This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identification and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support (...) meeting the requirements of the General Data Protection Regulation. (shrink)

This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

Different methods have been developed to address ethical issues during research. Most of these methods were developed at universities. In this article ethical parallel research within a Research and Technology Organization is described. Within a European project about perceived security, CPSI, the ethical issues were identified by ethicists cooperating in the project. The project CPSI was aimed at developing a research method that can be used by (local) government to monitor or assess perceived and actual security. Together with the researchers (...) a way was sought to address the ethical issues. Several issues could be addressed by choices with regard to the design of the validation study, in this case a survey. The ethical and legal reasons that were relevant for choices in the design of the validation study were made an integral part of these decisions. Some issues were already identified during the writing of the proposal others were only identified during the research. Participating in the research gave the ethicists access to all relevant information. It made it possible to address the ethical issues when they became relevant. Ethical reasons were part of some of the discussions on research method. It proved possible to address most ethical issues satisfactorily during the research project. (shrink)

While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the consequences (...) of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

The authors explore whether the need for ethical reflection on the part of designing engineers is dependent on the type of design process. They use Vincenti's distinction between normal and radical design and different levels of design hierarchy. These two dimensions are coupled with the concept of ill-structured problems, which are problems in which possible solutions cannot be ordered on a scale from better to worse. Design problems are better structured at lower hierarchical levels and in cases of normal design. (...) Better structured design problems require less ethical reflection on the part of designing engineers if such situations are characterized by the existence of generally accepted normative frameworks. Engineers could then deal with moral problems within the bounds of such frameworks and without the need for further reflection. On the basis of a number of empirical cases, the authors explore whether these ideas hold water. They discuss four cases ranging from a high-level radical design process to a low-level normal design process. (shrink)

This article supports calls for an increased integration of patients into taxonomic decision making in psychiatry by arguing that their exclusion constitutes a special kind of epistemic injustice: preemptive testimonial injustice, which precludes the opportunity for testimony due to a wrongly presumed irrelevance or lack of expertise. Here, this presumption is misguided for two reasons: the role of values in psychiatric classification and the potential function of first-person knowledge as a corrective means against implicitly value-laden, inaccurate, or incomplete diagnostic criteria (...) sets. This kind of epistemic injustice leads to preventable epistemic losses in psychiatric classification, diagnosis, and treatment. (shrink)

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The value-freedom of scientific knowledge is commonly hold to be a necessary condition for objectivity. Helen Longino’s contextual empiricism aims to overcome this connection. She questions the suitability of the normative ideal of value-freedom and develops an alternative conception of objectivity, which integrates social and epistemic aspects of scientific enquiry. The function of this notion of ‘social objectivity’ is to make value-laden assumptions assessable through a process of criticism, even if there cannot be any guarantee of their elimination. This assessability (...) requires common standards of evaluation, which are threatened by Longino’s rejection of the distinction between cognitive and non-cognitive values guiding theory choice. I will argue that in order to resolve this inherent tension, social objectivity has to be understood as based on a procedural epistemology and, differing from Longino’s own approach, must include the normative requirement to strive for consensus instead of allowing for epistemological pluralism. (shrink)

A dominant view of guilt and shame is that they have opposing action tendencies: guilt- prone people are more likely to avoid or overcome dysfunctional patterns of behaviour, making amends for past misdoings, whereas shame-prone people are more likely to persist in dysfunctional patterns of behaviour, avoiding responsibility for past misdoings and/or lashing out in defensive aggression. Some have suggested that addiction treatment should make use of these insights, tailoring therapy according to people’s degree of guilt-proneness versus shame-proneness. In this (...) paper, we challenge this dominant view, reviewing empirical findings from others as well as our own to question (1) whether shame and guilt can be so easily disentangled in the experience of people with addiction, and (2) whether shame and guilt have the opposing action tendencies standardly attributed to them. We recommend a shift in theoretical perspective that explains our main finding that both emotions can be either destructive or constructive for recovery, depending on how these emotions are managed. We argue such management depends in turn on a person’s quality of self-blame (retributive or ‘scaffolding’), impacting upon their attitude towards their own agency as someone with fixed and unchanging dispositions (shame and guilt destructive for recovery) or as someone capable of changing themselves (shame and guilt productive for recovery). With an eye to therapeutic intervention, we then explore how this shift in attitude towards the self can be accomplished. Specifically, we discuss empathy-driven affective and narratively-driven cognitive components of a process that allow individuals to move away from the register of retributive self-blame into a register of scaffolding ‘reproach’, thereby enabling them to manage their experiences of both shame and guilt in a more generative way. (shrink)

