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Questions have been raised over the acceptability of conducting human challenge studies in low and middle income countries. Most of these concerns are based on theoretical considerations and there exists little data on the attitudes of stakeholders in these countries. This study examines the view of researchers and REC members in Thailand regarding the design and conduct of challenge studies in the country. A questionnaire was developed based on ethical frameworks for human challenge studies. The target respondents included those who (...) had experience with health-related research at universities, non-university hospitals, and research institutes. A total of 240 respondents completed the on-line survey. In general, the respondents felt that the ethical issues raised by human challenge studies in LMICS do not differ significantly from those in high income countries, including: scientific rationale, safety, appropriate risks, and robust informed consent process. In contrast, issues that have been described as important for human challenge studies in LMICs were rated as having lower importance, including: a publicly available rationale, national priority, and community engagement. Responses did not vary significantly between researchers in different fields, nor between researchers and REC members. These findings provide an important perspective for assessing existing frameworks for human challenges studies in LMICs. (shrink)

The object of this investigation is to analyze the application of the concept of learning to machines and software as displayed in Artificial Intelligence (AI). This field has been approached from different philosophical perspectives. AI, however, has not yet received enough attention from a Wittgensteinian angle, a gap this thesis aims to help bridge. First we describe the use of the concept of learning in natural language by means of a familiar and of a less familiar case of human learning. (...) This is done to give us a general idea about the meaning of this concept. By building two basic machine learning algorithms, we introduce one of the technical meanings of learning in computer science, i.e. the use of this concept in machine learning. Based on a study and comparison between both uses, the one in ordinary language and the one in machine learning, we conclude that both usages exemplify one and the same family resemblance concept of learning. We apply this insight further in a critical discussion of two specific philosophical positions about the applicability of psychological or mental concepts to software and hardware, especially in AI. One of the contributions of this investigation is that the use of mental concepts concerning machines does not imply the ascription of a mind. (shrink)

Evidence-based practice is a model for clinical decision-making, representing an interdisciplinary approach to clinical practice that aims to optimize clinical decision-making by emphasizing the use of evidence from well-designed research. An evidence-based decision is made by the individual clinician on basis of the best evidence available, in accordance with the patient’s preferences and circumstances. Since 1992, EBP has been a central concept within a growing range of professional fields of health care. At the same time, EBP has been subject to (...) incessant criticism. EBP proponents have responded to criticism, and their responses have then become the object of further criticism. The basic principles of the EBP-model, along with the claims by proponents and opponents for and against these principles, which compose the EBP debate, are the main subjects of this thesis. The thesis has four chapters. In Chapter 1, the principles of Clinical epidemiology are presented as the main scientific framework of EBP. It is through this framework that epidemiologic, outcome-based data is considered the most reliable source of evidence for clinical interventions. In Chapter 2, the constitutive elements of EBP are analyzed, with particular attention to what kind of scientific knowledge and non-scientific knowledge and beliefs that are inherent in the concept of EBP. In addition, I differentiate between three theoretical concepts of EBP – “narrow”, “moderate”, and “maximal” – which differ relative to the degree to which “clinical expertise” and “patient autonomy” are included in the concept or not. I claim that only “moderate” EBP” is representative for an adequate understanding of the EBP model. Chapter 3 presents an analysis of central claims in the international EBP debate while Chapter 4 attends to central claims in the Norwegian EBP debate. I argue that the most relevant criticism pertains to the confidence in and the application of epidemiologic evidence-sources. This kind of criticism must be distinguished from the claim that EBP represents a narrow scope of evidence. The latter claim is based on a misunderstanding about what “evidence” entails in EBP literature and is representative to a narrow concept of EBP. Yet another kind of criticism, claiming that the EBP model ignores clinical expertise and patient autonomy, is also based on misunderstandings, largely due to lack of clarity in the EBP literature. A general conclusion is that the tendency to imply a narrow interpretation of EBP in much of the criticism, as well as the tendency to conceptual unclarities in much EBP literature, contribute to a less constructive debate. The thesis concludes by suggesting recommendations to both proponents and opponents, which can contribute to a more constructive basis for future EBP debates. (shrink)

This thesis explores the phenomenon of scientific myths distributed in academic discourses. Drawing on a set of myth-examples, I explicate a definition of the term ‘scientific myth’, arguing that it ought primarily to be characterised by the tension between a lack of epistemic warrant on the one hand, and an extensive proliferation in formal academic channels of publications on the other. I then delineate scientific myths from the closely associated pseudosciences: The sciences, although distributing some unreliable statements, do not bestow (...) upon such statements the same authority and importance as the pseudosciences do. From these demarcative deliberations, I proceed to address the question of myth diffusion, of how misconceptions grow to scientific myths. Discussing myth-propagation, I argue that a fundamental explanation for myth-spreading is deficient epistemic practices. Omissions of citations, although a both common and pertinent explanation, only account for some aspects of myth spreading. In the context of research debates, the issue of myth diffusion also includes efforts at debunking scientific myths in academic publications. Our findings indicate that there is an ‘Affirmative Citation Bias’, that counteracts debunking attempts by effectively disarming the critique: Instead of being distributed, the critique is buried in an avalanche of myth-affirming publications. Finally, I discuss whether scientific myths ought to be somewhat vindicated. They could conceivably have an anti-dogmatic function in academic debates, by representing alternatives to the established consensus, in accordance with Millsian and Feyerabendian ideals for truth seeking discourse. I conclude in the negative: Scientific myths have dogmatic aspects themselves. (shrink)

Wilfrid Sellars had an elaborate theory of self-knowledge about one’s own thoughts that anticipates some crucial claims and topics of current work on self-knowledge. In this contribution, I reconstruct Sellars’s theory of self-knowledge, and explore connections with more recent work on the topic. I argue that Sellars’s account undermines Shoemaker’s and Burge’s influential arguments against “perceptual” accounts of self-knowledge, and I discuss whether Sellars’s position is apt to give a plausible account of the relation between self-knowledge and phenomenal consciousness.

