In this article, tragedy and utopia are juxtaposed, and it is proposed that the problem of “medicalisation” is better understood in a framework of tragedy than in a utopian one. In utopia, it is presupposed that there is an error behind every setback and every side effect, whereas tragedy brings to light how side effects can be the result of irreconcilable conflicts. Medicalisation is to some extent the result of such a tragic conflict. We are given power by medical progress, (...) but are also confronted with our fallibility, thus provoking insecurity. This situation is illustrated by the sudden infant death syndrome . Recent epidemiological investigations have shown that infants sleeping in a prone position have a 15–20 times higher risk of dying from SIDS than infants sleeping in a supine position. A simple means of preventing infant death is suggested by this discovery, but insecurity is also created. What else has been overlooked? Perhaps a draught, or wet diapers, or clothes of wool are just as dangerous as sleeping prone? Further investigations and precautions will be needed, but medicalisation prevails. (shrink)

A questionnaire relating to attitudes towards setting economic priorities within the health care system was sent to all 151 general practitioners in Northern Norway. Of these, 109 (72 per cent) responded. Ninety-six per cent of the respondents agreed or partly agreed that the setting of economic priorities within the health care system was necessary. Ninety-three per cent had experienced a conflict between their responsibility towards the individual patient and the requirement for them to manage the health budget. The responses suggest (...) that doctors act more in the interests of their patient than the interests of society. However, 68 per cent reported having refrained from giving the best treatment to patients because it was too expensive. As many as 60 per cent of the respondents wanted more public guidelines. Only 10 per cent wanted doctors to have more influence in difficult questions arising from setting priorities. (shrink)

Parenting stress can influence caregiving behavior negatively, which in turn may harm children’s development. Identifying precursors of parenting stress, preferably beginning during pregnancy and throughout the first year of life, is therefore important. The present study aims to provide novel knowledge on this issue through a detailed examination of the association between maternal attachment style and later parenting stress. Moreover, we examine the role of several additional risk factors, specificially the mothers’ own adverse childhood experiences, as well as infants’ temperamental (...) characteristics. Data from a community based longitudinal study of 1,036 Norwegian mothers, collected during pregnancy and 12 months after childbirth, were used. Results showed that attachment style in pregnancy predicted parenting stress one year after birth. In addition, it was demonstrated that the mothers’ own adverse childhood experiences predicted postnatal parenting stress, and that attachment style operated as a mediator of this association. A significant association between perceived infant temperament and parenting stress was also found. The study illustrates how important is is to understand the multifactorial antecedents of parenting stress. The results may inform early intervention efforts aimed at supporting mothers and their partners in the potentially difficult transition period around childbirth. (shrink)

This paper describes the significance of key empirical findings from the recent and landmark study Caring and Aging with Pride: The National Health, Aging and Sexuality Study (with Karen I. Fredriksen‐Goldsen as the principal investigator), on lesbian, gay, bisexual, and transgender aging and health disparities. We will illustrate these findings with select quotations from study participants and show how nonconscious bias (i.e., activation of negative stereotypes outside conscious awareness) in the clinical encounter and health care setting can threaten shared (...) decision‐making and perpetuate health disparities among LGBT older adults. We recognize that clinical ethicists are not immune from nonconscious bias but maintain that they are well situated to recognize bias and resulting injustice by virtue of their training. Further, we discuss how clinical ethicists can influence the organization's ethical culture and environment to improve the quality and acceptability of health care for LGBT older adults. (shrink)

Supported by Ian Hacking’s concept of “intervention,” and Charles Taylor’s concept of “intentionality,” this article argues that doubting is acting, and that doubting is therefore subject to the same demands of responsibility as any other action. The argument is developed by using medical practice as a test-case. The central suggestion is that the demand of acting responsibly limits doubt in medicine. The article focuses on two such limitations to doubt. Firstly, the article argues that it is irresponsible to doubt that (...) our actions can harm other people. Secondly, the article argues that it is irresponsible not to strive for coherence between our utterances of doubt and our other actions. Incoherence here can cause “cultural impoverishment.” In a larger context this article also argues that medicine can enrich our epistemology, because medical knowledge displays important traits of knowledge that are downplayed in traditional epistemology derived from mathematics and physics. In particular, medicine makes it possible to get the relation between ethics and epistemology into sharper focus. The endpoint in medical epistemology is “responsible action,” and not certainty in and of itself. (shrink)