Gilbert et al. argue that the concerns about the influence of Deep Brain Stimulation on – as they lump together – personality, identity, agency, autonomy, authenticity and the self are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence (...) for that. Rather they show the challenges of doing research in a field that is stretched out over multiple disciplines. In that sense their paper is an important starting point for a discussion on methodology and offers valuable lessons for a future research agenda. (shrink)

Diagnostic terms in psychiatry like ‘schizophrenia’ and ‘bipolar disorder’ are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of ‘schizophrenia.’ Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their actual usage (...) and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders. (shrink)

This article examines the relation between the critical theory of Moishe Postone and the philosophy of Theodor Adorno. While the former is clearly influenced by the latter, these influences mostly stay implicit. When explicit, he does not so easily put his own thought in line with Adorno’s and is highly critical of him. I will investigate the ways in which ideas from Adorno made their way into Postone’s work, but also where the latter diverts from them. As will be shown, (...) Postone’s critical theory runs into a problem when one examines the immanent ground of his critical norm, freedom. Adorno, on the contrary, does succeed in employing the same norm in his own immanent critique. I will conclude that the problem Postone encounters can be avoided by being more of an ‘Adornian’, and that his theory allows this. (shrink)

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)

This article follows the history of the idea of adventure in the Soviet Union, which started as a dream of the great communist adventure but two decades into the revolution turned into the nightmare of the Great Terror. Adventure was implicated in the violent realities of Stalinism through tropes of the adventure genre, such as the loneliness of the adventurer in a precarious world impenetrable by reason. Understanding this situation requires a focus on philosophies of both adventure and terror. For (...) instance, Hegel’s philosophy of adventure will help us to reveal features of the lived experience in times of terror, whilst Mikhail Ryklin’s philosophy of terror sheds light on the significance of the adventure genre in the Soviet 1930s. This double focus allows articulation of a primary feature of violence that is often overlooked, namely, the fundamental reciprocity that structures it. In the Soviet context, we find historically neglected but critically important reflections on the relation between violence and adventure in the life and works of Lev Kopelev. We also find a unique deliberation on the dialectics of violence (and counter-violence) in Evgeni Shvarc’s adventure tale The Dragon (1943) which can be fruitfully read in dialogue with Arendt’s vital distinction between violence and power. Reconsidering these sources is an important task for today given that Russian politics has once again, 30 years after perestroika, regressed into mass violence. (shrink)

People struggling with addiction are neither powerless over their addiction, nor are they fully in control. Lewis vigorously objects to the brain disease model of addiction, because it makes people lose belief in their self-efficacy, and hence hinders their recovery. Although he acknowledges that there is a compulsive state in addiction, he objects to the claim that this compulsion is carved in stone. Lewis argues that the BDMA underestimates the agency of addicted people, and hence hinder their recovery. Lewis’s work (...) offers us a very much to be welcomed neurobiology of recovery. It offers addicted people a hopeful and respectful narrative for their recovery that treats them as agents rather than as damaged brains. However, I argue that overestimating people’s agency can also result in people losing belief in their self-efficacy. Lewis’s strong focus on the agency of addicted people might not match their experiences of struggle, hence reinforcing their feelings of guilt when they fail to control their use. I propose to replace the notion of addiction as a disease with a notion of a disease-like stage in addiction. I call this stage the duress stage in addiction, in which the addictive behaviour is largely impervious to the agent’s values and to available techniques of self-control. However, the agent can overcome this stage by developing new techniques of self-control, by building on their self-concept and belief in self-efficacy, by changing their environments and habits, and by engaging in projects that are meaningful to the agent. (shrink)

