This paper makes two main claims: first, that the need to protect health professionals' moral integrity is what grounds the right to conscientious objection in health care; and second, that for a given claim of conscientious objection to be acceptable to society, a certain set of criteria should be fulfilled. The importance of moral integrity for individuals and society, including its special role in health care, is advocated. Criteria for evaluating the acceptability of claims to conscientious objection are outlined. The (...) precise content of the criteria is dictated by the two main interests that are at stake in the dilemma of conscientious objection: the patient's interests and the health professional's moral integrity. Alternative criteria proposed by other authors are challenged. The bold claim is made that conscientious objection should be recognised by society as acceptable whenever the five main criteria of the proposed set are met. (shrink)

How may clinical ethics committees inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, (...) we argue that some novel working methods may be well suited to promote ethical reflection among clinicians, and that the CEC may be a suitable venue for discussing issues of organizational ethics. (shrink)

This article has two objectives. In the first part, I present a critical overview of the extensive anthropological literature that may be deemed “phenomenological.” Following this critique, which is built up around a classification into four different varieties of phenomenological anthropology, I discuss the relationship between phenomenological anthropology and the ontological turn (OT). Contrary to received wisdom within the anthropological discipline, I suggest that OT has several things in common with the phenomenological project. For the same reason, I argue, it (...) is not accurate to posit OT and phenomenology as opposing or antagonistic projects, as they are often depicted among critics and advocates of OT alike. On the contrary, I go as far as suggesting, OT may be understood as one of the most concerted attempts anthropology has produced to realize a distinctly anthropological version of Husserl’s method of phenomenological bracketing, namely what could be called the ontological epoché. (shrink)

In this paper I offer a normative account of development expertise. Although extending expertise beyond the traditional development experts to include local stakeholders, this normative account aims to delimit legitimate forms of expertise. I label this normative view third wave development expertise. Third wave expertise is distinguished from both the technocratic and the social constructivist views of development expertise. In particular, I discuss the notions of contributory and interactional expertise. Contributory expertise denotes the extent to which a group of agents (...) possesses knowledge which can make a significant contribution to development decision-making, while interactional expertise denotes the extent to which they are able to communicate this knowledge meaningfully. While local stakeholders may possess contributory expertise in matters of their own development, they may lack interactional expertise to communicate this knowledge. Resolving this issue, I argue, requires a mediator who can interact with and between external experts and local stakeholders. (shrink)

Dienes and Seth (2010) conclude that confidence ratings and post-decision wagering are two comparable and recommendable measures of conscious experience. In a recently submitted paper, we have however found that both methods are problematic and seem less suited to measure consciousness than a direct introspective measure. Here, we discuss the methodology and conclusions put forward by Dienes and Seth, and why we think the two experiments end up with so different recommendations.

Morten Frederiksen explores Carl Gustav Jung's elusive notion of synchronicity from a transrational perspective and relates synchronicity to the transpersonality of the "All-One". This is done by expanding the content and meaning of Wolfgang Dietrich's layers of Elicitive Conflict Mapping (ECM) through re-relating them to Ken Wilber's model of the structures of consciousness; with synchronicity as the literal connecting principle. The result, then, is an expanded notion of the transrational peace philosophy which includes Wilber's model of stages shorn of (...) its evolutionary slant and fathoms synchronicity in its theoretical outlook and practical application. Contents A Transrational Approach to Peace Studies through processing the Topic of Synchronicity Jungian Psychology and his Concept of Synchronicity Transrational Peace Philosophy and Consciousness Development Seven different Structures of Consciousness Consequences of Synchronicity for a transrational-oriented Peace Philosophy and Practice Target Groups Lecturers and Students of Psychology, Peace Students and Conflict Transformation Researchers Practitioners in the Field of Elicitive Conflict Transformation About the Author Morten Frederiksen is a Peace Researcher from the MA Program in Peace, Security, Development and International Conflict Transformation at the University of Innsbruck, Austria, and Coordinator of the Danish Development Aid Agency "U-landsforeningen Svalerne". (shrink)

