The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies (CHIs) and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

This paper aims at analysing the ancient Greek notions of catharsis (clearing up, cleaning), to holon (the whole) and therapeia (therapy, treatment, healing) to assess whether they may be of help in addressing a set of questions concerning the didactics of medical ethics: What do medical students actually experience and learn when they attend classes of medical ethics? How should teachers of medical ethics proceed didactically to make students benefit morally from their teaching? And finally, to what extent and in (...) what forms and formats can the kind of cathartic treatment envisaged by Plato still be considered a necessary preliminary to moral learning? The three questions will be addressed by means of a reconstructive analysis and assessment of the Platonic notions of catharsis and holistic therapy present in the Charmides and the Sophist. Besides, the didactic potential of Plato’s dialogue form and moral regimen will be tried out. The ultimate aim is to investigate the possibilities of developing a therapeutic conception of medical ethics. (shrink)

This paper aims at analysing the problem of remainder and regret in moral conflicts. Four different approaches are subject of investigation: a moral-theoretical strategy aimed at consistency; a narrative approach of moral coherence and open consensus; Plato's moral methodology of dialogue and aporetic resolution of moral conflicts and finally, an approach deduced from Greek tragedy of emotional resolution of moral conflicts. A central argument is that since there exists no theoretically convincing way of solving the problem of remainder and regret, (...) the attention should instead be directed towards finding alternative ways of coping with this problem. The three last approaches subject of investigation attempt - each in their own way - to do this. Teaching medical ethics to medical students and the burning issue of medical fallibility is used to demonstrate the relevance of these forms of resolution in a medical context. (shrink)

In 1997 a debate broke out about the ethical acceptability of using placebo as a comparative alternative to establishe effective treatment in trials conducted in developing countries for the purpose of preventing perinatal HIV-transmission. The debate has now been going on for more than five years. In spite of extensive and numerous attempts at resolving the controversy, the case seems far from being settled. The aim of this paper is to provide an updated account of the debate, by identifying empirical (...) arguments employed in the controversy and by critically assessing their use in the debate. A notion of resolution of moral conflicts will be introduced that makes it possible to give a more positive verdict on the moral results of this controversy. Finally, the procedural problem of safe-guarding the selection of empirical arguments against undue forms of normative bias will be addressed. (shrink)

From my flat on the eighth floor, I enjoy the panoramic view of the bay and beaches of Montevideo. Except for days of rain and stormy weather—which happen often in these months of winter—the beach is frequented by dogs and their masters and mistresses. I have a passion for dogs, and every morning and afternoon I take short breaks to watch from my window the playfulness of my four-feeted soulmates. They differ in race, color, and size, but from a bird’s-eye (...) view, these differences are negligible, as are the differences in their behavior: they all stop to sniff and deposit their “biological fingerprints” at exactly the same places, they leap and jump around, they move back and forward in different directions, always close to water—a few of them even risk brief visits into the water—and always ahead of their guardians, though not too far away from them. Only occasionally do I observe barking confrontations. Often, however, I see them joined in ceremonial acts aimed at repeatedly outshining each other with regard to “depositional” pace and outreach. (shrink)

At the end of a paper on international research ethics published in the July-August 2010 issue of the Hastings Center Report, London and Zollman argue the need for grounding our duties in international medical and health-related research within a broader normative framework of social, distributive, and rectificatory justice. The same goes for Thomas Pogge, who, in a whole range of publications during the past years, has argued for a human-rights-based approach to international research. In a thought-provoking paper in the June (...) 2010 issue of the American Journal of Bioethics, Angela J. Ballantyne argues that “the global bioethics priority” in medical and health-related research ethics today is how to do research fairly in an unjust world. (shrink)

In two articles about the controversy surrounding stem cell research, Søren Holm claims that no argument has so far been advanced in the debate to justify the necessity of destructive research on human embryos for the therapeutic potential of stem cell research to be achieved, and that it is up to the scientists themselves to produce “convincing arguments” for their case. This seemingly defeatist statement on behalf of bioethics originates from the viewpoint that neither a reiteration of old arguments about (...) the moral status of the human embryo nor the generation of new arguments of the same kind are likely to have any positive bearing on the controversy; on the other hand, the impact of science on the current debate is unquestionable, due to three “partially independent” developments. (shrink)

