This study aims at discovering the essential constituents involved in the experiences of guilt and shame. Guilt concerns a subject’s action or omission of action and has a clear temporal unfolding entailing a moment in which the subject lives in a care-free way. Afterwards, this moment undergoes a reconstruction, in the moment of guilt, which constitutes the moment of negligence. The reconstruction is a comprehensive transformation of one’s attitude with respect to one’s ego; one’s action; the object of guilt and (...) the temporal-existential experience. The main constituents concerning shame are its anchorage in the situation to which it refers; its public side involving the experience of being perceptually objectified; the exclusion of social community; the bodily experience; the revelation of an undesired self; and the genesis of shame in terms of a history of frozen now-ness. The article ends with a comparison between guilt and shame. (shrink)

What kind of a science is psychoanalysis? What constitutes its domain? What truth claims does it maintain? In this unique and scholarly work concerning the nature of psychoanalysis, Gunnar Karlsson guides his arguments through phenomenological thinking which, he claims, can be seen as an alternative to the recent attempts to cite neuropsychoanalysis as the answer to the crisis of psychoanalysis. Karlsson criticizes this effort to ground psychoanalysis in biology and neurology and emphasizes instead the importance of defining the (...) psychoanalytic domain from the vantage point of the character of consciousness. His understanding of the unconscious, the libido and the death drive offer new insights into the nature of psychoanalysis, and he also illuminates and develops neglected dimensions such as consciousness and self-consciousness. Karlsson's approach to psychoanalysis is rigorous yet original, and this book fills an intellectual gap with implications for both the theoretical understanding and clinical issues of psychoanalysis. (shrink)

In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses (...) can use self‐reflection to create an awareness of nursing, caring and ethical inner values in caring. (shrink)

The main purpose of this paper is to clarify some senses of dignity that are particularly relevant for the treatment and care of the elderly. I make a distinction between two quite different ideas of dignity, on the one hand the basic kind of dignity possessed by every human being, and on the other hand the dignity which is the result of a person's merits, whether these be inherited or achieved. Common to both these ideas is that having a dignity (...) entails having a set of rights, in the case of basic dignity the set of rights which we call human rights, the rights which the United Nations, among others, has tried to determine. The dignities of merit also provide some rights, although normally rights with limited scope covering, for instance, a professional area. This observation gives my preliminary answer to the fundamental question of what distinguishes dignity from other high values that could be attached to humans. I discuss further a kind of value that might be mistaken for a kind of dignity, viz. what I call public status. This status is to be distinguished from social status (the status of e.g. kings, governors, and officials) that I take to be a proper dignity of merit. The public status is the status gained solely via public perception and not directly via any merits on the part of the dignified. Finally, I turn to the topic of the dignity of the elderly and try to determine whether there is some dignity peculiar to the elderly, and which is over and above the basicMenschenwrde. My two preliminary proposals are the following: the elderly have a dignity of wisdom and they have a highly general dignity of merit, which results from their life-long efforts and achievements, and for this they deserve our gratitude. (shrink)

The main causes of suicide and how suicide could and should be prevented are ongoing controversies in the scientific literature as well as in public media. In the bill on public health from 2008, the Swedish Parliament adopted an overarching “Vision Zero for Suicide” and nine strategies for suicide prevention. However, how the VZ should be interpreted in healthcare is unclear. The VZ has been criticized both from a philosophical perspective and against the background of clinical experience and alleged empirical (...) claims regarding the consequences of regulating suicide prevention. This study is part of a larger research project in medical ethics with the overarching aim to explore whether the VZ is ethically justifiable. The aim is to enrich the normative discussion by investigating empirically how the VZ is perceived in healthcare. Interviews based on a semi-structured interview guide were performed with 12 Swedish psychiatrists. The interviews were analysed with descriptive qualitative content analysis aiming for identifying perceptions of the Vision Zero for Suicide as well as arguments for and against it. Though most of the participants mentioned at least some potential benefit of the Vision Zero for Suicide, the overall impression was a predominant skepticism. Some participants focused on why they consider the VZ to be unachievable, while others focused more on its potential consequences and normative implications. The VZ was perceived to be impossible to realize, nonconstructive or potentially counterproductive, and undesirable because of potential conflicts with other values and interests of patients as well as the general public. There were also important notions of the VZ having negative consequences for the working conditions of psychiatrists in Sweden, in increasing their work-related anxiety and thwarting the patient-physician relationship. (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)