In Ethiopia, conscientious objection (CO) to abortion provision is not allowed due to government regulations. We here report findings from a qualitative interview study of 30 healthcare professionals from different professions working with abortion in Addis Ababa, Ethiopia. CO is practised despite the regulations forbidding it. Most informants appeared to be unfamiliar with the prohibition or else did not accord it weight in their moral reasoning. Proponents of institutionalization/toleration of CO claimed that accommodation was often feasible in a hospital setting (...) because colleagues could take over. Opponents pointed to threats to patient access in rural settings especially. Both proponents and opponents invoked tenets of professional ethics, viz., the right not to be coerced into actions one deems unacceptable, or the duty to provide care, respectively. More societal and professional discussion of the ethics and regulation of CO, and a clearer link between legal regulation and ethical guidance for professionals, are called for. (shrink)

Tekster til Buddhismen. Selected and translated by Frede Möller-Kristensen. Gyldendal, Copenhagen 1980. 104 pp. Illustrated. D.Kr.68.50.

BackgroundCase consultation performed by clinical ethics committees (CECs) is a complex activity which should be evaluated. Several evaluation studies have reported stakeholder satisfaction in single institutions. The present study was conducted nationwide and compares clinicians’ evaluations on a range of aspects with the CEC’s own evaluation.MethodsProspective questionnaire study involving case consultations at 19 Norwegian CECs for 1 year, where consultations were evaluated by CECs and clinicians who had participated.ResultsEvaluations of 64 case consultations were received. Cases were complex with multiple ethical (...) problems intertwined. Clinicians rated the average CEC consult highly, being both satisfied with the process and perceiving it to be useful across a number of aspects. CEC evaluations corresponded well with those of clinicians in a large majority of cases. Having next of kin/patients present was experienced as predominantly positive, though practised by only half of the CECs. The educational function of the consult was evaluated more positively when the CEC used a systematic deliberation method.ConclusionsCEC case consultation was found to be a useful service. The study is also a favourable evaluation of the Norwegian CEC system, implying that it is feasible to implement well-functioning CECs on a large scale. There are good reasons to involve the stakeholders in the consultations as a main rule. (shrink)

Public reason demands that policies are justified to all reasonable citizens. Public health aims at protecting or improving aggregated health outcomes. Since health is not an uncontroversial value, an insurmountable chasm between public reason and public health seems to preclude any viable synthesis between the two outlooks. For any given public health policy, some reasonable citizen seems to have a reason to support ‘no policy’ over ‘some policy’, meaning that the policy cannot be justified to all. The paper first spells (...) out what exactly this conflict is about. Then, using smoking as a case, the paper outlines a model of reconciliation between public reason and public health that should give us some optimism if we want to have public health policies that are compatible with treating citizens as free and equal in the public reason sense. (shrink)

Many philosophers and medical scientists assume thatdisease categories or entities used to classify concrete cases ofdisease, are often defined by disease mechanisms or causalprocesses. Others suggest that diseases should always be definedin this manner. This paper discusses these standpoints criticallyand concludes that they are untenable, not only when `diseasemechanism' refers to an objective mechanism, but also when`mechanism' refers to a pragmatically demarcated part of thetotal ``objective'' causal structure of diseases. As an alternativeto principles that use the concept of disease mechanism (...) oranalogous concepts, a pragmatic approach is suggested anddescribed. This approach has been suggested before, but inproblematic or inadequate versions. This paper proposes a versioncompiled of two ``pragmatic principles'' and shows that they aremuch more adequate than the principle of disease mechanism. Withreference to a case study of a still ongoing internationaldiscussion of various candidates for a classification system formalignant lymphomas, including REAL (Revised European–AmericanClassification of Lymphoid Neoplasms) in which the concept ofdisease mechanism or analogous concepts plays a very small part,it is shown just how pivotal these two pragmatic principles canbe in actual discussions of definitions of diseases. Finally, itis pointed out that with regard to modern philosophy of languageit may, at least in some cases, be problematic to distinguishbetween the two pragmatic principles as they stand. (shrink)

ABSTRACTStories pervade sport. In elite spectator sport, stories play out in packed stadiums while being broadcast simultaneously to immense TV audiences. These stories, which present controversial...

