, based on a phenomenological description of the birth experience. The first part of the paper establishes birth as an uncanny experience, that is, an experience that is not only entirely unfamiliar, but even unimaginable. The way in which birth happens under unknowable circumstances creates a set of anxieties on top of the fundamental anxiety that emerges from the existential paradox by which it does not seem (...) possible for a body to give birth to another body. Would homebirth provide a remedy to the uncanniness? The result yielded by medical studies is confirmed by the phenomenological perspective taken here: homebirth might be reassuring for some, but not for everybody; choice of birth place is important. Once the birth process starts happening, another layer of strangeness is added: it turns out to be an experience of radical passivity and waiting, normally. The question thus becomes how to best care for somebody who is exposed to uncanniness, passivity, and waiting. Martin Heidegger’s concepts of care and discourse prove useful in examining how to facilitate rather than interrupt this process. It becomes necessary to think beyond verbal communication towards a wider concept of communication that involves silence and intercorporeality. Birth requires a special kind of being-with as being-there. (shrink)

This article explores how a nonreductionist account of Nietzsche's influence on Michel Foucault can enrich our understanding of key concepts in singular works of both philosophers. I assess this exegetical strategy by looking at the two dichotomies Apollinian/Dionysian and ars erotica/scientia sexualis in The Birth of Tragedy and volume 1 of The History of Sexuality, respectively. After exploring the relation between these two dichotomies, I link the science of sexuality to the Apollinian art instinct via the existence of Socratic (...) culture and argue against the "pleasure of analysis" as a sublated form of (Dionysian) ars erotica. These considerations lead to the notions of history in Nietzsche's and Foucault's philosophies that result in situating the polyvalent Ursprung of Greek tragedy and the descent of ars erotica and scientia sexualis in an antimetaphysical and nonteleological picture of historical development.. (shrink)

Blending western knowledge with eastern wisdom, this book tells how to nurture your child both physically and spiritually through various stages of growth. It explains normal age appropriate behaviour from birth to eight years old and beyond. It also offers practical advice on how to read the signs of tiredness, and different types of crying.

The Death of the Past argues that critical problems in the philosophy of history, such as the the truth of historical texts, how texts relate to the past that they are about, and the nature of historical explanation, can be successfully investigated if we accept the claim that historical writing is historicist--perspectival (from the standpoint of the historian) rather than purporting to be like an eyewitness account (as in the first-person "presentist" views critiqued by Enzo Traverso). This approach admits all (...) relevant evidence as subject to analysis in order to determine the widest point of view, as opposed to the biased "eyewitness" approach, which observes only partially. The link between the past itself and historical knowledge is radically broken, giving the latter the wisdom of hindsight across a broader temporal field from the events examined up to the present. The truth about the past is only accessible from a later point in time; "the past" itself is not a reality for the historian; it no longer exists. Frank Ankersmit offers a surprising foundation for the historicist notion of history: Leibniz' monadological universe, in which each monad or substance has its own point of view. There is no deeper ontology to which they owe their status--just an infinity of monads and a corresponding infinity of points of view on other monads. So with historical representations, statements about the past that can be either true or false but not depictions of the past itself. In striking contrast to Hayden White's view, Ankersmit insists that historical writing is no less rational than the sciences-- mathematical and scientific writing has its counterpart in the writing of history. (shrink)

ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were (...) conducted, and logistic models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

We examine 575 randomly selected articles on Zimbabwean immigrants from the South African Media database to expose discourses of exclusion and the production of the psycho-social condition – moral panic. We use critical discourse analysis, notions of remediation and immediacy to scrutinize discourse structures and other discursive strategies designed to conceal mediation and authorial prejudices, and to make the reader ‘experience’ the actual content. In addition to making the anti-immigrant rhetoric appear legitimate, and the danger immediate and real, we argue (...) that the apparent seamless content is often biased by selection and structured in such a way as to deny voice to immigrants and their advocates. Among other things, we conclude that since the readers’ interpretations are filtered through lenses of subjectivities defined by communicative contexts characterized by job scarcity, poverty, crime and wanting healthcare, the news content heightens anxiety and miseducates more than it enlightens readers on migration issues. Hence there is a danger of SAM becoming unwitting conveyors of the same vices they preach against. (shrink)