We summarize the ethnographic literature illustrating that “abnormal birth” circumstances and “ill omens” operate as cues to terminate parental investment. A review of the medical literature provides evidence to support our assertion that ill omens serve as markers of biological conditions that will threaten the survival of infants. Daly and Wilson (1984) tested the prediction that children of demonstrably poor phenotypic quality will be common victims of infanticide. We take this hypothesis one stage further and argue that some children (...) will be poor vehicles for parental investment yet are not of demonstrably poor quality at birth. We conclude that when people dispose of infants due to “superstitious beliefs” they are pursuing an adaptive strategy in eliminating infants who are poor vehicles for parental investment. (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)

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)

Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer survivors in young adults increased from 1 in 1,000 to 1 in 250 patients due to more aggressive therapies. Current therapies may have profound toxic effects on gamete function with infertility as an expected consequence of cancer therapy. Depending on the site and stage of cancer, age of the patient, and (...) the type of treatment, approximately 90% of men and women diagnosed with cancer may be at risk of permanent infertility.Fertility preservation has emerged as a discipline dedicated to improving the future reproductive potential of cancer survivors. Significant progress in the advancement of fertility preservation therapies and a heightened awareness of the availability of therapies has occurred in the past 10 years. The American Society of Clinical Oncology and the American Society of Reproductive Medicine have advanced these efforts by formally recognizing the importance of fertility awareness. (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.

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 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)

_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)

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)

Birth, in many societies, is considered to be a private affair. Although health and medical professionals usually assist, the only other people who share the birth process with mothers are their nearest and dearest. With the rise of information communication technologies, however, birth is no longer an exclusively private event. Some women are now sharing their birthing experiences with millions of viewers who are part of the online video ‘community’ YouTube Broadcast Yourself. Searching the word ‘birth’ (...) on YouTube results in close to one million ‘hits’. This article is based on a small-scale, qualitative research project, which involved viewing and making notes on several hundred online videos of birth on YouTube and the accompanying posts and commentaries about the videos. These data were analysed through a feminist, poststructuralist and geographical lens. Throughout the article the term ‘cyber/space’ is used to highlight the mutually constituted nature of ‘real’ and virtual spaces. The article concludes that although YouTube has the potential to open up new windows on birth, this potential is not yet being realized. YouTube does not overcome or render insignificant material expressions of power, instead it typically privileges US experiences of birth, reiterates discourses of ‘good’ mothering and censors particular (mainly vaginal) representations of birth. (shrink)

Is it wrong to bring children who will have serious diseases and disabilities into the world? In particular, is it unfair to them? The notion that existence itself can be an injury is the basis for a recent new tort known as "wrongful life" (Steinbock, 1986). This paper considers Feinberg's theory of harm as the basis for a claim of wrongful life, and concludes that rarely can the stringent conditions imposed by his analysis be met. Another basis for maintaining that (...) it is morally wrong to have children under extremely adverse conditions is suggested: a principle of parental responsibility. We also argue that having children under such conditions may be unfair to the children, even if they have not been (in Feinberg's sense) harmed. Finally, we consider when conditions are sufficiently awful that having children might be viewed as incompatible with being a good parent and unfair to the child. (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)

This book offers a comprehensive treatment of the philosophical system of the seventeenth-century philosopher Pierre Gassendi. Gassendi's importance is widely recognized and is essential for understanding early modern philosophers and scientists such as Locke, Leibniz and Newton. Offering a systematic overview of his contributions, LoLordo situates Gassendi's views within the context of sixteenth- and early seventeenth-century natural philosophy as represented by a variety of intellectual traditions, including scholastic Aristotelianism, Renaissance Neo-Platonism, and the emerging mechanical philosophy. LoLordo's work will be essential (...) reading for historians of early modern philosophy and science. (shrink)

The first part of the paper presents three little arguments from theism to idealism. The second part employs these arguments to make sense of a puzzling doctrine of Jewish mysticism: the doctrine of divine contraction (heb. tzimtzum).

This article describes what the earliest concepts are like and presents a theory of the spatial primitives from which they are formed. The earliest concepts tend to be global, like animal and container, and it is hypothesized that they consist of simplified redescriptions of innately salient spatial information. These redescriptions become associated with sensory and other bodily experiences that are not themselves redescribed, but that enrich conceptual thought. The initial conceptual base becomes expanded through subdivision, sometimes aided by language that (...) points up these divisions or suggests new spatial analyses, and by the analogical extension of spatially derived concepts to nonspatial domains. This formulation is contrasted with Fodor's (1998) metaphysical theory of concept formation. (shrink)

Based on interviews with 40 first-time mothers, the authors develop an argument that supplements the critique of medicalized childbirth by focusing on the social context in which women give birth. Particularly important about that context is women's privatized responsibility for babies' well-being, and a dearth of social supports for mothering, including the sharing of that responsibility by fathers. Contextualizing childbirth in this way makes clearer not only why many women are favorable toward medical intervention but also the decisions women (...) make during hospital births. The women we interviewed displayed widely ranging reactions to giving birth in the hospital. Describing their experiences, these women often emphasized pain and anxiety. Both conditions appear to have been relieved as effectively by social support as by medical assistance. Furthermore, women who had generally supportive partners were less likely to receive medical intervention during the birth and less likely to suffer postpartum depression. (shrink)

