From good intentions to real life: introducing crisis resolution teams in Norway In Norway, as in most western countries, the adult services for people experiencing mental health problems have gone through major changes over the last decades. A report submitted to the Norwegian Parliament in 1997 summarized several areas of improvement in the provision of mental health‐care to its population, and led to the introduction of a national mental health programme in 1998 for its implementation to be completed by 2008. (...) The most significant recent development in Norway is ‘Crisis Resolution/Home Treatment’ (CRHT) teams that provide an alternative to acute hospital care services. The major aim of this study is to explore an emerging form of community mental health‐care, and present a framework for establishment and examination of CRHT teams applying the user perspectives. An illustration of user experiences in an already established CRHT team provides a background for understanding implications of this form of service in relation to service users’ needs in acute crises. (shrink)

The acknowledgement of basic human vulnerability in relationships between mental health service users and professionals working in community-based mental health services (in Norway) was a starting point. The purpose was to explore how users of these services describe and make sense of their meetings with other people. The research is collaborative, with researcher and person with experienced-based knowledge cooperating through the research process. Data is derived from 19 interviews with 11 people who depend on mental health services for assistance at (...) least three times a week. Data is analysed according to the Interpretative Phenomenological Analysis (IPA). Results confirm that reciprocity is fundamental for relationships, and that recognizing the individual entails personal involvement. The participants describe a struggle, and recognizing this struggle may help the professional to achieve a deeper understanding of the individual. (shrink)

Hope is a central concept in nursing and other fields of health care. However, there is no consensus about the concept of hope. We argue that seeking consensus is futile given the multifaceted and multidimensional nature of the concept, but instead we encourage in‐depth studies of the assumptions behind talk about hope in specific contexts. Our approach to the ‘science of hope’ is inspired by philosophical pragmatism. We argue that hope is a concept that opens different rooms for action in (...) different contexts and that accordingly, all hope interventions are contextually sensitive. Careful attention to how the relative positions and power of nurses and patients influence what can be inferred from their different ways of talking about hope may make hopeful conversations more meaningful in health care relationships. (shrink)

The first sustained critique of how domestic courts in the EU apply the European Convention on Human Rights and interact with the European Court of Human Rights at Strasbourg. This book considers the British, French, and German approaches to the ECHR and shows that domestic courts apply and develop the Convention faithfully and positively.

An autobiographical account of a formative experience -- Cassirer's philosophy of symbolic forms -- Art and science as supplementing forms -- The parting of the ways and the divide in organizational theory -- Cassirer in the light of neuroscience -- Bringing Cassirer into organizations -- The institution as a symbolic form.

A so called “weak value” of an observable in quantum mechanics (QM) may be obtained in a weak measurement + post-selection procedure on the QM system under study. Applied to number operators, it has been invoked in revisiting some QM paradoxes (e.g., the so called Three-Box Paradox and Hardy’s Paradox). This requires the weak value to be interpreted as a bona fide property of the system considered, a par with entities like operator mean values and eigenvalues. I question such an (...) interpretation; it has no support in the basic axioms of quantum mechanics and it leads to unreasonable results in concrete situations. (shrink)

The purpose of this article is to present a normative theory of the goals of medicine (a theory that tells us in what respects medicine should benefit the patient) that is both comprehensive and unified. A review of the relevant literature suggests that there are at least seven plausible goals that are irreducible to each other, namely to promote functioning, to maintain or restore normal structure and function, to promote quality of life, to save and prolong life, to help the (...) patient to cope well with her condition, to improve the external conditions under which people live, and to promote the growth and development of children. However, it seems that all these goals need to be qualified in different ways, e.g. it does not seem reasonable to improve physiological function or functional ability unless this is expected to have positive effects on quality of life and/or length of life, or to improve the quality of life in any respect, or by any means. These qualifications all suggest that the proposed goals are, as goals, conceptually, and not just causally, related to one another, and that they should therefore not be regarded in isolation. Instead, we should think of the medical enterprise as having a multidimensional goal structure rather than a single goal. In order to depict clearly how the different goals are related to one another, a multidimensional model is constructed. (shrink)