Background: Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities. Objectives: To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities. Research design: Two online questionnaires about the municipal ethics activities. Participants and research context: A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to (...) the second survey (33% response rate). Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services. Findings: Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision. Discussion: This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators. Conclusion: It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors. (shrink)

When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of (...) ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout. (shrink)

The pursuit of happiness is a preoccupation for many people — and probably has been ever since the emergence of Homo sapiens sapiens. The scientific understanding of the brain basis of happiness and its pursuit is, however, still in its infancy. Here we focus on recent scientific research on the closely related concepts of pleasure and desire, and discuss their underlying neural mechanisms and their roles in happiness. We also speculate on potential contributions of the brain's default networks to orchestrating (...) cognitive aspects of meaningfulness that are important to happiness. Finally, we discuss how the lack of pleasure, anhedonia, is a central feature of emotional disorders such as depression and thus perhaps the most important obstacle to happiness for many people. (shrink)

The relation between first and higher order mental states is currently unknown. In particular, the relation between conscious experience and introspection is difficult as the same methods are used to investigate them. In order to make progress in the scientific understanding of consciousness, introspection or both, it is fundamental to understand whether their relation is serial or reciprocal. Although the amount of empirical evidence directly addressing this question is sparse, the little that exists suggests a more complex situation that must (...) be taken into account in order to characterise the relationship between first and higher order mental states. We propose a testable integrative model in an attempt to explain the existing data and to make new empirical predictions. (shrink)

The rise of Big Data in the social realm poses significant questions at the intersection of science, technology, and society, including in terms of how new large-scale social databases are currently changing the methods, epistemologies, and politics of social science. In this commentary, we address such epochal questions by way of a experiment: at the Danish Technical University in Copenhagen, an interdisciplinary group of computer scientists, physicists, economists, sociologists, and anthropologists is setting up a large-scale data infrastructure, meant to continually (...) record the digital traces of social relations among an entire freshman class of students. At the same time, fieldwork is carried out on friendship relations amongst the same group of students. On this basis, the question we pose is the following: what kind of knowledge is obtained on this social micro-cosmos via the Big and Small Data, respectively? How do the two relate? Invoking Bohr’s principle of complementarity as analogy, we hypothesize that social relations, as objects of knowledge, depend crucially on the type of measurement device deployed. At the same time, however, we also expect new interferences and polyphonies to arise at the intersection of Big and Small Data, provided that these are, so to speak, mixed with care. These questions, we stress, are important not only for the future of social science methods but also for the type of societal knowledge that may be expected from new large-scale social databases. (shrink)

BackgroundSurveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents’ stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects. MethodsSurvey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording (...) as well as two variations of question order were employed. Respondents were randomized to receive one of four questionnaire versions. ResultsThree thousand and fifty responses were received. There were moderate to large question wording and question order effects. A majority of Norwegian citizens favour the legalization of assisted dying for patients with terminal or chronic disease. ConclusionsStakeholders in the assisted dying debate need to acknowledge potential framing effects, and accordingly should interpret survey results with caution. The same holds for researchers who conduct attitude surveys in the field of bioethics. (shrink)

A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk (...) factors. Possible remedies are suggested. The potential for bias is greater when the case deliberation is performed by an individual ethics consultant than when an entire clinical ethics committee is involved. (shrink)

Abstract:It is a common belief that obesity is wholly or partially a question of personal choice and personal responsibility. It is also widely assumed that when individuals are responsible for some unfortunate state of affairs, society bears no burden to compensate them. This article focuses on two conceptualizations of responsibility: backward-looking and forward-looking conceptualizations. When ascertaining responsibility in a backward-looking sense, one has to determine how that state of affairs came into being or where the agent stood in relation to (...) it. In contrast, a forward-looking conceptualization of responsibility puts aside questions of the past and holds a person responsible by reference to some desirable future state of affairs and will typically mean that he or she is subjected to criticism, censure, or other negative appraisals or that he or she is heldcost-responsible in some form, for example, in terms of demanded compensation, loss of privileges, or similar. One example of this view is the debate as to whether the obese should be denied, wholly or partially, free and equal access to healthcare,notbecause they are somehow personally responsible in the backward-looking sense but simply because holding the obese responsible will have positive consequences. Taking these two conceptions of responsibility into account, the authors turn their analysis toward examining the relevant moral considerations to be taken into account when public policies regarding obesity rely on such a conception of responsibility. (shrink)

