Lærdom der lyser -- Calderón : livet er en drøm -- Carl von Linné : Nemesis Divina -- Friedrich Schlegel -- Grundtvig og Kierkegaard -- F.C. Sibbern : meddelelser af indholdet af et skrift fra aar 2135 -- Sjælens triumf -- Fantasiens Janushoved : den historiske roman og fremtidsvisionen -- Når oldtid bliver til nutid -- Angsten der helbreder : David Lodge og Kierkegaard som terapeut.

1. Digteren og kunstkritikeren.--2. Filosoffen og teologen.--3. Prædikanten, kirkestormeren og autobiografen.--4. Indledninger og tekstforklaringer.

BackgroundDefensive practice occurs when physicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks, rather than to advance patient care. This behaviour is counter to physicians’ ethical responsibilities, yet is widely reported in surveys of doctors in various countries. There is a lack of qualitative research on the drivers of defensive practice, which is needed to inform strategies to prevent this ethically problematic behaviour.MethodsA qualitative interview study investigated the views and experiences of (...) physicians in Australia on defensive practice and its contribution to low value care. Interviewees were recruited based on interest in medico-legal issues or experience in a health service involved in ‘Choosing Wisely’ initiatives. Semi-structured interviews averaged 60 min in length. Data were coded using the Theoretical Domains Framework, which encapsulates theories of behaviour and behaviour change.ResultsAll participants (n = 17) perceived defensive practice as a problem and a contributor to low value care. Behavioural drivers of defensive practice spanned seven domains in the TDF: knowledge, focused on inadequate knowledge of the law and the risks of low value care; skills, emphasising patient communication and clinical decision-making skills; professional role and identity, particularly clinicians’ perception of patient expectations and concern for their professional reputation; beliefs about consequences, especially perceptions of the beneficial and harmful consequences of defensive practice; environmental context and resources, including processes for handling patient complaints; social influences, focused on group norms that encourage or discourage defensive behaviour; and emotions, especially fear of missing a diagnosis. Overall, defensive practice is motivated by physicians’ desire to avoid criticism or scrutiny from a range of sources, and censure from their professional peers can be a more potent driver than perceived legal consequences.ConclusionsThe findings call for strengthening knowledge and skills, for example, to improve clinicians’ understanding of the law and their awareness of the risks of low value care and using effective communication strategies with patients. Importantly, supportive cultures of practice and organisational environments are needed to create conditions in which clinicians feel confident in avoiding defensive practice and other forms of low value care. (shrink)

Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of contextual changes. Nurses hold a crucial (...) position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing. (shrink)

Research into the use of videogames in education is on the rise, and they are cementing their position as part of the modernized, digital classroom. Sustainability education has also become a subject of interest among environmentally minded game developers and understanding the educational impact of such games is rapidly becoming an important field. This study examined the educational potential of the digital simulated ecosystem known as Eco, in order to reveal how playing Eco might promote environmental literacy and consciousness surrounding (...) ecosystems. Qualitative data from 7 respondents were subjected to a thematic analysis, revealing two main themes that highlight both game-based learning outcomes as well as barriers against learning. The findings indicate that Eco is a viable tool for promoting environmental literacy about ecosystems, and suggestions for future implementation of Eco are provided. (shrink)

With substance dualism and the existence of God, Swinburne (2004, The Existence of God, Oxford University Press, Oxford) and Moreland (2010, Consciousness and the Existence of God, Routledge, New York) have argued for a very powerful explanatory mechanism that can readily explain several philosophical problems related to consciousness. However, their positions come with presuppositions and ontological commitments which many are not prepared to share. The aim of this paper is to improve on the Swinburne-Moreland argument from consciousness by developing an (...) argument for the existence of God from consciousness without being committed to substance dualism. The argument proceeds by suggesting a solution to the exceptional-point-of-view problem, i.e., the question how it can be explained that there is a conscious being lucky enough to experience the point of view of a relatively tiny brain amidst a giant universe that is indifferent about which physical entities it brings about according to the laws of physics. (shrink)

It is often claimed that the intentions of physicians are multiple, ambiguous, and uncertain—at least with respect to end-of-life care. This claim provides support for the conclusion that the principle of double effect is of little or no value as a guide to end-of-life pain management. This paper critically discusses this claim. It argues that proponents of the claim fail to distinguish two different senses of “intention,” and that, as a result, they are led to exaggerate the extent to which (...) clinical intentions in end-of-life contexts are ambiguous and uncertain. It argues further that physicians, like others who make life and death decisions, have a duty to get clear on what their intentions are. Finally, it argues that even if the principle of double effect should be rejected, clinical intentions remain ethically significant because they condition the meaning of extraordinary clinical interventions, such as that of palliative sedation. (shrink)

""Catching Ourselves in the Act" is no less than an attempt to explain intelligence. Delightful how the author dismantles traditional views in.

Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral (...) doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves. (shrink)

Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of this therapeutic (...) optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)

The concept of imagination is notoriously ambiguous. Thus one must be cautious not to use ‘imagination’ as a placeholder for diverse phenomena and processes that perhaps have not much more in common than that they are difficult to assign to some other, better defined domain, such as perception, conceptual thought, or artistic production. However, this challenge also comes with great opportunities: the fecundity and openness of ‘imagination’ appeal to researchers from different disciplines with different approaches and questions, and it draws (...) together fields of enquiry that are initially considered far apart. Hence, arguably, the field of imagination is particularly poised for interdisciplinary enquiry. In the section on Imagination in Interdisciplinary Research, I will talk about some of the issues that have already entered that field of interdisciplinary inquiry. (shrink)

What standard or principle should guide decisionmaking concerning the permissibility of allowing children to be organ donors? For a long time, it has been widely assumed that the best interest of the child is the appropriate standard. But recently, several critics have charged that this standard fails to give due weight to the interests of the family and the intimate relationships that the family makes possible.1,2 This article reviews and rejects both the best-interest standard and the alternative standard recommended by (...) the critics. I then propose a new standard to help parents, healthcare professionals, and judges decide when it is and is not permissible for children to serve as organ donors. This new standard modifies and broadens the best-interest standard to allow it to account adequately for the contribution that intimate relationships make to the well-being of children. (shrink)

Functional explanations apply not only in cases of normal functioning, but also in the case of malfunctioning. According to a straightforward analysis, a bearer of the function to F is malfunctioning if and only if it does not F although it should do so. This makes malfunctions and malfunctionings analogous to negative causation and thus peculiarly problematic, because they seem to involve absent dispositions and absent processes. This analysis seems also to require that the function to F cannot be identical (...) with the disposition to F. Then we seem to be trapped in a dilemma: Either the realm of functions is separated from the realm of dispositions; then it seems that functions cannot be causally efficacious. Alternatively, functions are considered to be identical with dispositions; but then malfunctioning seems to be conceptually impossible. The paper defends and further develops the thesis of Röhl and Jansen that functions are not a special type of dispositions. For this purpose, it first reviews different varieties of malfunction and malfunctioning and suggests definitions of both malfunction and malfunctioning. It reviews how causal, etiological and intentional theories of functions can deal with these problems. In particular, the paper discusses the special-disposition account of the Basic Formal Ontology. Spear, Ceusters and Smith :103--128, 2016) have defended the special-disposition account of the Basic Formal Ontology by suggesting various strategies how a special-disposition account can deal with malfunctions. On the one side, the paper evaluates these strategies and indicates several problems arising from them. On the other hand, it describes how to account for the non-optionality and the causal efficacy of functions, if functions are not dispositions. While function types are not identical to disposition types, there are important interrelations between functions and dispositions, namely heuristically, from a design perspective for artefact functions, and from an evolutionary perspective for types of biological functions. (shrink)

This article presents an analysis and evaluation of what I call the “I’m not stupid” argument. This argument has ancient roots, which lie in Aristotle’s famous description of the weak man’s and strong man’s arguments. An “I’m not stupid” argument is typically used in a context of accusation and defense, by a defendant who argues that they did not commit the act of which they have been accused. The analysis of this type of argument takes the shape of an argumentative (...) pattern, which displays a full-fledged representation of its argumentation structure. It is based on a collection of ten contemporary instances of the “I’m not stupid” argument. Although ten instances constitute a small collection, the wide variation in the argumentative elements that they express explicitly or leave implicit made it possible to identify five new key premises in comparison with previous analyses of the weak man’s and strong man’s arguments (Walton, Tindale and Gordon 2014 in _Argumentation_ 28:85–119, 2014; Walton 2019 in _Argumentation_ 33:45–74, 2019). These new premises show that the crucial point of an evaluation of this argument is the arguer's supposedly rational character in making a gain-loss calculation. They also show that we need empirical data to strengthen our analyses of argument schemes and argumentation structures. (shrink)