While the theory of relative plausibility is presented by Allen and Pardo as a descriptive theory of the proof process, this commentary discusses their theory as a possible starting point for a prescriptive theory of evidence assessment. Generally, naturalness and simplicity are necessary for the success of such a theory. The theory of relative plausibility is very promising in this respect, as its key concept is the straightforward and intuitive notion of explanation, according to which an explanation is an answer (...) to a “why” question. Still, both the explanatory and the comparative dimensions of relative plausibility are in need of elaboration if one wants to give advice on evidence assessment in terms of Allen and Pardo’s framework. For one thing, it is necessary to examine the epistemological status of the various explanatory criteria regarding their potential as guides to truth or likelihood. Only epistemic criteria should be included in recommendations to fact-finders. Moreover, given the author’s interpretation of the ‘beyond any reasonable doubt’ standard, it is unclear what the comparative dimension amounts to in criminal trials. At least a comparison of the kind involved in the author's account of civil trials standards is absent in their interpretation of BARD. If the comparative dimension of relative plausibility is relevant at all in criminal trials, it must be clarified what is to be compared. (shrink)

The paper argues that, counter to Walter Sinnott-Armostrong and Ewen Kingston’s view, we are morally required to refrain from joyguzzling, i.e., driving a fuel-inefficient car for no other purpose than having a good time. It is undisputed that joyguzzling is an example of a situation where the uncoordinated actions of a large group of individuals lead to an undesirable outcome. Additionally, it is highly unlikely that any one individual’s actions will have a significant impact on that outcome. But there are (...) morally relevant differences between cases that share these characteristics. The paper clarifies the debate by introducing and discussing three different types of cases: drop-in-the-ocean cases, overkill cases and emergence cases. We argue that we may have moral obligations in drop-in-the-ocean cases, and that emissions of GHGs are not examples of overkill cases. Then we demonstrate through counterexamples that there are moral obligations in a subgroup of emergence cases we call joyguzzling-like cases. After criticizing the soundness of Kingston and Sinnott-Armstrong’s arguments, we critically address their relevance. We argue that Sinnott-Armstrong and Kingston fail to distinguish between two concepts of moral obligation — namely, autonomous and heteronomous moral obligation; that their most important arguments do not have any relevance to heteronomous obligations; and, finally, that heteronomous moral obligations are essential for social change. (shrink)

How can one be a good person? That, in essence, is the question I ask in this dissertation. More specifically, I ask how we, in general, can best go about the complex and never-ending task of trying to figure out what we should do and then do it. I answer that question in four articles, each dealing with an aspect of the model of morality presented by Adam Smith in The Theory of Moral Sentiments. The title of the dissertation, ‘How (...) to be a good sentimentalist’, thus refers to that particular philosophical framework. However, the answers I give should be relevant to any person concerned with how to be a good person. The first article, Moral Tuning, deals with the first part of the question, namely how we can best go about figuring out what it is that we should and should not do. Specifically, it deals with the question of whether, and if so how, individuals like you and I can critically reflect upon the norms of our own society, sorting the chaff of merely conventional norms from the wheat of genuinely moral ones. In brief, it is the question of whether we as individuals are autonomous in our relation to the norms of our own society. In answering this question, my co-authors and I argue that Smith’s use of musical metaphors in TMS, words like tone, pitch, and concord, can be understood as elements of an analogical model of morality. In contrast to earlier interpretations of Smith’s musical metaphors, which have seen music as an aesthetic object, we draw on recent developments in musicology to argue that music may also be construed as a practice. Construing the source domain of this analogical model as musical practice allows us to construe the target domain also as a practice—as moral tuning. This in turn allows us to argue that moral autonomy consists in realising the freedom inherent in the constant need to translate norms into action, and in so doing, to interpret and reinterpret, not only the actions, but the norms themselves. In other words, following the norms of our own society already implies that we are autonomous in relation to them. Being good sentimentalists thus begins with realising that we are free to question and reshape the moral standard of our own society. The second article, Love Redirected, deals with the second part of the question, namely how we can best go about doing what we already think we should do. This, then, is a question of moral motivation, more specifically a question about the difference between genuinely moral motivation and other kinds of motivation, like a selfish desire for praise. Smith himself argues that we not only desire the actual praise of other people, but to be worthy of their praise, to be ‘praiseworthy’. The desire to be praiseworthy, the ‘love of praiseworthiness’ is then the genuinely moral motivation, for it aims at nothing but the satisfaction of having done the right thing. The trouble with Smith’s answer is that he does not adequately connect his claim about praiseworthiness to the rest of his model. This has lead to some confusion in the secondary literature, and in the first part of Love Redirected, I seek to end this confusion by combining what Smith says in the various editions of TMS into a coherent argument for how the desire to be praiseworthy comes from redirecting our desire for praise from other people towards the ideal of the ‘impartial spectator’. I then go on to show how this reading also fits with modern psychological research on the moral development of children. Finally, I conclude that this redirection of our desire for praise requires not just negative, but positive emotional reinforcement. Therefore, becoming good sentimentalists involves taking pleasure in our moral successes, no less than we are pained at our failures. The third article, The Practical Impossibility of Being both Impartial and Well-informed, makes a first pass at dealing with the idea of the impartial spectator itself, an idea that is central to the answers given in the two first articles. The problem with the impartial spectator is that she is also supposed to be well-informed about those she judges. However, the demands of impartiality and of understanding pull in opposite directions: To be well-informed—to properly understand the situation and character of the person we judge—we must, typically, be sufficiently physically close to that person to see with our own eyes what they are going through. At the same time, this kind of physical closeness tends to entangle us in the kinds of emotional bonds that hinder an impartial evaluation. One might think that this tension could be eased or eliminated by relying less on physical closeness and more on the powers of our imagination to, as Smith frequently puts it, ‘bring home to us’ the situation of the person we are judging. However, using Construal Level Theory, I argue that merely imagining someone’s situation in detail and/or taking their perspective produces a similar effect to physical closeness, and hence that the tension between understanding and impartiality is practically inescapable. To be good sentimentalists, we must therefore recognise our limitations, and give up on the illusion of ever being fully understanding and perfectly impartial at the same time. The fourth article, The Partially Impartial Spectator as an Ethical Ideal, makes a second pass at dealing with the idea, or rather ideal, of the impartial spectator. It begins with the recognition that we frequently fail to be impartial spectators, both of others, and of ourselves. This is especially true in those cases where our views conflict with those of someone else. Building on research detailing the various ways in which cognitive and affective biases impact our perception of the world, our reasoning about our own views, and our ability to resolve disputes with others, I argue that merely trying harder to be impartial spectators is liable to backfire, rendering us just as biased as ever, to which is added an unshakeable confidence that we were right all along. Therefore, I go on to argue, we must try smarter. Trying smarter, I conclude, involves aiming for something less ideal, more achievable, and, most importantly, humbler, namely to be partially impartial spectators. Being a good sentimentalist thus beings with realising our freedom to interpret, continues in our taking pleasure in our moral successes, pauses at the realisation that we will never be truly impartial spectators, and ends with a commitment to continued improvement under the lodestar of the ideal of the partially impartial spectator. (shrink)