PurposeAs interest in technology ethics is increasing, so is the interest in bringing schools of ethics from non-Western philosophical traditions to the field, particularly when it comes to information and communication technology. In light of this development and recent publications that result from it, this paper aims to present responds critically to recent work on Confucian virtue ethics (CVE) and technology.Design/methodology/approachFour critiques are presented as theoretical challenges to CVE in technology, claiming that current literature insufficiently addresses: overall applicability, collective ethics (...) issues, epistemic overconfidence within technology corporations and amplification of epistemic overconfidence by the implementation of CVE. These challenges make use of general CVE literature and work on technology critique, political philosophy, epistemology and business ethics.FindingsImplementing CVE in technology may yield some benefits, but these may be outweighed by other outcomes, include strengthening hierarchies, widening inequities, increasing, rather than limiting, predictive activity, personal data collection, misinformation, privacy violations and challenges to the democratic process.Originality/valueThough not directly advocating against CVE, the paper reveals hitherto unidentified and serious issues that should be addressed before CVE are used to inform ethics guidelines or regulatory policies. It also serves as a foundation for further inquiry into how Eastern philosophy more broadly can inform technology ethics in the West. (shrink)

Physical and emotional intimacy between humans and robots may become commonplace over the next decades, as technology improves at a rapid rate. This development provides new questions pertaining to how people perceive robots designed for different kinds of intimacy, both as companions and potentially as competitors. We performed an randomized experiment where participants read of either a robot that could only perform sexual acts, or only engage in non-sexual platonic love relationships. The results of the current study show that females (...) have less positive views of robots, and especially of sex robots, compared to men. Contrary to the expectation rooted in evolutionary psychology, females expected to feel more jealousy if their partner got a sex robot, rather than a platonic love robot. The results further suggests that people project their own feelings about robots onto their partner, erroneously expecting their partner to react as they would to the thought of ones’ partner having a robot. (shrink)

Would primary care services benefit from the aid of a clinical ethics committee (CEC)? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation (...) and disagreement with next of kin; and priority setting, resource use and quality. Nursing homes and home care were the primary care services most often involved. Next of kin were present in 10 case deliberations, whereas patients were never present. The investigation indicates that it might be feasible for new CECs to attain a high level of activity including case deliberations within the time frame. It also confirms that significant, characteristic and complex moral problems arise in primary care services. (shrink)

The likely adverse effects of climate change call for political action. In this paper, we argue that the public reason framework—with its insistence on justifiability to all reasonable citizens, in spite of their profound disagreements—despite initial misgivings recommends itself as a framework for debate and decisions pertaining to climate change. We address two possible stumbling blocks: the exclusion of non-anthropocentric points of view, and the controversy over intergenerational justice. We argue that public reason can deal with these problems. Moreover, we (...) argue that both strongly idealized and moderately idealized versions are able to address these issues. Moreover, public reason, as a family of views emphasizing disagreement and justifiability to all reasonable citizens, can help secure the stability of political orders, and hence contribute to sustained and demanding efforts to combat the adverse effects of climate change. (shrink)