In policy-making the consumption of specially labelled products, and its role in improving the welfare of livestock, has attracted considerable attention. There is in many countries a diverse market for animal welfare-friendly products which is potentially confusing and may lack transparency. We ask whether special quality labels that involve medium levels of animal welfare, as compared with labels promoting premium levels of animal welfare, have a role to play in promoting improvements in animal welfare. The Danish pork market is our (...) reference case, but we also widen the context by comparing the markets for pork in three other European countries. Our findings suggest that in order to improve animal welfare through demand for welfare-friendly products it is important to maintain separate the market for products with strong animal welfare profiles from markets for products with medium levels of animal welfare where, often, animal welfare is bundled together with other food quality attributes. We conclude that such quality labels may indeed play an important role in promoting higher animal welfare standards provided that they offer real improvements in animal welfare as compared with standard products. They will be attractive to consumers with a positive, but not especially strong interest in animal welfare as an individual food attribute who would otherwise be inclined to purchase standard products. (shrink)

The last two decades have seen a heated debate between "halfers" and "thirders": those who believe Sleeping Beauty’s credence in a coin landing heads is 1/2 and those who believe it is 1/3 – as well as quite some alternative positions. This paper attempts to settle the debate in favour of thirdism. I present a new argument for thirdism which cannot be resisted using any of the previously used halfer strategies. My argument uses an analogy in which Sleeping Beauty has (...) a lucid dream on each day. To arrive at thirdism, she uses an unproblematic type of Bayesian conditionalisation, the principle of indifference, and the principal principle. I argue that all of these reasoning steps should be uncontroversial. Finally, I argue that all published defences of halfism are untenable. (shrink)

As a part of a research project on Dignity and Older Europeans Programme) I explore in this paper a set of notions of human dignity. The general concept of dignity is introduced and characterized as a position on a value scale and it is further specified through its relations to the notions of right, respect and self-respect. I present four kinds of dignity and spell out their differences: the dignity of merit, the dignity of moral or existential stature, the dignity (...) of identity and the universal human dignity. Menschenwürde pertains to all human beings to the same extent and cannot be lost as long as the persons exist. The dignity of merit depends on social rank and position. There are many species of this kind of dignity and it is very unevenly distributed among human beings. The dignity of merit exists in degrees and it can come and go. The dignity of moral stature is the result of the moral deeds of the subject; likewise it can be reduced or lost through his or her immoral deeds. This kind of dignity is tied to the idea of a dignified character and of dignity as a virtue. The dignity of moral stature is a dignity of degree and it is also unevenly distributed. The dignity of identity is tied to the integrity of the subject's body and mind, and in many instances, although not always, also dependent on the subject's self-image. This dignity can come and go as a result of the deeds of fellow human beings and also as a result of changes in the subject's body and mind. (shrink)

What follows is a modest example of theorizing an existent theory (Karlsson and Bergman 2017; Swedberg 2014). The theory in question is Margaret S. Archer’s (1995, 2000a) Morphogenesis/Morphostasis...

Contemporary philosophy of health and disease has been quite focused on the problem of determining the nature of the concepts of health and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atoms, metal, and rain are value-free and descriptive. According to this descriptive or naturalist line of thought, the notions of health and disease are furthermore related to the idea of a (...) normal or natural function. A bodily organ is healthy insofar as it functions normally, and it is diseased when it does not fulfill its functions. Other philosophers claim that the concept of health, together with other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. My purpose in this article is to scrutinize the relation between the notion of a natural function, on the one hand, and the concepts of health and disease on the other. In characterizing the notion of a normal function I will follow the classic analysis put forward by American philosopher Christopher Boorse. I will criticize Boorse’s proposal mainly by using arguments from the analysis of ordinary lay and medical language. I ask questions such as: what do we normally mean when we ascribe health or disease to a person? In the end I will recommend an analysis of these and related medical notions, which is unrelated to the notion of a natural function as normally interpreted. (shrink)

We consider an infinite hierarchy of systems of Alethic Modal Logic with so-called Levels of Perfection, and add to them suitable definitions of such interesting deontic categories as those of supererogation, offence, conditional obligation and conditional permission. We then state three problems concerning the proper characterization of the resulting logic(s) for our defined notions, and discuss two of these problems in some detail.