This piece continues my efforts to identify the link between the Philosophical Investigations’ criss-cross form and its conception of philosophy and philosophical methods. In my ‘The Philosophical Investigations and Syncretistic Writing’ I established a connection between the PI’s criss-cross form and Wittgenstein’s saying that philosophy proper is like ‘Dichtung’. In this chapter I link the criss-cross form with the PI’s conception of the example and the central role it receives in Wittgenstein’s later philosophy. I contrast the PI’s conception of philosophy (...) with a conception that is guided by a scientistic approach and regards philosophical problems as somewhat similar to normal science puzzles. While this approach is prominent nowadays, it is not a conception shared by the PI. Rather, it is exactly this approach that the PI opposes with its criss-cross form. I hold that the radical nature of the PI’s form has largely gone unnoticed in Wittgenstein reception, including among scholars who regard Wittgenstein as a ‘therapeutic’ philosopher. As in my 2013 paper, here too I refer to Ortner’s description of writing strategies as a valuable tool for identifying working strategies and turning points in Wittgenstein’s formation of the PI, especially ‘linear step-by-step’, ‘syncretistic’ and ‘puzzle’ writing. (shrink)

In Chapter IV of his Schreiben und Denken , the Austrian linguist Hanspeter Ortner distinguishes and describes ten writing strategies (“Schreibstrategien”). One of them is “syncretistic writing”. 1 A simple application of Ortner’s defi nition and description of syncretistic writing to the genesis of the Philosophical Investigations (PI) makes clear that the PI can be said to be of syncretistic origin. 2 Wittgenstein’s writing of the PI 3 can be characterized by Ortner’s eight features of syncretistic: his writing (1) hops (...) all over the place (“Sprunghaftigkeit”); (2) combines disparate elements from his writings (“Verbindung von weit Auseinanderliegendem”); (3) is semantically open, under-determined and under-determining (“Unterdeterminiertheit und semantische Offenheit”); (4) postpones gestalt-formation/ elaboration (“Aufschub der Gestaltbildung”); (5) invites and offers many opportunities for creative ideas (“viele Chancen für und Einladungen an den kreativen Einfall”); (6) gives freedom to choose the points of departure and reference (“Freiheit bei der Wahl des/der Startpunktes/e und des/der Gesichtspunktes/e”); (7) is hierarchically under-determined (“hierarchische Unterbestimmtheit”); (8) works side-by-side with the already “fi nished” and the newly begun, which implies long text building processes and parallel operations (“lange ‘Bauzeit’ und Nebeneinander von Fertiggestelltem und Neubegonnenem”). 4 -/- In the following, I will try to show in more detail how the genesis of the PI is characterized by these eight features. First, the writings that constitute the PI’s genesis are characterized by a strong discrepancy between the sequence of remarks in their textual order and the sequence of remarks in their physical order. Texts are put together from chronologically and argumentatively dispersed units. One example is Wittgenstein’s rearrangement of remarks from an earlier dictation (TS 208) into a new text in 1930 (TS 209, published by Rush Rhees as Philosophical Remarks ). In this new text, he abandoned both the original argumentative order and the chronological order and did not necessarily obey the criteria of consistency and coherence, not even on linguistic levels such as demonstrative reference. The work that -/- emerges is seen by many as an unordered agglomerate of remarks, although I have argued that this view can be challenged. 5 The second example is the revision and rearrangement of the so-called Big Typescript (TS 213) in 1933-34, which is paradigmatic in its triple use of (1) the text in the typescript, (2) the handwritten revisions of it in the typescript, and (3) text in other manuscripts. In his edition of the Philosophical Grammar (1969), Rush Rhees has tried to take this complicated network of revisions into account and to follow it painstakingly and faithfully; by looking at the manuscript sources for this edition 6 one realizes how much “hopping all over the place” was going on in the originals. Thirdly, MS 142, the “Urfassung” of the PI, was produced in 1936-37 from remarks stemming from different places in manuscripts and typescripts and various loci of discourse. MS 157b, 13v, contains a list of references to pages in TS 213 from which parts of the text were to be taken to write the “philosophy chapter” of this fi rst PI version; other sources include MS 140 (last page), MS 152, MS 156a, MS 156b and MS 157a, all yielding materials, lists and drafts for the text of MS 142. The fi nal example is TS 228: in the later stages of the PI genesis, Wittgenstein selected about 400 remarks from this typescript to include in TS 227, the typescript used as the printer’s copy for the PI. (shrink)

