The article presents and discusses an ongoing fellowship project entitled ‘Space for Interference’, conducted under the Norwegian Programme for Research Fellowships in the Arts. Two concrete site-specific art projects produced under Space for Interference serve as a point of departure for an investigation into methods of interference and the forms of address that artists use when intervening in other specialized fields in society. The institutions that provide the site for an art project have different social functions. We ask what may (...) be their motivation for allowing artists access to their physical environments, apparatuses, procedures, systems and discourses. The fact that the artists’ projects in these contexts function as a means of self-observation for the institutions seems obvious. Nevertheless, we seek to investigate the various economic and political factors that allow these institutions to include potentially critical activities, which aim to modify or transgress their systems, and thereby displaying how they are malleable and mobile bodies. One assertion we make is that by doing so the involved institutions prove to be modern, self-critical and flexible, thus complying with political requirements to adapt to the rapidly changing environments of the information and communication age. The perspective from systems theory in the Luhmannian tradition has proved useful since it shows how the issues of art may also be the problems of science, business, politics and the law in the complex and decentered social universe of today. The issues of contingency, insecurity, paradox and autoreflexivity, surplus meanings and the complexity and decentering of the subject are at the heart of contemporary art. Systems theory provides a way to link such practices theoretically with scientific discourse and with the advanced problem solving and criticality of other social domains, like politics, business and the media industries. (shrink)

Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also (...) included questions evaluating the participants’ experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable. (shrink)

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed (...) with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved. (shrink)

Most philosophers acknowledge ways of overcoming blame, even blame directed at a culpable offender, that are not forgiving. Sometimes continuing to blame a friend for their offensive comment just isn't worth it, so we let go instead. However, despite being a common and widely recognised experience, no one has offered a positive account of letting go. Instead, it tends to be characterised negatively and superficially, usually in order to delineate the boundaries of forgiveness. This paper gives a more complete and (...) systematic account of this important practice. We argue that the basic distinction between forgiving and letting go of blame follows from distinctions that many philosophers already accept. We then develop a positive account in terms of the reasons one has to let go rather than forgive and show that letting go is as valuable a part of our shared moral lives as forgiveness. (shrink)

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were (...) interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements. (shrink)

Non-moral blame seems to be widespread and widely accepted in everyday life—tolerated at least, but often embraced. We blame athletes for poor performance, artists for bad or boring art, scientists for faulty research, and voters for flawed reasoning. This paper argues that non-moral blame is never justified—i.e. it’s never a morally permissible response to a non-moral failure. Having explained what blame is and how non-moral blame differs from moral blame, the paper presents the argument in four steps. First, it argues (...) that many (perhaps most) apparent cases of non-moral blame are actually cases of moral blame. Second, it argues that even if non-moral blame is pro tanto permissible—because its target is blameworthy for their substandard performance—it often (perhaps usually) fails to meet other permissibility conditions, such as fairness or standing. Third, it goes further and challenges the claim that non-moral blame is ever even pro tanto permissible. Finally, it considers a number of arguments in support of non-moral obligations and argues that none of them succeed. (shrink)

In this article, we report findings from a qualitative study that explored how the relatives of intensive care unit patients experienced the nurses’ role and relationship with them in the end-of-life decision-making processes. In all, 27 relatives of 21 deceased patients were interviewed about their experiences in this challenging ethical issue. The findings reveal that despite bedside experiences of care, compassion and comfort, the nurses were perceived as vague and evasive in their communication, and the relatives missed a long-term perspective (...) in the dialogue. Few experienced that nurses participated in meetings with doctors and relatives. The ethical consequences imply increased loneliness and uncertainty, and the experience that the relatives themselves have the responsibility of obtaining information and understanding their role in the decision-making process. The relatives therefore felt that the nurses could have been more involved in the process. (shrink)

The volume documents, and makes an original contribution to, an astonishing period in twentieth-century philosophy—the progress of Arne Naess's ecophilosophy from its inception to the present. It includes Naess's most crucial polemics with leading thinkers, drawn from sources as diverse as scholarly articles, correspondence, TV interviews and unpublished exchanges. The book testifies to the skeptical and self-correcting aspects of Naess's vision, which has deepened and broadened to include third world and feminist perspectives. Philosophical Dialogues is an essential addition to the (...) literature on environmental philosophy. (shrink)