At present, the debate on global justice, a debate which is at the core of global ethics, is largely being conducted by European and American scholars from different disciplines without taking into account views and concepts from other regions of the world, particularly, from the Global South. The lack of a truly intercultural, interreligious, and international exchange of ideas provokes doubts whether the concepts of global justice introduced so far are able to transcend regional and cultural horizons. The article introduces (...) concepts of justice from African scholars, whose voices have remained marginal until now, like the Kenyan philosopher Henry Odera Oruka, the Ethiopian philosopher Teodros Kiros, and the debate on ubuntu, one of the most controversial concepts in southern Africa today. These concepts focus on issues that are seldom considered in the debate on global justice, such as the importance of bodily needs as a prerequisite for human beings to act as moral beings and the importance of human rel.. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

Bowman-Smart and colleagues (2023) argue that techniques to screen and analyze the fetal genome are rapidly evolving, and are sometimes already offered commercially. These new developments will all...

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

Pickard (2012) claims that the neurobiological or disease model of addiction hinders the recovery of people because it undermines their feeling of self-efficacy and agency. Sub- stance users are “not aided by being treated as victims of a neurobiological disease, as opposed to agents of their own recovery” (40).Although Pickard acknowledges that claims of powerlessness or loss of agency can have a functional role in the self-narratives of substance users in excusing them from blame, she primarily focuses on the negative (...) effects of the diseasemodel on the recovery of substance users. Preliminary evidence from in-depth interviews with heroin-dependent participants in our current cohort study on addiction and moral identity supports Pickard’s claims in part: Substance users describe grades of control, psychological distress, and loss of options, and an ambivalent attitude toward their belief in self-efficacy. However the interviews also provide points of critique. While Pickard is right to dismiss the more extreme claims of proponents of the disease model—namely, that drug use in addicts is literally compelled—user responses suggest that an understanding of the neurobiology of addiction might in some respects support rather than undermine a sense of agency. Moreover, there is reason to suppose that the relation be- tween substance use and psychological distress is not as straightforward as Pickard claims. In this respect we believe the debate must become more nuanced and move beyond a simple opposition between the disease model and the rational choice model endorsed by Pickard. (shrink)

In seinem Traktat über Prädestination diskutiert Ockham die philosophischen Schwierigkeiten, die das christliche Dogma der Vorherbestimmung des Menschen zu ewiger Seligkeit oder Verdammnis aufwirft als einen spezifischen Fall des Problems des logischen Determinismus. Es gelingt Ockham nicht, dieses Problem zu lösen, was einerseits in seinem semantischen Wahrheitsbegriff, andererseits in einer fehlenden Differenzierung zwischen einem ontologischen und einem logischen Verständnis von Kontingenz begründet liegt. Diese Punkte führen zu einer Reihe von Ambivalenzen in Ockhams Argumentation, die darauf hindeuten, dass dieser zwar über (...) die Grundlagen einer möglichen Lösung verfügt, diese aber aufgrund seiner ontologischen Sparsamkeit nicht kohärent umsetzt.In his treatise on predestination, Ockham discusses the philosophical riddles caused by this Christian dogma as a specific case of the problem of logical determinism. Ockham does not succeed in solving this problem, which is due to his semantic notion of truth as well as to a missing differentiation between an ontological and logical interpretation of contingency. These points lead to a number of ambivalences in his argumentation, which suggest that Ockham has the conditions of a possible solution available but his ontological parsimony inhibits their coherent implementation. (shrink)

BackgroundTranscranial direct current stimulation targeting the primary motor hand area may induce lasting shifts in corticospinal excitability, but after-effects show substantial inter-individual variability. Functional magnetic resonance imaging can probe after-effects of TDCS on regional neural activity on a whole-brain level.ObjectiveUsing a double-blinded cross-over design, we investigated whether the individual change in corticospinal excitability after TDCS of M1-HAND is associated with changes in task-related regional activity in cortical motor areas.MethodsSeventeen healthy volunteers received 20 min of real or sham TDCS on separate (...) days in randomized order. Real and sham TDCS used the classic bipolar set-up with the anode placed over right M1-HAND. Before and after each TDCS session, we recorded motor evoked potentials from the relaxed left first dorsal interosseus muscle after single-pulse transcranial magnetic stimulation of left M1-HAND and performed whole-brain fMRI at 3 Tesla while participants completed a visuomotor tracking task with their left hand. We also assessed the difference in MEP latency when applying anterior-posterior and latero-medial TMS pulses to the precentral hand knob.ResultsReal TDCS had no consistent aftereffects on mean MEP amplitude, task-related activity or motor performance. Individual changes in MEP amplitude, measured directly after real TDCS showed a positive linear relationship with individual changes in task-related activity in the supplementary motor area and AP-LM MEP latency.ConclusionFunctional aftereffects of classical bipolar anodal TDCS of M1-HAND on the motor system vary substantially across individuals. Physiological features upstream from the primary motor cortex may determine how anodal TDCS changes corticospinal excitability. (shrink)