With this dissertation I intend to give a contribution to the field peace and peacethematic. The hypothesis of the dissertation is that it is possible to read the Platonic corpus as a body of critique where Plato in the last resort stands forth as a voice pro peace. I employ a method denoted as slow reading, and I read the dialogues systematic from the outset of their internal dramatic dating. I present two main arguments. The first is that the Republic (...) can be read as dramatic backdrop for the other dialogues. The readings of the Republic will show, on the one hand, how Socrates legitimizes the discipline of philosophy by contrasting it to sophistry; on the other hand, that by awakening the well-established two-city-topos Socrates paves the way for a profound critique of Athenian cultural and moral values. This, in turn, leads to a redefinition of the concepts stasis and polemos which entails radical new thoughts that are not reducible to the contemporary warwaging politics. The second argument is related to the dialogues, which I denote as dramatic historical touchdowns. I relate to the theme encountering youths and highlights how Socrates, in conversations with young men intends to make them turn toward philosophy, which is an education and a path aiming toward freedom. Regarding the dialogues, I argue that the readers are invited to view how the past is recreated in the present, and to apprehend that this recreating is a dramatic and welldirected showing of how the past is responsible for the present conditions. In addition, I analyze the entrance of the Eleatic Stranger; he brings confusion at stage and through him, the Socratic practice of philosophy gradually fades away. The last text encountered is Socrates’ apology where I—through a rhetorical reading—show that he presented a coherent defense both as a philosopher and as a citizen. Overall, through the readings I intend to show that the Platonic corpus contains a critique of the values that led to the decay of Athens. Due to this critique and the dramatic staging of prominent personas not willing or able to change, the past was made responsible for the conditions of the present. By launching an alternative politeia and paideia that is not compatible to war-waging, and by showing the multiple and, thus individual, paths toward philosophy, Plato in the end stands forth as a powerful voice pro peace. (shrink)

This thesis sets out to treat Adam Smith’s work as a whole, showing how his two books, The Theory of Moral Sentiments and The Wealth of Nations, both are part of one underlying message rather than opposed to each other. A comprehensive introduction to Smith’s moral philosophy and his remarks on political economy will not only explain his central ideas and put them into context with each other, it will also illustrate how his thought evolved and was inspired by predecessors (...) and contemporaries. Moreover, the alleged Das Adam Smith Problem, holding a contradiction within Smith’s work, will briefly be outlined and put into its historical context. It will be examined, how it came into existence and why it seems, both historically and contentual, untenable. On this basis, this thesis will claim that Smith’s thoughts build one academic project and are connected by a red thread, which is present in both of his books at all time. (shrink)

This thesis argues that states have cosmopolitan obligations of a moral-legal character. These obligations are articulated as “cosmopolitan law”, which is a Kantian term referring to the morallegal norms that regulate the relation between states and foreigners. The main example of cosmopolitan law today is found in the right to asylum. In the first part, I argue that the globalized circumstances actualize the need for an extension of this law and therefore I consider some of the main contributors to the (...) extension of cosmopolitan law, namely Immanuel Kant, Hannah Arendt and Seyla Benhabib. I also situate this Kantian account in the immigration debate and conclude that I prefer Benhabib’s position compared to other positions in the current discussion. In the second part, I take some distance from Benhabib’s reading of Arendt and seek to explore an alternative reading informed by a Husserlian phenomenological perspective. I tend to agree with a more radical reading of Arendt, which seeks to balance the institutionalist and performative aspects of her thinking. My reading is grounded in a systematic conceptual analysis of Arendt’s more theoretical perspectives that are found in The Human Condition, in central chapters of The Origins, and in some of her essays. My main point is to show how central the significance of the co-presence of others is to her thinking. Through a phenomenological reading, the richest experiential mode of this co-presence – as “fully human” – is taken to be the basic experience that motivates Arendt’s typology of modes of activities and her normative ranking of principles of action. Further, informed by Alfred Schutz’s conceptual framework of social relations, I discuss in more detail what this experience of the “fully human” could entail. I argue that this mode of experience has normative implications both on the face-to-face level of interaction, and on the level of indirect interaction among strangers. The main implication of this reading is that Arendt’s contribution should not be understood – as Benhabib seems to suggest – only as an extension of the content of cosmopolitan law within the Kantian framework. Decisively, Arendt’s thinking should be considered as a reconceptualization of the guiding principles of political thought and a new concept of human dignity. I argue that this reconceptualization allows for an extension of cosmopolitan law more adequately adapted to the circumstances of our times than the Kantian framework. (shrink)

