This article explores the respective roles that medical and technological cognitive enhancements, on the one hand, and the moral and epistemic virtues traditionally understood, on the other, can play in enabling us to lead the good life. It will be shown that neither the virtues nor cognitive enhancements (of the kind we have access to today or in the foreseeable future) on their own are likely to enable most people to lead the good life. While the moral and epistemic virtues (...) quite plausibly are both necessary and sufficient for the good life in theory, virtue ethics is often criticised for being elitist and unachievable in practice for the vast majority. Some cognitive enhancements, on the other hand, might be necessary for the good life but are far from sufficient for such an existence. Here it will be proposed that a combination of virtue and some cognitive enhancements is preferable. (shrink)

For several decades, there have been increased requests to allow euthanasia in Sweden. The issue is a hot topic of debate among medical people, theologians, philosophers and parliamentarians. The authors in this book argue against the legalization of euthanasia.

The purpose of this study was to investigate what strategies people with severe functional disabilities who receive personal assistance in their homes use in their daily life to achieve autonomy, integrity, influence and participation. Qualitative interviews were carried out and subjected to qualitative latent content analysis. The main finding was expressed in terms of six subthemes: trying to keep a private sphere; striving to communicate; searching for possibilities; taking the initiative; striving to gain insight; and using one's temperament. These generated (...) the overall theme: maintaining dignity in close relationships. This study contributes an understanding of the strategies used by people who are dependent on personal assistance. Future efforts in nursing must focus on supporting personal assistants with ethical knowledge and guidance in order that people with severe functional disabilities are empowered to achieve autonomy, integrity, influence and participation in their daily lives. (shrink)

Based on a modern reading of Aristotle’s theory of friendship, we argue that virtual friendship does not qualify as genuine friendship. By ‘virtual friendship’ we mean the type of friendship that exists on the internet, and seldom or never is combined with real life interaction. A ‘traditional friendship’ is, in contrast, the type of friendship that involves substantial real life interaction, and we claim that only this type can merit the label ‘genuine friendship’ and thus qualify as morally valuable. The (...) upshot of our discussion is that virtual friendship is what Aristotle might have described as a lower and less valuable form of social exchange. (shrink)

The aim of this study was to investigate the experiences of persons with severe functional disabilities who receive personal assistance in their homes, the focus being on their daily life in relation to the ethical principles represented in the Swedish Disability Act: autonomy, integrity, influence and participation. Qualitative interviews were performed with 26 persons and thereafter subjected to qualitative latent content analysis. The experiences of personal assistance were very much in accordance with the said principles, the most important factor being (...) that one is met with understanding. The participants described situations in which their integrity was violated in that they were not treated as competent adults. This indicates the importance of future efforts in nursing to support personal assistants with ethical knowledge and supervision so that they can empower people with disabilities and thereby enable them to maintain their self-esteem and dignity. (shrink)

The aim of this study was to compare Swedish and Chinese nurses' experiences of ethical dilemmas and workplace distress in order to deepen understanding of the challenges neuroscience nurses encounter in different cultures. Qualitative interviews from two previously performed empirical studies in Sweden and China were the basis of this comparative study. Four common content areas were identified in both studies: ethical dilemmas, workplace distress, quality of nursing and managing distress. The themes formulated within each content area were compared and (...) synthesized into novel constellations by means of aggregated concept analysis. Despite wide differences in the two health care systems, the nurse participants had similar experiences with regard to work stress and a demanding work situation. They were struggling with similar ethical dilemmas, which concerned seriously ill patients and the possibilities of providing good care. This indicates the importance of providing nurses with the tools to influence their own work situation and thereby reducing their work-related stress. (shrink)

This article discusses some aspects of animal ethics from an Aristotelian virtue ethics point of view. Because the notion of friendship (philia) is central to Aristotle’s ethical theory, the focus of the article is whether humans and animals can be friends. It is argued that new empirical findings in cognitive ethology indicate that animals actually do fulfill the Aristotelian condition for friendship based on mutual advantage. The practical ethical implications of these findings are discussed, and it is argued that eating (...) meat from free-living animals is more morally acceptable than eating cattle because hunters (unlike farmers) do not befriend their prey. (shrink)

