Review of Adam Stout's Glastonbury Holy Thorn: Story of a Legend.

The article discusses how women murderers embedded in the victim-turned-avenger narrative function as vehicles of social criticism in three contemporary Swedish crime novels, Henning Mankell’s The Fifth Woman, Håkan Nesser’s Woman with Birthmark and Fredrik Ekelund’s Nina och sundet [Nina and the Strait]. The murderers’ performances of murder, based on parody and irony, question masculinity and its institutionalized practices. By rendering vulnerable the discourse of hegemonic masculinity, these performances prove their subversiveness and critical potential. At the same time they renew (...) the crime fiction genre and particularly the feminist crime novel in which female agency is identical with the agency of the detective. (shrink)

The article examines how discourse participants use language, the body and the local interactional and material context in the construction of offers. The data consist of eight hours of video recordings of everyday interactions in English and Finnish, and conversation analysis is used as the method. We focus on offers that make available to the recipient some concrete referent or material object or artifact in the current situation, that is, ‘concrete offers’. The article shows that such offers can be conceptualized (...) as consisting of two interlinked actions, one identifying the referent and the other explicating the offer. The article further argues that the frequent accomplishment over time of such complex actions may contribute to the emergence of a set of social action formats for offers. This action combination is explored by discussing offers that range from fully linguistically articulated ones, to types where embodied actions take an increasingly central role. (shrink)

The body in need of care is the subaltern of the neoliberal epistemic order: it is that which cannot be heard, and that which is muted, partially so even in care ethics. In order to read the writing by which the needy body writes the world, a new ethics must be articulated. Building on Jacques Derrida’s philosophy of deconstruction, Gayatri Chakravorty Spivak’s notions of subalternity and epistemic violence, critical disability scholarship, and corporeal care theories, in this article I develop an (...) ethics of needs. This is an ethical position that seeks to read the world that care needs write with the relations they enact. The ethics of needs deconstructs the world with a focus on those care needs that are presently responded to with neglect, indifference, or even violence: the absence of care. Specifically, the ethics of needs opens a space—a spacing, an aporia—for a more ethical politics of life than neoliberal biopolitics can ever provide, namely, the politics of life of needs. (shrink)

Farmers' relationship with nature isdetermined by the significance of agriculturefor human beings. When agriculture is definedas human activity that uses renewable naturalresources and aims to produce usable food andfiber products, agriculture is explicitlydefined as production. Farmers' relationshipwith nature is based on the principle ofproduction. This article discusses thecontradiction between the peasant values ofprotection of nature that many farmers inFinland still have and the environmental harmtheir production-oriented farming style causes.When farmers interpret their farming practicesas harmonious co-operation with nature, it isdifficult for (...) them to see the polluting effectsof their work. Paul B. Thompson's suggestionthat three religious–philosophical doctrines(hard work, the doctrine of grace, and the mythof garden) have made it easy for farmers toadopt productionist farming strategy is used asa framework to interpret farmers' narrativesconcerning their relationship with nature. Theresearch is qualitative and biographical. Thedata include life stories and biographicaltexts farmers wrote for a competition in1997. (shrink)

Die Beiträge dieses Buches unternehmen den Versuch, Praktische Philosophie in Begriffen einer negativistischen Sozialphilosophie zu rekonstruieren, die ein breites Spektrum von Phänomenen negativer Sozialität in ihrem eigenen Recht beschreibt und dabei davon ausgehen muss, dass sich diese Phänomene nicht in einer voll integrierten Gemeinschaft oder Gesellschaft aufheben lassen. Eine solche Sozialphilosophie geht den Gründen für die Irreduziblität des Negativen einerseits auf einer begrifflichen Ebene, andererseits aber auch in konkreten historisch-sozialphilosophischen, lexikalisch angeordneten Analysen nach. Getragen sind die Analysen von der Überzeugung, (...) dass ohne „Reibung“ an diesen Phänomenen auch ein Leben im Zeichen des Guten oder Gerechten jeglichen Halt an einem leibhaftigen In-der-Welt-Sein verlieren muss. Wir sind nicht nur unaufhebbarer Negativität ausgesetzt, sondern müssen auch verstehen, wie das der Fall ist, und welche Spielräume des Verhaltens sich uns darin eröffnen. (shrink)