The thesis discusses the justice of state punishment in response to criminal wrongs. The introductory chapter explores the logic of the concept of justice itself, proposing that we understand justice as the function of remedying injustice. This negative approach – studying justice through injustice – allows us to critically evaluate theories of retributive justice via the conceptions of the wrong in crime that they entail, and for which punishment is perceived as a remedy. Examples of the conceptions of the wrong (...) in crime considered in the first part of the thesis are: ‘infringement of mutual freedom’, ‘freeloading’, ‘undermining the mutual benefits of law’, ‘undeserved profit’, ‘harm to the victim’ and ‘material imbalance’. Punishment, upon each of these conceptions, is just to the extent that it remedies the particular wrong of the crime, for instance by cancelling its undeserved profits or by alleviating the harm of the victim. The first part of the thesis culminates in a prolonged discussion of what is deemed the most suitable theory of punishment in a modern democratic state, the ‘Freedom Perspective’ based on a Kantian-Hegelian framework, whereupon crime is wrong because it infringes upon mutual freedom. The second part discusses the possible injustice of punishing severely socially deprived offenders. Specifically, it considers four reasons for the justice of lowering or abstaining from punishment of this group of offenders. These reasons relate to the material, cultural and psychological factors which increase this group’s likelihood of committing crimes and of being punished. These factors are to some extent the result of unjust social structures in society. Hence, this part discusses the links between social justice and criminal justice. Finally, the thesis examines the justice of an alternative way of remedying the wrong in crime: restorative justice processes between victim, offender and other parties to the crime. The concluding remarks are devoted to the meta-issue of how to conceive of justice when facing competing, yet plausible claims of justice. (shrink)

The main objective of this study was to explore how Russian women have constructed motherhood within the Norwegian context. The empirical material came from qualitative, loosely structured interviews with nine middle-class, educated, Russian immigrant women in Bergen, Norway. In this study motherhood was understood as both constructed and contextual, and as part of a broader conceptual framework made up of the following: Baumrind's typology of parenting styles; a culture, gender and social class perspective on parenthood; and the interrelation between acculturation (...) and cultural identity in the context of immigrant parenting. Motherhood was also seen as a changing and changeable practice, both within a particular socio-cultural setting and in the context of the lives of these mothers, allowing for the possibility to explore the influence of transnational ties and historical change on the construction of cultural identity and immigrant motherhood. The interplay between structure and agency was explored in relation to the way in which study participants had adapted to, and reconciled, what they recognised as the possibilities and limitations of childrearing in Norwegian society. Regarding the position of informants as Russian immigrant mothers, examples were given that show the capacity of the research participants to navigate within the Norwegian social and cultural setting, and their recognition of the advantages and disadvantages of motherhood in this context. The agentive capacity of these women has been brought to the fore as an overarching theme across the three main aspects of this research: motherhood in the Norwegian context, gendered parenthood, and cultural identity and culture transmission. This study has explored the way in which the research participants conceived of their mothering role in relation to their knowledge of gender relations and cultural conceptions of motherhood in their host country, Norway, and their native country, Russia. The most significant findings that came across through the interview process was that these mothers were as much concerned with discussing and defining what Russianness' meant in their own lives and the lives of their children, as with highlighting the influence of Norwegian cultural values on their mothering practice. This impacted on both their discussion of gendered parenting roles and the transmission of Russian culture to their children. Part of their agentive capacity was manifested in the way in which they each chose to position themselves differently and selectively in relation to Norwegian and Russian cultural practices and to specific aspects of motherhood. Each mother was going through her own individual process of acculturation which involved exercising agency as part of the construction of immigrant motherhood. This study is adding to previous research by giving weight to intragroup differences and presenting individual research participants in both an in- depth and holistic way. (shrink)

Background: Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. Main text: We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. (...) Rather, we should focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. Conclusion: We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

This thesis is an investigation into the free will debate and the problem of free will. Is free will and moral responsibility possible in a determinate universe? As old as this problem is, philosophers are still grappling with it and the debate on this issue is still very much alive. How we address this problem depends on what definition of freedom we use, and it depends on whether we relate the concept of moral responsibility to freedom or not. I argue (...) that the position called hard incompatibilism is the position that coheres best with naturalism given the definition of freedom I support. By naturalism, it is meant a view that doesn`t contradict natural sciences. I aim for an understanding of action and morality that doesn`t introduce any phenomena that isn`t natural. Many arguments in favor of hard determinism when it comes to human agency are also satisfactory coherent with naturalism, but has weaknesses hard incompatibilism avoids. Indeterminism poses just as much of a threat to free will as determinism does, thus the best solution is to deny freedom all together and rather focus on control as a means to achieve our goals etc.. I attempt to show that with the most reasonable understanding of the concept of freedom", determinism is not - as compatibilists argue - compatible with free will. My main question is can hard incompatibilism offer a solution to the free will and moral responsibility problem that does not require a revolution of our reactive attitudes?" The relationship between free will and moral responsibility is what stands in the way of the compatibilist solution; it seems unfair and unreasonable to hold someone morally responsible for something they could not have done differently and for being someone they have not designed. In this thesis I show that one needs to accept a strong concept of freedom in order to argue that an agent is morally responsible for his actions. I will, however, distinguish between ultimate moral responsibility - which requires true free will, and the ability to respond to moral situations as a moral agent; practical moral responsibility- which I claim doesn`t require free will. By trying to give a naturalistic account of what morality might be- or at least by arguing in favor of seeing morality as something natural, I will try to show that the ability to act morally responsible has nothing to do with the ability to do otherwise" or design oneself, and that human agents can therefore be practically morally responsible even if hard incompatibilism is true. However, they cannot justifiably be subject to condemnation for their actions because they lack ultimate moral responsibility. This way, I end up denying the need for a revolution of our reactive attitudes as a result of believing in hard incompatibilism. And, possibly also calming the fear of those who think that denying free will can lead to chaos, when it comes to moral conduct. I end up concluding that a belief in hard incompatibilism would leave us pretty much with status quo when it comes to moral demeanor. The hard incompatibilist solution I`m suggesting allows us to keep our reactive attitude patterns the way they are described by Strawson and to judge when we feel like someone could have done better. However, the difference between this and the compatibilist solution is that the grounds for condemnation disappear because of its dependence on free will. (shrink)