It has been hypothesised that the reimbursement system pertaining to radiotherapy is influencing prescription practices for patients with cancer with bone metastases. In this paper, we present and discuss the results of an empirical study that was undertaken on patient records, referred to radiotherapy for the treatment of bone metastases, in a medium-size city, in southern Brazil, during the period of March 2006 to March 2014. Our findings seem to confirm this hypothesis: after a change in the reimbursement method, radiation (...) prescriptions were adapted accordingly, in order to maximise profits. Once such patients become highly vulnerable due to their diagnoses, they also become susceptible to a subtle form of exploitation; physicians let patients believe that more radiation will be better for their health, and they do so despite knowing otherwise, and as it seems, out of pecuniary interests. (shrink)

How are we individually and as a society to handle new and emerging technologies? This challenging question underlies much of the bioethical debates of modern times. To address this question we need suitable conceptions of the new technology and ways of identifying its proper management and regulation. To establish conceptions and to find ways to handle emerging technologies we tend to use analogies extensively. The aim of this article is to investigate the role that analogies play or may play in (...) the processes of understanding and managing new technology. More precisely we aim to unveil the role of analogies as analytical devices in exploring the "being" of the new technology as well the normative function of analogies in conceptualizing the characteristics and applications of new technology. Umbilical cord blood biobanking will be used as a case to investigate these roles and functions. (shrink)

The ongoing legal and bioethics debates on consent requirements for collecting, storing, and utilizing human biological material for purposes of basic and applied research—that is, genomic research biobanking—have already managed to pass through three ostensibly dissimilar stages.

BackgroundThe Ethiopian law on abortion was liberalized in 2005. However, as a strongly religious country, the new law has remained controversial from the outset. Many abortion providers have religious allegiances, which begs the question how to negotiate the conflicting demands of their jobs and their commitment to their patients on the one hand, and their religious convictions and moral values on the other.MethodA qualitative study based on in-depth interviews with 30 healthcare professionals involved in abortion services in either private/non-governmental clinics (...) or in public hospitals in Addis Ababa, Ethiopia. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework.ResultsFor the participants, religious norms and the view that the early fetus has a moral right to life count against providing abortion; while the interests and needs of the pregnant woman supports providing abortion services. The professionals weighed these value considerations differently and reached different conclusions. One group appears to have experienced genuine conflicts of conscience, while another group attempted to reconcile religious norms and values with their work, especially through framing provision of abortion as helping and preventing harm and suffering. The professionals handle this moral balancing act on their own. In general, participants working in the private sector reported less moral dilemma with abortion than did their colleagues from public hospitals.ConclusionsThis study highlights the difficulties in reconciling tensions between religious convictions and moral norms and values, and professional duties. Such insights might inform guidelines and healthcare ethics education. (shrink)

BackgroundEthiopia’s 2005 abortion law improved access to legal abortion. In this study we examine the experiences of abortion providers with the revised abortion law, including how they view and resolve perceived moral challenges.MethodsThirty healthcare professionals involved in abortion provisions in Addis Ababa were interviewed. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework.ResultsMost participants considered the 2005 abortion law a clear improvement—yet it does not solve all problems and has led to new dilemmas. As a main finding, the (...) law appears to have opened a large space for professionals’ individual interpretation and discretion concerning whether criteria for abortion are met or not. Regarding abortion for fetal abnormalities, participants support the woman’s authority in deciding whether to choose abortion or not, although several saw these decisions as moral dilemmas. All thought that abortion was a justified choice when a diagnosis of fetal abnormality had been made.ConclusionEthiopian practitioners experience moral dilemmas in connection with abortion. The law places significant authority, burden and responsibility on each practitioner. (shrink)