This article studies argumentation for acceptability of corporate environmental actions in corporate environmental statements, with emphasis on stakeholder relations and environmental values. Stakeholder theory is commonly taken as the basis for corporate environmental management, and rhetoric typical of the stakeholder approach dominates the field. Although environmental issues are strongly charged with values, the dominant stakeholder approach does not stress the value dimension. The data of the study consists of environmental statements by Finnish forerunning business corporations in the forefront of corporate (...) environmental responsibility. The results of the study indicate that the statements argue for the acceptability of corporate environmental actions through three power-related rhetorical forms that are competing ways to produce acceptability in the data: dominance, subordination and equality, and joint action. Each rhetorical form describes a power-based relationship between stakeholders and the corporation and leans on a specific value type producing legitimacy for that rhetoric form. (shrink)

Farmers' relationship with nature isdetermined by the significance of agriculturefor human beings. When agriculture is definedas human activity that uses renewable naturalresources and aims to produce usable food andfiber products, agriculture is explicitlydefined as production. Farmers' relationshipwith nature is based on the principle ofproduction. This article discusses thecontradiction between the peasant values ofprotection of nature that many farmers inFinland still have and the environmental harmtheir production-oriented farming style causes.When farmers interpret their farming practicesas harmonious co-operation with nature, it isdifficult for (...) them to see the polluting effectsof their work. Paul B. Thompson's suggestionthat three religious–philosophical doctrines(hard work, the doctrine of grace, and the mythof garden) have made it easy for farmers toadopt productionist farming strategy is used asa framework to interpret farmers' narrativesconcerning their relationship with nature. Theresearch is qualitative and biographical. Thedata include life stories and biographicaltexts farmers wrote for a competition in1997. (shrink)

Most things we see look colored to us. But what is color? Where, if anywhere, is it? Why do we see it? When do we see it correctly? And how should we go about answering these surprisingly difficult questions? This essay surveys philosophical work on color and color perception.

The article deals with Le Collège de Sociologie, an elective organization founded in 1937 by a group of French thinkers, among whom were Georges Bataille, Roger Caillois and Michel Leiris. It tries to show how the notion of `force' or of `power', constitutive to the `new mythology' the members of the Collège wanted to create, was in fact deeply ambivalent in nature. This ambivalence can be traced back to the internal ambiguities of the Durkheimian theory of the `collective effervescence', which (...) is shown to have influenced not only the collegians' notion of the sacred, but also their conception of power. This ambiguous theoretical heritage is curiously reflected in the conflicting conceptions Bataille and Caillois held of the notion of power — one of the major controversies, which later led to the dissolution of the Collège. The thesis defended here is that the seeds of this controversy lie already in the internal ambiguities of the Durkheimian theory and that these ambivalences were in a certain manner reproduced not only in the dispute between Caillois and Bataille, but also in much of the contemporary social theory drawing its inspiration from the Durkheimian sociology of the sacred. (shrink)

Corporate responsibility has often been criticised as a decoupled organisational phenomenon: a publicly espoused rule that is not followed in daily organisational practices. We argue that a crucial reason for this criticism arises from the dominant in-house assumption of CR literature, which mitigates tensions and contradictions in organisational life by claiming that integrated rules result in coupled practices. We aim to provide new insights by problematising this in-house assumption and by examining how members of two organisations discursively make sense of (...) CR, as a daily rule-bound practice, via three strategies: integration, differentiation and fragmentation. We elaborate the contemporary literature on CR as a daily organisational practice by examining the significance of discursive sensemaking for organisational rules for further development and learning regarding CR. We then discuss the significance of our results for understanding CR as a coupled/decoupled phenomenon. (shrink)

What is the function of color vision? In this paper, I focus on perceptual phenomena studied in psychophysics and argue that the best explanation for these phenomena is that the color visual system is a perceptual enhancement system. I first introduce two rival conceptions of the function of color vision: that color vision aims to detect or track the fine-grained colors of distal objects and scenes (Seeing Color) and that it aims to help organisms discriminate, detect, track and/or recognize ecologically (...) important objects, properties, and relations more directly (Seeing with Color). I then discuss two kinds of systematic perceptual phenomena investigated by psychophysicists: approximate color constancy and color induction. I argue from the premise that Seeing with Color better accommodates and explains these phenomena to the conclusion that it is the conception that an empirically-guided philosopher of color ought to adopt. (shrink)