How did the relations between philosophy and science evolve during the 17th and the 18th century? This book analyzes this issue by considering the history of Cartesianism in Dutch universities, as well as its legacy in the 18th century. It takes into account the ways in which the disciplines of logic and metaphysics became functional to the justification and reflection on the conceptual premises and the methods of natural philosophy, changing their traditional roles as art of reasoning and as science (...) of being. This transformation took place as a result of two factors. First, logic and metaphysics were used to grant the status of indubitable knowledge of natural philosophy. Second, the debates internal to Cartesianism, as well as the emergence of alternative philosophical world-views progressively deprived such disciplines of their foundational function, and they started to become forms of reflection over given scientific practices, either Cartesian, experimental, or Newtonian. (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)

Globally, there is a lack of adherence to the WHO definition of live birth. This is leading to untenable ethical inconsistencies due to significant variation in which infants are being acknowledged and registered as alive. If an infant is not registered as alive, there can be no acknowledgement of their rights as a child, and there are subsequent implications for worldwide child health resources and funding. Being alive should not be a quality that is geographically determined. This paper explores (...) the differing definitions that are used regarding live birth and the ethical and practical implications for infants, their families and child health worldwide. (shrink)

Pragmatism, taken not just as a philosophical movement but as a way of addressing problems, strongly influenced the debate on the foundations of probability during the first half of the twentieth century. Upholders of different interpretations of probability such as Hans Reichenbach, Ernest Nagel, Rudolf Carnap, Frank Ramsey, and Bruno de Finetti, acknowledged their debt towards pragmatist philosophers, including Charles Sanders Peirce, William James, Clarence Irving Lewis, William Dewey and Giovanni Vailati. In addition, scientist-philosophers like Ernst Mach, Ludwig Boltzmann, Henri (...) Poincaré, Pierre Duhem, and Karl Pearson, who heralded a conception of science and knowledge at large that was close to pragmatism, were very influential in that debate. Among the main interpretations of probability – frequentism, propensionism, logicism and subjectivism -, the latter is no doubt the closest to the pragmatist outlook. This paper concentrates on three representatives of the subjective theory, namely Frank Ramsey, Bruno de Finetti and Émile Borel. (shrink)

Introduction -- Context -- Overview of themes -- Reading the text -- Reception and influence.

This article argues that citizens have a basic right to invite family members and spouses into their society on the basis of Rawlsian egalitarian premises. This right is argued to be just as basic as other recognized basic rights, such as freedom of speech. The argument suggests further that we must treat immigration and family reunification, in particular, as central issues of domestic justice. The article also examines the implications of these points for the importance of immigration in liberal domestic (...) justice and suggests avenues for further research on the interplay of considerations of justice towards citizens and non-citizens. (shrink)

Philip Pettit’s The Birth of Ethics endeavours to illuminate the nature of morality by telling its genealogy. To help the reader appreciate the promise of this approach, Pettit begins by directing us to the case of money. If we want to understand what money is, we’re well advised to explore the social-historical conditions under which beings like us would have developed this medium of exchange. Doing so provides a more or less complete explanation of the emergence of money that (...) ‘demystifies’ its character. It is similar, Pettit suggests, with morality. If we want to understand what morality is, we should explore the ‘social conditions under which creatures of our ilk would have been more or less naturally driven, without conscious planning, to evolve and apply ethical concepts’. The reference to ‘creatures of our ilk’ is not idle. The leading idea is that we want to explain not how moral thinking in fact emerged among our actual ancestors, but rather how it more or less had to emerge among creatures like us in situations similar to ours. (shrink)

Mihaela Miroiu, Otilia Dragomir (eds.), Naşterea. Istorii trăite (Giving Birth. Life-stories), Iaşi: Polirom, 2010.

The reception of Elaine Scarry’s landmark text, The Body in Pain, focuses in part on exploring how pain might be understood as beneficial or therapeutic. Childbirth is often cited as the paradigmatic instance of this kind of beneficial pain. This essay examines conceptualizations of labour pain in biomedical, natural childbirth and reproductive justice movements that explore the limits of Scarry’s description of pain as ‘unshareable’. Political struggles over pain in childbirth centre on the legibility of pain in labour. Feminist and (...) natural childbirth activists have developed an understanding of pain at birth as central to maternal subjectivity, where pain is a biopolitical force and its management a means of self-transformation. Alongside calls for reproductive justice, the essay considers how the visibility and expressivity of labour pain could contribute to what Imogen Tyler and Lisa Baraitser term a new ‘natal politics’ that addresses concerns for the disproportionate injury and death experienced by Black birth givers. (shrink)