In an increasingly globalized world, empathy has been identified as a core competency of future global citizens and thus as an important skill to be fostered in global citizenship education (GCE). Despite this, however, what empathy is, and how it can play the pivotal role often claimed for it in the literature, have not been adequately explored. Here, Eirik Risberg argues that, pace the common conception of empathy, empathy should not be construed narrowly, as an affective concept, but broadly, (...) as a cognitive and epistemic concept. Drawing on recent work in philosophy and psychology, Risberg explores a suggestion that construes empathy as a complex self-directed perspective-taking of the situation of another. While this may constitute a conception of empathy that is more modest than the most ardent proponents of empathy would like, it has the benefit of avoiding the objections that have been leveled against empathy as a moral concept and thus allows us to maintain that empathy is a valuable skill to be cultivated in educating global citizens for the twenty-first century. (shrink)

In a recent paper, Takacs and Bourrat (Biol Philos 37:12, 2022) examine the use of geometric mean reproductive output as a measure of biological fitness. We welcome Takacs and Bourrat’s scrutiny of a fitness definition that some philosophers have adopted uncritically. We also welcome Takacs and Bourrat’s attempt to marry the philosophical literature on fitness with the biological literature on mathematical measures of fitness. However, some of the main claims made by Takacs and Bourrat are not correct, while others are (...) correct but not for the reasons they give. (shrink)

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...) aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

In recent years, several formalisms for program construction have appeared. One such formalism is the type theory developed by Per Martin-L f. Well suited as a theory for program construction, it makes possible the expression of both specifications and programs within the same formalism. Furthermore, the proof rules can be used to derive a correct program from a specification as well as to verify that a given program has a certain property. This book contains a thorough introduction to type theory, (...) with information on polymorphic sets, subsets, monomorphic sets, and a full set of helpful examples. (shrink)

Harm-reduction approaches are used to reduce the burden of risky human behaviour without necessarily aiming to stop the behaviour. We discuss what an introduction of harm reduction for doping in sports would mean in parallel with a relaxation of the antidoping rule. We analyse what is ethically at stake in the following five levels: (1) What would it mean for the athlete (the self)? (2) How would it impact other athletes (the other)? (3) How would it affect the phenomenon of (...) sport as a game and its fair play basis (the play)? (4) What would be the consequences for the spectator and the role of sports in society (the display)? and (5) What would it mean for what some consider as essential to being human (humanity)? For each level, we present arguments for and against doping and then discuss what a harm-reduction approach, within a dynamic regime of a partially relaxed antidoping rule, could imply. We find that a harm-reduction approach is morally defensible and potentially provides a viable escape out of the impasse resulting from the impossibility of attaining the eradication of doping. The following question remains to be answered: Would a more relaxed position, when combined with harm-reduction measures, indeed have less negative consequences for society than today9s all-out antidoping efforts that aim for abstinence? We provide an outline of an alternative policy, allowing a cautious step-wise change to answer this question and then discuss the ethical aspects of such a policy change. (shrink)

This anthology focuses on “practical” forms and expressions of knowledge, like thinking through artistic media or by crafting things out of materials. The ten chapters follow and review various tracks in conceptions of contemporary knowledge, exploring human knowledge and experience from the perspective of human activities or practices, professional, artistic, domestic, or whatever. A guiding idea is that human knowledge seldom, perhaps never, fits into the traditional dualism between thinking and doing. -/- The chapters are written by philosophers and musicians (...) – some with a double experience as artists and theoreticians. The themes are philosophical, but above all, they touch on questions that are essential for how we understand ourselves as thinking and playing bodies, indeed as parts of nature. The book does not propose one single “theory of knowledge” but steps towards a more diverse and open attitude to the meaning of knowledge. -/- We hope that the texts will be of interest and useful in both disciplinebased and professional education: in philosophy, art schools, tea cher education, and in other programmes where tacit and practical knowledge are essential for the (future) practitioners. It is possible to independently read, and profit from, most of the chapters. (shrink)

The recent discussion of the concept of mental disorder has focused on what makes a mental disorder a disorder. A question that has received less attention is what makes a mental disorder mental rather than somatic. We examine three views on this issue -- namely, the internal cause view, the symptom view, and the pluralist view -- and assess to what extent these accounts are plausible. Three strategies used to pinpoint the mental in psychiatry are identified, namely negative characterizations, exemplification (...) of paradigmatic mental features, and an appeal to intentional content. We also examine different versions of nihilism. Finally, it is observed that the discussion of what makes a mental disorder mental has largely been unaffected by conceptions of the mental in the philosophy of mind. (shrink)

One of the claims sometimes advanced in favour of anti-doping is that allowing doping would lead to a uniform increase in performance in comparison to no doping. The idea is that if all athletes wo...

