In this article a brief overview is given of the field of medical ethics in Sweden in recent years. The presentation concentrates on the occurrence of official ethical norms for physicians, current ethical committees, the educational situation, legislation in force, and some essential features of the ethical debate on a few central issues.

This article examines three aspects of the problem of understanding Benjamin Libet’s idea of conscious will causally interacting with certain neural activities involved in generating overt bodily movements. The first is to grasp the notion of cause involved, and we suggest a definition. The second is to form an idea of by what neural structure(s) and mechanism(s) a conscious will may control the motor activation. We discuss the possibility that the acts of control have to do with levels of supplementary (...) motor area activity and with the activation of populations of excitatory and inhibitory interneurons. The third aspect is to conceive of the main features of Libet’s proposed conscious mental field (CMF). We consider both an ontological and an epistemological interpretation of the CMF being nonphysical. In an attempt to refute the idea that Libet’s dualist mind–brain interactionism would violate the law of conservation of energy, we suggest that a CMF may alter the probability of the ion-channel gating by influencing structures of a size to which quantum mechanics needs to be applied. We argue that given the suggested definition of cause, and given the epistemological interpretation of the CMF being nonphysical, nothing would necessarily rule out that an element of a CMF, conscious will, may causally interact with neural activities in the brain. This defense of the idea of conscious will being causally efficacious has a bearing not only on the understanding of the mind–brain relation but also on the free will debate. (shrink)

This article presents a brief general view of the recent literature and the scholarly activity in the field of philosophy of medicine in Scandinavia. The focus of attention is not on medical ethics, but on studies on topics like decision theory, medical classification, causality, causal explanations, concept formation, and on analyses of different ideals of medical science and clinical practice. A few principal works on medical ethics are mentioned by way of introduction and a brief account of a highly topical (...) debate on the legislation on artificial insemination in Sweden is given at the end. (shrink)

A great number of constructive suggestions for the analysis of the concepts and models treated are presented in this book, which mirrors a current debate within the theory of medicine by covering three central topics: the concepts of health and disease; definition and classification in medicine; and causal explanation in medicine. Among the issues dealt with are: How should the concepts of health and disease be characterized in order to be of relevance to clinical practice? Should we try to define (...) particular diseases in explicit terms? What should be the criteria for selecting causes when explaining disease or death? These problems are treated from various points of view, the contributors being drawn from the fields of clinical medicine, epidemiology, psychiatry, social medicine, philosophy, and history of medicine. (shrink)

It has been suggested that if the preservation and development of consciousness in the biological evolution is a result of natural selection, it is plausible that consciousness not only has been influenced by neural processes, but has had a survival value itself; and it could only have had this, if it had also been efficacious. This argument for mind-brain interaction is examined, both as the argument has been developed by William James and Karl Popper and as it has been discussed (...) by C.D. Broad. The problem of identifying mental phenomena with certain neural phenomena is also addressed. The main conclusion of the analysis is that an explanation of the evolution of consciousness in Darwinian terms of natural selection does not rule out that consciousness may have evolved as a mere causally inert effect of the evolution of the nervous system, or that mental phenomena are identical with certain neural phenomena. However, the interactionistic theory still seems, more plausible and more fruitful for other reasons brought up in the discussion. (shrink)

The survival and development of consciousness in biological evolution call for an explanation. An interactionistic mind-brain theory seems to have the greatest explanatory value in this context. An interpretation of an interactionistic hypothesis, recently proposed by Karl Popper, is discussed both theoretically and based on recent experimental data. In the interpretation, the distinction between the conscious mind and the brain is seen as a division into what is subjective and what is objective, and not as an ontological distinction between something (...) immaterial and something material. The interactionistic hypothesis is based on similarities between minds and physical forces. The conscious mind is understood to interact with randomly spontaneous spatio-temporal patterns of action potentials through an electromagnetic field. Consequences and suggestions for future studies are discussed. (shrink)

In this paper Popper formulates and discusses a new aspect of the theory of mind. This theory is partly based on his earlier developed interactionistic theory. It takes as its point of departure the observation that mind and physical forces have several properties in common, at least the following six: both are located, unextended, incorporeal, capable of acting on bodies, dependent upon body, capable of being influenced by bodies. Other properties such as intensity and extension in time may be added. (...) It is argued that a fuller understanding of the nature of forces is essential for the analysis of the mind-brain problem. The relative autonomy and indeterministic nature of mind is stressed. Indeterminism is treated in relation to a theorem of Hadamard. The computer theory of mind and the Turing test are criticized. Finally the evolution of mind is discussed. (shrink)