Objective To examine medical students’ views on conscientious objection and controversial medical procedures.Methods Questionnaire study among Norwegian 5th and 6th year medical students.Results Five hundred and thirty-one of 893 students responded. Respondents object to a range of procedures not limited to abortion —notably euthanasia, ritual circumcision for boys, assisted reproduction for same-sex couples and ultrasound in the setting of prenatal diagnosis. A small minority would object to referrals for abortion. In the case of abortion, up to 55% would tolerate conscientious (...) refusals, whereas 42% would not. Higher proportions would tolerate refusals for euthanasia or ritual circumcision for boys.Discussion A majority of Norwegian medical students would object to participation in euthanasia or ritual circumcision for boys. However, in most settings, many medical students think doctors should not be able to refuse participation on grounds of conscience. A minority would accept conscientious refusals for procedures they themselves do not object to personally. Most students would not accept conscientious refusals for referrals.Conclusions Conscientious objection remains a live issue in the context of several medical procedures not limited to abortion. Although most would want a right to object to participation in euthanasia, tolerance towards conscientious objectors in general was moderate or low. (shrink)

Background: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. Aim: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential (...) loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. Method: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. Results: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. Conclusion: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them. (shrink)

Teleology has a complicated history in the biological sciences. Some have argued that Darwin’s theory has allowed biology to purge itself of teleological explanations. Others have been content to retain teleology and to treat it as metaphorical, or have sought to replace it with less problematic notions like teleonomy. And still others have tried to naturalize it in a way that distances it from the vitalism of the nineteenth century, focusing on the role that function plays in teleological explanation. No (...) consensus has seemed possible in this debate. This paper takes a different approach. It argues that teleology is a perfectly acceptable scientific notion, but that the debate took an unfortunate misstep some 2300 years ago, one that has confused things ever since. The misstep comes in the beginning of Aristotle’s Physics when a distinction is made between two types of teleological explanation. One type pertains to artifacts while the other pertains to entities in nature. For Aristotle, artifacts are guided by something external to themselves, human intentions, while natural entities are guided by an internal nature. We aim to show that there is, in fact, only one type of legitimate teleological explanation, what Aristotle would have considered a variant of an artifact model, where entities are guided by external fields. We begin with an analysis of the differences between the two types of explanation. We then examine some evidence in Aristotle’s biological works suggesting that on account of his natural-artifactual distinction, he encountered difficulties in trying to provide teleological accounts of spontaneous generation. And we show that it is possible to resolve these difficulties with a more robust version of an artifact model of teleology, in other words, with an externalist teleology. This is McShea’s model, in which goal-directed entities are guided by a nested series of upper-level fields. To explain teleological behavior, this account invokes only external physical forces rather than mysterious internal natures. We then consider how field theory differs from other efforts to naturalize teleology in biology. And finally, we show how the account enables us to grapple with certain difficult cases – genes and intentions – where, even in biology today, the temptation to posit internal natures remains strong. (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)

There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. Thus, (...) both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries. (shrink)

More than one single professional group deals with therapeutic manipulations of the spine and the joints. Osteopaths, Chiropractors, Naprapaths, Physical Therapists (and a contingent Physicians) all share this interest. Each profession is also very clear about where its bulk of knowledge stems from. The disciplines that are reckoned as the oldest are from the USA. A number of “inventors” are to be found, all without a formal university degree in Medicine. Andrew Taylor Still (1828–1917) came up with his system of (...) Osteopathy in 1874. Daniel D. Palmer (1845–1913), the man behind Chiropractic, founded his system in 1894, and Palmer’s colleague and former student, Oakley Smith (1880–1967), developed Naprapathy in 1906/1907. Physical Therapists working with what is called Orthopaedic Manual Physical Therapy are on the other hand not claiming American ancestry, nor do their body of knowledge and clinical skills originate from outside the medical profession. It is an offspring of Orthopaedic Medicine (OM) which was an invention by Physicians. Date and place of birth is said to be 1929 in England. This article turns the above-mentioned chronology on its head. It will show that Orthopaedic Medicine likely is the oldest system. It will also unearth OM’s sturdy roots in a strong but forgotten, and even hidden, discourse of Mechanical Medicine found in 19th century Europe, which was ruled by Physical Therapists. Why “we” do not know about this “history” is analysed and explained from a variety of perspectives. (shrink)

My purpose in this article is to raise the problem of meaning in sport. The problem has two aspects. One is whether sport has any meaning in itself. The other is about how sport can be a part of a...