I have two main goals in this paper. My first goal is to sketch a new view of color perception. The core of the view can be expressed in the following two theses: (i) the overarching function of color vision is to enable and enhance the manifestation of relevant (species-specific) competences and (ii) color experiences are correct when they result from processing that directly and non-accidentally subserves the manifestation of such competences. My second goal is to show that the view (...) can accommodate and account for a wide variety of color perceptual phenomena, including many problem cases. Importantly, the framework allows us to differentiate between two kinds of good cases of color perception: ideal cases where the demands of the relevant competences converge and non-ideal cases where the demands of the relevant competences diverge and clash. (shrink)

The essay argues that narrative approaches to human personhood which conceptualize the goal of human personhood in terms of the fulfillment of a capacity for self-constitution by means of deliberate choices tend to make inordinate and inhuman claims for human agency. The narrative approaches of the psychoanalyst and psychoanalytic theorist, Roy Schafter, and of the theologian and ethicist, Stanley Hauerwas, illustrate this. Both thinkers implicitly deny the permanent vulnerability of human agency in the area of the appropriation of narratives. In (...) the case of Hauerwas, this also implies a denial of theneed for God’s grace in the area of the appropriation of narratives. The work of the philosopher, Paul Ricoeur, serves as a contrast to Schafer and Hauerwas and demonstrates that a narrative approach to human persons does not need to make inordinate claims for an autonomous human capacity for self-constituion. The last part of the essay shows how the rejection of the need for God’s grace in the area of the appropriation of narratives is connected to a rejection of the idea of innocent suffering. (shrink)

BackgroundBreakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation.Main textThis paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination of crucial (...) ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus.ConclusionsThe development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy. (shrink)

The centrality of trust in traditional doctor–patient relationships has been criticized as inordinately paternalistic, yet in today's discussions about medical ethics—mostly in response to disruptive innovation in healthcare—trust reappears as an asset to enable empowerment. To turn away from paternalistic trust‐based doctor–patient relationships and to arrive at an empowerment‐based medical model, increasing reference is made to the importance of nurturing trust in technologies that are supposed to bring that empowerment. In this article we stimulate discussion about why the move towards (...) patient empowerment may not be able to keep clear of the criticism of trust in traditional patient–doctor relationships. First, we explore how such a shift in trust dynamics might corrode patient empowerment in the name of patient empowerment. Second, we examine how a translocation of trust may at best push the “trust issue” elsewhere and at worst make it harder to evaluate trustworthiness. (shrink)

Rahner presents an example of an ambivalent stance towards human materiality. the essay provides a discussion of rahner's use of the concept of materiality in his metaphysics of human knowledge and shows that rahner's anthropology contains two arguments which define the limitations of human materiality in different ways. one of these arguments affirms that human materiality is essential and good, whereas the other stand seems to deny the goodness and the permanence of human materiality.

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. (...) The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus, normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary. (shrink)

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according (...) to which the satisfaction of this desire is regarded as a way to meet one’s presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people’s lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns. (shrink)

In this study I describe and interpret the arguments that are used in the interviews with environmental managers in the production of acceptable environmental action in business. The interest especially focuses on stakeholder relations and environmental values produced in the argumentation. In the results of the study I indicate that different types of arguments are used to produce acceptability that, while they may be conflicting, all of them are arguable.

Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’ 1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics for healthcare’s contribution to climate change. Recent research analyses, for instance, the ‘greening’ of informed consent and related bioethical principles. 2 3 (...) It is unclear what the duty of practising sustainable healthcare means at the level of doctor–patient interaction. Parsa-Parsi _et al_ flag the potential conflict in the ICoME’s provisions if ‘the actions of physicians are influenced by environmental considerations to the detriment of patients’ (p. 2), noting that the ICoME does not provide a handhold to improve understanding of such tensions. The code ‘does not... (shrink)

Review of Per Faxneld's Det ockulta sekelskiftet. Esoteriska strömningar i Hilma af Klints tid.

