BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Background The high public demand for healthcare services during the COVID-19 pandemic and strict infection control measures, coupled with threat of severe illness and death, and limited resources, led to many healthcare workers (HCWs) experiencing ethically challenging situations (ECSs). Objective To systematically explore first-hand accounts of ECS-evoking moral distress among HCWs during this public health emergency. Research design This was an open cohort study. All participants were asked whether they had been in ECS-evoking moral distress during the pandemic. Those who (...) had were asked to describe these situations. Answers were systematically analyzed according to three levels of root causes for ECSs, using thematic analysis. Participants and research context In January 2022, 977 HCWs from four Norwegian university hospitals participated. Ethical considerations The study received ethical approval from the Norwegian Ethical Review Authority (No. 130944). Results In total, 508 participants (52%) reported that they had experienced ECS-evoking moral distress during the pandemic, whereof 323 provided a qualitative description. We found that while a few reported ECSs caused at the patient level, and some described situations at the unit/team level, the vast majority reported situations caused at the system level, predominantly related to resource scarcity, particularly poor staffing. Conclusion Our findings strongly indicate that efforts to mitigate moral distress among HCWs should be targeted at the system level. More specifically, the study findings highlight resource limitations, particularly poor staffing, as a major cause of moral distress during the pandemic. (shrink)

Sustainability science seeks to extend scientific investigation into domains characterized by a distinct problem-solving agenda, physical and social complexity, and complex moral and ethical landscapes. In this endeavor it arguably pushes scientific investigation beyond its usual comfort zones, raising fundamental issues about how best to structure such investigation. Philosophers of science have long scrutinized the structure of science and scientific practices, and the conditions under which they operate effectively. We propose a critical engagement between sustainability scientists and philosophers of science (...) with respect to how to engage in scientific activity in these complex domains. We identify specific issues philosophers of science raise concerning current sustainability science and the contributions philosophers can make to resolving them. In conclusion we reflect on the steps philosophers of science could take to advance sustainability science. (shrink)

Written over the last 18 months of his life and inspired by his interest in G. E. Moore's defence of common sense, this much discussed volume collects Wittgenstein's reflections on knowledge and certainty, on what it is to know a proposition for sure.

In a celebrated experiment, Joshua Knobe showed that people are much more prone to attribute intentionality to an agent for a side effect of a given act when that side effect is harmful than when it is beneficial. This asymmetry has become known as ‘the Knobe Effect’. According to Knobe's Moral Valence Explanation, bad effects trigger the attributions of intentionality, whereas good effects do not. Many others believe that the Knobe Effect is best explained in terms of the high amount (...) of blame attributed in the harm condition, and the low amount of praise attributed in the help condition. This Blame Hypothesis explains the high number of intentionality attributions in the harm condition in terms of the high degree of blame people ascribe, and the low number of intentionality attributions in the help conditions in terms of the low degree of praise people attribute. We replicated Knobe's original experiment and conducted a logistic regression on the results to probe more deeply into the relationship between attributions of intentionality and responsibility. The statistical analysis revealed a hitherto unknown interaction effect: intentionality correlates with blame, but not with praise. This interaction effect is consistent with the Moral Valence Hypothesis, but inconsistent with the Blame Hypothesis, as well as with two of the three other hypotheses discussed here. (shrink)

This paper argues that the main global critiques of scientism lose their punch because they rely on an uncharitable definition of their target. It focuses on epistemological scientism and divides it into four categories in terms of how strong (science is the only source of knowledge) or weak (science is the best source of knowledge) and how narrow (only natural sciences) or broad (all sciences or at least not only the natural sciences) they are. Two central arguments against scientism, the (...) (false) dilemma and self‐referential incoherence, are analysed. Of the four types of epistemological scientism, three can deal with these counterarguments by utilizing two methodological principles: epistemic evaluability of reliability and epistemic opportunism. One hopes that these considerations will steer the discussion on scientism to more fruitful pastures in the future. For example, there are interesting methodological considerations concerning what evaluability or reliability and epistemic opportunism entail. (shrink)

We present a case study of how mathematicians write for mathematicians. We have conducted interviews with two research mathematicians, the talented PhD student Adam and his experienced supervisor Thomas, about a research paper they wrote together. Over the course of 2 years, Adam and Thomas revised Adam’s very detailed first draft. At the beginning of this collaboration, Adam was very knowledgeable about the subject of the paper and had good presentational skills but, as a new PhD student, did not yet (...) have experience writing research papers for mathematicians. Thus, one main purpose of revising the paper was to make it take into account the intended audience. For this reason, the changes made to the initial draft and the authors’ purpose in making them provide a window for viewing how mathematicians write for mathematicians. We examined how their paper attracts the interest of the reader and prepares their proofs for validation by the reader. Among other findings, we found that their paper prepares the proofs for two types of validation that the reader can easily switch between. (shrink)

