This chapter outlines how biotechnology can be seen as a challenge to our notion of nature, and how the complexity of the concept of nature in itself is a challenge in the debate on enhancement of capacities in humans, animals and plants by means of biotechnology. It then explores how the same concept contributes to the ethical arguments both for and against enhancement of human capacities, focusing on two central aspects of the enhancement debate namely: (i) the debate that focuses (...) on enhancement as an overreaching form of therapy; and (ii) the debate that focus on enhancement as the goal in itself. Finally, the chapter summarizes the contribution of the concept of nature in terms of the challenges that its inherent complexity poses to the ethical and philosophical debate on enhancement technologies, also briefly discussing how “nature” and “naturalness” can be said to have moral relevance in the enhancement debate. (shrink)

In the present Western cultural and political context, the concept of nature plays a central role in the debate about new technologies. However, the concept of nature is complex and reflects more than one frame of reference stemming from a long historical tradition. ‘Nature’ is referred to: a) as the object (phenomenon) toward which the debate is directed, and b) as the normative frame of reference that either justifies or rejects the technological method in specific situations. This paper argues, that (...) this double character of ‘nature’ is not particular for the debate on ethical concern for the non-human nature, rather it constitutes the complexity of the concept itself. This, in turn, leads to a more fundamental question, namely: What is ‘nature’?—Or rather: Is ‘nature’ to be defined? (shrink)

The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...) applications, health equity, and justice considerations of the distributive, formal and social types. The outcomes of these analyses demonstrate that there are ethically compelling reasons for emergency departments to adopt an ethics-informed, policy-based approach to the longitudinal care and management of living-at-risk, frequent users of emergency departments. From a formal justice perspective, the development and uses of such an approach are justified by a demonstrable relevant difference between living-at-risk, frequent users of emergency departments and other persons and groups of patients who visit emergency departments. We propose an example of such a policy-based approach. Examples of possible, pragmatic applications of this approach, which help ensure that aREDFUs who present to the ED are managed in a fair and optimally consistent manner, are provided for the consideration of an urban emergency department’s policymaking working group. (shrink)

An argument is developed that supports a simulationist account about the foundations of infants' and young children's understanding that other people have mental states. This argument relies on evidence that infants come to the world with capacities to send and receive affective cues and to appreciate the emotional states of others – capacities well suited to a social environment initially made up of frequent and extended emotional interactions with their caregivers. The central premise of the argument is that the foundation (...) of infants' understanding of other minds is built upon an early-developing capacity to share others' emotion experiences. The emotion experiences elicited in interactions between caregivers and infants enable the elaboration of this primitive understanding into a more fully developed understanding of psychological subjects. The evidence presented in support of these claims derives from a wide range of studies of the phenomena of emotional contagion, affective communication, and emotion regulation involving infants, young children, and adults. (shrink)

Nowadays, special attention is given to the hazards associated with genetic engineering and new inventions in biotechnology, and in fear of severe consequences, researchers, institutions and governments are required to act responsibly. The term “responsibility” may be defined in numerous ways. The definition considered in this paper, is one we believe is in common use: “Generally speaking, a person has a special responsibility for a particular outcome if they knowingly brought it about and it would not exist if not for (...) what they did”. This concept of moral responsibility rests on what we term the three ‘I's’: individual, intentional and informed. Responsibility is individual in the sense that it must be directed towards someone. A second requirement of moral responsibility presupposes the ability to do otherwise, i.e. it presupposes each human being as an intentional actor, capable of acting according to his/her own free will. In order for someone to be responsible for their actions, the choice between alternatives must be informed. The article focus' on these three aspects of responsibility in order to reveal how difficult it is to apply and make sense of this definition with regard to new inventions in science. (shrink)