The mainstream view in contemporary analytic philosophy is that perception is primarily in the business of representing the mind-independent world as it is. My dissertation explores an alternative conception: that the goal of perception is to guide successful action and that perceptions do not need to track mind-independent properties to play this action-guiding role. I focus on two types of perception: color perception and pain perception. I start with the former and advocate a pragmatist, empirically-guided approach which begins by inquiring (...) into the function of color vision. After arguing that none of the extant philosophical views of color are satisfactory, I answer the function question by focusing on systematic color perceptual phenomena investigated by psychophysicists. I argue that the human color visual system is an enhancement system: that is, its job is to help us better discriminate, track, and recognize meaningful objects, properties, and relations. I then build on this idea using the notion of ‘competence-embeddedness.’ I propose that color vision is embedded in a network of competences: the aim of color vision is to help organisms manifest these competences, and color experiences are correct when they result from competence-enhancing processing. The framework is explanatorily robust. For example, it allows me to conceptualize many textbook color illusions as special cases of successful color perception where the demands of the relevant competences clash. Finally, I use the notion of ‘competence-embeddedness’ to develop a new account of pain. I argue that the pain system is not a bodily disturbance detector, but a sophisticated, context-responsive security system whose primary goal is to help organisms manifest important behavioral and cognitive competences. (shrink)

What is the function of pain? A popular view in contemporary philosophy is that the pain system is a bodily disturbance detector: pain states track/detect and represent bodily disturbances and the phenomenal character of the (sensory dimension of) pain supervenes on this representational content. The view can accommodate paradigmatic pain cases, e.g., when pain follows from stepping on a nail. Once we consider more complex pain phenomena, however, it has seemingly little to offer. In this paper, I discuss dissociation between (...) pains and bodily disturbances, variation in pain thresholds, the effects of repeated stimulation on experienced pain intensity, and the modulation of pain experience by cognitive and emotional states. I argue that these phenomena suggest that the pain system is not a bodily disturbance detector, but a sophisticated security system. (shrink)

The implementation of care robotics in care settings is identified by some authors as a disruptive innovation, in the sense that it will upend the praxis of care. It is an open ethical question whether this alleged disruption will also have a transformative impact on established ethical concepts and principles. One prevalent worry is that the implementation of care robots will turn deception into a routine component of elderly care, at least to the extent that these robots will function as (...) simulacra for something that they are not (i.e. human caregivers). At face value, this may indeed seem to indicate a concern for how this technology may upend existing practices and relationships within a care setting. Yet, on closer inspection, this reaction may rather point to a rediscovery and a revaluation of a particularly well-entrenched value or virtue, i.e. veracity. The virtue of veracity is one of the values that is mobilized to argue against a substitution of human caregivers (while a combination of care robots and human caregivers is much more accepted). The subject of this paper is to explore how the moral panic surrounding care robots should not so much be interpreted as an anticipated and probable disruptor in a care setting, but rather as a sensitizing – in a way conservationist – argument that identifies veracity as an established value that is supposed to be protected and advanced in present day and future care settings. (shrink)

People have various desires, but it is a contested moral issue when a desire becomes of such importance that it legitimizes a moral claim on others. This paper explores how the normative significance of desire satisfaction can be assessed and argues that a normatively significant desire can constitute a pro tanto obligation to help satisfy it. The paper presents a framework that relates the normative significance of a given desire to the general goal of living a reasonably valuable life and (...) inquires how the latter can be given determinate content without excluding a heterogeneity of the personal good. The paper contends that the set of possibly normatively significant desires is thus restricted by considerations about intelligibility, adequacy, and replaceability, which are mediated by societal background theories. (shrink)