The “practice turn” in philosophy of science has strengthened the connections between philosophy and scientific practice. Apart from reinvigorating philosophy of science, this also increases the relevance of philosophical research for science, society, and science education. In this paper, we reflect on our extensive experience with teaching mandatory philosophy of science courses to science students from a range of programs at University of Copenhagen. We highlight some of the lessons we have learned in making philosophy of science “fit for teaching” (...) outside of philosophy circles by taking selected cases from the students’ own field as the starting point. We argue for adapting philosophy of science teaching to particular audiences of science students, and discuss the benefits of drawing on research within science education to inform curriculum and course design. This involves reconsidering teaching resources, assumptions about students, intended learning outcomes, and teaching formats. We also argue that to make philosophy of science relevant and engaging to science students, it is important to consider their potential career trajectories. By anticipating future contexts and situations in which methodological, conceptual, and ethical questions could be relevant, philosophy of science can demonstrate its value in the education of science students. (shrink)

Mathematicians appear to have quite high standards for when they will rely on testimony. Many mathematicians require that a number of experts testify that they have checked the proof of a result p before they will rely on p in their own proofs without checking the proof of p. We examine why this is. We argue that for each expert who testifies that she has checked the proof of p and found no errors, the likelihood that the proof contains no (...) substantial errors increases because different experts will validate the proof in different ways depending on their background knowledge and individual preferences. If this is correct, there is much to be gained for a mathematician from requiring that a number of experts have checked the proof of p before she will rely on p in her own proofs without checking the proof of p. In this way a mathematician can protect her own work and the work of others from errors. Our argument thus provides an explanation for mathematicians’ attitude towards relying on testimony. (shrink)

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

This article criticises the notion that critical/political/ethical consumerism can solve issues related to sustainability and food production. It does this by analysing the complexity of the concept of sustainability as related to food choices. The current trend of pursuing a sustainable food production through critical purchase decisions rather than through regulation is shown to be problematic, as shopping for a more sustainable food system might be much harder than initially believed due to the conflicting values and inherent trade-offs entailed in (...) the different notions of sustainability. Thus, critical consumerism may give way to false expectations as the complexity of choices transpires. One obvious way out is to let decisions regarding food choices be made earlier in the food production chain as well as through new modes of governance engaging members of civil society in their capacity as citizens rather than consumers. This entails complementing society’s reliance on critical consumerism with a citizen-oriented and political process in support of making more sustainable food choices. (shrink)

Stress-related psychopathology is on the rise, and there is a pressing need for improved prevention strategies. Positive appraisal style, the tendency to appraise potentially threatening situations in a positive way, has been proposed to act as a key resilience mechanism and therefore offers a potential target for preventive approaches. In this article, we review n = 99 studies investigating associations of positive cognitive reappraisal, an important sub-facet of positive appraisal style, with outcome-based resilience and relevant other outcomes, which are considered (...) resilience-related. According to the studies reviewed, positive cognitive reappraisal moderates the relation between stressors and negative outcomes and is positively related to several resilience-related outcomes. It also mediates between other resilience factors and resilience, suggesting it is a proximal resilience factor. (shrink)

In this chapter we examine Moti Mizrahi’s claim that philosophers’ opposition of scientism is founded on their worry that scientism poses “a threat to the soul or essence of philosophy as an a priori discipline”. We find Mizrahi’s methodology for testing this thesis wanting. We offer an alternative hypothesis for the increased resistance of scientism: the antipathy started as a reaction to the New Atheist movement. We also consider two varieties of weak scientism, narrow and broad, and argue that narrow (...) versions of scientism draw unnatural and unfounded distinctions within science. Mizrahi belongs somewhere between these two types, but he commits the same mistakes as proponents of the narrow variety. We demonstrate that Mizrahi’s defence of weak scientism is problematic, once again, due to methodological reasons. As an alternative, we propose that weak scientism should be based on epistemic opportunism. Epistemic opportunism explains the success of science with scientists’ willingness to adopt any methods that demonstrably work. We also show how opportunistic scientism can avoid charges of triviality. (shrink)

Translated into Danish by Henrik Jøker Bjerre.