The basic work for this book was carried out during the spring of 1989 in Edinburgh, where I had been granted a research position at The Institute for Advanced Studies in the Humanities. I should like to express here my indebtedness to the Institute for the opportunity thus afforded me. I should also like to say how very grateful I am for the stimulating conversations I had there with Professor Timothy Sprigge and Dr. Elizabeth Telfer. Dr. Telfers’s own treatise Happiness (...) has been a major influence on my view of the questions involved. The basic view of health and illness presented in this book is more fully set out in my On the Nature of Health. As in the case of my previous larger projects, I have received a great amount of support and may wise comments from Professor Ingmar Pörn, Helsinki. Three Danish experts – Anton Aggernaes, Erik Ostenfeld and Peter Sandøe – have made valuable comments. Professor Heng ten Have, Nijmegen, has improved my reading of the philosophy of Jeremy Bentham. I should also like to thank my colleagues at the Department of Health and Society, University of Linköping, for helping me to avoid a number of the pitfalls that can so easily stumble into when it comes to a treatise like this. Especially I should like to mentioned Per-Erik Liss, Ingemar Nordin and Bo Petersson, all three of whom have read and commented on the entire manuscript. A Swedish version of this book, Livskvalitet och hälsa, came out in 1991. I have been made quite a number of corrections and additions, one type of addition being replies to critical points made in reviews of the Swedish version. I should like to thank Malcolm Forbes for valuable help putting my English into publishable condition. Linköping, May 1993 Lennart Noredenfelt. (shrink)

Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atom, metal and rain are value-free and descriptive. To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person. On (...) the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory. Other philosophers claim that the concept of health, together with the other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. A statement that he or she is healthy does not merely imply certain scientific facts regarding the person’s body or mind but implies also a (positive) evaluation of the person’s bodily and mental state. My task in this paper will be, first, to present the two principal rival types of theories and present what I take to be the main kind of reasoning by which we could assess these theories, and second, to present a deeper characterization of the principal rival theories of health and illness. (shrink)

This book presents a unique examination of mental illness. Though common to many mental disorders, delusions result in actions that, though perhaps rational to the individual, might seem entirely inappropriate or harmful to others. This book shows how we may better understand delusion by examining the nature of compulsion.

It is a contradictory argument to say on the one hand that social systems are always open and that there is nothing between closed and open systems, and on the other that there are pseudo-closed systems. Further, Petter Næss has shown that multivariate regression analysis can be used to help uncover mechanisms, something that should be impossible if social systems were always open. He has in addition found that the meaningful activity of urban planning requires for its existence the possibility (...) to make crude, qualitative predictions, which should also be impossible for the same reason. Critical realists therefore need to rethink the whole question of closed and open social systems. (shrink)

Background: The majority (70%) of cardiac arrests in Sweden are experienced in the patient’s home. In these situations, the ambulance nurses may encounter several ethical dilemmas. Aim: The aim was to investigate Swedish specialist ambulance nurses’ experiences of ethical dilemmas associated with cardiac arrest situations in adult patients’ homes. Methods: Nine interviews were conducted with specialist ambulance nurses at four different ambulance stations in the southeast region of Sweden. Data were analysed using content analysis. Ethical considerations: Ethical principles mandated by (...) the Swedish Research Council were carefully followed during the whole process. Findings: Two main themes with six sub-themes were identified: The scene – creating a sheltered space for caring and Ethical decision-making. The results showed that ethical dilemmas might occur when trying to create a sheltered space to preserve the patients’ integrity and dignity. A dilemma could be whether or not to invite significant others to be present during the medical treatment. Ethical decision-making was dependent on good communication and ethical reasoning among all parties. In certain situations, decisions were made not to commence or to terminate care despite guidelines. The decision was guided by combining the medical/nursing perspectives and ethical competence with respect to the human being’s dignity and a will to do good for the patient. The nurses followed the voice of their heart and had the courage to be truly human. Conclusion: The ambulance nurses were guided by their ethos, including the basic motive to care for the patient, to alleviate suffering, to confirm the patient’s dignity and to serve life and health. (shrink)

Whitehead’s process philosophy offers a wide range of speculatively generalized concepts that allow for an application in transdisciplinary research. The notion of projection is an often-overlooked detail of his philosophy that not only appears in his far-reaching theory of perception, but also constitutes an integral part of his theory of extension as the formal foundation of his metaphysical project. His perceptive theory relies on the idea of projection as the fundamental ontological relationship that lifts the past into the present. Projections (...) of sensa describe one side of the ‘double-barreled’ theory of perception and the spatial relations of the contemporary world. The microscopic projection is just as fundamental for perception and for the integrity of a relational theory of becoming, as the perceptual projection is necessary ingredient for symbolic modes of experience. The simple projection in the mode of presentational immediacy is the basis of temporary stability of events and of any perceptual situation in the biological realm. Whitehead was aware of the possible misconceptions that this term might lead to. Discussing his remarks on the hierarchical variety of different modes of projection can resolve those misconceptions and throw a new light on the importance of projection for interdisciplinary inquiries. (shrink)

In spite of stricter provisions inthe new EU directive on deliberate release ofgenetically modified organisms (GMOs), criticsstill advocate a moratorium on permits forcultivation of GMOs. However, in an attempt tomeet concerns raised by the public, thedirective explicitly gives Member States thepossibility to take into consideration ethicalaspects of GMOs in the decision-making. Thisarticle investigates the potential effects ofsuch formulation by means of an empiricalanalysis of experiences gained the last yearsfrom similar Swedish regulations for GMOs,aiming at promoting sustainable development.The faulty implementation shown (...) in the Swedishcase indicates that legal stipulations forethics as such have limited importance. It issuggested that public participation is animportant factor for successful implementationof the ethics of sustainable development. (shrink)