Die Arbeit entwickelt erstmals eine von hermeneutischen Grundannahmen geleitete systematische Theorie des Films und reflektiert deren methodische Konsequenzen für die Analyse und Interpretation von Filmen. Auf der Grundlage einer zeichen- und sprechakttheoretischen Bestimmung filmischer Kommunikation werden die wichtigsten Strukturen filmischen Erzählens (Kameraführung, Montage, Erzählsituationen, verbale und nonverbale Figurenrede, Perspektivenstrukturen, uneigentliche Bilderrede) einer theoretischen und methodenpraktischen Reflexion unterzogen.

In this paper I will argue that liberal multiculturalism is neither a necessary nor a convincing extension of liberalism. In evaluating the two main strands of liberal multiculturalism, I will first analyse the approaches of Charles Taylor and Bhikhu Parekh as the main proponents of the version that focuses on the cultures themselves and raises the issue of the value of cultures in connection with public discourse. I will then turn to Amy Gutmann and Will Kymlicka as liberal multiculturalists who (...) use the liberal norm of individual equality as a starting point. I will show that the arguments adduced in favour of liberal multiculturalism fail, due to the following shortcomings. Taylor’s approach is underspecified with respect to the relationship between the process of evaluating cultures and its outcome. Gutmann’s theory fails to bridge the gaps between the individual, cultural belonging and positive duties of the state. Parekh’s and Kymlicka’s theories lead back to liberalism. I conclude that the idea of cultural difference has little of substance to add to the liberal view of social justice. (shrink)

This article gives an overview of the influence of the work of Michel Foucault on the philosophy of Agamben. Discussed are Foucault’s influence on the Homo Sacer cycle, on (the development) of Agamben’s notion of power (and on his closely related notion of freedom and art of life), as well as on Agamben’s philosophy of language and methodology. While most commentaries focus on Agamben’s interpretation of Foucault’s concept of biopower, his work also contains many interesting references to Foucault on freedom (...) and possibilities—and I think that it is here that Foucault’s influence on Agamben is most deeply felt. This article focuses on the shifts Agamben takes while looking for the Entwicklungsfähigkeit in the work of Foucault. (shrink)

»Artistic Research« ist in aller Munde - ein Modewort der Gegenwartsdebatte, das Vereinnahmungen ebenso provoziert wie Zurückweisungen. Doch was meinen wir, wenn wir von der Kunst als Forscherin sprechen? Kann Kunst als eine Einsichten generierende, reflexive Praxis angesehen werden, die sich in ästhetischen Artikulationen formuliert? Welche Einsicht über welche Welt könnte sie bereitstellen? Eine umfassende epistemologische Ästhetik, die sich dem künstlerischen Forschen als Methode und Praxis annimmt, gibt es bisher nicht. In diesem Grundlagenwerk stellt sich Anke Haarmann den Fragen (...) nach den originären Methoden, historischen Vorläufern, spezifischen Artikulationsformen und konkreten Handlungsweisen künstlerischen Forschens. (shrink)

Excerpt: How does subjective well-being change over the life course and what concepts do people draw upon when they answer questions about their well-being? Does well-being indeed change or are people endowed with a set level of happiness around which their well-being fluctuates? These are some of the questions this paper will address with a focus on three domains of life: family, work, and health.