Background Making appropriate end-of-life decisions in the intensive care unit (ICU) requires shared interprofessional decision-making. Thus, a decision-making climate that values the contributions of all team members, addresses diverse opinions and seeks consensus among team members is necessary. Little is known about religion’s influence on ethical decision-making climates. Therefore, this study aimed to examine the association between religious belief and ethical decision-making climates. Methods The study was a cross-sectional analytical observation study as a part of the prospective observational DISPROPRICUS study. (...) A total of 2,275 nurses and 717 physicians from 68 ICUs representing 12 countries in Europe and the US participated. All participants were asked which religion (if any) they belonged to and how important their religion (if any) was for their professional attitude towards end-of-life care. Perceptions of ethical decision-making climates were evaluated using a validated, 35-item self-assessment questionnaire that evaluates seven factors. Using cluster analysis, ICUs were categorised into four ethical decision-making climates: good, average (with nurses’ involvement at the end of life), average (without nurses’ involvement at the end of life) and poor. Results Of the 2,992 participants, 453 (15%) were religious (had religious convictions and found them important or very important for their attitude towards end-of-life care). The remaining 2,539 were non-religious (i.e. had religious convictions but assessed that they were not important for their attitude towards end-of-life care). When adjusting for country and ICU, the overall perception of the four ethical climates was associated with religious beliefs, with non-religious healthcare providers having more positive perceptions of the ethical climates compared to religious healthcare providers (p < 0.01). Within good climates, non-religious healthcare providers rated leadership by physicians (p < 0.01), interdisciplinary reflection (p = 0.049) and active decision-making by physicians (p = 0.02) as more positive compared to religious participants. In poor climates, religious healthcare providers had a more positive perception of the active involvement of nurses (p = 0.01). Within the other climates, no differences were found. Conclusions Overall perceptions of ethical decision-making climates were associated with religious beliefs, with non-religious healthcare providers generally having a more positive perception of the ethical climates than religious healthcare providers. (shrink)

Resilience is often promoted as a boundary concept to integrate the social and natural dimensions of sustainability. However, it is a troubled dialogue from which social scientists may feel detached. To explain this, we first scrutinize the meanings, attributes, and uses of resilience in ecology and elsewhere to construct a typology of definitions. Second, we analyze core concepts and principles in resilience theory that cause disciplinary tensions between the social and natural sciences. Third, we provide empirical evidence of the asymmetry (...) in the use of resilience theory in ecology and environmental sciences compared to five relevant social science disciplines. Fourth, we contrast the unification ambition in resilience theory with methodological pluralism. Throughout, we develop the argument that incommensurability and unification constrain the interdisciplinary dialogue, whereas pluralism drawing on core social scientific concepts would better facilitate integrated sustainability research. (shrink)

© The Author 2016. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved.Cell walls of grasses, including cereal crops and biofuel grasses, comprise the majority of plant biomass and intimately influence plant growth, development and physiology. However, the functions of many cell wall synthesis genes, and the relationships among and the functions of cell wall components remain obscure. To better understand the patterns of cell wall accumulation and identify genes that act in grass (...) cell wall biosynthesis, we characterized 30 samples from aerial organs of rice at 10 developmental time points, 3-100 d post-germination. Within these samples, we measured 15 cell wall chemical components, enzymatic digestibility and 18 cell wall polysaccharide epitopes/ligands. We also used quantitative reverse transcription-PCR to measure expression of 50 glycosyltransferases, 15 acyltransferases and eight phenylpropanoid genes, many of which had previously been identified as being highly expressed in rice. Most cell wall components vary significantly during development, and correlations among them support current understanding of cell walls. We identified 92 significant correlations between cell wall components and gene expression and establish nine strong hypotheses for genes that synthesize xylans, mixed linkage glucan and pectin components. This work provides an extensive analysis of cell wall composition throughout rice development, identifies genes likely to synthesize grass cell walls, and provides a framework for development of genetically improved grasses for use in lignocellulosic biofuel production and agriculture. (shrink)