The aim of this paper is to investigate Plato’s conception of the whole in the Phaedrus and the theory of medical dialectic underlying this conception. Through this analysis Plato’s conception of kairos will also be adressed. It will be argued that the epistemological holism developed in the dialogue and the patient-typology emerging from it provides us with a way of perceiving individual situations of medical discourse and decision-making that makes it possible to bridge the gap between observations of a professional (...) nature, i.e. of diagnostics and therapy—of whom to treat and in what magnitude—and individual patients’ perceptions of their situation. Besides, it will be argued that such a patient-typology represents a conceptual framework to assess and deal normatively with patients’ ailments and needs that is more robust than the current standards in use, i.e. the Subjective Standard, the Reasonable Person Standard and the Professional Practice Standard. Finally, it will be argued that the possession of kairos, which according to Plato is the hallmark of a true physician, represents a normative conception of time that today’s medicine is in need of revisiting. (shrink)

New medical technologies provide us with new possibilities in health care and health care research. Depending on their degree of novelty, they may as well present us with a whole range of unforeseen normative challenges. Partly, this is due to a lack of appropriate norms to perceive and handle new technologies. This article investigates our ways of establishing such norms. We argue that in this respect analogies have at least two normative functions: they inform both our understanding and our conduct. (...) Furthermore, as these functions are intertwined and can blur moral debates, a functional investigation of analogies can be a fruitful part of ethical analysis. We argue that although analogies can be conservative; because they bring old concepts to bear upon new ones, there are at least three ways in which they can be creative. First, understandings of new technologies are quite different from the analogies that established them, and come to be analogies themselves. That is, the concepts may turn out to be quite different from the analogies that established them. Second, analogies transpose similarities from one area into another, where they previously had no bearing. Third, analogies tend to have a figurative function, bringing in something new and different from the content of the analogies. We use research-biobanking as a practical example in our investigations. (shrink)

Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship (“bedside rationing”) is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of (...) his argument yet build on his genuine insights. In our analysis, Wyller’s critique of bedside rationing is instructive both for harbouring some very common misconceptions that must be exposed and refuted, but also for offering important words of caution. In particular, bedside rationing must be performed in ways that do not harm the physician–patient relationship. Read irenically, Wyller’s critique is a reminder of what must not be lost in our painful endeavour to update the ethics of medicine to encompass the unavoidability of rationing. (shrink)

Healthcare professionals encounter many moral challenges in their daily clinical practice. However, there have been few studies on the subject matter in Tanzania. This study aims to provide an account of moral challenges faced by healthcare professionals in Tanzanian hospitals, their understanding of clinical ethics, and the ethics education they have received. Many participants reported receiving some kind of ethics training through formal education and on-the-job training. Some participants understood ethics in healthcare settings as adherence to established laws, regulations, guidelines, (...) procedures, norms, and rules essential in clinical practice. Analysis of the data identified four themes of moral challenges. These challenges are related to 1) decision-making and communication in clinical practice, 2) scarcity of medical resources and prioritization in clinical practice, 3) withdrawal of curative treatment, and 4) conflicts between professional judgment, religious convictions and adherence to alternative treatments. Based on the findings, we suggest a context-sensitive form of clinical ethics training to prepare healthcare professionals to recognize and address these moral challenges. (shrink)

Nanomedicine offers remarkable options for new therapeutic avenues. As methods in nanomedicine advance, ethical questions conjunctly arise. Nanomedicine is an exceptional niche in several aspects as it reflects risks and uncertainties not encountered in other areas of medical research or practice. Nanomedicine partially overlaps, partially interlocks and partially exceeds other medical disciplines. Some interpreters agree that advances in nanotechnology may pose varied ethical challenges, whilst others argue that these challenges are not new and that nanotechnology basically echoes recurrent bioethical dilemmas. (...) The purpose of this article is to discuss some of the ethical issues related to nanomedicine and to reflect on the question whether nanomedicine generates ethical challenges of new and unique nature. Such a determination should have implications on regulatory processes and professional conducts and protocols in the future. (shrink)