This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jönköping, Växjö and Kristianstad in the south of Sweden. A principal component factor analysis (varimax) was (...) performed using data obtained from the students in the spring of 1994 (n = 122) and in the spring of 1996 (n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3% of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term ‘ascendancy’ refers to self-confidence, and ‘vigour’ denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jönköping changed significantly (paired samples t-test) between 1994 and 1996 (p = 0.028), but that for the Växjö and Kristianstad students did not. The mean of Index P was 44.3% at Växjö, which was greater than the international average for college students (42.3%); it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jönköping (p = 0.032) and Kristianstad (p = 0.025). Index P was very heterogeneous for the group of students at Växjö, with the result that the paired samples t-test reached a value close to significance only. (shrink)

How to measure fitness in the theory of natural selection? A fitness measure that has been proposed in both the biological and the philosophical literature is the expected relative reproductive success. The aim of this article is to examine the relationship between expected relative reproductive success and future actual evolutionary success. Doing so will not only clarify the use of expected relative reproductive success as a fitness measure but also shed light on the role of fitness in the theory of (...) natural selection. _1_ Introduction _2_ The Role of Fitness _3_ Geometric Mean versus Expected Relative Reproductive Success _4_ Reconciliation _5_ Reconciliation Continued _6_ Alternative Justifications _7_ Conclusion. (shrink)

Many of the major challenges facing global society are unstructured collective harms (e.g., global warming): collective in the sense that they arise as the result of the actions of, or interactions among, multiple agents, and unstructured in the sense that there is no coordination or intention to cause harm among these agents. But how should we distribute moral responsibility for these harms? In this paper, an answer is proposed to this question. This answer builds on but develops existing proposals by (...) drawing together literatures that speak to different aspects of the question. First, it is argued that the notion of causal contribution needs to be broadened to include the idea of causation as production. Second, it is discussed how the voluntariness and foreseeability conditions are best interpreted in this context. Third, literature on moral taint is drawn to introduce additional objective (external) criteria. (shrink)

Quantum mechanical weak values of projection operators have been used to answer which-way questions, e.g. to trace which arms in a multiple Mach–Zehnder setup a particle may have traversed from a given initial to a prescribed final state. I show that this procedure might lead to logical inconsistencies in the sense that different methods used to answer composite questions, like “Has the particle traversed the way X or the way Y?”, may result in different answers depending on which methods are (...) used to find the answer. I illustrate the problem by considering some examples: the “quantum pigeonhole” framework of Aharonov et al., the three-box problem, and Hardy’s paradox. To prepare the ground for my main conclusion on the incompatibility in certain cases of weak values and logic, I study the corresponding situation for strong/projective measurements. In this case, no logical inconsistencies occur provided one is always careful in specifying exactly to which ensemble or sample space one refers. My results cast doubts on the utility of quantum weak values in treating cases like the examples mentioned. (shrink)

Is science in the midst of a crisis of replicability and false discoveries? In a recent article, Alexander Bird offers an explanation for the apparent lack of replicability in the biomedical sciences. Bird argues that the surprise at the failure to replicate biomedical research is a result of the fallacy of neglecting the base rate. The base-rate fallacy arises in situations in which one ignores the base rate—or prior probability—of an event when assessing the probability of this event in the (...) light of some observed evidence. By extension, the replication crisis would result from ignoring the low prior probability of biomedical hypotheses. In this paper, my response to Bird’s claim is twofold. First, I show that the argument according to which the replication crisis is due to the low prior of biomedical hypotheses is incomplete. Second, I claim that a simple base-rate fallacy model does not account for some important methodological insights that have emerged in discussions of the replication crisis. (shrink)