In this paper we discuss what we believe to be one of the most important features of near-future AIs, namely their capacity to behave in a friendly manner to humans. Our analysis of what it means for an AI to behave in a friendly manner does not presuppose that proper friendships between humans and AI systems could exist. That would require reciprocity, which is beyond the reach of near-future AI systems. Rather, we defend the claim that social AIs should be (...) programmed to behave in a manner that mimics a sufficient number of aspects of proper friendship. We call this “as-if friendship”. The main reason for why we believe that ‘as if friendship’ is an improvement on the current, highly submissive behavior displayed by AIs is the negative effects the latter can have on humans. We defend this view partly on virtue ethical grounds and we argue that the virtue-based approach to AI ethics outlined in this paper, which we call “virtue alignment”, is an improvement on the traditional “value alignment” approach. (shrink)

This study was concerned with the clarification of the experience of pivotal moments in therapy. By pivotal moment is understood an event within the therapeutic process that leads to enduring change experienced as an important improvement in the life-experience of the client. Retrospective descriptions of a therapeutic process were obtained from three clients in which a distinguishable chain of events could be discerned that the clients identified as a pivotal moment. The descriptive material was analyzed according to the descriptive phenomenological (...) psychological method developed by Amedeo Giorgi on the basis of the philosophical phenomenology of Husserl and Merleau-Ponty. The results show that the pivotal moment is experienced as a figural moment within the therapeutic process where a serious challenge to old assumptions takes place, necessitating a break from old cognitive, affective and behavioral patterns in a context of trust and safety within the therapeutic relationship. (shrink)

In this paper we articulate confirmation and disconfirmation as components in human motivation. We develop a theory of motivation on the basis of a model of human action and we explore aspects of confirmation and disconfirmation in the context of the meeting of dysphagic patients with their physicians. We distinguish four central elements in confirmation and disconfirmation and use these and the relations between them for the purpose of constructing a typology. Finally, on the basis of the results obtained we (...) interpret a small volume of remarks reflecting the meaning field of some dysphagic patients in relation to their physicians. The underlying motive is to develop tools for understanding health care processes. The SAUC-Confirmation-Model and the theoretical framework in which it is embedded should be seen from that point of view. (shrink)

In this article we argue that the principle of need, on some interpretations, could be used to justify the spending of publically funded health care resources on cognitive enhancement and that this also holds true for individuals whose cognitive capacities are considered normal.The increased, and to an extent, novel demands that the modern technology and information society places on the cognitive capacities of agents, e.g., regarding good and responsible decision-making, have blurred the line between treatment and enhancement. More specifically, it (...) has shifted upwards. As a consequence, principles of need on their most reasonable interpretations can be used to support publically funded cognitive enhancement. At least this is so, if broader aims than curing and ameliorating diseases are included in the goals of health care. We suggest that it would be plausible to see health care as accepting such broader goals already today. (shrink)

This article evaluates the experience of an extraordinary mental change of novice female runners that is connected to long-distance running. Two female participants were interviewed regarding their life-changing experience associated with endurance exercise. Descriptions of the lived experience from women who train for marathons were gathered and a phenomenological analysis of the data was conducted which suggests that the women underwent a mental change that improved their self-confidence and enhanced relationships with their selves and others. The six constituents that emerged (...) were: Participants Perception of an Enhancing Outdoor Environment, Life-Style Changes Resulting in More Openness to Others and Self, Discoveries Concerning Self-Improvements, Sustaining a Desired Mental Disposition, Empowerment in Considering New Possibilities, and Support for Encountering Future Challenges. This article demonstrates how a mental change associated with long-distance running positively impacts participants’ personal and professional lives. (shrink)

PurposeThe purpose of this paper is to argue that playing computer games for lengthy periods of time, even in a manner that will force the player to forgo certain other activities normally seen as more important, can be an integral part of human flourishing.Design/methodology/approachThe authors' claim is based on a modern reading of Aristotle's Nichomacean Ethics. It should be emphasized that the authors do not argue that computer gaming and other similar online activities are central to all people under all (...) circumstances; but only seek to show that the claim holds true for some people under some circumstances and the authors try to spell out the relevant circumstances in detail.FindingsThe authors provide a list of situations in which playing computer games for lengthy periods of time, in a manner that will force the player to forgo certain other activities normally seen as more important, is an integral part of human flourishing.Originality/valueThe paper puts some novel pressure on the widely‐held belief that playing computer games for lengthy periods of time, in a manner that will force the player to forgo certain other activities normally seen as more important. The paper claims that playing some computer games and partaking in some forms of online activities could be highly conducive to what it actually means in practice to take care of oneself and, to paraphrase Aristotle, to be eager for fine actions. (shrink)