Do people classify nature in ways that can be described as archetypes? Could it be that these can be interpreted as health promotive? More and more researchers today suggest that archetypes can be used to analyze, describe, and develop green spaces. In parallel, an increasing number of research results since the 1980s have shown that human health and well-being are positively affected by stays in certain nature areas. The qualities in these nature areas which stand out to be most health-promoting (...) are interpreted to be properties of nature that humans through evolution are prepared to perceive in a positive way. In this study, 547 respondents in southern Sweden answered a questionnaire on properties in natural areas. Through cluster analysis, these properties have been grouped into 10 types of nature and landscape. The 10 clusters are related to specific phenomena and places in Scandinavian nature, which could be described as archetypal. These natural phenomena and places are discussed, partly based on references to archaic Scandinavian mythology, Scandinavian lifestyle, and cultural canon, and partly on research on evolution, human preferences, and how nature can affect human health. We discuss how these nature archetypes evoke anxiety, fear, and distancing as well as calmness, tranquility, and connection. However, researchers have so far focused on how visits to natural environments have affected the sympathetic nervous system, and not realized the possibility of including the calm and connection system as well as the oxytocin in their explanatory models. In a follow-up article, we intend to develop a model for how the nature archetypes can interact with the calm and connection system. (shrink)

The nature of physical measurements performed on microscopic systems is discussed, and it is suggested that the procedures which are conventionally referred to as “measurements” fall into at least three different categories. The connection between observation processes and irreversible processes is stressed. The customary quantum mechanical treatment of irreversible processes is discussed, and its deficiencies from the philosophical point of view are criticized. The standpoint that quantum mechanics should not be considered as a basic philosophical system but rather as an (...) immensely useful “tool” is defended. Some attempts at developing a more “basic” theory are discussed, and a hypothesis is put forward concerning the role of entropy within some possible future nonlocal hidden-variable theory. (shrink)

Background: Perfectionism is increasing over time and associated with various mental health problems. Recent research indicates adverse childhood experiences may play a role in the development of perfectionism. In addition, perfectionism is marked by interpersonal problems with implications for treatment outcome.Aim: This study aimed to fill an important gap in the predominantly quantitative literature field by exploring how individuals with perfectionism understand the relationship between painful experiences and how they relate to others.Method: Nine individuals with perfectionism were interviewed using McAdam's (...) life-story interview. Thematic analysis was used to analyze the interviews.Results: Four themes emerged: “A childhood with big responsibilities,” “I am still the responsible one,” “Keeping others at a distance to protect the inner self,” and “Achieving physical distance to get a fresh start.” These themes are grouped into two overarching themes: “You can't always trust people” and “A distancing from others.”Conclusion: Findings highlight taking responsibility and social distancing serve an important function for perfectionistic individuals in response to painful relational events. We discuss how themes of control and agency impact individuals' relationship to mental health and turning toward others for help. The findings provide greater complexity to understanding perfectionism as a “barrier to treatment.”. (shrink)

Stephanie Collins’ Group Duties offers interesting new arguments and brings together numerous interconnected issues that have hitherto been treated separately. My critical commentary focuses on two particularly original and central claims of the book: (1) Only groups that are united under a group-level decision-making procedure can bear duties. (2) Attributions of duties to other groups should be understood as attributions of “coordination duties” to each member of the group, duties to take steps responsive to the others with a view to (...) the group’s φ-ing or express willingness to do so. In support of the first claim, Collins argues that only groups that can make decisions can bear duties, and that the ability to make decisions requires the relevant sort of decision-making procedure. I suggest that both parts of this argument remain in need of further support. I furthermore argue that Collins’ account of coordination duties gets certain kinds of cases wrong, and suggest that attributions of duties to groups without decision-making procedures are more plausibly understood as attributing shared duties. (shrink)

Gunnar Olsson's tale follows an explorer from the oldest creation epics extant to the power struggles of today, an attempt to codify the taken-for-granted, a struggle with the invisible powers that make us so obedient and so predictable.

For Husserl, kinaesthetic capability is a key piece of the process of perception. By ensuring the junction between the actual and the potential, it allows the exhibition of an object that is always more than what appears. Kinaesthetic capability preserves the transcendence of the object by preventing the phenomenon from being confined to pure actuality. This idea, however, poses significant challenges when one questions the nature of the possibilities that are at stake here. Especially, the perceived seems to enjoy a (...) kind of emancipation from these capabilities as they actually are. How can one justify that the structures of the perceived world are the intentional correlate of the kinaesthetic skills of the subject if such structures continue to regulate the sense of the appearing objects when those skills are neutralized? We will see that only a genetic perspective, assuming the intrinsically historical character of the subject, provides a satisfactory answer to this question, and that this perspective leads to placing into question the actualist position that Husserl sometimes tends to adopt. (shrink)

