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Christian Munthe
University of Gothenburg
  1.  81
    Shared Decision Making, Paternalism and Patient Choice.Lars Sandman & Christian Munthe - 2010 - Health Care Analysis 18 (1):60-84.
    In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM (...)
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  2.  27
    The Ethics of Screening in Health Care and Medicine: Serving Society Or Serving the Patient?Niklas Juth & Christian Munthe - 2012 - Springer Verlag.
    This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.
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  3.  9
    Sustainability Principle for the Ethics of Healthcare Resource Allocation.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2021 - Journal of Medical Ethics 47 (2):90-97.
    We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...)
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  4.  29
    The Price of Precaution and the Ethics of Risk.Christian Munthe - 2011 - Springer.
    Since a couple of decades, the notion of a precautionary principle plays a central and increasingly influential role in international as well as national policy and regulation regarding the environment and the use of technology. Urging society to take action in the face of potential risks of human activities in these areas, the recent focus on climate change has further sharpened the importance of this idea. However, the idea of a precautionary principle has also been problematised and criticised by scientists, (...)
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  5. Shared Decision-Making and Patient Autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (...)
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  6.  10
    Price of Precaution of Human-Pig Chimeras for Transplantation Purposes.Christian Munthe - 2019 - Journal of Medical Ethics 45 (7):447-448.
    In response to Koplin and Wilkinson, I argue, first, that the uncertain clinical prospects of human-pig chimera based transplantation makes the reason to spend resources for clarifying whether such practice might imply serious ethical breach due to enhanced cognitive capacities of the chimeras rather weak. T he benefits of further pursuing this avenue of research is so uncertain, so that taking even very unclear risks of serious ethical breach is not worth the price in terms of spent resources, and therefore (...)
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  7.  75
    Adherence, Shared Decision-Making and Patient Autonomy.Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe - 2012 - Medicine, Health Care and Philosophy 15 (2):115-127.
    In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What (...)
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  8.  52
    A Normative Approach to Artificial Moral Agency.Dorna Behdadi & Christian Munthe - 2020 - Minds and Machines 30 (2):195-218.
    This paper proposes a methodological redirection of the philosophical debate on artificial moral agency in view of increasingly pressing practical needs due to technological development. This “normative approach” suggests abandoning theoretical discussions about what conditions may hold for moral agency and to what extent these may be met by artificial entities such as AI systems and robots. Instead, the debate should focus on how and to what extent such entities should be included in human practices normally assuming moral agency and (...)
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  9.  23
    A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal.Christian Munthe - 2015 - Bioethics 29 (1):36-45.
    A new landscape of prenatal testing is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development (...)
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  10.  19
    Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?Leila El-Alti, Lars Sandman & Christian Munthe - 2019 - Health Care Analysis 27 (1):45-59.
    In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined (...)
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  11.  51
    Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research.Christian Munthe, Lars Sandman & Daniela Cutas - 2012 - Health Care Analysis 20 (3):231-249.
    This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view (...)
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  12.  4
    Cutting Red Tape to Manage Public Health Threats: An Ethical Dilemma of Expediting Antibiotic Drug Innovation.Christian Munthe & Niels Nijsingh - 2019 - Bioethics 33 (7):785-791.
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  13. The Return of Lombroso? Ethical Aspects of Preventive Forensic Screening.Christian Munthe & Susanna Radovic - 2015 - Public Health Ethics 8 (3):270-283.
    The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some (...)
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  14.  48
    The Price of Precaution and the Ethics of Risk.Christian Munthe - manuscript
    The precautionary principle (PP) has been criticised for almost every intellectual sin one may imagine: unclarity, impracticability, rigidity, implausibility etc. Recognising the rather obvious fact that there is no such thing as one PP, this paper attempts to address this criticism on a more constructive note than merely view it as forcing us to be "for or against" precaution. This is done by connecting an underlying ethical ideal regarding the imposition of risks present in most formulations of PP to the (...)
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  15.  6
    Digital Contact Tracing and Exposure Notification: Ethical Guidance for Trustworthy Pandemic Management.Robert Ranisch, Niels Nijsingh, Angela Ballantyne, Anne van Bergen, Alena Buyx, Orsolya Friedrich, Tereza Hendl, Georg Marckmann, Christian Munthe & Verina Wild - forthcoming - Ethics and Information Technology.
