Nekrolog över Svante Hansson (1938-2023).

Trust among current and future patients is essential for the success of biobank research. The submission of an informed consent is an act of trust by a patient or a research subject, but a strict application of the rule of informed consent may not be sensitive to the multiplicity of patient interests at stake, and could thus be detrimental to trust. According to a recently proposed law on “genetic integrity” in Sweden, third parties will be prohibited from requesting or seeking (...) genetic information about an individual. Cumbersome restrictions on research may be lifted, thus creating a more favourable climate for medical research. (shrink)

The empirical basis for this article is threeyears of experience with ethical rounds atUppsala University Hospital. Three standardapproaches of ethical reasoning are examined aspotential explanations of what actually occursduring the ethical rounds. For reasons given,these are not found to be satisfyingexplanations. An approach called ``imaginativeethics'', is suggested as a more satisfactoryaccount of this kind of ethical reasoning. Theparticipants in the ethical rounds seem to drawon a kind of moral competence based on personallife experience and professional competence andexperience. By listening to (...) other perspectivesand other experiences related to one particularpatient story, the participants imaginealternative horizons of moral experience andexplore a multitude of values related toclinical practice that might be at stake. Inhis systematic treatment of aesthetics in theCritique of Judgement, Kant made use ofan operation of thought that, if applied toethics, will enable us to be more sensitive tothe particulars of each moral situation. Basedon this reading of Kant, an account ofimaginative ethics is developed in order tobring the ethical praxis of doctors and nursesinto sharper relief. The Hebraic and theHellenic traditions of imagination are used inorder to illuminate some of the experiences ofethical rounds. In conclusion, it is arguedthat imaginative ethics and principle-basedethics should be seen as complementary in orderto endow a moral discourse with ethicalauthority. Kantian ethics will do the job if itis remembered that Kant suggested only amodest, negative role of principle-baseddeliberation. (shrink)

Clear-cut cases of decision-making under risk (known probabilities) are unusual in real life. The gambler’s decisions at the roulette table are as close as we can get to this type of decision-making. In contrast, decision-making under uncertainty (unknown probabilities) can be exemplified by a decision whether to enter a jungle that may contain unknown dangers. Life is usually more like an expedition into an unknown jungle than a visit to the casino. Nevertheless, it is common in decision-supporting disciplines to proceed (...) as if reasonably reliable probability estimates were available for all possible outcomes, i.e. as if the prevailing epistemic conditions were analogous to those of gambling at the roulette table. This mistake can be called the tuxedo fallacy. It is argued that traditional engineering practices such as safety factors and multiple safety barriers avoid this fallacy and that they therefore manage uncertainty better than probabilistic risk analysis (PRA). PRA is a useful tool, but it must be supplemented with other methods in order not to limit the analysis to dangers that can be assigned meaningful probability estimates. (shrink)

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal (...) identity, and cultural effects. (shrink)

It is almost universally acknowledged that risks have to be weighed against benefits, but there are different ways to perform the weighing. In conventional risk analysis, collectivist risk-weighing is the standard. This means that an option is accepted if the sum of all individual benefits outweighs the sum of all individual risks. In practices originating in clinical medicine, such as ethical appraisals of clinical trials, individualist risk-weighing is the standard. This implies a much stricter criterion for risk acceptance, namely that (...) the risk to which each individual is exposed should be outweighed by benefits for that same individual. The different choices of risk-weighing methods in different policy areas seem to have emerged from traditional thought patterns and social relations, rather than from explicit deliberations on possible justifications for the alternative ways to weigh risks against benefits. It is not obvious how the prevalent differences in risk-weighing practices can be reconstructed in terms of consistent underlying principles of preventive health or social priority-setting. (shrink)

This article is an attempt at a systematic account of decision making under greater uncertainty than what traditional, mathematically oriented decision theory can cope with. Four components of great uncertainty are distinguished: (1) the identity of the options is not well determined (uncertainty of demarcation) ; (2) the consequences of at least some option are unknown (uncertainty of consequences); (3) it is not clear whether information obtained from others, such as experts, can be relied on (uncertainty of reliance); and (4) (...) the values relevant for the decision are not determined with sufficient precision (uncertainty of values). Some possible strategy types are proposed for each of these components. Decisions related to environmental issues are used to illustrate the proposals. (shrink)