The article discusses translation as a critical approach to how we see culture. According to the anthropologist Marianne Gullestad culture is part of mechanism of exclusion when it is linked to identity or “sameness”. Belonging to the same culture becomes a criterion for being included into a society, whereas having a different cultural belonging is a criterion for exclusion. Culture is thus placed within an oppositional logic of same-different. By seeing a parallel between languages and cultures, translation indicates another kind (...) of thinking which is not based on this oppositional logic and hence question the reason for exclusion and inclusion. By the help of philosopher Paul Ricoeur the article looks at Martin Luther’s translation of the Bible in the 16th century as an example of how to avoid seeing linguistic sameness and difference as the only point of departure for thinking relations between languages, and analogically speaking: relations between cultures. (shrink)

Can resource-poor countries bear any stringent obligations in the pursuit of equity in the distribution of global health opportunities between individuals globally? Distributive justice is primarily about resource transfer from those who have more than enough to those who are suffering severe scarcity. In the particular case of distributive justice in global health, given that most health opportunities cost money and given that the idea of ‘resource-poor countries’ entails that such countries lack sufficient resources in general and in particular health (...) resources, the question of this work may seem a rhetorical one, seeking “no” as an obvious answer. On the contrary, however, despite the reality of severe resource scarcity among poor countries, the main thesis defended in this work is that poor countries ought to bear certain stringent obligations in the pursuit of global distributive justice in general. This obligation applies even in the specific case of the pursuit of justice in the global distribution of certain basic health opportunities among individuals globally. This work is based on a general claim that in efforts to ensure distributive justice it is not enough to look at what amounts of resources should flow from the global haves to the global have-nots. The work demonstrates that even though resource flow from the global rich to the global poor is a necessary condition for achieving distributive justice in the current global circumstances, there is evidence which suggests that this may not be a sufficient condition for the achievement of global distributive justice; or at least reducing the current global inequities. Bearing in mind that global injustice, in this case, means unjust distribution of global resources and opportunities rather than global inequality per se, this work suggests that potential beneficiaries of redistribution need to behave in ways which confirm that current inequalities in global distribution of life chances and all opportunities for survival and human well-being are unjust in a sense that the current global maldistribution of resources cannot be attributed to their moral fault. If the current global inequalities can be attributed to their moral fault, then they ought to bear morally binding obligations to their citizens and those whose resources are to be redistributed. Short of this proviso it will not be possible to achieve global distributive justice in the strict sense of the word. It is this proviso that leads to an enquiry into possible obligations of poor countries in ensuring global distributive justice. This reasoning about what it may necessarily take to achieve global distributive justice is motivated by an insight that ignoring the victims’ obligations may lead to further injustice especially if affluent countries are morally required to transfer their resources to cover deficits in victim countries, which deficits arise out of the moral fault of those governments. The insight also extends to the possibility that current efforts might fail to achieve the desired global threshold distribution of material and social well-being for poor country citizens especially if their governments behave like economic ‘black holes.’. (shrink)

Background: Although health is a right of all individuals without any distinction, the realisation of this right has remained very difficult for the marginalised populations of poor countries. Inequitable distribution of health opportunities globally is a major factor in explaining why this is the case. Whereas the Protection, Promotion and Fulfilment of the health rights of poor country citizens are a joint responsibility of both domestic and external governments, most governments flout their obligations. So far disproportionate effort has been dedicated (...) to reaffirming and interpreting these obligations as opposed to investigating the fundamental question regarding why these obligations have nevertheless remained largely unfulfilled. Further the normative question regarding what ought to be done about the shortcomings of current obligations has been largely ignored. Methods: We conduct a critical content analysis of existing literature on efforts towards the realisation of the health rights of marginalised populations in our attempt to ascertain their capacity to guarantee basic health opportunities to marginalised populations. In our analysis we treat issues of ‘health rights’ and ‘justice in global health’ as having unity of purpose – guaranteeing basic health opportunities to the marginalised populations. Results: We identify two sets of reasons for the failure of present obligations for global distributive justice in general: a set of ‘superficial reasons’ and a set of ‘fundamental reasons’ which account for the superficial reasons. Discussion: In order to overcome these reasons we propose a strategy which consists in specifying a number of minimum and less-demanding obligations for both external and domestic governments to guarantee to all individuals a certain threshold of health goods and services. We argue that these minimum obligations can be freely accepted and fully complied with or enforced with “a thin system of enforcement” without significant threat to national sovereignty and autonomy. Conclusion: The futility of countries’ obligations for the health rights of the global poor as is the case with global distributive injustice is because of lack of political will to specify and enforce such obligations. Minimum obligations should be specified and enforced with a “thin system” which is consistent with principles of national sovereignty and autonomy. (shrink)