    There is growing interest in contact tracing apps for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. (...)
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  16.  46
    The Goals of Public Health: An Integrated, Multidimensional Model.Christian Munthe - 2008 - Public Health Ethics 1 (1):39-52.
    While promoting population health has been the classic goal of public health practice and policy, in recent decades, new objectives in terms of autonomy and equality have been introduced. These different goals are analysed, and it is demonstrated how they may conflict severly in several ways, leaving serious unclarities both regarding the normative issue of what goal should be pursued by public health, what that implies in practical terms, and the descriptive issue of what goal that actually is pursued in (...)
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  17.  24
    A Virtue of Precaution Regarding the Moral Status of Animals with Uncertain Sentience.Simon Knutsson & Christian Munthe - 2017 - Journal of Agricultural and Environmental Ethics 30 (2):213-224.
    We address the moral importance of fish, invertebrates such as crustaceans, snails and insects, and other animals about which there is qualified scientific uncertainty about their sentience. We argue that, on a sentientist basis, one can at least say that how such animals fare make ethically significant claims on our character. It is a requirement of a morally decent person that she at least pays attention to and is cautious regarding the possibly morally relevant aspects of such animals. This involves (...)
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  18.  13
    Permissibility or Priority? Testing or Screening? Essential Distinctions in the Ethics of Prenatal Testing.Christian Munthe - 2017 - American Journal of Bioethics 17 (1):30-32.
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  19.  23
    The Black Hole Challenge: Precaution, Existential Risks and the Problem of Knowledge Gaps.Christian Munthe - 2019 - Ethics, Policy and Environment 22 (1):49-60.
    ABSTRACTSo-called ‘existential risks’ present virtually unlimited reasons for probing them and responses to them further. The ensuing normative pull to respond to such risks thus seems to present us with reasons to abandon all other projects and commit all time, efforts and resources to the management of each existential risk scenario. Advocates of the urgency of attending to existential risk use arguments that seem to lead to this paradoxical result, while they often hold out a wish to avoid it. This (...)
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  20. The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions.Anders Herlitz, Christian Munthe, Marianne Törner & Gun Forsander - 2016 - Health Communication 31 (8):964-973.
    This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...)
     
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  21.  26
    The Legal Ethical Backbone of Conscientious Refusal.Christian Munthe & Morten Ebbe Juul Nielsen - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (1):59-68.
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  22.  10
    Individual Responsibility as Ground for Priority Setting in Shared Decision-Making.Lars Sandman, Erik Gustavsson & Christian Munthe - 2016 - Journal of Medical Ethics 42 (10):653-658.
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  23.  9
    The Ethics of Antibiotic Resistance: Towards an Agenda for Feasible and Justified Global Health Policy.Christian Munthe, Niels Nijsingh, Karl de Fine Licht & D. G. Joakim Larsson - 2019 - Bioethics 33 (7):731-733.
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  24.  5
    Error Trawling and Fringe Decision Competence: Ethical Hazards in Monitoring and Address Patient Decision Capacity in Clinical Practice.Thomas Hartvigsson, Christian Munthe & Gun Forsander - 2018 - Clinical Ethics 13 (3):126-136.
    This article addresses how health professionals should monitor and safeguard their patients’ ability to participate in making clinical decisions and making subsequent decisions regarding the implementation of their treatment plan. Patient participation in clinical decision-making is essential, e.g. in self-care, where patients are responsible for most ongoing care. We argue that one common, fact-oriented patient education strategy may in practice easily tend to take a destructive form that we call error trawling. Illustrating with empirical findings from a video study of (...)
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  25.  34
    The Morality of Scientific Openness.Christian Munthe & Stellan Welin - 1996 - Science and Engineering Ethics 2 (4):411-428.
    The ideal of scientific openness — i.e. the idea that scientific information should be freely accessible to interested parties — is strongly supported throughout the scientific community. At the same time, however, this ideal does not appear to be absolute in the everyday practice of science. In order to get the credit for new scientific advances, scientists often keep information to themselves. Also, it is common practice to withhold information obtained in commissioned research when the scientist has agreed with his (...)