In the first part of this paper, I clear the ground from frequent misconceptions of the relationship between fact and value by examining some uses of the adjective “natural” in ethical controversies. Such uses bear evidence to our “natural” tendency to regard nature as the source of ethical norms. I then try to account for the origins of this tendency by offering three related explanations, the most important of which is evolutionistic: if any behaviour that favours our equilibrium with the (...) environment is potentially adaptive, nothing can be more effective for this goal than developing an attitude toward the natural world that considers it as a dispenser of sacred norms that must be invariably respected. By referring to the Aristotelian notion of human flourishing illustrated in the first part of the paper, in the second I discuss as a case study some ethical problems raised by mini-chips implantable in our bodies. I conclude by defending their potential beneficial effects of such new technological instruments. (shrink)

SUGGESTED COURSES Introductory level A (Requires very little background in logic .): 4: -9 - - -7 -2 Introductory level B: -9,:+-+ -,2:+,2: -,3:20+-22+ -7 -2 ...

This article offers a perspective on the role of philosophy in relation to other academic disciplines and to society in general. Among the issues treated are the delimitation of philosophy, whether it is a science, its role in the community of knowledge disciplines, its losses of subject matter to other disciplines, how it is influenced by social changes and by progress in other disciplines, and its role in interdisciplinary work. It is concluded that philosophy has an important mission in promoting (...) clarity, precision, and open‐mindedness in academic research and in society at large. (shrink)

In order to explore public views on nanobiotechnology (NBT), convergence seminars were held in four places in Europe; namely in Visby (Sweden), Sheffield (UK), Lublin (Poland), and Porto (Portugal). A convergence seminar is a new form of public participatory activity that can be used to deal systematically with the uncertainty associated for instance with the development of an emerging technology like nanobiotechnology. In its first phase, the participants are divided into three “scenario groups” that discuss different future scenarios. In the (...) second phase, the participants are regrouped into three “convergence groups”, each of which contains representatives from each of the three groups from the first phase. In the final third phase, all participants meet for a summary discussion. This pilot project had two aims: (1) to develop and assess the new methodology and (2) to gather advice and recommendations from the public that may be useful for future decisions on nanobiotechnology (NBT). Participants emphasized that they wanted the technology to focus on solutions to environmental and medical problems and to meet the needs of developing countries. The need for further public participation and deliberation on NBT issues seemed to be acknowledged by all participants. Many of them also raised equality concerns. Views on the means by which NBT should be steered into socially useful directions were more divided. In particular, different views were expressed on how much regulation of company activities is needed to curb unwanted developments. The participants’ responses in a questionnaire indicate that the methodology of the convergence seminars was successful for decision-making under uncertainty. In particular, the participants stated that their advice was influenced both by access to different possible future developments and by the points of view of their co-participants, which is what the method is specifically intended to achieve. (shrink)

An agent can usually hold a very large number of beliefs. However, only a small part of these beliefs is used at a time. Efficient operations for belief change should affect the beliefs of the agent locally, that is, the changes should be performed only in the relevant part of the belief state. In this paper we define a local consequence operator that only considers the relevant part of a belief base. This operator is used to define local versions of (...) the operations for belief change. Representation theorems are given for the local operators. (shrink)

Five types of constructions are introduced for non-prioritized belief revision, i.e., belief revision in which the input sentence is not always accepted. These constructions include generalizations of entrenchment-based and sphere-based revision. Axiomatic characterizations are provided, and close interconnections are shown to hold between the different constructions.

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.

Extended antipaternalism means the use of antipaternalist arguments to defend activities that harm (consenting) others. As an example, a smoker’s right to smoke is often invoked in defence of the activities of tobacco companies. It can, however, be shown that antipaternalism in the proper sense does not imply such extended antipaternalism. We may therefore approve of Mill’s antipaternalist principle (namely, that the only reason to interfere with someone’s behaviour is to protect others from harm) without accepting activities that harm (consenting) (...) others. This has immediate consequences for the ethics of public health. An antipaternalist need not refrain from interfering with activities such as the marketing of tobacco or heroin, boxing promotion, driving with unbelted passengers, or buying sex from “voluntary” prostitutes. (shrink)

An agent can usually hold a very large number of beliefs. However, only a small part of these beliefs is used at a time. Efficient operations for belief change should affect the beliefs of the agent locally, that is, the changes should be performed only in the relevant part of the belief state. In this paper we define a local consequence operator that only considers the relevant part of a belief base. This operator is used to define local versions of (...) the operations for belief change. Representation theorems are given for the local operators. (shrink)

Five types of constructions are introduced for non-prioritized belief revision, i.e., belief revision in which the input sentence is not always accepted. These constructions include generalizations of entrenchment-based and sphere-based revision. Axiomatic characterizations are provided, and close interconnections are shown to hold between the different constructions.