In January 2006, one of the major cases of scientific fraud in recent years broke in the media. It was discovered that the Norwegian researcher John Sudbø had falsified the complete set of data on which an article published in the Lancet in 2005 had been based.1 The article had 14 authors, and Professor Jan Helge Solbakk, Professor of Medical Ethics at the University of Oslo, was quoted in Norwegian media as saying that “… also the 13 other (...) co-authors in the research scandal have muck on their hands…” and: “That none of the 13 has discovered what took place shows clearly that they have not been close to fulfilling the criteria for being co-authors.”2One of the co-authors complained to the Norwegian Medical Association’s Council for Professional Ethics about these comments, …. (shrink)

Non-classical views about important issues in logic and its philosophy are a distinctive trait of Shahid Rahman's work. This volume has been designed, on the occasion of his 50th birthday, as a gathering place for unconventional approaches, original ideas and attempts to question well-established standards. Some of the world top philosophers and logicians contributed to a brilliant collection of papers, some of which doubtlessly leave their mark on the work to come in logic and in philosophy of formal sciences. Contributors (...) are: Philippe Balbiani, Diderik Batens, Johan van Benthem, Giacomo Bonanno, Walter A. Carnielli, Newton C. A. Da Costa, Michel Crubellier, Francisco A. Doria, Dov M. Gabbay, Olivier Gasquet, Gerhard Heinzmann, Andreas Herzig, Jaakko Hintikka, Justine Jacot, Reinhard Kahle, Erik C. W. Krabbe, Decio Krause, Franck Lihoreau, Kuno Lorenz, Ilkka Niiniluoto, Graham Priest, Stephen Read, Manuel Rebuschi, Greg Restall, Gabriel Sandu, Gerhard Schurz, Francois Schwarzentruber, Yaroslav Shramko, Goran Sundholm, John Symons, Christian Thiel, Nicolas Troquard, Tero Tulenheimo, Jean Paul Van Bendegem, Daniel Vanderveken, Yde Venema, Heinrich Wansing, Jan Wolenski and John Woods. (shrink)

Festschrift for prof. Helge Malmgren. -/- Contents: • Kristoffer Ahlström: Two Levels of Epistemic Inquiry; • Jan Almäng: Till frågan om trancendentala argument; • Kent Gustavsson: Perceptionens gåta; • Björn Haglund: Some Notes on Induction; • Ingvar Johansson: Money and Fictions; • Frank Lorentzon: Intuition och kunskap; • Ingmar Persson: Double Effect Troubles; • Filip Radovic: Wittgenstein om tautologier och andra logiska satser; • Claes Strannegård: Anthropomorphic Artificial Intelligence; • Bolof Stridbeck: Den motbjudande slutsatsen & den plågade filosofen; • (...) Christer Svennerlind: Armstrong on Instantiation as Partial Identity; • Anders Tolland: Mr Darcys berättigade stolthet; • Björn Vickhoff: H-speech: the Musical Self - A Phenomenological Approach to Music & Emotion; • Dag Westerståhl: On the Aristotelian Square of Opposition; • Carl-Gustaf Wikstrand: On Pain States & Mental Causation;. (shrink)

We extend stit logic by adding a spatial dimension. This enables us to distinguish between powers and opportunities of agents. Powers are agent-specific and do not depend on an agent’s location. Opportunities do depend on locations, and are the same for every agent. The central idea is to define the real possibility to see to the truth of a condition in space and time as the combination of the power and the opportunity to do so. The focus on agent-relative powers (...) and space-relative opportunities firmly roots effectivity of an autonomous choice making agent in a space–time picture. Our space–time view will be classically Newtonian, since we will assume relativistic phenomena do not play a role in agentive effectivity. We show how our semantics naturally distinguishes between different kinds of histories; histories that reflect real possibilities and histories that reflect counterfactual possibilities. Furthermore, we discuss how the spatial picture sheds light on conceptual problems plaguing the central stit property of ‘independence of agency’. At several points in the article we will emphasise and defend the differences with Belnap’s theory of agency in relativistic branching space–times. (shrink)

