The Delegation for Medical Ethics within the Swedish Society of Medicine has taken the initiative to create national ethical guidelines on cardiopulmonary resuscitation. The reasons behind this initiative were indications of differences in the way decisions about cardiopulmonary resuscitation were made and documented and requests expressed by health-care professionals for new national ethical guidelines. During the process of creating the guidelines, a number of workshops were held with representatives from the delegation and clinical experts from various branches of medicine. Several (...) versions of the working document were sent to consultation bodies with requests for comments. We therefore believe that the final guidelines are well supported by the medical profession in Sweden. The purpose of this article is to present ethical issues on which it was difficult to reach consensus due to divergent opinions expressed by the people and organisations involved. The arguments for and against a particular point of... (shrink)

Comparative philosophy is dependent upon translation, often translations that will help preserve some fundamental commitments: to linguistic mastery, to the recovery or preservation of an original, and to the protection of an authenticity that will ground these commitments. Such a view can sometimes obscure a nostalgia for questionable causes. Comparative philosophy, especially with continental affinities, often relies on two moves: first, a boundary must be found (or produced) between philosophy itself and other forms of writing (literature or fiction, say), to (...) ensure proper grounding. Second, it must be understood that this boundary depends upon an underlying philosophy of language: language speaks us, it speaks Being; to dwell in a different language is to dwell in a different house of being (Martin Heidegger). But how might this project – its historiography of return and grounding, and its mythologizing of linguistic and ontological recovery – be challenged by the very practice of translation itself? Perhaps this challenge is one of translation’s philosophical benefits. (shrink)

The possibility of enhancing human abilities often raises public concern about equality and social impact. This chapter aims at one particular group of technologies, cognitive enhancement, and one particular fear, that enhancement will create social divisions and possibly expanding inequalities. The chapter argues that cognitive enhancements could offer significant social and economic benefits. The basic forms of internal cognitive enhancement technologies foreseen today are pharmacological modifications, genetic interventions, transcranial magnetic stimulation, and neural implants. Cognitive enhancements can influence the economy through (...) reduction of losses, individual economic benefits, and society‐wide benefits. The strongest objection to the introduction of any enhancement technology is that it will create inequality, injustice, and unfairness. While there are clear economic and social benefits to cognitive enhancement, there exist anumber of obstacles to its development and use. One obstacle is the present system for licensing drugs and medical treatments. (shrink)

As cognitive neuroscience has advanced, the list of prospective internal, biological enhancements has steadily expanded. Education and training, as well as the use of external information‐processing devices, may be labeled as “conventional” means of cognition enhancement (CE). They are often well established and culturally accepted. By contrast, methods of enhancing cognition through “unconventional” means, such as ones involving deliberately created nootropic drugs, gene therapy, or neural implants, are nearly all to be regarded as experimental at the present time. Transcranial magnetic (...) stimulation (TMS), genetic interventions, brain‐computer interfaces and new senses are highly experimental and unlikely to be important over the next 15 years. Many of the concerns about enhancement are nonspecific to the tools used to achieve it, which means that enhancement–ethic scrutiny should also apply to nonbiological external enhancements. (shrink)

This study presents a qualitative description of situations at work that staff members perceive as giving rise to ethical issues. All staff members working with patients across seven wards were given the opportunity to freely describe ethical considerations in an ethical diary over the course of one week. One hundred and five staff members kept a diary. The diaries were analysed with qualitative content analysis where four dominant themes emerged: good care, order and clarity, loyalty, and inadequacy. These results contain (...) statements in which patients are respected and listened to, as well as statements that express a desire for relatively strict, routine-based care. Relatively few statements were of a reflective or discussing nature which highlights the need for clinical ethical support. There is a need of a visible and supportive leadership which encourages ethical reflection. Reflections on real cases could provide an opportunity to challenge existing practices and thereby promote ethical awareness. (shrink)