The Diagnostic and Statistical Manual of Mental Disorders has elicited numerous criticisms throughout its history. Its particularly controversial status has not been resolved by the recent release of the DSM-5 ; rather, the new edition has amplified debates in psychiatry as well as philosophy and the wider public. To a certain extent, such controversies are to be expected because of the influential role the DSM plays in science and health care. Researchers have often been required to use the DSM classification (...) to get funded and published, clinicians need to use it for diagnosis, and patients need a DSM code to get reimbursed for treatment.1 Classification in psychiatry shapes the course of research... (shrink)

When doing research among vulnerable populations, researchers are obliged to protect their subjects from harm. We will argue that traditional ethical guidelines are not sufficient to do this, since they mainly focus on direct harms that can occur: for example, issues around informed consent, fair recruitment and risk/harm analysis. However, research also entails indirect harms that remain largely unnoticed by research ethical committees and the research community. Indirect harms do not occur during data collection, but in the analysis of the (...) data, and how the data is presented to the scientific and wider societal community. Highly stigmatized research subjects, like substance‐dependent parents, are especially at risk of encountering indirect harm, because the prejudice against them is so persistent. In this paper we discuss two forms of indirect harm. First, researchers have to be aware how their results will be preceived by society. Even when subjects are presented in an objective way, further, out of porportion stigmatization can occur. Researchers sometimes try to counteract this by whitewashing their results, at the risk of downplaying their respondents’ problems. The second risk researchers face is that their own normative judgements influence how they question such parents, report results and interpret statements. Researchers’ own normative judgements may influence the way they present their subjects. This article reviews a broad range of research that exhibits such indirect harms, discussing how and why indirect harms occur and formulating corresponding recommendations on how to prevent them. (shrink)

The nomadic Kazaks inhabiting Xinjiang Province, China, retain many aspects of their pre‐Islamic way of life, including the use of methods of traditional healing usually classified under the rubric of "shamanism." These practices are closely related to those in Kazakstan, Mongolia, and other parts of the former Soviet Union.The present study addresses aspects of traditional healing in use among the Xinjiang Kazaks in recent times, and presents a native taxonomy of these practices obtained during recent fieldwork in Xingjiang. Special attention (...) is paid to the use of words, sound, and movement in healing contexts by elders and specialized individuals. (shrink)

While Vilém Flusser’s writings on (media) philosophy and communication have found a wide readership across the globe, another ‘Flusser’ has been present all along, interwoven perhaps, namely that of the ‘obsessive futurologist’. Flusser, the futurologist, does not only imagine or predict media-technological universes unfolding with, among, and for us, but he, in his insistence that ‘communication is anthropology’, also imagines scenarios of possible worlds to come. In his little-known book Angenommen: Eine Szenenfolge (1989), available in English translation as What If? (...) Twenty-Two Scenarios in Search of Images (2023), he designs sketches of an Anthropocene fraught with nightmares and wonders. What If? offers insight into the radical futures of a slipstream Anthropocene that have to do with speculative design, with Flusser’s concept of design as ‘crafty’ or slippery, and with art and the immense creative potential of failure versus reasonable, ‘good’ computing or calculability. (shrink)

The reception and revival of Ibn Rušd in the Arab world of the 20th century provides a profound insight into the efforts of prominent Arab intellectuals to redefine Islamic culture and reveals the possibilities and limits of a dialogue with the West.

Background In Scandinavia 13–28% of gynecology patients have experienced abuse in health care in their life time, which contradicts the ethical obligations not to harm the patient and to protect the patient's dignity. Concerning learning to act ethically, scholars have emphasized the importance of combining theoretical and practical dimensions. This article explores Forum Play as a way of learning to act ethically in abusive situations in health care. Method Ten health-care workers participating in a Forum Play course took part in (...) this study. To explore participants' experiences of Forum Play, semi-structured interviews were conducted and processed by using the grounded theory analysis techniques of coding and constant comparison. Results The analysis resulted in the core category “developing response–ability.” It encompasses the processes bringing about the ability to respond adequately to situations where abuse occurs and the conditions for these processes, as well as the participants' achieved understanding of the third person's potential to act in a situation with a power imbalance. Forum Play allows participants to reflect on both verbal and body language, and gives them time to enact and think through issues of moral agency. Conclusion The simulated reality of Forum Play offers a platform where learning to act ethically in abusive situations in health care is facilitated by providing a safe space, suspending constricting structural conditions such as hierarchies and lack of time, fostering moral imagination, allowing creativity in developing and trying out a variety of acting alternatives, and reflecting upon the observed and experienced situation. (shrink)