In this article, tragedy and utopia are juxtaposed, and it is proposed that the problem of “medicalisation” is better understood in a framework of tragedy than in a utopian one. In utopia, it is presupposed that there is an error behind every setback and every side effect, whereas tragedy brings to light how side effects can be the result of irreconcilable conflicts. Medicalisation is to some extent the result of such a tragic conflict. We are given power by medical progress, (...) but are also confronted with our fallibility, thus provoking insecurity. This situation is illustrated by the sudden infant death syndrome . Recent epidemiological investigations have shown that infants sleeping in a prone position have a 15–20 times higher risk of dying from SIDS than infants sleeping in a supine position. A simple means of preventing infant death is suggested by this discovery, but insecurity is also created. What else has been overlooked? Perhaps a draught, or wet diapers, or clothes of wool are just as dangerous as sleeping prone? Further investigations and precautions will be needed, but medicalisation prevails. (shrink)

A questionnaire relating to attitudes towards setting economic priorities within the health care system was sent to all 151 general practitioners in Northern Norway. Of these, 109 (72 per cent) responded. Ninety-six per cent of the respondents agreed or partly agreed that the setting of economic priorities within the health care system was necessary. Ninety-three per cent had experienced a conflict between their responsibility towards the individual patient and the requirement for them to manage the health budget. The responses suggest (...) that doctors act more in the interests of their patient than the interests of society. However, 68 per cent reported having refrained from giving the best treatment to patients because it was too expensive. As many as 60 per cent of the respondents wanted more public guidelines. Only 10 per cent wanted doctors to have more influence in difficult questions arising from setting priorities. (shrink)

Parenting stress can influence caregiving behavior negatively, which in turn may harm children’s development. Identifying precursors of parenting stress, preferably beginning during pregnancy and throughout the first year of life, is therefore important. The present study aims to provide novel knowledge on this issue through a detailed examination of the association between maternal attachment style and later parenting stress. Moreover, we examine the role of several additional risk factors, specificially the mothers’ own adverse childhood experiences, as well as infants’ temperamental (...) characteristics. Data from a community based longitudinal study of 1,036 Norwegian mothers, collected during pregnancy and 12 months after childbirth, were used. Results showed that attachment style in pregnancy predicted parenting stress one year after birth. In addition, it was demonstrated that the mothers’ own adverse childhood experiences predicted postnatal parenting stress, and that attachment style operated as a mediator of this association. A significant association between perceived infant temperament and parenting stress was also found. The study illustrates how important is is to understand the multifactorial antecedents of parenting stress. The results may inform early intervention efforts aimed at supporting mothers and their partners in the potentially difficult transition period around childbirth. (shrink)

This paper describes the significance of key empirical findings from the recent and landmark study Caring and Aging with Pride: The National Health, Aging and Sexuality Study (with Karen I. Fredriksen‐Goldsen as the principal investigator), on lesbian, gay, bisexual, and transgender aging and health disparities. We will illustrate these findings with select quotations from study participants and show how nonconscious bias (i.e., activation of negative stereotypes outside conscious awareness) in the clinical encounter and health care setting can threaten shared (...) decision‐making and perpetuate health disparities among LGBT older adults. We recognize that clinical ethicists are not immune from nonconscious bias but maintain that they are well situated to recognize bias and resulting injustice by virtue of their training. Further, we discuss how clinical ethicists can influence the organization's ethical culture and environment to improve the quality and acceptability of health care for LGBT older adults. (shrink)

Supported by Ian Hacking’s concept of “intervention,” and Charles Taylor’s concept of “intentionality,” this article argues that doubting is acting, and that doubting is therefore subject to the same demands of responsibility as any other action. The argument is developed by using medical practice as a test-case. The central suggestion is that the demand of acting responsibly limits doubt in medicine. The article focuses on two such limitations to doubt. Firstly, the article argues that it is irresponsible to doubt that (...) our actions can harm other people. Secondly, the article argues that it is irresponsible not to strive for coherence between our utterances of doubt and our other actions. Incoherence here can cause “cultural impoverishment.” In a larger context this article also argues that medicine can enrich our epistemology, because medical knowledge displays important traits of knowledge that are downplayed in traditional epistemology derived from mathematics and physics. In particular, medicine makes it possible to get the relation between ethics and epistemology into sharper focus. The endpoint in medical epistemology is “responsible action,” and not certainty in and of itself. (shrink)