The wilderness is one of the most widely recognized sources of transcendent emotion. Various recent studies have demonstrated nature’s power to induce intense emotions. The study at hand will generate conceptual and operational definitions of sublime emotion toward nature. Taking into consideration the recent research on feelings of awe, an instrument is devised to measure sublime emotion toward nature. The proposed scale’s reliability and validity is tested in a sample of 280 participants from the general population of Madrid. Results show (...) that sublime emotion was defined by two conceptual components: awe, and inspiring energy, both obtained using the computer program FACTOR. After reliability and validity analysis, the Sublime Emotion toward Nature (SEN) scale included 18 items, distributed into awe (6 items, α =.881) and inspiring energy (12 items, α=.933). Awe was defined by feelings of fear, threat, vulnerability, fragility, and respect for nature, which is perceived as vast, powerful, and mysterious. Inspiring energy was defined by feelings of vitality, joy, energy, oneness, freedom, eternity, and harmony with the universe. The SEN is an adequate instrument to measure transcendent emotions provoked by direct wilderness exposure or memory thereof. (shrink)

Modern medical ethics in the English-speaking world is commonly thought to derive from the medical philosophy of the Scotsman John Gregory (1725-1773) and his younger associates, the English Dissenter Thomas Percival (1740-1804) and the American Benjamin Rush (1745-1813). This book is the first extensive study of this suggestion. Dr Haakonssen shows how the three thinkers combined Francis Bacon's and the Scottish Enlightenment's ideas of the science of morals and the morals of science. She demonstrates how their medical ethics was a (...) successful adaptation of traditional moral ideas to the dramatically changing medical world especially the voluntary hospital. In accounting for the dynamics of this process, she rejects the anachronism that modern medical ethics was a new paradigm. (shrink)

This article examines clinical wisdom, which has emerged from a broader study about nurse managers' influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses' experience and clinical practice by giving voice to the nurses themselves, and to look for differences in their practice. This was a qualitative study based on semistructured interviews followed by analysis founded on Gadamerian hermeneutics. The article describes how proficient nurses experience their practice. Proficient practice (...) constitutes clinical wisdom based on responsibility, thinking and ethical discernment, and a drive for action. The study showed that poor working conditions cause proficient nurses to regress to non-proficient performance. Further studies are recommended to allow deeper searching into the area of working conditions and their relationship to lack of nurse proficiency. (shrink)

It does not seem terribly unfair to say that studies of both rhetoric and dialogue have tended, by and large, to pass over listening in favor of speaking. In scholarly as well as quotidian parlance, it would appear that both rhetoric and dialogue are principally concerned with speech, banishing listening to the silent subservience of rhetoric's other. Whichever way it is glossed—as rhetoric, dialogue, language, or argumentation—the Western conception of logos emphasizes speaking at the expense of listening. And the problem (...) with conceiving of logos in terms of speech and speaking is not only that it ignores the importance of listening but also that it obscures how listening makes the ethical response possible. Drawing on the philosophy of Emmanuel Levinas, this article examines the ethical exigency of the face and its relation to primordial discourse in order to disclose the otherwise hidden ethical significance of listening and its vocation as a form of co-constitutive communicative action that can “listen persons to speech.”. (shrink)

Healthcare apps er blevet en omfattende industri. Vi kan ganske gratis downloade tusindvis af apps, som sætter os i stand til at monitorere alt fra vores fysiske form til vores mentale velbefindende, og vi kan gennem denne monitorering, producere endeløse datamængder og viden om os selv og vores liv – altså skabe et «monitoreret mig». Men hvordan forholder vi os til denne mulighed? I nærværende artikel tages udgangspunkt i foreløbige resultater fra et igangværende ph.d. projekt, hvor brugen af apps og (...) biofeedback anvendes i praksis, til at belyse en stigende stressproblematik blandt lærere i den danske folkeskole. Artiklens ærinde er, at tematisere de normer og fortolkningsrammer, som kommer til syne, når aktørerne selv italesætter sit «monitorerede mig» og hernæst diskutere, i hvilken position, disse normer og tolkninger af teknologien i anvendelse, bringer aktøren. Er «det monitorerede mig» en mulighed for frisættende autonomi – en empowerment? Eller bidrager monitoreringen i stedet til individualisering eller patologisering, hvor vi gennem ejerskabet af vores egen fortælling, producerer et overansvar for eksempelvis hvilken behandling vi skal modtage, eller hvordan vores arbejdsmiljø bør være?Nøgleord: Etik, humanistisk sundhedsforskning, selvmonitorering, Ecological Momentary StorytellingEnglish summary: The Monitored Me - empowerment or pathologization?Healthcare apps have become a major industry. We can freely download thousands of apps, that enable us to monitor everything, from our physical condition to our mental well-being, and we can through the monitoring produce endless amounts of data and knowledge about our inner selves and our lives - creating a “monitored me”. But how is this technological possibility dealt with, in practice? The present article presents and discusses results from a case study in which apps and biofeedback were used to illuminate an increasing stress problem among teachers in the Danish preliminary school system. The focus of the article is to analyze the self-interpretation framework that appears when the users of the technology articulate the "monitored me” and hereafter discuss how these self-interpretations position the user. Is “the monitored me” an opportunity for liberating autonomy – for empowerment? Or does it contribute to individualization or pathologization? (shrink)