Drawing on a social construction theory of ownership in biological material this paper discusses which differences in biological material might motivate differences in treatment and ownership rights. The analysis covers both the perspective of the person from whom the material originates and that of the potential recipient. Seven components of bundles of rights, drawing on the analytical tradition of Tony Honoré, and their relationship to various types of biological material are investigated. To exemplify these categories the cases of a heart, (...) a kidney, stem cells and hair are used. (shrink)

This article seeks to contribute to the discussion on the nature of choice in virtue theory. If several different actions are available to the virtuous agent, they are also likely to vary in their degree of virtue, at least in some situations. Yet, it is widely agreed that once an action is recognised as virtuous there is no higher level of virtue. In this paper we discuss how the virtue theorist could accommodate both these seemingly conflicting ideas. We discuss this (...) issue from a modern Aristotelian perspective, as opposed to a purely exegetic one. We propose a way of resolving what seems to be a major clash between two central features of virtue ethics. Our proposal is based on the notion of parity, a concept which recently has received considerable attention in the literature on axiology. Briefly put, two alternatives are on a par (or are ‘roughly equal’) if they are comparable, although it is not the case that one is better than the other, nor that they are equally good. The advantages of applying the concept of parity to our problem are twofold. Firstly, it sheds new light on the account of choice in virtue theory. Secondly, some of the criticisms that have been mounted against the possibility of parity can be countered by considering the notion of choice from a virtue theory perspective. (shrink)

Can humans be friends with animals? If so, what would the moral implications of such friendship be? In a previous issue of this journal, we argued that humans can indeed be friends with animals and that such friendships are morally valuable. The present article is a comment on Mark Rowlands’s reply to our original article. We argue that our original argument is not undermined by Rowlands’s attack.

In this article, there is a suggestion that the application of certain key concepts or procedures of Husserlian phenomenology can be helpful in the practice of therapy. It is well known that how a therapist is present to a client and his or her story is critical for the success of therapy. What is less clear, however, is how to address this "way of being" in therapy and what kinds of interventions are helpful to clients. In addressing some of these (...) difficult issues, the Husserlian concepts found to be helpful are Husserl's chief directive to go "back to the matters themselves," the distinction among real and irreal objects, presence to the order of phenomena, the phenomenal realm, the intentional-fulfilling-identifying nature of conscious acts, the phenomenological-psychological reduction, and the discovery and description of eidetic structures of experience. These fundamental philosophical distinctions are taken up within a psychological perspective and elaborated and used within a phenomenological psychological perspective. (shrink)

Michael Barilan’s article “From Hope in Palliative Care to Hope as a Virtue and a Life Skill” is an interesting and informative contribution to the debate on the nature of ‘a good death.’ Broadly speaking, the author seeks to explore “the roles and meanings of promotion focus goals in human life” and how hope can aid in alleviating suffering (Barilan 2012, 171). The subject is topical and courtesy of being clinically active, Barilan is able to add a welcome perspective. Very (...) briefly, the article sets out to develop a more inclusive idea of hope, involving ‘personal freedom’ and ‘valuation.’ for example, and then proceeds to explore the role of hope, in this version, for the patients in palliative care .. (shrink)

This article challenges the common assumption that the character virtues can be divided into two groups, one consisting of other-regarding virtues and oneof self-regarding virtues. On such accounts the other-regarding virtues are often said to focus on advancing the good of others, whereas the self-regarding virtuesprimarily benefit the agent herself. Here, however, it will be shown that virtues like friendship, particular justice, even temper and benevolence—traditionally seen as other-regarding—all contain strong self-regarding aspects. The central claim of the article is that (...) these self-regarding aspects of the other-regarding virtues arenecessary components of complete virtue. Given the scope of these virtues, an agent has to act virtuously in her dealings with herself as well as with others inorder to qualify as fully virtuous. While this account draws on a number of Aristotelian ideas it should be noted that it is not intended as an authoritative, or exegetic, reading of Aristotle. (shrink)