Controversies arise over abortion, assisted dying and conscientious objection in healthcare. The purpose of the study was to examine the relationship between attitudes towards these bioethical dilemmas, and secularity and religiosity. Data were drawn from a 2017 web-based survey of a representative sample of 1615 Norwegian adults. Latent moderated structural equations modelling was used to develop a model of the relationship between attitudes. The resulting model indicates that support for abortion rights is associated with pro-secular attitudes and is a main (...) “driver” for support for assisted dying and opposition to conscientious objection. This finding should be regarded as a hypothesis which ought to be tested in other populations. If the relationship is robust and reproduced elsewhere, there are important consequences for CO advocates who would then have an interest in disentangling the debate about CO from abortion; and for health systems who ought to consider carefully how a sound policy on CO can safeguard both patient trust in the services and the moral integrity of professionals. It is suggested that if religiosity wanes and pro-secular and pro-abortion attitudes become more widespread, support for CO might decline, putting into question whether present policies of toleration of conscientious refusals will remain acceptable to the majority. (shrink)

Despite the commonly held view that confessing to doping is morally right, few former elite athletes who have doped confess to doping. In this paper, I ask whether elite athletes who have d...

Background Rationing and allocation decisions at the clinical level – bedside rationing – entail complex dilemmas that clinicians and managers often find difficult to handle. There is a lack of mechanisms and aids for promoting fair decisions, especially in hard cases. Reports indicate that clinical ethics committees sometimes handle cases that involve bedside rationing dilemmas. Can CECs have a legitimate role to play in bedside rationing? Main text Aided by two frameworks for legitimate priority setting, we discuss how CECs can (...) contribute to enhanced epistemic, procedural and political legitimacy in bedside rationing decisions. Drawing on previous work we present brief case vignettes and outline several potential roles that CECs may play, and then discuss whether these might contribute to rationing decisions becoming legitimate. In the process, key prerequisites for such legitimacy are identified. Legitimacy places demands on aspects such as the CEC’s deliberation process, the involvement of stakeholders, transparency of process, the opportunity to appeal decisions, and the competence of CEC members. On these conditions, CECs can help strengthen the legitimacy of some of the rationing decisions clinicians and managers have to make. Conclusions On specified conditions, CECs can have a well-justified advisory role to play in order to enhance the legitimacy of bedside rationing decisions. (shrink)

Det er efterhånden en udbredt antagelse, at Jean-Jacques Rousseau i mange hen- seender kan betragtes som den (ikke særligt) skjulte bagmand bag meget af det, vi i vore dage generelt betegner som populisme. I dette paper undersøger jeg den påstand. For det første argumenterer jeg i forlængelse af Quentin Skinner for, at det i det hele taget er problematisk at indordne klassiske tænkere i kategorier, de ikke selv kendte til. For det andet argumenterer jeg for, at dette problem i særlig (...) grad gælder Rousseau, hvis tænkning i høj grad synes at modsætte sig enhver form for klassifikation. Ikke desto mindre forsøger jeg for det tredje at besvare spørgsmålet om, hvorvidt Rousseau faktisk var populist – og ender med at konkludere, at det er en tvivlsom påstand. Artiklens egentlige konklusion er imidlertid, at det egentligt givtige ved at genbesøge Rousseau snarere ligger i, at han tvinger os til at gentænke vores politiske vokabularer på en måde, der rokker ved hævdvunde forestillinger. (shrink)

Sideløbende med arbejdet med sine tre store Kritikker skrev Kant en række mindre afhandlinger om politik og historie. To af dem, 'Ide til en almen historie med verdensborgerlig hensigt' og 'Besvarelse af spørgsmålet: Hvad er oplysning?', publiceredes i 1784 med blot en måneds mellemrum i henholdsvis november- og decemberhæftet af Berlinische Monatsschrift.

It is widely assumed that human learning and the structure of human languages are intimately related. This relationship is frequently suggested to derive from a language-specific biological endowment, which encodes universal, but communicatively arbitrary, principles of language structure (a Universal Grammar or UG). How might such a UG have evolved? We argue that UG could not have arisen either by biological adaptation or non-adaptationist genetic processes, resulting in a logical problem of language evolution. Specifically, as the processes of language change (...) are much more rapid than processes of genetic change, language constitutes a both over time and across different human populations, and, hence, cannot provide a stable environment to which language genes could have adapted. We conclude that a biologically determined UG is not evolutionarily viable. Instead, the original motivation for UG arises because language has been shaped to fit the human brain, rather than vice versa. Following Darwin, we view language itself as a complex and interdependent which evolves under selectional pressures from human learning and processing mechanisms. That is, languages themselves are shaped by severe selectional pressure from each generation of language users and learners. This suggests that apparently arbitrary aspects of linguistic structure may result from general learning and processing biases deriving from the structure of thought processes, perceptuo-motor factors, cognitive limitations, and pragmatics. (shrink)