The aim of this hermeneutic study was to gain a broader understanding of nurses’ workload and what characterizes a nurse’s experience in terms of the various levels of intensity of nursing care. Twenty-nine nurses participated in seven focus groups. The interpretation process took place in six different phases and the three laws of dialectics were used as interpretation rules. An optimal nursing care intensity level can be understood as a situation characterized by the balance between the intensity of care needed (...) by patients and the external and internal factors of the current nursing care situation. The nurses’ work situation can be understood as a dialectic struggle between ‘being’ and ‘not being’ a good nurse; this can be said to be the underlying root metaphor. Nursing care can be understood as consisting of ‘complex and meaningful caring situations’. Dialectics can be used as a fruitful method of revealing the complexity of clinical reality. (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 following article presents preliminary reflections on a processual theory of health and disease. It does this by steering the discussion more toward an ontology of organisms rather than conceptual analysis of the semantic content of the terms “health” and “disease.” In the first section, four meta-theoretical assumptions of the traditional debate are identified and alternative approaches to the problems are presented. Afterwards, the view that health and disease are constituted by a dynamic relation between demands imposed on an organism (...) and individual presuppositions for adequate response is developed. In the last section, the paper takes stock of three possible objections to and clarifies some implications of this approach to the notions of health and disease. (shrink)

Two related aspects of the present ‘knowledge capitalism’ stage of globalisation are discussed in this article: the transformation of education to make it more directly supportive of educational growth and competition, and the growing demands on educational research to provide scientific evidence for education policy and practice, using narrowly defined methods and techniques. It is argued that both developments have profound consequences for the construction and use of educational theory, and the vital need for critical discussion and communication in this (...) respect is emphasised. (shrink)

In this paper, I explore the concept conduct of everyday life, namely routines and real life, as they are confronted with empirical observations. The observations are from a study of changes in the conduct of everyday life for individuals who attended a patient education course. The course was a part of their treatment after a hospitalisation with depression in a psychiatric ward. I use analysis of the main individual, Steven’s, conduct of everyday life and illustrate my points with models of (...) conduct of everyday life made using beads. The conceptualisation of conduct of everyday life is expanded through three points. Firstly, cyclic routines can matter and fulfill life, which can support the ongoing discussion about the concept conduct of everyday life. Secondly, I show that, from a first person perspective, what matters in conduct of everyday life is more complex than what is possible to grasp analytically through a dualistic opposition between cyclic everyday conduct and the particular meaningful conduct of everyday life. Thirdly, I expand on the notion of timeouts/breaks as solely something that lifts us out of mundane everyday life. I conclude that it makes a more comprehensive analysis to perceive all conduct of everyday life as having profound personal meaning and to analyse the individuals' concerns in relation to their social self-understanding and localisation at a certain time. (shrink)