In this study, we directly contrast two approaches that have been proposed to explain the SNARC effect. The traditional direct mapping account suggests that a direct association exists between the position of a number on the mental number line and the location of the response. On the other hand, accounts are considered that propose an intermediate step in which numbers are categorized as either small or large between the number magnitude and the response representations. In a magnitude comparison task, we (...) departed from the usual bimanual left/right response dimension and instead introduced the unimanual close/far dimension. A spatial-numerical association was observed: small numbers were associated with a close response, while large numbers were associated with a far response, regardless of the movement direction (left/right). We discuss why these results cannot be explained by assuming a direct mapping from the representation of numbers on a mental number line to response locations and discuss how the results can be explained by the alternative accounts. (shrink)

Recent medical innovations like ‘omics’ technologies, mobile health (mHealth) applications or telemedicine are perceived as part of a shift towards a more preventive, participatory and affordable healthcare model. These innovations are often regarded as ‘disruptive technologies’. It is a topic of debate to what extent these technologies may transform the medical enterprise, and relatedly, what this means for medical ethics. The question of whether these developments disrupt established ethical principles like respect for autonomy has indeed received increasing normative attention during (...) the past years. Yet, more fundamental ethical considerations of a possible disruption of the concept of ‘medical necessity’ (and the potential ensuing clinical ramifications) have been limited if not absent. It is our modest – though morally and practically relevant – aim to address this objective in this article, by exploring how the current wave of allegedly disruptive innovation is invoking a resurgence of this concept and related debates on ‘the’ goal(s) of medicine. (shrink)

We expand on Della Croce’s ambition to interpret “epistemic injustice” as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce’s attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of (...) epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson’s concept of “contributory injustice” and Scheman’s concept of “perceptual autonomy,” we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy. (shrink)

Germline genome editing is often disapproved of at the international policy level because of its possible threats to human dignity. However, from a critical perspective the relationship between this emerging technology and human dignity is relatively understudied. We explore the main principles that are referred to when 'human dignity' is invoked in this context; namely, the link with eugenics, the idea of a common genetic heritage, the principle of equal birth and broader equality and justice concerns. Yet the concept is (...) also used in favour of germline genome editing as it might improve the overall well-being of future generations. We conclude that dignity concerns do not justify a complete ban on safe heritable genome editing but should inform the implementation of side constraints to ensure that the value judgements about human traits that are inherent in this practice do not result in a diminished basic respect for those people affected by them. (shrink)

Many pregnant women use pregnancy related mHealth applications, encompassing a variety of pregnancy apps and wearables. These are mostly directed at supporting a healthier fetal development. In this article we argue that the increasing dominance of PRmHealth stands in want of empirical knowledge affirming its beneficence in terms of improved pregnancy outcomes. This is a crucial ethical issue, especially in the light of concerns about increasing pressures and growing responsibilities ascribed to pregnant women, which may, in turn, be reinforced by (...) PRmHealth. A point can be made that it would be ethically askew if PRmHealth does not lead to improved pregnancy outcomes, while at the same time increasing maternal duties to closely monitor fetal development. We conclude that more research is needed to get a view on the benefits and burdens of PRmHealth in order to ethically assess whether the latter are proportionate to the former. If not, there is a case in saying that endorsement of PRmHealth is overdemanding. (shrink)

I am happy to comment on T S Petersen’s1 examination of the ‘individualization argument against non-medical egg freezing ’. Petersen intervenes in the ethical discussion on egg freezing by critically reconsidering a specific type of argument against oocyte cryopreservation for reasons that are not directly related with medical issues. Petersen dissects the claim that such non-medical usage is ‘an individualistic and morally problematic solution to the social problems that women face, for instance, in the labour market’.1 Proponents of this argument (...) believe that egg freezing should not be used by women on an individual level to solve social problems but that one should instead address gendered inequalities on the labour market. Petersen asserts that this individualisation argument is unconvincing—although morally appealing—because of empirically and ethically flawed assumptions. I am enthusiastic—with some minor reservations—about his unravelment of the individualisation argument and his call for more empirical backing. As I understand his presentation, the argument that is the subject of Petersen’s analysis is a recurring argumentative trope in the broader realm of assisted reproduction ethics. For instance, the anticipated positive effect of artificial womb technology in terms of liberation from reproductive and related social inequalities is one of the most dominant ectogenesis …. (shrink)