Obligations of global justice rest mainly on the global rich but also to a lesser extent on the global poor. The governments of poor countries are obliged to fulfill requirements of non-aggression, good governance and decency, along with all other requirements which facilitate the achievement of global justice. So far, obligations of poor countries seem to be taken as given yet the behavior of governments in poor countries and occurrences therein attest to the contrary;this suggests a need to mainstream these (...) obligations in discussions about global justice. If poor countries do not live up to these requirements obstacles arise to the realization of global justice; and they act unjustly in relation to citizens of rich countries which provide them with aid. Uganda is taken as a case in point. (shrink)

In this paper I claim that there are moral reasons for making climate denialism illegal. First I define climate denialism, and then I discuss its impact on society and its reception in the media. I build my philosophical arguments mainly on John Stuart Mill and Thomas M. Scanlon. According to Mill’s utilitarian justification of free speech, even untrue opinions are valuable in society’s pursuit of more truth. Consequently one might think that Mill’s philosophy would justify climate denialists’ right to free (...) speech. A major section of the paper argues against that view. The main arguments are: Climate denialism is not beneficial because its main goal is to produce doubt, and not truth. Climate denialism is not sincerely meant, which is a necessary condition for Mill to accept utterances. Climate denialists bring harm, by blocking necessary action on climate change. Primarily they harm future generations and people in developing countries. Hence the case can be made in terms of global justice: Would future generations and people in developing countries support my claim? I think so, or so I argue. My argument from global justice is built on Scanlon’s distinction between the interests of participants, the interests of audiences, and the interests of bystanders. The climate denialists have participant interests ‘in being able to call something to the attention of a wide audience’. Audience interests consist in ‘having access to expressions that we wish to hear or read, and even in being exposed to some degree to expressions we have not chosen’. Future generations and people in poor countries are bystanders to the climate debate. If the debate postpones necessary actions, it is the bystanders who must pay the price. I argue that bystanders’ costs outweigh participants’ and audiences’ interests, and that this is an argument for a statutory ban on climate denialism.Article first published online: 21 DEC 2015. (shrink)

Background. Despite common recognition of joint responsibility for global health by all countries particularly to ensure justice in global health, current discussions of countries’ obligations for global health largely ignore obligations of developing countries. This is especially the case with regards to obligations relating to health financing. Bearing in mind that it is not possible to achieve justice in global health without achieving equity in health financing at both domestic and global levels, our aim is to show how fulfilling the (...) obligation we propose will make it easy to achieve equity in health financing at both domestic and international levels. Discussion. Achieving equity in global health financing is a crucial step towards achieving justice in global health. Our general view is that current discussions on global health equity largely ignore obligations of Low Income Country governments and we recommend that these obligations should be mainstreamed in current discussions. While we recognise that various obligations need to be fulfilled in order to ultimately achieve justice in global health, for lack of space we prioritise obligations for health financing. Basing on the evidence that in most LICs health is not given priority in annual budget allocations, we propose that LIC governments should bear an obligation to allocate a certain minimum percent of their annual domestic budget resources to health, while they await external resources to supplement domestic ones. We recommend and demonstrate a mechanism for coordinating this obligation so that if the resulting obligations are fulfilled by both LIC and HIC governments it will be easy to achieve equity in global health financing. Summary. Although achieving justice in global health will depend on fulfilment of different categories of obligations, ensuring inter- and intra-country equity in health financing is pivotal. This can be achieved by requiring all LIC governments to allocate a certain optimal per cent of their domestic budget resources to health while they await external resources to top up in order to cover the whole cost of the minimum health opportunities for LIC citizens. (shrink)

Experimental molecular medicine has developed into a major scientific discipline. It has during the last 60 years had significant impact on health, and disease, and on the understanding of life. The main aim of this study was to investigate how experimental molecular medicine produces knowledge. Trough a discussion of works of thinkers like Claude Bernard, Georges Canguilhem, Hans-Jörg Rheibnerger and Bruno Latours I develop an understanding of experimental molecular medicine as a hybrid activity. In the knowledge production social, technological and (...) practical factors are intrinsically connected. The second question posed in this work was whether a philosophical reflection over the knowledge production in experimental molecular medicine could lead to self-reflection and a subsequent change of the theory-practice within experimental molecular medicine itself? I suggest that by using Georges Canguilhem's concept of biological normativity it is possible to develop an understanding of how biological systems are constructed to deal with world of dangers, unanticipated events, and environmental variations that make up the life of an organism. (shrink)

The central ideas in this work are health as a moral entitlement and equity in health. It is a discourse on distributive justice in health and takes Uganda as a case study. It describes Uganda health system especially the extent and distribution of health-related injustice brought about by severe poverty and the manner health resources are raised and allocated. This manner disproportionately adversely affects the poor's access to health services and endangers their livelihoods due to catastrophic health expenditure. This work (...) further critically reviews the theory of utilitarianism which is popularly used in the allocation of scarce health resources. Utilitarianism is accepted as good for ensuring efficiency in health resource allocation, but not good enough to ensure equity in health. This being the case a discussion of other ethical principles of health resource allocation that attempt to close the 'fairness gap' left by the theory of utilitarianism becomes necessary. Having critically examined QALYs and other moral principles, it emerges that a discourse on these per se is good but not good enough to guarantee equity in health in Uganda, even if a harmony between these suggestions were found. The main reason for this is that the said discourse is based on a subtle, yet wrong assumption, that all health services in Uganda are financed by the state and therefore health equity would be achieved if those resources are equitably distributed. This assumption ignores the fact that due to severe poverty and a very steep social gradient, out-of-pocket payment for health services is a prohibitive factor in the use of private health services. This leads to unequal access to health services between social classes since 50% of health out-put is from the private health service providers, hence must be paid for. This points to the fact that there is a strong spiral cause relationship between poverty and health inequity, the fact that is ignored in the discourse on QALYs and other allocation principles that aim at health equity. Therefore, since the poor are disproportionately adversely affected in the current system, developing an equitable financing mechanism for the health care system which takes into consideration the special needs of the poor should be a key priority in Uganda. (shrink)