The World Health Organization has issued international instructions for certification and classification (coding) of the coronavirus disease (COVID-19) as cause of death. Central to these instructions is the selection of the underlying cause of death for a public health preventive purpose. This article focuses on two rules for this selection: (1) that a death due to COVID-19 should be counted independently of pre-existing conditions that are suspected of triggering a severe course of COVID-19 and (2) that COVID-19 should not be (...) considered as due to anything else. The article argues that observance of the first rule may not always lead to an optimal selection from a preventive point of view and that in the future the ascertainment of an animal source of the coronavirus (SARS-CoV-2) would make it possible to reconceptualize ‘COVID-19‘ and create a zoonotic classification code by means of which a factor of a greater preventive value could be selected than what is currently possible. (shrink)

Citation data have become an increasingly significant source of information for historians, sociologists, and other researchers studying the evolution of science. In the past few decades elaborate methodologies have been developed for the use of citation data in the study of the modern history of science. This article focuses on how citation indexes make it possible to trace the background and development of discoveries as well as to assess the credit that publishing scientists assign to particular discoverers. Kuhn's notion of (...) discovery is discussed. The priority dispute over the discovery of the AIDS virus is used as an example. (shrink)

The main objective of this essay is to validate some of the principal, currently competing, mammalian consciousness-brain theories by comparing these theories with data on both cognitive abilities and brain organization in birds. Our argument is that, given that multiple complex cognitive functions are correlated with presumed consciousness in mammals, this correlation holds for birds as well. Thus, the neuroanatomical features of the forebrain common to both birds and mammals may be those that are crucial to the generation of both (...) complex cognition and consciousness. The general conclusion is that most of the consciousness-brain theories appear to be valid for the avian brain. Even though some specific homologies are unresolved, most of the critical structures presumed necessary for consciousness in mammalian brains have clear homologues in avian brains. Furthermore, considering the fact that the reptile-bird brain transition shows more structural continuity than the stem amniote-mammalian transition, the line drawn at the origin of mammals for consciousness by several of the theorists seems questionable. An equally important point is that consciousness cannot be ruled out in the absence of complex cognition; it may in fact be the case that consciousness is a necessary prerequisite for complex cognition. (shrink)

A change in sense of self is an outcome commonly associated with Buddhist meditation. However, the sense of self is construed in multiple ways, and which changes in self-related processing are expected, intended, or possible through meditation is not well understood. In a qualitative study of meditation-related challenges, six discrete changes in sense of self were reported by Buddhist meditators: change in narrative self, loss of sense of ownership, loss of sense of agency, change in sense of embodiment, change in (...) self-other or self-world boundaries, and loss of sense of basic self. Changes in sense of self could be transient or enduring, positive or distressing, enhancing or impairing. These changes were also given varied appraisals, ranging from insights associated with Buddhist doctrines to psychopathologies such as depersonalization. In this study of practitioners reporting meditation-related challenges, more global changes in sense of self were associated with higher levels of impairment. These results have implications for both Buddhist meditation as well as mindfulness-based interventions. (shrink)

While Mindfulness-Based Interventions have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific and common therapeutic factors to client improvements within an MBI. Participants with mild-severe depression participated in an 8-week MBI. Specific therapeutic factors and social common factors were (...) entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors. (shrink)

KARLSSON V, LINDAHL B and BERGBOM I. Nursing Inquiry 2012; 19: 247–258 Patients’ statements and experiences concerning receiving mechanical ventilation: a prospective video‐recorded studyProspective studies using video‐recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients’ statements, communication and facial expressions during a video‐recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and (...) lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients’ conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope. (shrink)

Stig Kanger made important contributions to logic and formal philosophy. Kanger's most original achievements were in the areas of general proof theory, the semantics of modal and deontic logic, and the logical analysis of the concept of rights. But he contributed significantly to action theory, preference logic and the theory of measurement as well. This is the second of two volumes dedicated to the work of Stig Kanger. The first volume is a complete collection of Kanger's philosophical papers. The present (...) volume contains critical essays on the various aspects of Kanger's work as well as some biographical sketches. Lennart Åqvist, Jan Berg, Brian Chellas, Anatoli Degtyarev, Lars Gustafsson, Sören Halldén, Kaj Børge Hansen, Sven Ove Hansson, Risto Hilpinen, Jaakko Hintikka, Ghita Holmström-Hintikka, Lars Lindahl, Sten Lindström, Ingmar Pörn, Dag Prawitz, Wlodek Rabinowicz, Krister Segerberg, Amartya Sen, Sören Stenlund, Göran Sundholm, and Andrei Voronkov have contributed to this volume. (shrink)

The major contributions of operationism have been negative, largely because operationists failed to distinguish logical theories of reference from empirical accounts of language. Behaviorism never finished an adequate formulation of verbal reports and therefore could not convincingly embrace subjective terms. But verbal responses to private stimuli can arise as social products through the contingencies of reinforcement arranged by verbal communities.

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)