Taking up ordinal notations derived from Skolem hull operators familiar in the field of infinitary proof theory we develop a toolkit of ordinal arithmetic that generally applies whenever ordinal structures are analyzed whose combinatorial complexity does not exceed the strength of the system of set theory. The original purpose of doing so was inspired by the analysis of ordinal structures based on elementarity invented by T.J. Carlson, see [T.J. Carlson, Elementary patterns of resemblance, Annals of Pure and Applied Logic 108 (...) 19–77], [G. Wilken, Σ1-Elementarity and Skolem hull operators, Annals of Pure and Applied Logic 145 162–175], and [G. Wilken, Assignment of ordinals to patterns of resemblance, The Journal of Symbolic Logic ]. Within the arithmetical context laid bare in this work, the “-numbers” play a role analogous to the role epsilon numbers play in the ordinal arithmetic based on the notion of Cantor normal form. (shrink)

PurposeTo explore and describe a trained communication partner’s use of responsive strategies in dyadic interaction with adults with Rett syndrome.IntroductionResponsive partner strategies facilitate social, communicative, and linguistic development. The common feature is that the communication partner responds contingently to the other’s focus of attention and interprets their acts as communicative. Research on responsive partner strategies that involves individuals with significant communication and motor disabilities remains sparse. The same applies to if, and how, the use of communication aids impacts on the (...) partner’s use of responsive strategies.Materials and methodsA therapist, trained in responsive partner strategies and aided communication interacted during 14 sessions with each of three participants. The participants were adults with Rett syndrome. A gaze-controlled device and responsive strategies were used during all sessions. The Responsive Augmentative and Alternative Communication Style scale was used to assess the partner’s responsiveness. RAACS consists of 11 items including ratings of to what extent the partner is being attentive to, confirms, and expands the individual’s communication. During eight of the 14 sessions, aided AAC Modelling was also used, i.e., the communication partner pointed at symbols on the gaze-controlled device while interacting. In addition to RAACS, each time the communication partner confirmed or expanded on communication when the participants used the gaze-controlled device and the participants did not use the gaze-controlled device was counted. Descriptive statistics were used to present the results. Non-parametric tests were used to compare means between the two conditions and between participants.ResultsInter-rater agreement for the different RAACS items ranged from 0.73 to 0.96 and was thus found to be fair to excellent. The communication partner’s use of responsive strategies varied when communicating with different participants and the scores were higher when aided AAC modeling was used. The communication partner’s number of responses and use of responsive strategies were higher when the participants communicated through a gaze-controlled device.ConclusionThe communication partner’s use of responsive and scaffolding strategies is not a fixed construct but varies in interactions with different non-speaking persons. The same is true whether the non-speaking person uses a gaze-controlled device with digitized speech or not. (shrink)

There’s a general assumption that teleology and function do not exist in inanimate nature. Throughout biology, it is generally taken as granted that teleology (or teleonomy) and functions are not only unique to life, but perhaps even a defining quality of life. For many, it’s obvious that rocks, water, and the like, are not teleological, nor could they possibly have stand-alone functions. This idea - that teleology and function are unique to life - is the target of this paper. I (...) begin with an overview of McShea’s field theoretic account of teleology. I start with the field theoretic account because it presents a promising analysis of teleological systems. It is promising because, in not making any assumptions about life’s special status in teleological systems, it avoids counterexamples that have problematized other accounts. I then consider some of the prominent efforts that have been made to attempt to avoid ascribing functions or teleology to some form of inanimate nature. In my assessment, none of the efforts are successful. I conclude by offering mineral evolution as a case study to show how inanimate nature can be both teleological and functional. The evolution of mineral species reveals that teleology and function extend to inanimate nature, and that teleology and function come in degrees. (shrink)

In [2] T. J. Carlson introduces an approach to ordinal notation systems which is based on the notion of Σ₁-elementary substructure. We gave a detailed ordinal arithmetical analysis (see [7]) of the ordinal structure based on Σ₁-elementarity as defined in [2]. This involved the development of an appropriate ordinal arithmetic that is based on a system of classical ordinal notations derived from Skolem hull operators, see [6]. In the present paper we establish an effective order isomorphism between the classical and (...) the new system of ordinal notations using the results from [6] and [7]. Moreover, on the basis of a concept of relativization we develop mutual (relatively) elementary recursive assignments which are uniform with respect to the underlying relativization. (shrink)