From the very beginnings of his thought, Thomas Garrigue Masaryk was convinced that modern man, and likewise the culturally and politically emancipated Czech nation, was in a deep existential crisis closely linked with the spread of irreligiosity. Masaryk gradually came to believe that this crisis could be positively overcome on two levels. On a theoretical level, he relied on his specific classification and systematization of the sciences. On a practical level, which was directly based on his notion of positive sciences (...) and a strictly rational scientific approach, it was a matter of developing a new direction and method, which he characteristically conceived of as realism. On the eve of the First World War, Masaryk’s position became understandably radicalized. He distanced himself from a more objectivist view of religion and countered theism with a scientific and philosophical anthropism. (shrink)

This brief paper is a general treatment of war – its morality and its political and social effects. Accordingly, we discuss primarily those armed interactions between nations, or, in “civil” wars, those aimed at securing the reins of government. These must, we contend, be inherently immoral on one side – the one which “starts” the war in question – and inherently moral on the other, who after all are defending their lives against the first. To say this requires a moral (...) theory, which we briefly develop. It proceeds on Hobbesian-contractarian lines: if mankind occupies a “state of nature,” then we will all be worse off than if we join with each other in adopting the restrictions of morality – fundamentally, and primarily, of nonviolence, of living at peace with each other. This raises a question about the very rationality of war, to be sure. And yet, war we have, in considerable and unfortunate abundance. How can this be? Some tentative answers are suggested. (shrink)

Despite the growing interest in female expatriates, few empirical studies have focussed on corporate career development activities available to women. Given the faltering corporate support for female business expatriates in general, one may presume that such organizational activities are less available to women than to men. To test this proposition, a large number of Western female and male business expatriates assigned to Hong Kong responded to a mail survey. Controlling for differences between the two gender groups, three significant gender differences (...) were found, all indicating a lower availability of these corporate activities to women than to men, partially supporting expectations. These corporate career development activities were fast track programs, individual career counseling and career planning workshops. Implications of these findings for globalizing firms as well as for their female employees are discussed in detail. (shrink)

Notes on the life of Adolf Lindenbaum, a complete bibliography of his published works, and selected references to his unpublished results.

This paper synthesizes confirmation by instances and confirmation by successful predictions, and thereby the Hempelian and the hypothetico-deductive traditions in confirmation theory. The merger of these two approaches is subsequently extended to the piecemeal confirmation of entire theories. It is then argued that this synthetic account makes a useful contribution from both a historical and a systematic perspective.

We give combinatorial and computational characterizations of the NP search problems definable in the bounded arithmetic theories $T_{2}^{2}$ and $T_{3}^{2}$.

Starting from a Foucaultian perspective, the article draws attention to current developments that neutralise democracy through the 'governmentalisation of democracy' and processes of 'governmental subjectivation'. Here, ideas of Rancière are introduced in order to clarify how democracy takes place through the paradoxical process of 'political subjectivation', that is, a disengagement with governmental subjectivation through the verification of one's equality in demonstrating a wrong. We will argue that democracy takes place through the paradoxical process of political subjectivation, and that today's consensus (...) society tends to depoliticize all processes of subjectivation. A final step in the argumentation is to introduce the concept of 'pedagogic subjectivation'—to be understood as the experience of potentiality—that is to be distinguished from governmental subjectivation and also from political subjectivation. The concept 'pedagogic subjectivation' is proposed as a way of thinking of the school as a public place. (shrink)

Men's passage to fatherhood: an analysis of the contemporary relevance of transition theory This paper presents a theoretical analysis of men's experiences of pregnancy, birth and early fatherhood. It does so using a framework of ritual transition theory and argues that despite its earlier structural‐functionalist roots, transition theory remains a valuable framework, illuminating contemporary transitions across the life course. The paper discusses the historical development of transition or ritual theory and, drawing upon data generated during longitudinal ethnographic interviews with men (...) undergoing the transition to fatherhood, analyses its relevance in understanding contemporary experiences of fatherhood. (shrink)

As corporate social responsibility involves a voluntary business endeavour to address social and environmental issues beyond legal compliance, governments cannot fall back on hierarchical command-and-control policies to support it. As such, it is complementary with the increasing popularity of public policies known as New Governance policies, where the government is engaged in a horizontal inter-organizational network of societal actors and where public policy is both formed and executed by the interacting and voluntary efforts from a multitude of stakeholders. However, such (...) policies are known to generate substantive uncertainty about the content of CSR and its related issues, strategic uncertainty regarding the behavior of the actors involved and institutional uncertainty related to the interaction process involved in the institutional change. We explore New Governance policy instruments to address these uncertainties in the context CSR and discuss the experiences with these methods in the European Union. (shrink)