The administration of pro re nata medications is the responsibility of the nurse. However, ethical uncertainties often happen due to the inability of incapacitated patients to collaborate with the nurse in the process of decision making for pro re nata medication administration. There is a lack of integrative knowledge and insufficient understanding regarding ethical considerations surrounding the administration of pro re nata medications to incapacitated patients. Therefore, they have been discussed in this paper and practical strategies to avoid unethical practices (...) have been suggested. The complicated caring situation surrounding the administration of pro re nata medications is intertwined with ethical issues affecting the consideration of the patient's wishes and interventions that override them. The patient's right of autonomy and treatment refusal, surrogacy role, paternalism, and coercion are the main ethos of ethical pro re nata medication administration. Education and training can help nurses avoid legal and ethical issues in pro re nata medicines management and improve the quality and safety of healthcare. Empirical research is needed to improve our understanding of this phenomenon in the multidisciplinary environment of medicines management. (shrink)

Despite Augustine's reputation as the father of Christian intolerance, one finds in his thought the surprising claim that within non-Christian writings there are 'some truths in regard even to the worship of the One God.' The essays here uncover provocative points of comparison and similarity between Christianity and other religions to further such an Augustinian dialogue.

Stethoscopes, x-rays and other medical technologies are two-edged swords. They make medical treatment and diagnosis more accurate and effective, but do at the same time reveal our perceptual inadequacy. By transcending our senses, these technologies reveal that we can be seriously diseased without experiencing any symptoms at all. This situation has changed our attitude towards our relations and ourselves. The situation can be analysed using Jürgen Habermas’ conception of systems colonisation of the lifeworld. Medical technologies colonise our life world. They (...) change the way we think and act. They make us all accept that we can become patients almost any minute, even if we feel perfectly healthy. Sense transcending technologies turn us all into proto-patient. (shrink)

In this article, I defend luck at the expense of risk. Or, more precisely, I try to make a distinction that gives both concepts fair treatment. I start by making it clear that luck stands in opposition to control and not to causation. Both luck and risk are related to causal uncertainty. But it is warranted to talk about risk only when the uncertainty involved is brought under control, as it is in some familiar forms of fair gambling such as (...) dicing and roulette. Life is however not a fair gamble. We rarely have the kind of control over the preconditions of life that we have over the preconditions of say dicing. Luck therefore has profound influence on our lives and our health. This means that the standard conception of responsibility - that is, that we stand responsible only for consequences that we control - breaks down far more often than what is usually acknowledged. I therefore end the article by arguing that the standard conception of responsibility ought to be supplemented with a different conception that I have called "responsibility because of social involvement.". (shrink)

In this book, award-winning historian of religion Paula Fredriksen tells the surprising story of early Christian concepts of sin, exploring the ways that sin came to shape ideas about God no less than about humanity.

Ocherk 1. Voprosy ontologii -- Ocherk 2. Voprosy ėtiki i ėstetiki -- Ocherk 3. Voprosy gnoseologii i aksiologii.

The diversity of nanotechnologies and of the governance challenges that their applications raise calls for exploration and learning across different cases. We present an Upstream Oversight Assessment (UOA) of expected benefits and potential harms of nanoparticles made of a synthetic polymer (PLGA) to improve vaccines for farmed salmon. Suggested by Jennifer Kuzma and colleagues, an UOA may help identify and prioritise research needs, and it may support evaluations of the adequacy of relevant existing regulatory frameworks. In this work, the UOA (...) approach is modified and supported with elements from the uncertainty analysis framework developed by Warren Walker and colleagues. Empirically, we draw on relevant available published literature and insights generated in an ongoing nanoparticle salmon vaccine project, in which one of the authors participates. Nanotechnologies have not previously been encountered in the regulatory context of fish vaccines, which in part raises unique challenges due to prospective large scale vaccine use in semi-open aquatic systems. Strengthened through cooperation between ELSA and technology researchers we found the UOA useful for an early mapping of benefits and concerns, and for identifying areas in need of further research prior to a nanoparticle based salmon vaccine is developed and taken into use. We consider our approach to represent one among several complementing initiatives that seek to contribute to early stage evaluations of possible negative side effects, broadly conceived, in order to facilitate a more robust nanotechnology development. (shrink)