This book shows how pressing issues in bioethics – e.g. the ownership of biological material and human cognitive enhancement – successfully can be discussed with in a virtue ethics framework. This is not intended as a complete or exegetic account of virtue ethics. Rather, the aim here is to discuss how some key ideas in Aristotle’s Nicomachean Ethics, when interpreted pragmatically, can be a productive way to approach some hot issues in bioethics. In spite of being a very promising theoretical (...) perspective virtue ethics has so far been underdeveloped both in bioethics and neuroethics and most discussions have been conducted in consequentialist and/or deontological terms. ​. (shrink)

Sweden is probably one of the most secularized nations in the world. Therefore religious arguments tend to play a smaller role in the public bioethical debate than in most other countries. Issues such as abortion, stem-cell research, and therapeutic cloning have been far less controversial in Sweden than elsewhere. Instead, other issues have dominated recent bioethical debates in Sweden, in particular those concerning privacy and the control over biological information about individuals.

Clinical Ethics, Ahead of Print. It could hardly be denied that healthcare should be patient-centred. However, some of the practices commonly described as patient-centred care may have ethically problematic consequences. This article identifies and discusses twelve ethical conflicts that may arise in the application of person-centred care. The conflicts concern e.g. privacy, autonomous decision-making, safeguarding medical quality, and maintaining professional egalitarianism as well as equality in care. Awareness of these potential conflicts can be helpful in finding the best way to (...) ensure that healthcare has its focus on the needs and interests of the patients. Patient-centred care may have to take different forms, depending of the nature of the disease, the patient’s life situation, and the economic, organizational and technological resources available to the healthcare unit. (shrink)

In Sweden, efforts to govern end-of-life care through policies have been ongoing since the 1970s. The aim of this study is to analyse how policy narratives on palliative care in Sweden have been formulated and have changed over time since the 1970s up to 2018. We have analysed 65 different policy-documents. After having analysed the empirical material, three policy episodes were identified. In Episode 1, focus was on the need for norms, standards and a psychological end-of-life care with the main (...) goal of solving the alleged deficiencies within end-of-life care in hospital settings. Episode 2 was characterised by an emphasis on prioritising end-of-life care and dying at home, and on the fact that the hospice care philosophy should serve as inspiration. In Episode 3, the need for a palliative care philosophy that transcended all palliative care and the importance of systematic follow-ups and indicators was endorsed. Furthermore, human value and freedom of choice were emphasised. In conclusion, the increase of policy-documents produced by the welfare-state illustrate that death and dying have become matters of public concern and responsibility. Furthermore, significant shifts in policy narratives display how notions of good palliative care change, which in turn may affect both the practice and the content of care at the end of life. (shrink)

More than perhaps anybody else in the world, the Swedish social scientist Björn Wittrock has contributed - both on the intellectual and institutional level - to making a truly global science possible. This book is devoted to an appreciation of his contributions.

The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, `Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, (...) appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress. (shrink)

This book explores how one can bring about changes in the brain through meditation, both through attention-focus training and through compassion training. Recent findings in the natural sciences have confirmed that it is possible for humans to achieve these structural and functional changes through various life-style practices. It is argued that meditation enables us to influence some aspects of our biological make-up and, for example, could boost our cognitive flexibility as well as our ability to act compassionate. Such changes are (...) likely to facilitate the instilling of a number of epistemic virtues which have great bearing on our quality of life. This book offers the reader an accessible introduction to a set of neuro-enhancement methods, with a special focus on meditation techniques, and explores how such practices could contribute to make us better decision-makers and improve our moral virtues. The book is suitable for anyone looking for a text discussing the effects of neuro-enhancement from a secular ethics perspective. (shrink)