This collection of essays contains revised versions of papers delivered at a conference entitled “Duty, Interest, and Practical Reason: Aristotle, Kant, and the Stoics” that was organized by Stephen Engstrom and Jennifer Whiting at the University of Pittsburgh in 1994. One of the main aims of the conference was to bring together scholars on Aristotle, the Stoics, and Kant to reevaluate the common view that Greek and Kantian ethics represent fundamentally opposed conceptions of ethical theory and the roles of morality (...) and happiness in practical reasoning. According to a common view, the ancients are eudaimonists; they derive or justify the virtues by showing how they contribute to the agent’s own eudaimonia or happiness. By contrast, Kant sharply criticizes eudaimonism for deriving or justifying morality in terms of happiness. This criticism applies to eudaimonism of all sorts, even Stoic eudaimonism, which is perhaps closer in some respects to Kant’s own views, and of which he is somewhat less critical than he is of other forms of eudaimonism. For Kant, moral duty and respect for the moral law must be grounded in reason itself and cannot be made to depend on any independent standard. These and related assumptions about ancient and Kantian ethics have helped structure much contemporary systematic work in ethical theory, as well as common conceptions of these ethical traditions. But this common view has been under reexamination lately; some of the most interesting work in the history of ethics in recent years has been in Greek and Kantian ethics, and much of it challenges one or another aspect of the received view of the ethical theory and moral psychology of Kant or the Greeks. However, with some exceptions, renewed interest and recent work in these two traditions has proceeded in parallel. The conference aimed to correct this, by bringing together some of the most distinguished scholars of ancient and modern ethics to compare and assess the role of moral duty and happiness in the two traditions. Most of the essays have such a comparative assessment as their main theme; but even those that focus more exclusively on one of the traditions contribute indirectly to this comparative assessment. (shrink)

Introduction -- Part I: Willing as practical knowing -- The will and practical judgment -- Fundamental practical judgments : the wish for happiness -- Part II: From presuppositions of judgment to the idea of a categorical imperative -- The formal presuppositions of practical judgment -- Constraints on willing -- Part III: Interpretation -- The categorical imperative -- Applications -- Conclusion.

This chapter examines Soren Kierkegaard's views and relationship with the Church, explaining that while Kierkegaard was a frequent churchgoer, he also considered the Church a corrupt and disgraceful business enterprise. It discusses Kierkegaard's criticism on the development of the Church as an institution and analyses various aspects of his ecclesiastical conception of the Church. The chapter also considers Kierkegaard's own experiences in writing and delivering sermons.

Inference has long been a concern in epistemology, as an essential means by which we extend our knowledge and test our beliefs. Inference is also a key notion in influential psychological or philosophical accounts of mental capacities, from perception via utterance comprehension to problem-solving. Consciousness, on the other hand, has arguably been the defining interest of philosophy of mind over recent decades. Comparatively little attention, however, has been devoted to the significance of consciousness for the proper understanding of the nature (...) and role of inference. It is commonly suggested that inference may be either conscious or unconscious. Yet how unified are these various supposed instances of inference? Does either enjoy explanatory priority in relation to the other? In what ways or senses, can an inference be conscious, or fail to be conscious, and how does this matter? This book brings together original essays from established scholars and emerging theorists that illustrate how several current debates in epistemology, philosophy of psychology, and philosophy of mind can benefit from reflections on these and related questions about the significance of consciousness for inference. Contributors include: Kirk Ludwig and Wade Munroe; Michael Rescorla; Federico Bongiorno and Lisa Bortolotti; Berit Brogaard; Nicholas Allott; Jake Quilty-Dunn and Eric Mandelbaum; Corine Besson; Anders Nes; David Henderson, Terry Horgan, and Matjaž Potrč; Elijah Chudnoff; and Ram Neta. (shrink)

BackgroundPsychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work (...) situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.MethodsAll staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.ResultsThe majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.ConclusionsPaternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision. (shrink)