In the middle of the 1980s, logical tools were discovered that make it possible to model changes in belief and knowledge in entirely new ways. These logical tools turned out to be applicable both to human beliefs and to the contents of databases. This is the first textbook in this new area. It contains both discursive chapters with a minimum of formalism and formal chapters in which proofs and proof methods are presented. By using different selections from the formal section (...) the book can be used on all levels of University education. (shrink)

Although it has often been claimed that all the information contained in second‐order probabilities can be contained in first‐order probabilities, no practical recipe for the elimination of second‐order probabilities without loss of information seems to have been presented. Here, such an elimination method is introduced for repeatable events. However, its application comes at the price of losses in cognitive realism. In spite of their technical eliminability, second‐order probabilities are useful because they can provide models of important features of the world (...) that are cognitively more plausible than those that can be obtained with single‐level probabilities. (shrink)

Background:Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection.Aim:The aim of this study was to gain a deeper understanding of how the ethics rounds (...) were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff.Research design:An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews.Participants and research context:A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed.Ethical considerations:The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards.Findings:The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work.Discussion:A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care.Conclusion:By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. (shrink)

Time and communication are important aspects of the medical consultation. Physician behavior in real-life pediatric consultations in relation to ethical practice, such as informed consent (provision of information, understanding), respect for integrity and patient autonomy (decision-making), has not been subjected to thorough empirical investigation. Such investigations are important tools in developing sound ethical praxis.

The relatively new discipline of risk analysis promises to provide objective guidance in some of the most controversial issues in modern high‐technology societies. Four conditions are discussed that must be satisfied for this promise to be fulfilled. Since none of these conditions is satisfied, risk analysis does not keep its promise. In its attempts to reduce genuinely political issues to technocratic calculations, it neglects many of the factors that should influence decisions on risk acceptance. A list of tentative guidelines is (...) given for numerical decision support that encourages democratic decision‐making instead of trying to evade it. (shrink)

Disposition ascription has been discussed a good deal over the last few decades, as has the revisionary metaphysical view of ordinary, persisting objects known as 'fourdimensionalism'. However, philosophers have not merged these topics and asked whether four-dimensional objects can be proper subjects of dispositional predicates. This paper seeks to remedy this oversight. It argues that, by and large, four-dimensional objects are not suited to take dispositional predicates.

This book explains how the logic of theory change employs formal models in the investigation of changes in belief states and databases. The topics covered include equivalent characterizations of AGM operations, extended representations of the belief states, change operators not included in the original framework, iterated change, applications of the model, its connections with other formal frameworks, and criticism of the model.

Despite Vision Zero’s moral appeal and its expansion throughout the world, it has been criticized on different grounds. This chapter is based on an extensive literature search for criticism of Vision Zero, using the bibliographic databases Philosopher’s Index, Web of Science, Science Direct, Scopus, Google Scholar, PubMed, and Phil Papers, and by following the references in the collected documents. Even if the primary emphasis was on Vision Zero in road traffic, our search also included documents criticizing Vision Zero policies in (...) other safety areas, such as public health, the construction and mining industries, and workplaces in general. Based on the findings, we identify and systematically characterize and classify the major arguments that have been put forward against Vision Zero. The most important arguments against Vision Zero can be divided into three major categories: moral arguments, arguments concerning the rationality of Vision Zero, and arguments aimed at the practical implementation of the goals. We also assess the arguments. Of the 13 identified main arguments, 6 were found to be useful for a constructive discussion on safety improvements. (shrink)

Healthcare depends increasingly on advanced medical technology. In addition, other forms of technology contribute to determine how our lives are influenced by disease and disability. The extent to which persons with impaired bodily functions are forced to live their lives differently than other people depends to a large part on a variety of technologies, from wheelchairs to computer interfaces, from hearing aids to garage doors. This wide-ranging influence of technology has important ethical aspects, but has seldom been discussed in bioethics, (...) the ethics of technology, or other branches of applied ethics. (shrink)