This article discusses the feedback on students’ ethics essays provided by eight markers in the Faculty of Medical Sciences at Newcastle University. It highlights significant shortcomings, including failures to identify instances where students had failed to select and to conclude on ethical issues, logical errors, misunderstandings of ethical arguments made in the literature, instances of simple deference, and a lack of critical engagement with relevant literature. Markers also made a large number of linguistic errors and, on many occasions, failed to (...) explain clearly what they meant. Some indication is given of what the cost of this might be to health care students as well as to those who are affected by the quality of their ethical decisions. The article concludes by providing some guidance on how this cost might be reduced at Newcastle University as well as in many other institutions where similar problems are likely to exist. (shrink)

Bayesian model selection has frequently been the focus of philosophical inquiry (e.g., Forster, Br J Philos Sci 46:399–424, 1995; Bandyopadhyay and Boik, Philos Sci 66:S390–S402, 1999; Dowe et al., Br J Philos Sci 58:709–754, 2007). This paper argues that Bayesian model selection procedures are very diverse in their inferential target and their justification, and substantiates this claim by means of case studies on three selected procedures: MML, BIC and DIC. Hence, there is no tight link between Bayesian model selection and (...) Bayesian philosophy. Consequently, arguments for or against Bayesian reasoning based on properties of Bayesian model selection procedures should be treated with great caution. (shrink)

What if in discussion the critic refuses to recognize an emotionally expressed argument of her interlocutor as an argument, accusing him of having presented no argument at all. In this paper, we shall deal with this reproach, which taken literally amounts to a charge of having committed a fallacy of non-argumentation. As such it is a very strong, if not the ultimate, criticism, which even carries the risk of abandonment of the discussion and can, therefore, not be made without burdening (...) oneself with correspondingly strong obligations. We want to specify the fallacies of non-argumentation and their dialectic, i.e., the proper way to criticize them, the appropriate ways for the arguer to react to such criticism, and the appropriate ways for the critic to follow up on these reactions. Among the types of fallacy of non-argumentation, the emphasis will be on the appeal to popular sentiments . Our aim is to reach, for cases of non-argumentation, a survey of dialectical possibilities. By making the disputants themselves responsible for the place of emotion in their dialogues, we hope to contribute to a further development of the theory of dialectical obligations. (shrink)

This study explores the role feminist ideology played in long-term structural changes in feminist organizations. The vehicle for this exploration was a comparative case study of 14 feminist women's health centers that were started in the 1970s and were still in existence in the early 1990s. Drawing on interviews and site visits, the author describes the early collectivist structures, highlights some of the crises these organizations faced, and describes three structural ideal types that emerged in the 1990s. The analysis suggests (...) three ideological issues that directed structural change: the importance of maintaining a system for the equitable distribution of power, the importance of growth versus autonomy, and the importance of feminism as an organizational outcome or internal process. (shrink)

Agency without Actors? New Approaches to collective Action is rethinking a key issue in social theory and research: the question of agency. The history of sociological thought is deeply intertwined with the discourse of human agency as an effect of social relations. In most recent discussions the role of non-humans gains a substantial impact. Consequently the book asks: Are nonhumans active, do they have agency? And if so: how and in what different ways? The volume offers a critical state-of-the-art debate (...) of internationally and nationally leading scholars within Sociology, Social Anthropology and STS on agency (Latour, Law, Michael, Rammert etc.). It fosters the productive exchange of empirical settings and theoretical views by outlining a wide range of novel accounts that link human and non-human agency. It tries to understand social-technical, political and environmental networks as different forms of agency that produce discrete and identifiable entities like humans, animals, technical artifacts. It also asks how different types of (often conflicting) agency and agents actors are distinguished in practice, how they are maintained and how they interfere with each other. (shrink)