Cheyne and Girard characterize felt presence during sleep paralysis attacks as a pre-hallucinatory expression of a threat-activated vigilance system. While their results may be consistent with this interpretation, they are nonetheless correlational and do not address a parsimonious alternative explanation. This alternative stipulates that FP is a purely spatial, hallucinatory form of a common cognitive phenomenon—social imagery—that is often, but not necessarily, linked with threat and fear and that may induce distress among susceptible individuals. The occurrence of both fearful and (...) non-fearful FPs in a multiplicity of situations other than sleep paralysis attacks supports the notion that FPs are hallucinatory variants of social imagery and that they are not necessarily bound to threat-activated vigilance. Evidence linking FPs with anxiety disorders supports the notion that the distress they evoke may be mediated by a more general affective distress personality factor. To illustrate the predominantly spatial character of FP hallucinations, similarities between FP and phantom limbs are summarized and the possibility that these two phenomena are parallel expressions of a mirror neuron system is considered. (shrink)

This article presents a discourse model of polling that investigates what poll discourse is, how it is structured and how it functions. In contrast to most polling research, which presupposes polling to be primarily a psychological measurement tool, this article explores how it is primarily a discursive form of social interaction. Using the tools of discourse analysis, the model reveals that far from reflecting the beliefs and preferences of citizens, poll questions can instead tacitly evoke and sustain conservative and status (...) quo ideologies. Hence polls can play a significant role in constructing what is admissible and legitimate in political discourse. (shrink)

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are (...) presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed. (shrink)

Based on a historical and a contemporary fieldwork at a Danish hospital, this article offers a genealogical and philosophical exploration of the development of nurses’ doing and focus within a hospital setting from the 1800 s to the present day. This exploration finds that nurses’ doing has changed during history, which is reflected in their focus. Thus, nurses’ focus has developed from, what the Danish philosopher Uffe Juul Jensen refers to as a situation‐oriented, to a disease‐oriented practice, and while new (...) values are established, the conception of care as a core value in nursing seems to have receded. This article also argues that today's nurses are doing what doctors did in the 19th century. The French philosopher Michel Foucault discusses how things repeat themselves in new ways and new contexts. The nursing profession has become ‘a career open to the talents’ where nurses with the appropriate skills and talents are able to build a career, within which they provide status, position and legitimacy. The conclusion of the article discusses the significance of this development for patients and the nursing profession. (shrink)

Nicht viele Philosophen haben eine solch große Resonanz in der Öffentlichkeit erfahren wie Hans Jonas. Das lag nicht ausschließlich an seinem Bestseller "Das Prinzip Verantwortung", der 1979/80 zu einem Medienereignis wurde. Jonas' Verdienst war es, eine ethische Debatte über die Zukunft des Menschen befeuert zu haben, die den Zeitgeist traf. Doch sind die Ideen von Hans Jonas heute noch zeitgemäß? Wie haben sich einzelne Themen weiterentwickelt? Der vorliegende Band diskutiert die Denkwege von Hans Jonas und versammelt einige Antworten von ausgewiesenen (...) Jonas-Experten. (shrink)

BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ participation (...) and involvement in ACP- conversations may promote nursing home patients’ participation in decisions on future treatment and end-of-life care. Based on empirical data and family ethics perspectives, the purpose of this study is to add insights to the complexity of ACP-conversations and illuminate how a family ethics perspective may improve the quality of the ACP and promote nursing home patients’ participation in advance care planning.MethodsParticipant observations of ACP-conversations in eight nursing homes. The observations were followed by interviews with patients and relatives together on how they experienced being part of the conversation, and expressing their views on future medical treatment, hospitalization and end-of-life issues.ResultsWe found that the way nursing home patients and relatives are connected and related to each other, constitutes an intertwined unit. Further, we found that relatives’ involvement and participation in ACP- conversations is significant to uncover, and give the nursing home staff insight into, what is important in the nursing home patient’s life at the time. The third analytical theme is patients’ and relatives’ shared experiences of the dying and death of others. Drawing on past experiences can be a way of introducing or talking about death.ConclusionsAn individual autonomy approach in advance care planning should be complemented with a family ethics approach. To be open to family ethics when planning for the patient’s future in the nursing home is to be open to diversity and nuances and to the significance of the patient’s former life and experiences. (shrink)