According to Aristotle in his Nicomachean Ethics, character-development is closely connected to perception and our emotional pull towards objects of desire. The problem is, though The Ethics is brimming with a variety of psychological mechanisms, we lack supporting theories to understand how they work together. My aim with this thesis is to establish the theoretical scaffolding necessary with Aristotle's text as a theoretic basis. To test the theories, if have constructed a though-experiment that concerns a person undergoing early development. This (...) thesis inquires in which transitions and methods are present in the Nicomachean Ethics that inform us of our development of desiring capacities and capabilities to seek out objects of desire that are in fact good. In order to explain Aristotle's arguments on the necessity of motivational development, I have presented an overview of what we can call an Aristotelian psychology. I examine which components the soul consists of, in Aristotle's terminology, but especially how we can conceive of them influencing each other and functioning in practice. By separating these transitions into emotional development, intellectual development and social development, I discuss which factors play into our capabilities to desire the good". In my treatment of Aristotle's theory of motivational' development I discovered how emotions and thought influence each other, that the intellect is a sensing organ in its own right and that development of our desiring faculties relies heavily on social recognition. (shrink)

In this dissertation I reflect on the concept of culture from a political, philosophical and anthropological angle. The perspective from where I attempt to analyze them all together is epistemological. This means two things: first of all it consists in a critical reflection that focus on the concepts and logics that constitutes the way we understand culture. One tendency is that the view of culture as something closed and static is being reproduced despite the intention or conviction that the opposite (...) is true. This means that we have not fully comprehended that which hinders us in developing a non-essentialist thinking, or that we comprehend it but still have difficulties of articulating an alternative. A central objective in the dissertation is thus the description of the problem or epistemological obstacle that hinders the development of our thinking. Secondly, an epistemological perspective implies an attempt at taking this epistemological obstacle into account in order to supersede it and thus indicate a thinking about culture which does not work on essentialist premises. The question of obstacle and superseding this obstacle is a question of what kind of language we should use when we discuss culture. In order to do this I am scrutinizing the metaphor branchements as it is used by anthropologist Jean-Loup Amselle, and translation as it is discussed by philosopher Paul Ricoeur. Together they intervene into two aspects, or themes, central in the constitution of culture: identity and language. As I try to show do we need both a genealogical account for the constitutive role of identity and language on culture, and alternative ways to conceptualise them. The thesis aims at elaborating branchements and translation further by looking at the epistemological implications these notions could have for both understanding the hindrance and the overcoming of the hindrance. Culture seems to have a rather confused meaning depending on who discusses it, where and how it is discussed. Culture is conceived as both a problem and as a solution, as significant and insignificant to human beings, and it is conceived as both static and as dynamic. My philosophical contribution to this is to reflect on what we mean by the concept of “culture” when we discuss these questions and why the mixing of levels creates confusion as to what we are discussing and what kind of concept of culture we end up with. One central question in these discussions is if culture is static, pure and closed, or open and dynamic. If it is so that culture is open and dynamic, why is it still so difficult to break with the idea that it is closed? Why does a view of culture as something pure and closed seem to be reproduced? This question takes us into a philosophical and epistemological discussion on the conditions for thinking culture in a culturally diverse society. One of my claims is that the reason why the view of culture as closed is reproduced is the way culture is discussed in the political discourse. Because, here, in the political discourse, culture is linked to identity or a certain version of it: identity is placed within an oppositional logic. And this oppositional logic recognizes only that which is identical or different. Furthermore, when linked to culture identity becomes closely connected to the idea of origin suggesting that human beings must be understood as having a pure source as point of departure. It is when re-invoking identity and origin that culture can receive a role in the exclusion and inclusion into a society and thus becomes an obstacle to how we can think an open society. Even though the perspective of the dissertation is epistemological in the sense that I want to reflect critically on the link between culture and identity in the political discourse, I also want to go further than just describing this problem. Since what is at stake concerns the question of building and living in a society together this obstacle must be surpassed. Another kind of thinking should at least be attempted. In order to develop thinking that does not work on purity and closure as premises, we must be critical to the conditions that allow us to continue to think in terms of purity and closure, at the same time as a change of language for understanding culture is in order. The problem then becomes whether it is possible to think culture without purist and essentialist premises. The driving hypothesis of the dissertation is that the metaphor branchements, as used by Amselle in anthropology, and translation, as it is understood by Ricoeur, represent notions that can help us with this. Breaking with the idea of origina and identity-thinking in the early anthropology’s comparative method, raciology and the hybrid as metaphor for culture, branchements describes a network without a pure beginning or end. Translation on the other hand breaks with the obstacle of seeing languages either as diverse and untranslatable or as already united and translatable. It is my intention to discuss the obstacle of culture as an interlacing of anthropology and political discourse. I discuss how the use of metaphors and alternative terms in relation to practices helps anthropology to overcome its epistemological obstacles, how this obstacle has partly been transferred to the political discourse, and finally how the theoretical-practice of branchements and translation can helps us to develop another kind of thinking. (shrink)