Tensions between respect for autonomy and paternalism loom large in Ferrario et al ’s discussion of artificial intelligence (AI)-based preference predictors.1 To be sure, their analysis (rightfully) brings out the moral matter of respecting patient preferences. My point here, however, is that their consideration of AI-based preference predictors in treatment of incapacitated patients opens more fundamental moral questions about the desirability of over-ruling considered patient preferences, not only if these are disclosed by surrogates, but possibly also in treating competent patients. (...) I do not advocate such an evolution—the moral desirability of that calls for a much broader debate, one in which the meaning of ‘doing good’ in medicine, and how this intersects with normative views on ‘the goal(s) of medicine’ would be central elements. While my aim in this piece is more modest, I nonetheless hope to approach it sideways, by indicating how the contribution by Ferrario et al reopens discussion about paternalism and the normativity of preferences in medicine. This follows from what these authors give as reason for endorsing this technology in care for incapacitated patients. Their argument for employing such tools in case of incapacitation is based on the premise that advice of surrogate decision-makers about care preferences is suboptimal because of their biased perception …. (shrink)

Mobile health tools are often said to empower users by providing them with the information they need to exercise control over their health. We aim to bring clarity to this claim, and in doing so explore the relationship between empowerment and autonomy. We have identified three distinct models embedded in the empowerment rhetoric: empowerment as information, empowerment as control, and empowerment as values. Each distinct model of empowerment gives rise to an associated problem. These problems, the Problem of Interpretation, the (...) Value Alignment Problem, and the Priority Problem, show that mobile health tools in their current form are either insufficient for empowerment or are self‐defeating. These digital health technologies encourage users to adopt an individualized conception of autonomy, one that may weaken the doctor–patient relationship and undermine practices in shared decision making, and ultimately may not deliver on improving the health outcomes for those that need it the most. (shrink)

It has been suggested that future application of stem-cell derived gametes might lead to the possibility for same-sex couples to have genetically related children. Still, for this to become possible, the technique of gamete derivation and techniques of reprogramming somatic cells to a pluripotent state would have to be perfected. Moreover, egg cells would have to be derived from male cells and sperm cells from female cells, which is believed to be particularly difficult, if not impossible. We suggest a more (...) plausible scenario to provide same-sex couples with the possibility to parent a child who is genetically related to both parents. Although technical feasibility is an advantage, disadvantages are that cooperation of a donor of the opposite sex is still required and that the partners are genetically linked to the resulting child in a different degree. However, since in our scenario the donor's genetic contribution would not outweigh any of the parents' genetic contribution, this alternative route may ease the fear for a possible parental claim by the donor. Like many other applications in the field of infertility treatment, the goal to create SCD-gametes for reproductive purposes is largely based on the high value attributed to genetic parenthood. Although we believe that genetic relatedness is neither a necessary nor a sufficient condition for ‘good’ parenthood, we do believe that many people may consider our scenario a welcome alternative. (shrink)

Despite the frequent invocation of ‘false hope’ and possible related moral concerns in the context of assisted reproduction technologies, a focused ethical and conceptual problematisation of this concept seems to be lacking. We argue that an invocation of ‘false hope’ only makes sense if the fulfilment of a desired outcome (eg, a successful fertility treatment) is impossible, and if it is attributed from an external perspective. The evaluation incurred by this third party may foreclose a given perspective from being an (...) object of hope. However, this evaluation is not a mere statistical calculation or observation based on probabilities but is dependent on several factors that should be acknowledgeable as morally relevant. This is important because it allows room for, and encourages, reasoned disagreement and moral negotiation. Accordingly, the object of hope itself, whether or not based on socially embedded desires or practices, can be a topic of debate. (shrink)

The article presents a Gramscian reading of organisational interventions within the framework of developmental work research. Developmental work research is based on Engeström’s concepts of activity system and expansive learning cycle. It utilizes the theoretical vocabulary provided by Marx and Ilyenkov and is situated in the traditions of cultural-historical and critical research. In recent years, critical commentaries have pointed to a need to reconsider questions related to transformation, contradictions and power within the approach. The Gramscian reading here suggests that the (...) concepts of transformism, hegemony and dialectic pedagogy could open potential ways to reformulate certain elements of both the practice of organisational intervention and the theoretical principles of developmental work research. (shrink)