Lessons of history are often referred to in public discourse, but seldom in scholarly discussions. This book wants to change this by introducing an innovative scholarly, analytical model of historical lessons, starting from the basic three-fold perspective that you simultaneously are history, share history, and make history. Not any history is useful for extracting or using lessons. Here, what are denoted as borderline historical events, demonstrating both time-specific and time-transcending qualities, are suggested as useful materials. Scholarly works on the Holocaust (...) and Soviet terror, from Raul Hilberg's and Robert Conquest's classical works of the 1960s to more recent books by Jan Gross and Timothy Snyder, are analyzed to identify lessons of history, and their change during a full half-century. (shrink)

Suggestions for transforming ecological sustainability into operative social choice mechanisms can be viewed through the bifocal lens of limits on, and opportunities for, the ecological state. Using lines of reasoning brought in from the comparative study of environmental policy, this article tries to stake out how far the ecological state can go in pursuing objectives of sustainable development without intruding on values and objectives fundamental to democracy. The article discusses social choice mechanisms in terms of the ecological state's authority, management (...) capacities, effectiveness, and legitimacy, drawing up the image of the ecological state as a ' green fist in a velvet glove' with the ultimate objective of integrating 'ecological' evaluations into the public mind so that they become as 'natural' as those 'economic' criteria presently applied. Concluding that such 'ecological' consciousness involves a great leap in ecological information processing and dissemination within and throughout societies, the article invokes the sustainability and success of democratic social welfare states which base authoritative command on enlightened debate and deliberation as evidence that such a leap can be successfully made through processes of informed consensus. (shrink)

Bengt Brülde in his article ``The Goals of Medicine. Towards a Unified Theory'' has proposed a normative theory of the goals of medicine within which the concept of quality of life plays a crucial role. In Brülde's analysis, however, the very concept of medicine is deliberately left quite vague and it is therefore difficult to see how the goals of medicine are related to the goals of closely allied enterprises such as health promotion and social welfare. In this reply I (...) therefore propose an analysis of these related conceptual areas. I do this mainly in two respects. Following the nomenclature in a previously published article I propose a systematic conceptual framework for all varieties of health enhancement and distinguish different notions of medicine within this framework. A consequence of this analysis is, for instance, that the means and also the immediate goals of medicine in its broadest sense are more diversified than the means and immediate goals of medicine in its narrowest sense. From this position I expand the topic further by comparing medicine and health enhancement with social welfare and try to trace the basic features between – as well as the common properties of – these different enterprises. (shrink)

The paper presents an infinite hierarchy of sound and complete axiomatic systems for Two-Dimensional Modal Tense Logic with Historical Necessity, Agents and Acts. A main novelty of these logics is their capacity to represent formally (i) basic action-sentences asserting that such and such an act is performed/omitted by an agent, as well as (ii) causative action-sentences asserting that by performing/omitting a certain act, an agent causes that such and such a state-of-affairs is realized (e.g. comes about/ceases/remains/remains absent). We illustrate how (...) the formal machinery of our systems can be used to reconstruct a number of interesting ideas in the Logic of Agency and Action that have been proposed by authors like von Wright, von Kutschera, Belnap and Segerberg. (shrink)

The aim of this study was to explore the ethical foundations for a caring conversation. The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown (...) to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to be asymmetrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible. (shrink)

This book is a contribution to the general philosophy of action and the philosophy of welfare. The author makes separate analyses of concepts such as action, ability, interaction, action-explanation, happiness, health, illness and disability. At the same time he explores and substantiates the idea of a strong interdependence between the concept of action and some of the central concepts of welfare, in particular health and illness and related concepts.

In recent decades, economists have developed methods for measuring the country-wide level of inequality of opportunity. The most popular method, called the ex-ante method, uses data on the distribution of outcomes stratified by groups of individuals with the same circumstances, in order to estimate the part of outcome inequality that is due to these circumstances. I argue that these methods are potentially biased, both upwards and downwards, and that the unknown size of this bias could be large. To argue that (...) the methods are biased, I show that they ought to measure causal or counterfactual quantities, while the methods are only capable of identifying correlational information. To argue that the bias is potentially large, I illustrate how the causal complexity of the real world leads to numerous non-causal correlations between circumstances and outcomes and respond to objections claiming that such correlations are nonetheless indicators of unfair disadvantage, that is, inequality of opportunity. (shrink)