Metaphilosophy is itself philosophy about philosophy. It is not something before or independent of philosophy. Both Kai Nielsen and Richard Rorty are deeply concerned (someone might say obsessively preoccupied) with metaphilosophy. They both are thoroughly historicist and contextualist resolutely rejecting any form of a transcendental or metaphysical turn. They argue against claims to absolute validity (as well as against absolutism in any form) and a natural order of reasons: some 'Reason' to which any rational agent must be committed. They (...) both see philosophy as a transitional genre first (historically speaking) from religion then metaphysics and more latterly from scientistic conceptions of the world. But they differ about what philosophy is transitional to. For Rorty it is historical narrative and utopian proposals; for Nielsen it is critical theory. Rorty claims this, Nielsen's intentions to the contrary notwithstanding, commits him to enlightenment rationalism. Nielsen replies that his form of critical theory is deeply historicist and contextual without being resolutely atheoretical. This plays out in political orientation to Nielsen's being a socialist while Rorty is a social democrat. (shrink)

Through examining Douglass's and Fanon's concrete experiences of oppression, Cynthia R. Nielsen demonstrates the empirical validity of Foucault's theoretical analyses concerning power, resistance, and subject-formation. Going beyond merely confirming Foucault's insights, Douglass and Fanon expand, strengthen, and offer correctives to the emancipatory dimensions of Foucault's project. Unlike Foucault, Douglass and Fanon were not hesitant to make transhistorical judgments condemning slavery and colonization. Foucault's reticence here signals a weakness in his account of human being. This weakness sets him at cross-purposes (...) not only with Scotus, but also with Douglass and Fanon. Scotus's anthropology provides a basis for transhistorical moral critique; thus he is a valuable dialogue partner for those concerned about social justice and human flourishing. (shrink)

John Rawls’s recommendation that political philosophy should be kept free of metaphysics has recently come under attack by Jean Hampton. According to her philosophy as a Socratic quest has to orient itself by radical probing and that unavoidingly involves us in metaphysical commitment. Non-Socratic philosophy in the later Rawls, she claims, reduces itself to a mere ‘modus vivendi’. In defending Rawls the article makes clear how Hampton underrates the method of reflective equilibrium. Rawls makes a rationally reconstructed use of the (...) Socratic ideal, that can be turned not only against Hampton’s critique of Rawls, but also against its relativist appropriation by Richard Rorty. (shrink)

This is an examination of some Left critiques of Rawls. Stress is put, not on his underlying moral methodology, including his contractarianism, though surely there is need for such a critique as well, but on an examination of his principles of justice, particularly his equal liberty principle and his difference principle. This is often thought to be the heart of his theory. It is argued that Rawls’ asociological and ahistorical approach and his ignoring of questions of power and of ideology (...) and his lack of an adequate conceptualization of liberty lead to major distortions in his account. Both principles are shown to be problematic and the equal liberty principle is shown to be in conflict with the difference principle. (shrink)

In mammals, a network of cellular circadian clocks organizes physiology and behavior along the 24‐h day cycle. The traditional hierarchical model of circadian clock organization with a central pacemaker and peripheral slave oscillators has recently been challenged by studies combining tissue‐specific mouse mutants with transcriptome analyses. First, a surprisingly small number of tissue rhythms are lost when only local clocks are ablated and, second, transcriptional circadian rhythms appear to be regulated by a complex mix of local and systemic factors. As (...) reviewed here, these findings suggest a more integrated model of clock network interaction with the central pacemaker as the main source of behavioral and systemic–physiological rhythms and peripheral clocks controlling some local rhythms while at the same time acting as gatekeepers that temporally adjust cellular responses to external stimuli. (shrink)

Explores listening as a fundamental human endowment connected with language and thought, and its potential for social, personal, and political action. Incorporates historical, literary, intercultural, scientific, musical, and philosophical perspectives"--Provided by publisher.