All definitions of mental disorder are backed up by arguments that rely on general criteria (e.g., that a definition should be consistent with ordinary language). These desiderata are rarely explicitly stated, and there has been no systematic discussion of how different definitions should be assessed. To arrive at a well-founded list of desiderata, we need to know the purpose of a definition. I argue that this purpose must be practical; it should, for example, help us determine who is entitled to (...) publicly funded health care. I then propose eight conditions of adequacy that can be used to assess competing definitions (e.g., the ordinary language condition, the coherence condition, and the condition of normative adequacy). These conditions pull in different directions, however, and we must decide which are most important. I also suggest that there is no single definition that can help us deal with all the relevant practical issues. (shrink)

We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a dispositionalist stance, many (...) of the processes within an evidence-based practice framework are better accounted for. Further, some of the problems associated with the health research, e.g. external validity of causal findings, dissolve. (shrink)

Ockham’s razor is the idea that simpler hypotheses are to be preferred over more complex ones. In the context of medical diagnosis, this is taken to mean that when a patient has multiple symptoms, a single diagnosis should be sought that accounts for all the clinical features, rather than attributing a different diagnosis to each. This paper examines whether diagnostic parsimony can be justified by reference to probability theory. I argue that while attempts to offer universal justifications of diagnostic parsimony (...) fail, a more constrained use of this diagnostic principle can be supported. (shrink)

Attributions of what we shall call normative responsibilities play a central role in everyday moral thinking. It is commonly thought, for example, that parents are responsible for the wellbeing of their children, and that this has important normative consequences. Depending on context, it might mean that parents are morally required to bring their children to the doctor, feed them well, attend to their emotional needs, or to see to it that someone else does. Similarly, it is sometimes argued that countries (...) that emit most greenhouse gases are responsible for preventing catastrophic climate change. This responsibility might imply that these countries are morally required to take necessary steps individually and jointly to come to an agreement on and implement a workable plan, and to avoid steps that worsen the situation. More trivially, the grading of your student’s essays might be your responsibility, as might making sure there is wine at tomorrow’s picnic, and you might thus be required to see to it that essays are competently graded and suitable wine brought to the picnic. -/- Though attributions of normative responsibilities are legion, such responsibilities have received surprisingly little philosophical attention compared to its normative relatives, obligations and reasons, and compared to retrospective responsibility. This chapter hopes to improve on this situation by taking on two main tasks. The first, attempted in section 1, is to spell out the general structure of normative responsibility, in particular the relation between normative responsibilities and corresponding obligations and demands. We suggest that normative responsibilities are constituted by normative requirements that the responsible agents care appropriately about how well things go in certain regards, and that obligations generally can be seen as straightforward upshots of requirements to care. -/- The second task, taken on in section 2, is to provide an overview of prominent sources of normative responsibility and its distribution among agents. Why would the children’s wellbeing be the parents’ responsibility? Why not the neighbor’s, or the state’s, or everyone’s? Here we discuss a range of possible sources, including agents’ abilities, costs involved in taking on the responsibility in question, retrospective responsibility for the situation, promises or contracts, and certain social relationships. (shrink)

This article examines how one of the most striking differences between the central doctrines of the Catholic Church and the secular context of Swedish society, attitudes to abortion, is managed by the Swedish church hierarchy and commentators in the official newsletter of the Catholic Church of Sweden. Using Foucauldian concepts of power, the article concludes that in its marginal position, the Catholic Church in Sweden mixes the traditional pastoral and sovereign power of the church with the way pastoral power is (...) exerted in modern society, in its efforts to continue asserting its influence over the possible courses of action for pregnant women. While traditionally abortion has been a woman’s crime, in the Swedish Catholic context it becomes rather the crime of the secular society. This means also that the image of woman as being responsible for her decisions and in need of forgiveness gives way to an image of woman as a victim in need of understanding. (shrink)