The administration of pro re nata medications is the responsibility of the nurse. However, ethical uncertainties often happen due to the inability of incapacitated patients to collaborate with the nurse in the process of decision making for pro re nata medication administration. There is a lack of integrative knowledge and insufficient understanding regarding ethical considerations surrounding the administration of pro re nata medications to incapacitated patients. Therefore, they have been discussed in this paper and practical strategies to avoid unethical practices (...) have been suggested. The complicated caring situation surrounding the administration of pro re nata medications is intertwined with ethical issues affecting the consideration of the patient's wishes and interventions that override them. The patient's right of autonomy and treatment refusal, surrogacy role, paternalism, and coercion are the main ethos of ethical pro re nata medication administration. Education and training can help nurses avoid legal and ethical issues in pro re nata medicines management and improve the quality and safety of healthcare. Empirical research is needed to improve our understanding of this phenomenon in the multidisciplinary environment of medicines management. (shrink)

Despite Augustine's reputation as the father of Christian intolerance, one finds in his thought the surprising claim that within non-Christian writings there are 'some truths in regard even to the worship of the One God.' The essays here uncover provocative points of comparison and similarity between Christianity and other religions to further such an Augustinian dialogue.

Stethoscopes, x-rays and other medical technologies are two-edged swords. They make medical treatment and diagnosis more accurate and effective, but do at the same time reveal our perceptual inadequacy. By transcending our senses, these technologies reveal that we can be seriously diseased without experiencing any symptoms at all. This situation has changed our attitude towards our relations and ourselves. The situation can be analysed using Jürgen Habermas’ conception of systems colonisation of the lifeworld. Medical technologies colonise our life world. They (...) change the way we think and act. They make us all accept that we can become patients almost any minute, even if we feel perfectly healthy. Sense transcending technologies turn us all into proto-patient. (shrink)

In this article, I defend luck at the expense of risk. Or, more precisely, I try to make a distinction that gives both concepts fair treatment. I start by making it clear that luck stands in opposition to control and not to causation. Both luck and risk are related to causal uncertainty. But it is warranted to talk about risk only when the uncertainty involved is brought under control, as it is in some familiar forms of fair gambling such as (...) dicing and roulette. Life is however not a fair gamble. We rarely have the kind of control over the preconditions of life that we have over the preconditions of say dicing. Luck therefore has profound influence on our lives and our health. This means that the standard conception of responsibility - that is, that we stand responsible only for consequences that we control - breaks down far more often than what is usually acknowledged. I therefore end the article by arguing that the standard conception of responsibility ought to be supplemented with a different conception that I have called "responsibility because of social involvement.". (shrink)

In this book, award-winning historian of religion Paula Fredriksen tells the surprising story of early Christian concepts of sin, exploring the ways that sin came to shape ideas about God no less than about humanity.

The diversity of nanotechnologies and of the governance challenges that their applications raise calls for exploration and learning across different cases. We present an Upstream Oversight Assessment (UOA) of expected benefits and potential harms of nanoparticles made of a synthetic polymer (PLGA) to improve vaccines for farmed salmon. Suggested by Jennifer Kuzma and colleagues, an UOA may help identify and prioritise research needs, and it may support evaluations of the adequacy of relevant existing regulatory frameworks. In this work, the UOA (...) approach is modified and supported with elements from the uncertainty analysis framework developed by Warren Walker and colleagues. Empirically, we draw on relevant available published literature and insights generated in an ongoing nanoparticle salmon vaccine project, in which one of the authors participates. Nanotechnologies have not previously been encountered in the regulatory context of fish vaccines, which in part raises unique challenges due to prospective large scale vaccine use in semi-open aquatic systems. Strengthened through cooperation between ELSA and technology researchers we found the UOA useful for an early mapping of benefits and concerns, and for identifying areas in need of further research prior to a nanoparticle based salmon vaccine is developed and taken into use. We consider our approach to represent one among several complementing initiatives that seek to contribute to early stage evaluations of possible negative side effects, broadly conceived, in order to facilitate a more robust nanotechnology development. (shrink)