This paper provides a new rationale for equating brain death with the death of the human organism, in light of well-known criticisms made by Alan D Shewmon, Franklin Miller and Robert Truog and a number of other writers. We claim that these criticisms can be answered, but only if we accept that we have slightly redefined the concept of death when equating brain death with death simpliciter. Accordingly, much of the paper defends the legitimacy of redefining death against objections, before (...) turning to the specific task of defending a new rationale for equating brain death with death as slightly redefined. (shrink)

In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)

Paediatric Intensive Care Units (PICU) are complex interdisciplinary environments where challenging, high stakes decisions are frequently encountered. We assert that appropriate decisions are more likely to be made if the decision-making process is comprehensive, reasoned, and grounded in thoughtful deliberation. Strategies to overcome barriers to high quality decision-making including, cognitive and implicit bias, group think, inadequate information gathering, and poor quality deliberation should be incorporated. Several general frameworks for decision-making exist, but specific guidance is scarce. In this paper, we provide (...) specific guidance on collaborative complex decision-making for PICUs. The proposed approach is on principles of procedural justice and pragmatic hermeneutics. The process encompasses set-up/planning, information gathering, question formulation, analysis (perspectives, values, and principles), action plan development, decision documentation, and a review and appeal mechanism. The process can be adapted to suit other clinical contexts. Research evaluating the process, exploring how best to develop education for clinicians, and how to build a culture that values high quality deliberation, is worthwhile. (shrink)

Introducing formal causation / Ludger Jansen and Petter Sandstad -- Form, intention, information : from scholastic logic to artificial intelligence / Gyula Klima -- Formal causation : accidental and substantial / David S. Oderberg -- A non-hylomorphic account of formal causation / Petter Sandstad and Ludger Jansen -- Formal causes for powers theorists / Giacomo Giannini and Stephen Mumford -- Away with dispositional essences in trope theory / Jani Hakkarainen and Markku Keinänen -- Functional powers / Michele Paolini (...) Paoletti -- An Aristotelian approach to existential dependence / Benjamin Schnieder and Jonas Werner -- Finean feature dependence and the Aristotelian alternative / Wolfgang Sattler -- A problem for natural-kind essentialism and formal causes / José Tomás Alvarado and Matthew Tugby -- Form as cause and the formal cause : Aristotle's answer / James G. Lennox -- Form, cause, and explanation in biology : a neo-Aristotelian perspective / Christopher J. Austin -- Formal explanation and mechanisms of conceptual representation / Sandeep Prasada. (shrink)

In this article I address the idea that in Husserl’s eidetic ontology all possibilities are fixed ‘in advance’ so that actual objects and events—despite their contingency—can only ever unfold possibilities that are ‘permitted’ to them by their essences. I show how this view distorts Husserl’s ontology and argue that this distortion stems from a misconstrual of the relations between essences and facts, and between ideal and real possibilities. These ‘local’ misconstruals reflect, I contend, a ‘global’ misunderstanding that mistakes descriptive distinctions (...) for ‘real’ separations, and that remains indebted to a non-Husserlian understanding of the a priori–a posteriori-distinction. In support of this argument, I first lay out the relevant objection to Husserl’s eidetics as I understand it. Then, I clarify the relation between ideal and real possibilities in the context of Husserl’s eidetics as I see it. Finally, I make a general point about the status of Husserl’s ontological differentiations ‘in the midst of life,’ namely in how what they differentiate is effective and (tacitly) manifest ever only as one moment (amongst many) of the complex whole that is a concrete life of consciousness. I end with some remarks on what this might mean for future phenomenological research on the imagination. (shrink)

Being an "untimely review", this paper reviews Aristotle's 'Categories' as if they were published today, in the era of computerised information, where categorisation becomes more and more essential for information retrieval. I suggest a systematic ordering of Aristotle's list of categories and argue that Aristotle's discussion of ontological dependency and his focus on concrete entities are still a source of new insight and can indeed be read as a contribution to the emerging field of applied ontology and ontological engineering.