It is now generally agreed that we have to rely on value judgments to distinguish mental disorders from other conditions, but it is not quite clear how. To clarify this, we need to know more than to what extent attributions of disorder are dependent on values. We also have to know (1) what kind of evaluations we have to rely on to identify the class of mental disorder; (2) whether attributions of disorder contain any implicit reference to some specific evaluative (...) standard; and (3) whether the concept of mental disorder is value laden in the definitional or in the epistemic sense. I will argue that the evaluations we have to rely on are mainly considerations of harm, but that we also need to rely on other evaluations; that there should be no references to specific evaluative standards; and that even though mental disorders are necessarily undesirable, "mental disorder" may well be a descriptive phrase. (shrink)

The paper discusses Bayesian convergence when the truth is excluded from the analysis by means of a simple coin-tossing example. In the fair-balance paradox a fair coin is tossed repeatedly. A Bayesian agent, however, holds the a priori view that the coin is either biased towards heads or towards tails. As a result the truth is ignored by the agent. In this scenario the Bayesian approach tends to confirm a false model as the data size goes to infinity. I argue (...) that the fair-balance paradox reveals an unattractive feature of the Bayesian approach to scientific inference and explore a modification of the paradox. (shrink)

The paper examines the claim that significance testing violates the Principle of Total Evidence. I argue that p-values violate PTE for two-sided tests but satisfy PTE for one-sided tests invoking a sufficient test statistic independent of the preferred theory of evidence. While the focus of the paper is to evaluate a particular claim about the relationship of significance testing and PTE, I clarify the reading of this methodological principle along the way.

The paper offers a partial vindication of Sterelny’s view on the role of error rates and reliability in his theory of decoupled representation based on modelling techniques borrowed from the biological literature on evolution in stochastic environments. In the case of a tight link between tracking states and behaviour, I argue that in its full generality Sterelny’s account instantiates the base-rate fallacy. With regard to non-tightly linked behaviour, I show that Sterelny’s account can be vindicated subject to an adequate evolutionary (...) model and a suitable notion of reliability. (shrink)

Although Bayesian methods are widely used in phylogenetic systematics today, the foundations of this methodology are still debated among both biologists and philosophers. The Bayesian approach to phylogenetic inference requires the assignment of prior probabilities to phylogenetic trees. As in other applications of Bayesian epistemology, the question of whether there is an objective way to assign these prior probabilities is a contested issue. This paper discusses the strategy of constraining the prior probabilities of phylogenetic trees by means of the Principal (...) Principle. In particular, I discuss a proposal due to Velasco (Biol Philos 23:455–473, 2008) of assigning prior probabilities to tree topologies based on the Yule process. By invoking the Principal Principle I argue that prior probabilities of tree topologies should rather be assigned a weighted mixture of probability distributions based on Pinelis’ (P Roy Soc Lond B Bio 270:1425–1431, 2003) multi-rate branching process including both the Yule distribution and the uniform distribution. However, I argue that this solves the problem of the priors of phylogenetic trees only in a weak form. (shrink)

:While Bayesian methods are widely used in economics and finance, the foundations of this approach remain controversial. In the contemporary statistical literature Bayesian Ockham’s razor refers to the observation that the Bayesian approach to scientific inference will automatically assign greater likelihood to a simpler hypothesis if the data are compatible with both a simpler and a more complex hypothesis. In this paper I will discuss a problem that results when Bayesian Ockham’s razor is applied to nested economic models. I will (...) argue that previous responses to the problem found in the philosophical literature are unsatisfactory and develop a novel reply to the problem. (shrink)

The paper starts with a presentation of the pure happiness theory, i.e. the idea that the quality a person’s life is dependent on one thing only, viz. how happy that person is. To find out whether this type of theory is plausible or not, I examine the standard arguments for and against this theory, including Nozick’s experience machine argument. I then investigate how the theory can be modified in order to avoid the most serious objections. I first examine different types (...) of epistemic modifications of the theory (e.g. the idea that a person’s happiness is more valuable for her if it is based on a correct perception of her own life), and then turn to a number of modifications which all make the value of a person’s happiness depend on whether the evaluative standard on which her happiness is based satisfies certain requirements. In connection with this, I present and defend my own modified version of the happiness theory. (shrink)