Prologue, invitation to thinking about God In the Hebrew Bible? -- Part I, questions about God? -- Why does God in the Bible have a body? -- What do God's body parts in the Bible mean? -- Why is God angry in the Bible? -- Does God in the Bible have gender or sexuality? -- Part II, questions about God in the world? -- What can creation tell us about God? -- Who-or what-is the Satan? -- Why do people suffer (...) according to the Hebrew Bible? -- Epilogue, God in the Bible and beyond. (shrink)

Many books explain what is known about the universe. This book investigates what cannot be known. Rather than exploring the amazing facts that science, mathematics, and reason have revealed to us, this work studies what science, mathematics, and reason tell us cannot be revealed. In The Outer Limits of Reason, Noson Yanofsky considers what cannot be predicted, described, or known, and what will never be understood. He discusses the limitations of computers, physics, logic, and our own thought processes. Yanofsky describes (...) simple tasks that would take computers trillions of centuries to complete and other problems that computers can never solve; perfectly formed English sentences that make no sense; different levels of infinity; the bizarre world of the quantum; the relevance of relativity theory; the causes of chaos theory; math problems that cannot be solved by normal means; and statements that are true but cannot be proven. He explains the limitations of our intuitions about the world -- our ideas about space, time, and motion, and the complex relationship between the knower and the known. Moving from the concrete to the abstract, from problems of everyday language to straightforward philosophical questions to the formalities of physics and mathematics, Yanofsky demonstrates a myriad of unsolvable problems and paradoxes. Exploring the various limitations of our knowledge, he shows that many of these limitations have a similar pattern and that by investigating these patterns, we can better understand the structure and limitations of reason itself. Yanofsky even attempts to look beyond the borders of reason to see what, if anything, is out there. (shrink)

Study of Hans-Georg Gadamer's and Julius Stenzel's interpretations of Plato.

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory - providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

The first major work in the history of philosophy to bear the title "Metaphysics" was the treatise by Aristotle that we have come to know by that name. But Aristotle himself did not use that title or even describe his field of study as 'metaphysics'; the name was evidently coined by the first century C.E. editor who assembled the treatise we know as Aristotle's Metaphysics out of various smaller selections of Aristotle's works. The title 'metaphysics' -- literally, 'after the Physics' (...) -- very likely indicated the place the topics discussed therein were intended to occupy in the philosophical curriculum. They were to be studied after the treatises dealing with nature (ta phusika). In this entry, we discuss the ideas that are developed in Aristotle's treatise. (shrink)

Walter Glannon argues that our proposal for routine recovery of transplantable cadaveric organs is unacceptable After carefully reviewing his counterarguments, we conclude that, although some of them have merit, none are sufficiently strong to warrant abandoning this plan. Below we respond to each of Glannon's concerns.

Ariès traces Western man's attitudes toward mortality from the early medieval conception of death as the familiar collective destiny of the human race to the modern tendency, so pronounced in industrial societies, to hide death as if it were an embarrassing family secret.

"Sir Hermann Bondi, NatureThe late S. Chandrasekhar was best known for his discovery of the upper limit to the mass of a white dwarf star, for which he received ...

Many religious people are alarmed about features of the current age - violence in the media, a pervasive hedonism, a marginalization of religion, and widespread abortion. These concerns influence politics, but just as there should be a separation between church and state, so should there be a balance between religious commitments and secular arguments calling for social reforms. Robert Audi offers a principle of secular rationale, which does not exclude religious grounds for action but which rules out restricting freedom except (...) on grounds that any rational citizen would accept. The book describes the essential commitments of free democracy, explains how religious and secular moral considerations can be integrated to facilitate co-operation in a world of religious pluralism, and proposes ideals of civic virtue that express the mutual respect on which democracy depends. Audi offers a balanced and sophisticated treatment of the relations between religion and politics in a modern, secular society. (shrink)