A representation theorem is obtained for contraction operators that are based on Levi's recent proposal that selection functions should be applied to the set of saturatable contractions, rather than to maximal subsets as in the AGM framework. Furthermore, it is shown that Levi's proposal to base the selection on a weakly monotonic measure of informational value guarantees the satisfaction of both of Gärdenfors' supplementary postulates for contraction. These results indicate that Levi has succeeded in constructing a well-behaved operation of contraction (...) that does not satisfy the postulate of recovery. (shrink)

Analytical tools that give precision to the concept of "independence of syntax" are developed in the form of a series of substitutivity principles. These principles are applied in a study of the rôle of language in belief revision theory. It is shown that sets of sentences can be used in models of belief revision to convey more information than what is conveyed by the combined propositional contents of the respective sets. It is argued that it would be unwise to programmatically (...) restrain the use of sets of sentences to that of representing propositional contents. Instead, the expressive power of language should be used as fully as possible. Therefore, syntax-independence should not be seen as a criterion of adequacy for language-based models of information-processing, but rather as a property that emerges from some but not all the idealization processes through which such models are constructed. (shrink)

In standard Bayesian probability revision, the adoption of full beliefs (propositions with probability 1) is irreversible. Once an agent has full belief in a proposition, no subsequent revision can remove that belief. This is an unrealistic feature, and it also makes probability revision incompatible with belief change theory, which focuses on how the set of full beliefs is modified through both additions and retractions. This problem in probability theory can be solved in a model that (i) lets the codomain of (...) the probability function be a hyperreal-valued rather than the real-valued closed interval [0, 1], and (ii) identifies the full beliefs as the propositions whose probability is either 1 or infinitesimally smaller than 1. In this model, changes in the probability function will result in changes in the set of full beliefs (belief set), which constitutes a submodel that can be conceived as the “tip of the iceberg” within the larger model that also contains beliefs on lower levels of probability. The patterns of change in the set of full beliefs in this modified Bayesian model coincides with the corresponding pattern in a slightly modified version of AGM revision, which is commonly conceived as the gold standard of (dichotomous) belief change. The modification only concerns the marginal case of revision by an inconsistent input sentence. These results show that probability revision and dichotomous belief change can be unified in one and the same framework, or – if we so wish – that belief change theory can be subsumed under a modified version of probability revision that allows for iterated change and for the removal of full beliefs. (shrink)

The AGM theory of belief contraction is extended tomultiple contraction, i.e. to contraction by a set of sentences rather than by a single sentence. There are two major variants: Inpackage contraction all the sentences must be removed from the belief set, whereas inchoice contraction it is sufficient that at least one of them is removed. Constructions of both types of multiple contraction are offered and axiomatically characterized. Neither package nor choice contraction can in general be reduced to contractions by single (...) sentences; in the finite case choice contraction allows for reduction. (shrink)

Modern belief revision theory is based to a large extent on partial meet contraction that was introduced in the seminal article by Carlos Alchourrón, Peter Gärdenfors, and David Makinson that appeared in 1985. In the same year, Alchourrón and Makinson published a significantly different approach to the same problem, called safe contraction. Since then, safe contraction has received much less attention than partial meet contraction. The present paper summarizes the current state of knowledge on safe contraction, provides some new results (...) and offers a list of unsolved problems that are in need of investigation. (shrink)

It is often claimed that the social sciences cannot be reduced to a lower-level individualistic science. The standard argument for this position is the Fodorian multiple realizability argument. Its defenders endorse token–token identities between “higher-level” social objects and pluralities/sums of “lower-level” individuals, but they maintain that the properties expressed by social science predicates are often multiply realizable, entailing that type–type identities between social and individualistic properties are ruled out. In this paper I argue that the multiple realizability argument for explanatory (...) holism is unsound. The social sciences are indeed irreducible, but the principled reason for this is that the required token–token identifications cannot in general be carried through. In consequence, paradigmatic social science predicates cannot be taken to apply to the objects quantified over in the lower-level sciences. The result is that typical social science predicates cannot even be held to be co-extensive with individualistic predicates, which means type–type identifications are ruled out too. Multiple realizability has nothing to do with this failure of co-extensiveness, because the relevant social science predicates are not multiply realized in the sense intended by the explanatory holists, a sense which presupposes reductive token–token identifications. (shrink)

A model of coherentist belief contraction is constructed. The outcome of belief contraction is required to be one of the coherent subsets of the original belief set, and a set of plausible properties is proposed for this set of coherent subsets. The contraction operators obtained in this way are shown to coincide with well-known belief base operations. This connection between coherentist and foundationalist approaches to belief change has important implications for the philosophical interpretation of models of belief change.