The allocation of vaccines and therapeutics for Covid‐19 obviously raises ethical questions, and physicians and ethicists have begun to address them. Writers have identified various criteria that should guide allocation decisions, but the criteria often conflict and need to be balanced against one another. This article proposes a model for thinking about how different considerations that are relevant to the distribution of vaccines and scarce treatments for Covid‐19 could be integrated into an allocation procedure. The model employs the construct of (...) a weighted lottery, which is a construct that has been employed in other contexts that involve the distribution of scarce resources. The article highlights the advantages of applying a weighted lottery to the Covid‐19 context and offers an illustration for how it might work in practice. The primary aim of the article is to articulate the structural features of a weighted lottery for this context and to bring out its advantages over other methods for allocating Covid‐19 medications. (shrink)

In this paper, I draw from Kantian and Husserlian reflections on the self-awareness of thinking for a contribution to the cognitive phenomenology debate. In particular, I draw from Kant’s conceptions of inner sense and apperception, and from Husserl’s notions of lived experience and self-awareness for an inquiry into the nature of our awareness of our own cognitive activity. With particular consideration of activities of attention, I develop what I take to be Kant’s and Husserl’s “agentive” and “proprietary” accounts. These, I (...) believe, augment contemporary discussions in interesting ways and further bolster the case for cognitive phenomenology. Moreover, the historical comparison highlights a number of assumptions made today that were not yet part of the framework at the time of Kant or at the time of Husserl. This helps reflect on the legitimacy of these assumptions. (shrink)

We are currently in the midst of a revival of interest in thevirtues. A number of contemporary moral philosophers havedefended a virtue-based approach to ethics. But does thisrenewal of interest in the virtues have much to contributeto medical ethics and medical practice? This paper criticallydiscusses this question. It considers and rejects a number ofimportant arguments that purport to establish the significanceof the virtues for medical practice. Against these arguments,the paper seeks to show that while the virtues have a genuinerole to (...) play in medical ethics, it is a limited role, one thatis subordinate to the role that other moral concepts such asrules and principles play. (shrink)

Este trabajo presenta algunos aspectos introductorios a la lectura de las "Oraciones Inaugurales", el De nostri y el De mente heroica, y la "Sabiduría primitiva de los italianos", tenidas en cuenta por el traductor al español de estas obras viquianas, recientemente publicadas en un volumen .This papers presents some preliminary aspects related with the Inaugural Lectures , the De nostri, De mente heroica and the "Primitive Wisdom of Italians" which the Spanish translator has taken into account shortly before those works (...) appear in one single volume. (shrink)

A model for the trapping of animals with a circular pitfall is formulated. The model's assumptions are: The animals move independently according to the same Brownian motions. The boundary of the pitfall acts as an absorbing or elastic barrier. Initially a fixed number of animals is independently homogeneously distributed over a finite study area, or the initial positions follow a homogeneous planar Poisson process. The model depends on three free parameters: the motility of the animals, their reaction to the pitfall, (...) the initial density.It appears that the catches in disjoint time intervals are multinomially or independently Poisson distributed. The parameters of these distributions are obtained by solving certain partial differential equations. (shrink)

A fetus may survive an intentional interference with its intrauterine environment (1) if gestational age is mistaken and the procedure of induced abortion does not kill the fetus, (2) if a change of heart takes place after abortifacient drugs are taken and the abortion does not proceed, and (3) if a high-multiple pregnancy is reduced to a singleton or a twin pregnancy to improve the likelihood that the remaining fetuses will reach viability. In each case, through cause or coincidence, an (...) abnormal baby may be born. The well-intentioned physician, responding to a patient's medical or psychological needs, risks a legal action in negligence or assault brought by a deformed surviving child. This hazard means that medical termination of pregnancy and selective pregnancy reduction put the practising physician at substantial risk in a way not usually associated with induced abortion. (shrink)

In order to develop the ontology of tendencies for use in the representation of medical knowledge, tendencies are compared with other kinds of entities possessing the realizable-realization structure, specifically: dispositions, propensities, abilities and virtues. The peculiarities of tendencies are discussed and a standard schema of tendency ascription is developed in order to represent the relations between the ascriptions of tendency tokens to particulars and the ascriptions of tendency types to universals. Two nonstandard cases and their epistemic variants are discussed.