Richard Janko's acclaimed translation of Aristotle's _Poetics_ is accompanied by the most comprehensive commentary available in English that does not presume knowledge of the original Greek. Two other unique features are Janko's translations with notes of both the _Tractatus Coislinianus_, which is argued to be a summary of the lost second book of the Poetics, and fragments of Aristotle’s dialogue On Poets, including recently discovered texts about catharsis, which appear in English for the first time.

In print for the first time in over ten years, Act and Crime provides a unified account of the theory of action presupposed by both Anglo-American criminal law and the morality that underlies it. The book defends the view that human actions are always volitionally caused bodily movements and nothing else. The theory is used to illuminate three major problems in the drafting and the interpretation of criminal codes: 1) what the voluntary act requirement both does and should require; 2) (...) what complex descriptions of actions prohibited by criminal codes both do and should require ; and 3) when two actions are 'the same' for purposes of assessing whether multiple prosecutions and multiple punishments are warranted. The book both contributes to the development of a coherent theory of action in philosophy, and it provides both legislators and judges a grounding in three of the most basic elements of criminal liability. (shrink)

In this short, dense essay, Jean Cavaillès evaluates philosophical efforts to determine the origin - logical or ontological - of scientific thought, arguing that, rather than seeking to found science in original intentional acts, a priori meanings, or foundational logical relations, any adequate theory must involve a history of the concept. Cavaillès insists on a historical epistemology that is conceptual rather than phenomenological, and a logic that is dialectical rather than transcendental. His famous call (cited by Foucault) to abandon "a (...) philosophy of consciousness" for "a philosophy of the concept" was crucial in displacing the focus of philosophical enquiry from aprioristic foundations toward structural historical shifts in the conceptual fabric. This new translation of Cavaillès's final work, written in 1942 during his imprisonment for Resistance activities, presents an opportunity to reencounter an original and lucid thinker. Cavaillès's subtle adjudication between positivistic claims that science has no need of philosophy, and philosophers' obstinate disregard for actual scientific events, speaks to a dilemma that remains pertinent for us today. His affirmation of the authority of scientific thinking combined with his commitment to conceptual creation yields a radical defense of the freedom of thought and the possibility of the new. (shrink)

Tri filosofskikh "opravdanii︠a︡" (teodit︠s︡ei︠a︡, antropodit︠s︡ei︠a︡, kosmodit︠s︡ei︠a︡ Serebri︠a︡nogo veka) -- Russkai︠a︡ sofiologii︠a︡ i kabbala -- S. Bulgakov : nauka sofiologii︠a︡ (ili konet︠s︡ religii) -- Tretiĭ Zavet o. Sergii︠a︡ Bulgakova -- Tretʹezavetnai︠a︡ misterii︠a︡ ("malai︠a︡" trilogii︠a︡ Bulgakova).

v. 1. pt. 1. Babaji's glimpses of the Tamil 18 Siddhas. pt. 2. [non-Roman data].

In Alfonso de Cartagena's 'Memoriale virtutum' (1422) María Morrás and Jeremy Lawrance offer a new edition from the manuscripts of a compilation of Aristotle's Nicomachean Ethics addressed by the major Castilian intellectual of the day, bishop Alfonso de Cartagena, to the heir to the throne of Portugal, crown prince Duarte. The work was a speculum principis, an education for the future king in the virtues suitable to a statesman; Cartagena's choice of Aristotle was thus a significant index of the advent (...) of new Renaissance ideas. This edition shows how the "memorial" throws light on the ideological transformation of society those ideas would bring, setting new ethical guidelines for the ruling class at the crossroads between medieval feudalism and Renaissance absolutism. (shrink)

Verse treatises on Advaita Jaina, and Nyaya philosophy.