AimsTo examine attitudes towards physician-assisted suicide (PAS) among physicians in Sweden and compare these with the results from a similar cross-sectional study performed in 2007.ParticipantsA random selection of 250 physicians from each of six specialties (general practice, geriatrics, internal medicine, oncology, surgery and psychiatry) and all 127 palliative care physicians in Sweden were invited to participate in this study.SettingA postal questionnaire commissioned by the Swedish Medical Society in collaboration with Karolinska Institute in Stockholm. ResultsThe total response rate was 59.2%. Slightly (...) fewer than half [47.1% (95% CI 43.7–50.5)] of the respondents from the six specialties accepted PAS, which is significantly more than accepted PAS in the 2007 study [34.9% (95% CI 31.5–38.3)]. Thirty-three percent of respondents were prepared to prescribe the needed drugs. When asked what would happen to the respondent’s own trust in healthcare, a majority [67.1% (95% CI 63.9–70.3)] stated that legalizing PAS would either not influence their own trust in healthcare, or that their trust would increase. This number is an increase compared to the 2007 survey, when just over half [51.9% (95% CI 48.0–55.2)] indicated that their own trust would either not be influenced, or would increase.ConclusionsThe study reveals a shift towards a more accepting attitude concerning PAS among physicians in Sweden. Only a minority of the respondents stated that they were against PAS, and a considerable proportion reported being prepared to prescribe the needed drugs for patient self-administration if PAS were legalized. (shrink)

In _Plato on Democracy and Political technē_ Anders Dahl Sørensen offers an in-depth investigation of Plato’s discussions of democracy’s ‘epistemic potential’, arguing that this question is far more central to his political thought than is usually assumed.

The dual character of invariance under transformations and definability by some operations has been used in classical works by, for example, Galois and Klein. Following Tarski, philosophers of logic have claimed that logical notions themselves could be characterized in terms of invariance. In this article, we generalize a correspondence due to Krasner between invariance under groups of permutations and definability in L∞∞ so as to cover the cases that are of interest in the logicality debates, getting McGee’s theorem about quantifiers (...) invariant under all permutations and definability in pure L∞∞ as a particular case. We also prove some optimality results along the way, regarding the kinds of relations which are needed so that every subgroup of the full permutation group is characterizable as a group of automorphisms. (shrink)

It is often supposed one can draw a distinction, among the assumptions on which an inference rests, between certain background assumptions and certain more salient, or foregrounded, assumptions. Yet what may such a fore-v-background structure, or such structures, consist it? In particular, how do they relate to consciousness? According to a ‘Boring View’, such structures can be captured by specifying, for the various assumptions of the inference, whether they are phenomenally conscious, or access conscious, or else how easily available they (...) are to such consciousness. According to an ‘Interesting View’, there are fore-v-background structures over and above such classifications. The chapter gestures at reasons for thinking that an Interesting View at least merits exploration. The paper discusses some recent contributions to such a view in analytical philosophy; some remarks in Husserl on what he dubbed the horizonal dimension of acts of consciousness; and psychological work on the role of gist or schema representations in perception and memory. It is proposed that background assumptions can figure in consciousness by being as it were condensed into a consciously, though inattentively, entertained notion of their overall thematic gist, where this thematic gist gives the drift of a possible elucidation of how or why such-and-such salient grounds mean that so-and-so conclusion holds. (shrink)

This paper examines a specific appeal to philosophical anthropology—Andy Clark's—and the role it plays in shaping his account of our fundamental cyborg humanity." By focusing on the theme of embodiment, we also inquire into how phenomenology might benefit from Clark's account as well as how Clark's account might benefit from further engagement with phenomenology. Throughout, we explore inter- and intra-disciplinary questions that highlight the contribution the philosophy of technology can make to our understanding of embodiment and philosophical anthropology.

This paper explores the connection between wonder and meaning, in particular ‘the meaning of life’, a connection that, despite strong intrinsic connections between wonder and the (philosoph...

Kant holds that the human cognitive power is divided into two "stems", understanding and sensibility. This doctrine has seemed objectionably dualistic to many critics, who see these stems as distinct parts, each able on its own to produce representations, which must somehow interact, determining or constraining one another, in order to secure the fit, requisite for cognition, between concept and intuition. This reading cannot be squared, however, with what Kant actually says about theoretical cognition and the way understanding and sensibility (...) cooperate in it. Such cognition, as Kant conceives of it, satisfies two conditions: it has unity, and it depends on the existence of its object. The first of these conditions entails that the cognitive power must lie in spontaneity, or understanding, while the second implies that this spontaneity depends on receptivity, or sensibility, to be the cognitive power that it is. Consideration of how these capacities must be conceived as cooperating in cognition reveals them to be related, not as interacting parts, but as form and matter. Such a conception of their relation may at first glance seem to be merely another version of dualistic thinking; in fact, however, a proper appreciation of it eliminates the appearance of dualism and helps allay an associated concern that Kant's distinction would taint our cognition with an unacceptable subjectivism. (shrink)