'Behavioral Methods in Consciousness Research' is the first book of its kind, providing an overview of methods and approaches for studying consciousness. The chapters are written by leading researchers and experts who describe the methods they actually use in their own studies, along with their pitfalls, problems, and difficulties.

This paper presents an integrated discussion of methods and ethics by drawing on participatory research with children in Ethiopia and Kenya. It examines the complex social, ethical, practical and methodological dilemmas of research with HIV-affected children, and explores how we confronted some of these dilemmas before, during and after fieldwork. The paper interrogates the role and limitations of ‘global’ ethical standards in childhood research, and the ways in which the researchers’ gender, ethnicity/race, material power, knowledge and insider-outsider position all intersect (...) to affect: (a) the level of children's involvement in the research process; (b) the generation of knowledge about the field; and (c) the negotiation of ethics in collaborative ways. We argue that doing ethical research with HIV-affected children should not be based solely on dominant and de-contextualised understandings of ethics, knowledge and social relations, but should be negotiated reflexively and through dialogue with participants, including the children, their guardians and ‘local’ community members—all with the aim of doing good and avoiding harm in the research process. (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)

Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults (response rate 8.5%). A majority of respondents supports increased access to prenatal screening with ultrasound (...) (60%) and/or full genome sequencing of fetal DNA (55%) available for all pregnant women. Significant minorities indicate, however, that a public offer of prenatal screening for all pregnant women would signal that people with Down syndrome are unwanted (46%) or could be criticized for contributing to a ‘sorting society’ (48%). Results indicate deeper ambivalences and a cultural sensitivity to the ethical challenges of prenatal screening and subsequent abortions. The specific diagnosis of Down syndrome and the fear of becoming a ‘sorting society’ which sorts human life due to diagnoses, appear to play prominent roles in citizen deliberations. The low response rate means that a non-response bias cannot be excluded, yet reasons why results are still likely to be of value are discussed. (shrink)

Memory is fleeting. New material rapidly obliterates previous material. How, then, can the brain deal successfully with the continual deluge of linguistic input? We argue that, to deal with this “Now-or-Never” bottleneck, the brain must compress and recode linguistic input as rapidly as possible. This observation has strong implications for the nature of language processing: (1) the language system must “eagerly” recode and compress linguistic input; (2) as the bottleneck recurs at each new representational level, the language system must build (...) a multilevel linguistic representation; and (3) the language system must deploy all available information predictively to ensure that local linguistic ambiguities are dealt with “Right-First-Time”; once the original input is lost, there is no way for the language system to recover. This is “Chunk-and-Pass” processing. Similarly, language learning must also occur in the here and now, which implies that language acquisition is learning to process, rather than inducing, a grammar. Moreover, this perspective provides a cognitive foundation for grammaticalization and other aspects of language change. Chunk-and-Pass processing also helps explain a variety of core properties of language, including its multilevel representational structure and duality of patterning. This approach promises to create a direct relationship between psycholinguistics and linguistic theory. More generally, we outline a framework within which to integrate often disconnected inquiries into language processing, language acquisition, and language change and evolution. (shrink)

In a recent article, [Sergent, C. & Dehaene, S. . Is consciousness a gradual phenomenon? Evidence for an all-or-none bifurcation during the attentional blink, Psychological Science, 15, 720–729] claim to give experimental support to the thesis that there is a clear transition between conscious and unconscious perception. This idea is opposed to theoretical arguments that we should think of conscious perception as a continuum of clarity, with e.g., fringe conscious states [Mangan, B. . Sensation’s ghost—the non-sensory “fringe” of consciousness, Psyche, (...) 7, 18]. In the experimental study described in this article, we find support for this opposite notion that we should have a parsimonious account of conscious perception. Our reported finding relates to the hypothesis that there is more than one perceptual threshold [Merikle, P.M., Smilek, D. & Eastwood, J.D. . Perception without awareness: perspectives from cognitive psychology, Cognition, 79, 115–134], but goes further to argue that there are different “levels” of conscious perception. (shrink)

