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)

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)

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)

_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)

Most scholars think not. But in this pioneering book, John H. Zammito challenges that view by revealing a precritical Kant who was immensely more influential than the one philosophers think they know.

Uncovering the historical roots of naturalistic, secular contemporary ethics, in this volume Michael Gill shows how the British moralists of the seventeenth and eighteenth centuries completed a Copernican revolution in moral philosophy. They effected a shift from thinking of morality as independent of human nature to thinking of it as part of human nature itself. He also shows how the British Moralists - sometimes inadvertently, sometimes by design - disengaged ethical thinking, first from distinctly Christian ideas and then from theistic (...) commitments altogether. Examining in detail the arguments of Whichcote, Cudworth, Shaftesbury, and Hutcheson against Calvinist conceptions of original sin and egoistic conceptions of human motivation, Gill also demonstrates how Hume combined the ideas of earlier British moralists with his own insights to produce an account of morality and human nature that undermined some of his predecessors' most deeply held philosophical goals. (shrink)

The notion of being a burden to others is mostly discussed in the context of care‐intensive diseases or end‐of‐life decisions. But the notion is also crucial in decision‐making at the beginning of life, namely regarding prenatal testing. Ever more sophisticated testing methods, especially non‐invasive prenatal testing (NIPT), allow the detection of genetic traits in the unborn child that may cause disabilities. A positive result often influences the decision of the pregnant women towards a termination of the pregnancy. Thus, critics claim (...) that these testing methods send a negative message to people with disabilities. At the core of this is what we call the burden assumption. This assumption claims that children with disabilities are necessarily a burden to others, especially to their parents and other family members. In this paper, we discuss what being a burden to others means in this context and how such an attitude can be avoided without restraining reproductive autonomy. A closer examination shows that the burden assumption is mostly based on misinformation and a false model of disability. Empirical studies as well as narrative evidence from parents who raise a child with disabilities show that the burden assumption is wrong. Raising a child with disabilities does not necessarily mean a decrease in the quality of life. We show how the burden assumption can be challenged through an advanced genetic counselling that combines empirical evidence with narratives from a first‐person perspective. (shrink)

Reading the New Nietzsche is devoted to a comprehensive analysis of the four most important and widely read of Nietzsche's works. After a largely biographical introduction, a chapter is devoted to each work. Read in succession they give an overall philosophical account of Nietzsche's thought.

Low birth weight, intrauterine growth retardation, and prematurity are overwhelming risk factors associated with infant mortality and morbidity. The lack of efficacious prenatal screening tests for these three outcomes illuminates the problems inherent in bivariate estimates of association. A biocultural strategy for research is presented, integrating societal and familial levels of analysis with the metabolic, immune, vascular, and neuroendocrine systems of the body. Policy decisions, it is argued, need to be based on this type of biocultural information in order (...) to impact the difficult-to-change problems of low birth weight, intrauterine growth retardation, and prematurity. (shrink)