Zusammenfassung Hintergrund Die exponentiell wachsende Verfügbarkeit von Gesundheitsdaten bietet Forschenden ungeahnte Potenziale für Innovationen. Gleichzeitig gehen mit der Verwertung von Big Data auch große ethische Herausforderungen einher, die es zu bewältigen gilt, um den Anforderungen an verantwortungsvolle Forschung und Innovation gerecht zu werden (Gerke et al. 2020; Howe III und Elenberg 2020). Datensouveränität und die damit verbundenen Grundsätze der Selbstbestimmung und der informierten Zustimmung sind dabei zentrale Ziele. Allerdings hat deren konsistente Umsetzung enorme Konsequenzen für die Datenerhebung und -verarbeitung in (...) der Praxis. Dies trifft insbesondere angesichts einer Zunahme an Quantität und Komplexität von Daten im Gesundheitswesen zu. Denn aufgrund des Potenzials, relevante aber bisher verborgene Informationen aus der Datenmenge zu erschließen, ist eine zunehmende Anwendung von künstlicher Intelligenz (KI) in diesem Bereich zu erwarten (Jiang et al. 2017). Folglich besteht ein Bedarf an ethisch fundierten Handlungsanweisungen, die helfen, Datensouveränität und informierte Zustimmung in der klinischen Forschung umzusetzen. Material und Methoden Durch Anwendung einer narrativen Literaturrecherche in Kombination mit einem Design-Thinking-Ansatz soll das vorliegende Papier einen Beitrag zur Literatur leisten, indem die folgende Forschungsfrage beantwortet wird: Welche praktischen Anforderungen gibt es für eine konsequente Umsetzung von Datensouveränität und informierter Einwilligung im Gesundheitswesen? Ergebnisse Es wird gezeigt, dass Privatsphäre wahrende Technologien, menschenzentriert entwickelte Nutzungs- und Interaktionslösungen, erklärbare und vertrauenswürdige KI, Nutzerakzeptanz und -vertrauen, Patientenbeteiligung und eine wirksame Gesetzgebung zentrale Voraussetzungen für Datensouveränität und Selbstbestimmung in der klinischen Forschung sind. Die Bedeutung für die Entwicklung von IT-Lösungen im deutschen Gesundheitssystem wird dargelegt. (shrink)

Attachment is the way we relate to others. The way we attach to others is developed early in childhood, can be impaired by early traumatic life events, and is disturbed in many psychiatric disorders. Here we give a short overview about attachment patterns in psychiatric disorders with a focus on depression, and discuss two recent empirical studies of our own that have investigated attachment related brain activation using fMRI. In the first study with patients with borderline personality disorder we used (...) a paradigm in which patients produced narratives in response to attachment pictures and measured brain activity while participants were talking. Our results are consistent with the view that BPD pathology might be correlated with traumatic attachment fear related to autobiographic abuse and loss experiences. In the second study we investigated patients with major depression undergoing therapy in a longitudinal design. In this study we used a design with individualized stimuli that were extracted from narratives produced outside of the scanner. We found that patients, as compared to healthy controls, showed differences in a pre-post comparison. The significant correlation of changes in the subgenual cingulate and medial prefrontal cortex with symptom improvement provides evidence that these regions are involved in mediating therapy related effects. (shrink)

A consistent finding in research on conditional reasoning is that individuals are more likely to endorse the valid modus ponens (MP) inference than the equally valid modus tollens (MT) inference. This pattern holds for both abstract task and probabilistic task. The existing explanation for this phenomenon within a Bayesian framework (e.g., Oaksford & Chater, 2008) accounts for this asymmetry by assuming separate probability distributions for both MP and MT. We propose a novel explanation within a computational-level Bayesian account of reasoning (...) according to which “argumentation is learning”. We show that the asymmetry must appear for certain prior probability distributions, under the assumption that the conditional inference provides the agent with new information that is integrated into the existing knowledge by minimizing the Kullback-Leibler divergence between the posterior and prior probability distribution. We also show under which conditions we would expect the opposite pattern, an MT-MP asymmetry. (shrink)

Background The rapidly growing quantity of health data presents researchers with ample opportunity for innovation. At the same time, exploitation of the value of Big Data poses various ethical challenges that must be addressed in order to fulfil the requirements of responsible research and innovation (Gerke et al. 2020 ; Howe III and Elenberg 2020 ). Data sovereignty and its principles of self-determination and informed consent are central goals in this endeavor. However, their consistent implementation has enormous consequences for the (...) collection and processing of data in practice, especially given the complexity and growth of data in healthcare, which implies that artificial intelligence (AI) will increasingly be applied in the field due to its potential to unlock relevant, but previously hidden, information from the growing number of data (Jiang et al. 2017 ). Consequently, there is a need for ethically sound guidelines to help determine how data sovereignty and informed consent can be implemented in clinical research. Methods Using the method of a narrative literature review combined with a design thinking approach, this paper aims to contribute to the literature by answering the following research question: What are the practical requirements for the thorough implementation of data sovereignty and informed consent in healthcare? Results We show that privacy-preserving technologies, human-centered usability and interaction design, explainable and trustworthy AI, user acceptance and trust, patient involvement, and effective legislation are key requirements for data sovereignty and self-determination in clinical research. We outline the implications for the development of IT solutions in the German healthcare system. (shrink)