In Sweden, palliative care has, over the past decades, been object to policies and guidelines with focus on how to achieve “good palliative care”. The aim of this study has been to analyse how experts make sense of the development and the current state of palliative care. Departing from this aim, focus has been on identifying how personal experiences of ‘the self’ are intertwined with culturally available meta-level concepts and how experts contribute to construct new scripts on palliative care. Twelve (...) qualitative interviews were conducted. Four scripts were identified after analysing the empirical material: 1. script of paths towards working within palliative care; 2. script of desirable and deterrent reference points; 3. script of tensions between improvement and bureaucracy; and 4. script of low status and uncertain definitions. The findings of this study illustrate how experts in complex ways intertwine experiences of ‘the self’ with meta-levels concepts in order to make sense of the field of palliative care. The participants did not endorse one “right way” of “good” deaths. Instead, palliative care was considered to be located in a complex state where the historical development, consisting of both desirable ideals, death denials and lack of guidelines, and more recent developments of strives towards universal concepts, “improvement” and increased bureaucracy altogether played a significant role for how palliative care has developed and is organised and conducted today. (shrink)

Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for (...) the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future. (shrink)

Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients’ intention and perceived ability to act in future situations where they risk experiencing abuse.

The purpose of this study was to explore how one person experienced the early years of dementia as she was living through the pre-clinical and earlyclinical stages of Alzheimer’s disease. Interviews were held onfour occasions over a period of three years. The data were analyzed usingthe descriptive phenomenological psychological method, in which theresearcher approached the data from a caring perspective. The livedexperience of early-stage Alzheimer’s disease showed to be acomplex transitional phenomenon that involves a dynamic process of personaladjustment. The process (...) is set in motion as the participant receives thediagnosis and will eventually lead her towards a state of increased opennessand receptiveness toward the disease. The results describe this process asit unfolds in the context of the overall experience, and the variousadjustments that the participant undertakes. Some reflections concerning theplausible needs of patients with early-stage Alzheimer’s diseaseare included in the discussion. (shrink)

On virtue ethical grounds, Barbro Fröding and Martin Peterson recently recommended that near-future AIs should be developed as ‘Friendly AI’. AI in social interaction with humans should be programmed such that they mimic aspects of human friendship. While it is a reasonable goal to implement AI systems interacting with humans as Friendly AI, I identify four issues that need to be addressed concerning Friendly AI with Fröding’s and Peterson’s understanding of Friendly AI as a starting point. In (...) a first step, I briefly recapitulate Fröding’s and Peterson’s arguments for Friendly AI. I then highlight some issues with Fröding’s and Peterson’s approach and line of reasoning and identify four problems related to the notion of Friendly AI, which all pertain to the role and need for humans’ moral development. These are that one should consider the moral tendencies and preferences of the humans interacting with a friendly AI, it needs to be considered whether the humans interacting with a Friendly AI are still developing their virtues and character traits, the indirect effects of replacing humans with Friendly AI should be considered with respect to the possibilities for humans to develop their moral virtues and that the question whether the AI is perceived as some form of Artificial General Intelligence cannot be neglected. In conclusion, I argue that all of these four problems are related to humans moral development and that this observation strongly emphasizes the role and need for humans moral development in correlation to the accelerating development of AI-systems. (shrink)

Though the authors of this commentary have deep felt doubts about the fruitfulness of Björkman and Hansson’s analysis of bodily rights, they do not doubt their capacity to develop both creative and provocative thoughtsIt is always welcoming to be confronted with thoughts that, even though one wholeheartedly disagrees with them, have the effect of stimulating one’s own reflections on matters, which without such confrontations, would have been less distinct, less critical—and we would gladly admit, less polemical. Thus it is thanks (...) to Barbro Björkman and Sven Ove Hansson’s article, “Bodily rights and property rights”, that we have been able to set our present course into these murky waters. The issue they want to address is by no means of a kind that lends itself easily to theoretical speculation. This has, perhaps, as much to do with the inherent intricacy of the issue itself as with the controversy it has managed to arouse. The issue is: is it possible to have ownership over one’s own body—that is, is it appropriate to treat the body and its components as property? What are the implications of conceptualising the body and its parts in terms of property? Should one, as a general rule, be able to sell and buy human biological material? If so, who should be allowed to buy and sell it? Does the sale or donation of one’s own bodily parts imply a transfer of ownership rights to the buyer or receiver, or is it rather that ownership of human bodily parts can only be acquired after the material has been, say, manipulated in a laboratory?Contrary to Björkman and Hansson, who see “the primary normative issue” to be “what combination of rights a person should have to a particular item of biological material”, we believe that their decision to construe …. (shrink)