Obtaining human genetic samples is vital for many biobank research purposes, yet, the ethics of obtainment seems to many fraught with difficulties. One key issue is consent: it is by many considered ethically vital that consent must be fully informed (at least ideally speaking) in order to be legitimate. In this paper, we argue for a more liberal approach to consent: a donor need not know all the specifics of future uses of the sample. We argue that blanket consent is (...) ethically defensible, and that this is buttressed by considerations of (justified) trust-relations. Given robust institutional oversight, blanket consent is a permissible form of consent in the bio-banking context. (shrink)

The nub of the following argument is that there is a conflict between the idea of (liberal) neutrality on the one hand, and an intuitively plausible idea of political representation on the other. The conflict arises when neutrality is seen as a condition for political legitimacy: neutralist political representation is only legitimate insofar as the representative does not advance political ideas based on conceptions of the good that are not endorsed by the whole of the (reasonable) polity. However, we often (...) encounter examples of political representation that do not live up to this demand but nevertheless seem legitimate. Hence, neutralists should explain either why this counterintuitive notion of representation does not follow from neutrality or explain what representatives are meant and allowed to do in such a political arrangement. A plausible neutralist rejoinder to this is to say that legitimacy is not dependent on neutrality for all political decisions. Neutrality is important (only or predominantly) regarding a certain body of political decisions, viz., using the Rawlsian idiom, 'constitutional essentials and matters of basic justice.' However, such a two-levelled approach is not without its problems. I argue that a skein of theoretical and practical challenges to the two-levelled approach undermines, or at least weakens, this attempt to solve the problem about representation and neutrality, and that the two-levelled approach is unclear in certain key aspects. The aim of the article is, however, quite modest. It is not to challenge neutrality per se ; rather, it is a call for further clarification of the issues pertaining to the relationship between neutrality and representation. (shrink)

This paper explores a redescription of ‘fair play’ as loyalty. Focusing on the context of elite sport and the case of anti-doping, the paper develops an adaptation of Richard Rorty’s call to dispen...

By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons. The (...) objector's moral integrity might be equally threatened in objections based on professional reasons as in objections based on personal beliefs. Second, the literature on conscientious objection typically presupposes that conflicts of conscience pertain to well-circumscribed and typical situations which can be identified as controversial without attention to individualising features of the concrete situation. However, the case shows that conflicts of conscience can sometimes be more particular, born from concrete features of the actual situation, and difficult, if not impossible, to predict before they arise. Guidelines should be updated to address such ‘situation-based’ conscientious refusals explicitly. (shrink)

Background Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Method Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Results Three hundred thirty-nine reports from 38 (...) CECs were studied. We found 78 activities where resource use or priority setting were explicitly highlighted as main topics. Of these, 29 were seminars or other educational activities, 21 were deliberations on individual patient cases, whereas 28 were discussions of principled or general cases. Individual patient cases concerned various distributional dilemmas where values were at stake. Six main topics and seven roles for the CEC were identified. CECs handle issues concerning the introduction of new costly drugs, extraordinarily costly established treatment, the application of priority setting criteria, resource use for vulnerable groups, resource constraints compromising practice, and futility of care. The CEC can act as an analyst, advisor, moderator, disseminator, facilitator, watch dog, and guardian of values and laws. Discussion In order to fulfil their responsibilities in handling priority setting cases, CECs need knowledge of both the ethics and the institutionalized systems of priority setting. There is potential for developing this aspect of the CECs’ work further. Conclusions The Norwegian CECs are involved in priority setting decisions where they can play multiple constructive roles. In particular, they advise and raise awareness of ethical aspects in resource allocations; bridge clinical practice with higher-level decisions; and promote fair resource allocation and stakeholder rights and interests. (shrink)