L’enjeu de cet article est d’explorer l’histoire longue de l’Anthropocène pour identifier des perspectives de libération dans le présent. Discutant les hypothèses d’Engels sur la naissance de la propriété et du patriarcat, de James Scott sur l’invention conjointe de l’agriculture et des États, ou de Marijas Gimbutas sur les civilisations matrifocales de l’Europe archaïque, Veronika Bennholdt-Thomsen montre que la racine des crises socio-écologiques en cours doit être cherchée du côté de la domestication des femmes, c’est-à-dire de l’appropriation de leur (...) corps et de leurs savoirs en matière de subsistance et de reproduction. Mais elle montre aussi que cette domestication n’est jamais achevée et qu’elle tend même à perdre du terrain face au renouvellement contemporain de l’agriculture paysanne de subsistance, au sein de laquelle les femmes occupent le premier plan. C’est donc dans l’expérience et les pratiques des paysannes que réside la possibilité d’un monde meilleur. (shrink)

Since the middle of the 20th century, philosophers and legal scholars have debated the precise definition of punishment. This chapter surveys the debate, identifies six potential conditions of punishment, and critically reviews each of them: 1) the response condition, which holds that punishment must be in response to wrongdoing, 2) the culpability condition, which holds that punishment must be of a person morally responsible for wrongdoing, 3) the authority condition, which holds that punishment must be imposed by a relevant authority, (...) 4) the hard treatment condition, which holds that punishment must impose hard consequences on the punishee, 5) the intentionality condition, which holds that punishment must be intentional, and 6) the censure condition, which holds that punishment must communicate disapproval. The article argues that it is often unclear that there is a version of the condition that provides optimal lexical fit. It discusses the implications of this analysis, and concludes that there may be less reason to worry about the lack of an authoritative definition than has sometimes been assumed, but that definitional clarity remains an objective worth pursuing. (shrink)

In order to explore one aspect of the engaging nature of computer games, this study will propose a method that aims at classifying the experience of engagement in video games. Inspired by a literature review, we will focus on the fundamental causes of engagement that motivate a player so much that he or she wants to continue playing. By organizing this willingness to continue playing into six broad types of causes of engagement—intellectual, physical, sensory, social, narrative, and emotional—we describe a (...) typology of player engagement and a method that is intended to map players’ experience of engagement while playing video games. The engagement mapping method is inspired by card sorting found from a perspective of usability testing, and in order to exemplify the use of the method, occurrences of the six types of engagement were investigated during gameplay in Angry Birds and Wii Sports. (shrink)

Automated decision making for sentencing is the use of a software algorithm to analyse a convicted offender’s case and deliver a sentence. This chapter reviews the moral arguments for and against employing automated decision making for sentencing and finds that its use is in principle morally permissible. Specifically, it argues that well-designed automated decision making for sentencing will better approximate the just sentence than human sentencers. Moreover, it dismisses common concerns about transparency, privacy and bias as unpersuasive or inapplicable. The (...) chapter also notes that moral disagreement about theories of just sentencing are plausibly resolved by applying the principle of maximising expected moral choiceworthiness, and that automated decision making is better suited to the resulting ensemble model. Finally, the chapter considers the challenge posed by penal populism. The dispiriting conclusion is that although it is in theory morally desirable to use automated decision-making for criminal sentencing, it may well be the case that we ought not to try. (shrink)

This paper makes a contribution to ongoing debates about whether and how we can empirically assess the potential, limitations, and actual impacts of public-private partnerships in developing countries. Several United Nations and bilateral aid agencies have called for the development of impact assessment methodologies that can help clarify when, how, where, and for whom partnerships work. This paper scrutinizes some of the key assumptions underlying this debate, arguing that no objective ' truth' about the effects of PPPs can be discovered (...) through the use of such methodologies. The paper then investigates what can actually be known about a PPP's effects by testing a PPP IA framework that is recommended by the Organization for Economic Cooperation and Development. This is done using a case study from Pakistan. The paper shows that IA methodology may provide an indication of how well a PPP has fared, but not why the PPP has turned out the way it has. At the same time, win-win and win-lose outcomes may exist simultaneously, even for the same stakeholder in the PPP. While the importance of ensuring proper design, monitoring, and IA of PPPs cannot be denied, their effects must be seen as an outcome of struggles between a variety of actors over the distribution of social and environmental hazards associated with broader processes of economic development and industrialization. (shrink)