A brain emulation would be a one‐to‐one simulation where every causal process in the brain is represented, behaving in the same way as the original. Opponents of animal testing often argue that much of it is unnecessary and could be replaced with simulations. Personal identity is going to be a major issue with brain emulations, both because of the transition from an original unproblematic single human identity to successor identity/identities that might or might not be the same, and because software (...) minds can potentially have multiple realizability. The process might produce distressed minds that have rights yet have an existence not worth living, or that lack the capacity to form or express their wishes. Emulations will experience and behave on a timescale set by the speed of their software. Brain emulations would not be self‐contained, and their survival would depend upon hardware over which they might not have any control. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Kant claims that the concept of the highest good, the idea of happiness in proportion to virtue, is grounded in the moral law. But this claim has often been challenged. How can Kant justify including happiness in the highest good? Why should only the virtuous be worthy of happiness? This paper argues that when the moral law is interpreted as the criterion for valid application of the concept of the good, the concept of the highest good does indeed follow from (...) the moral law. It also argues that the duty to promote the highest good harmonizes with other duties. (shrink)

This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillance-enabling technology. I call attention (...) to a “positivist problem” that has to do with the connection between the design context and the use context, which VSD seems to presuppose, and I argue that it is necessary to clearly distinguish between the two, since the designers’ intentions do not always correspond with the users’ practice; in fact, the relation between design and use is very complex and principally unpredictable. Thus, a design theory must accept that foresight is limited to anticipation rather than prediction. To overcome the positivist problem, I suggest a phenomenological approach to technology inspired by Don Ihde’s concept of multistability. This argument, which is general in nature and thus applies to any theory of design ethics, is intended as a constructive criticism, which can hopefully contribute to the further development of design ethics. (shrink)

Perceptual processes differ from cognitive, this paper argues, in functioning to be causally controlled by proximal stimuli, and being modular, at least in a modest sense that excludes their being isotropic in Jerry Fodor's sense. This claim agrees with such theorists as Jacob Beck and Ben Phillips that a function of stimulus-control is needed for perceptual status. In support of this necessity claim, I argue, inter alia, that E.J. Green's recent architectural account misclassifies processes deploying knowledge of grammar as perceptual. (...) _Pace_ Beck and Phillips, however, I argue a function of stimulus-control is insufficient for perceptual as opposed to cognitive status. One consideration in favour of such insufficiency, noted but (I argue) not convincingly rebutted by these theorists, concerns perpetually grounded demonstrative thought. Two other considerations trade on the fact that a function of stimulus-control can arise not from blind nature but intentional design or social institutions, where so-functioning processes may but need not be perceptual. I offer two cases where such processes are cognitive, viz. skilful play-by-play announcing of ongoing events, and voluntary visualizing of ongoing events under the guidance of apt play-by-play announcements, dubbed announcement-driven visualizing (ADV). The cognitive status of these three diverse phenomena cannot be explained by an absence of a perception-like representational format or content (for ADV has such) or by a presence of personal-level mental states causally mediating between stimuli and outputs (for perception has such). A bettter explanation invokes, I argue, the non-modular character of the generating process. (shrink)

This major collection of essays offers the first serious challenge to the traditional view that ancient and modern ethics are fundamentally opposed. In doing so, it has important implications for contemporary ethical thought, as well as providing a significant re-assessment of the work of Aristotle, Kant and the Stoics. The contributors include internationally recognised interpreters of ancient and modern ethics. Four pairs of essays compare and contrast Aristotle and Kant on deliberation and moral development, eudaimonism, self-love and self-worth, and practical (...) reason and moral psychology. The final pair of essays introduces the Stoics as an example of how the apparently antithetical views of Aristotle and the Stoics might be reconciled. (shrink)