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)

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.

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)

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)

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)

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.

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 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)

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).

In nine lively essays, bioethicist J. David Velleman challenges the prevailing consensus about assisted suicide and reproductive technology, articulating an original approach to the ethics of creating and ending human lives. He argues that assistance in dying is appropriate only at the point where talk of suicide is not, and he raises moral objections to anonymous donor conception. In their place, Velleman champions a morality of valuing personhood over happiness in making end-of-life decisions, and respecting the personhood of future children (...) in making decisions about procreation. These controversial views are defended with philosophical rigor while remaining accessible to the general reader. Written over Velleman's 30 years of undergraduate teaching in bioethics, the essays have never before been collected and made available to a non-academic audience. They will open new lines of debate on issues of intense public interest."--Publisher's website. (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)

The main theme of Nietzsche’s first published work, The Birth of Tragedy, is that the affirmation of life requires ‘illusion’ which allows us to cope with the ‘insight into the horrible truth’ of our condition. This article argues that Nietzsche held the same position in his later works: that illusion is a necessary to affirm life. The discussion is organized as follows. Section 1 sets out the core thesis of BT vis-à-vis the relationship between affirmation and illusion. Section 2 (...) examines the role of illusion in one of Nietzsche’s litmus tests of affirmation found in The Gay Science of 1882, ‘amor fati’—that is, the ability ‘to see as beautiful what is necessary in things’. Sections 3, 4, and 5 consider Nietzsche’s understanding of ‘self-creation’ and how, through the employment of ‘distance’ and ‘pretence’, it engenders an affirmation of existence. Finally, Section 6 attempts a provisional assessment of Nietzsche’s conception of affirmation. (shrink)

Various tribes deny that males have a role in causing pregnancy. Edmund Leach thinks members don’t actually believe tribal dogma. I propose that there is a practical value in denying our biological knowledge.

Fifty adults who had made monetary contributions to political campaigns were interviewed to determine differences between liberals and conservatives in terms of personality, child-rearing attitudes, and birth order/sex variables. Study 1 found liberals to favor nonrestrictive controls both on self and on children, while conservatives tended to favor the opposite. Women were more likely than men to be liberals, and all first-born females were liberals. In Study 2, the sample as a whole was high in self-esteem and autonomy, and (...) there were no significant differences between liberals and conservatives. Although saying that liberals are Democrats and conservatives are Republicans is accurate to some extent, it misses the fact that many do not identify with either party but consider themselves to be independents. (shrink)

This article concerns John Gay’s 1731 essay ‘Preliminary Dissertation Concerning the Fundamental Principle of Virtue or Morality’. Gay undertakes two tasks here, the first of which is to supply a criterion of virtue. I argue that he is the first modern philosopher to claim that universal happiness is the aim of moral action. In other words: Gay is the first utilitarian. His second task is to explain the source of moral motivation. He draws upon the principles of association to argue (...) (a) that we develop benevolent motives by associating the idea of our happiness with that of others and (b) that we come to approve of benevolence by recognizing that our happiness is inextricably connected with the general happiness. While some scholars have taken an interest in Gay’s essay, a sustained treatment of its contents does not exist, despite its acknowledged influence on Hume, Hartley, James Mill, and John Stuart Mill. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Vessel of Honor: The Virgin Birth and the Ecclesiology of Vatican II by Brian A. GraebeAaron Pidel S.J.Vessel of Honor: The Virgin Birth and the Ecclesiology of Vatican II. By Brian A. Graebe (Steubenville, OH: Emmaus Academic, 2021), 351 pp.Though Mary's undiminished virginity in giving birth (virginitas in partu) was long understood to be an event as miraculous and a teaching as authoritative as her (...) virginity in conceiving (virginitas ante partum), virginitas in partu underwent a kind of existential reinterpretation in the middle of the twentieth century. Authors such as Albert Mitterer and Karl Rahner suggested that, physically speaking, Jesus's birth might have happened like any other, rupturing the hymen, distending the birth canal, and causing Mary pain, albeit not in the spiritually disintegrating way common to postlapsarian humanity. These arguments effectively "unsettled" the traditional understanding of virginitas in partu, leading theologians of the highest stature to distinguish between the doctrine itself and the anatomical aspects attached to it over time. Fr. Brian Graebe has written a fine book arguing that the bodily dimensions of the virgin birth, including the physical "seal" of virginity, belong to the substance of the doctrine. This more inclusive understanding not only does better justice to the data of tradition, he argues, but illuminates the ecclesiology of the Second Vatican Council. The book impresses by its theologically reflective method, its clarity of exposition, [End Page 1106] and its depth of research—especially into the archival and antepreparatory sources of Vatican II.Vessel of Honor responds in effect to Rahner's argument that physical intactness is peripheral to the dogmatic core of Mary's virginity in partu. To show otherwise, Rahner contended, one would need to show that such a doctrine can be found directly in the apostolic teaching, or that it, "being implicitly contained therein, has grown out of the apostolic doctrine, by a legitimate historical, logical, and theological process, as its authentic development" (68–69). If the bodily aspects of this doctrine really belonged to the deposit of faith, in other words, one would need to show how they are implied in the traditio divino-apostolica, as well as how they cohere organically with the rest of the deposit. The two major parts of Vessel of Honor respond in turn to each aspect of Rahner's challenge.The first three chapters argue that Mary's bodily integrity in parturition belongs at least implicitly to the traditio divino-apostolica. Turning first to the postapostolic tradition, Fr. Graebe shows that—apart from the early exceptions of Origen and Tertullian—patristic sources either affirm or strongly imply a miraculous delivery. This constant witness culminates in the Lateran Council (649 AD), which, while not itself an ecumenical council, was received into the magisterium of Pope Martin and affirmed by the Third Council of Constantinople (680 AD). Its teaching that Mary "gave birth without corruption" (incorruptibiliter... genuisse) would be defended by Paschasius, Ratramnus, Thomas Aquinas, and others. This consensus remained undisturbed until the eve of Vatican II.Even at Vatican II, Fr. Graebe argues in the next chapter, the Council Fathers intended to reaffirm the more inclusive idea of virginitas in partu against those who would marginalize its bodily dimensions. Here he really breaks new ground, delving deep into the antepreparatory, preparatory, and conciliar drafting history. He shows convincingly that many of the chief drafters of the final formula—"Our Lord, who did not diminish his mother's virginal integrity but sanctified it..." (Lumen Gentium §57)—saw it as excluding Rahner's and Mitterer's minimalizing interpretations. Drawing on material from the Vatican Apostolic Archives, Fr. Graebe shows that some of the very theologians who voted to omit the pointed phrase "in the birth itself" (in ipsomet partu) did so for tonal rather than substantive reasons.The third chapter argues that Mary's physical integrity in birth is to be believed with divine and Catholic faith, despite the ongoing confusion introduced by Rahner and others. Admittedly, Vatican II did not define but merely reaffirmed the traditional understanding of virginitas in partu. But there are other reasons for including it in the traditio divino-apostolica. [End Page 1107] Drawing heavily... (shrink)

Background Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. Methods This article examines two cases—vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on (...) class='Hi'>birth trends and outcomes. Results Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother’s versus the infant’s health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Conclusion Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes. (shrink)