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  26.  2
    Screening for Multi-Drug-Resistant Gram-Negative Bacteria: What is Effective and Justifiable?Christina Åhrén, Anna Lindblom, Christian Munthe & Niels Nijsingh - 2020 - Monash Bioethics Review 38 (Suppl 1):72-90.
    Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus aureus we (...)
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  27.  8
    Conscientious Refusal in Healthcare: The Swedish Solution.Christian Munthe - 2017 - Journal of Medical Ethics 43 (4):257-259.
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  28.  54
    Ethical Issues in Forensic Psychiatric Research on Mentally Disordered Offenders.Christian Munthe, Susanna Radovic & Henrik Anckarsã„ter - 2010 - Bioethics 24 (1):35-44.
    This paper analyses ethical issues in forensic psychiatric research on mentally disordered offenders, especially those detained in the psychiatric treatment system. The idea of a 'dual role' dilemma afflicting forensic psychiatry is more complicated than acknowledged. Our suggestion acknowledges the good of criminal law and crime prevention as a part that should be balanced against familiar research ethical considerations. Research aiming at improvements of criminal justice and treatment is a societal priority, and the total benefit of studies has to be (...)
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  29.  2
    What High-Income States Should Do to Address Industrial Antibiotic Pollution.Erik Malmqvist & Christian Munthe - 2020 - Public Health Ethics 13 (3):275-287.
    Antibiotic resistance is widely recognized as a major threat to public health and healthcare systems worldwide. Recent research suggests that pollution from antibiotics manufacturing is an important driver of resistance development. Using Sweden as an example, this article considers how industrial antibiotic pollution might be addressed by public actors who are in a position to influence the distribution and use of antibiotics in high-income countries with publicly funded health systems. We identify a number of opportunities for these actors to incentivize (...)
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  30.  31
    Divisibility and the Moral Status of Embryos.Christian Munthe - 2001 - Bioethics 15 (5-6):382-397.
    The phenomenon of twinning in early fetal development has become a popular source for doubt regarding the ascription of moral status to early embryos. In this paper, the possible moral basis for such a line of reasoning is critically analysed with sceptical results. Three different versions of the argument from twinning are considered, all of which are found to rest on confusions between the actual division of embryos involed in twinning and the property of early embryos to be divisible, be (...)
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  31. The Best Interest of Children and the Basis of Family Policy: The Issue of Reproductive Caring Units.Christian Munthe & Thomas Hartvigsson - 2012 - In Daniela Cutas & Sarah Chan (eds.), Families: Beyond the Nuclear Ideal. Bloomsbury Academic.
    The notion of the best interest of children figures prominently in family and reproductive policy discussions and there is a considerable body of empirical research attempting to connect the interests of children to how families and society interact. Most of this research regards the effects of societal responses to perceived problems in families, thus underlying policy on interventions such as adoption, foster care and temporary assumption of custodianship, but also support structures that help families cope with various challenges. However, reference (...)
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  32.  5
    Precaution, Bioethics and Normative Justificaton.Christian Munthe - 2015 - Monash Bioethics Review 33 (2-3):219-225.
    Daniel Steel’s new book on the precautionary principle illustrates the need to work ahead to fuse perspectives of epistemology and philosophy of science with those of ethics to accomplish progress in the debate on the proper role of precaution in a broad selection of bioethical areas. Steel advances the territory greatly with regard to conceptual clarity and epistemology, but from a bioethics standpoint he is mistaken in discounting the need for ethical underpinnings of a sound theory of the precautionary principle.
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  33. The Morality of Interference.Christian Munthe - 1999 - Theoria 65 (1):55-69.
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  34.  35
    Genetic Treatment and Preselection. Ethical Differences and Similarities.Christian Munthe - manuscript
    Medical genetic interventions can be performed in two ways. First, genetic defects may be repaired (gene therapy). Secondly, a possible future individual (an embryo or a possible combination of gametes) may be preselected because of its favourable genetic make-up (by using genetic diagnostic methods and procedures from reproductive medicine so called Preimplantation Genetic Diagnosis). The first kind of intervention means that someone gets medical treatment in the normal sense, however, the second kind does not. Rather, in that case, the potential (...)
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  35.  31
    Should Promotion of Autonomy Be a Goal of Public Health?Christian Munthe - manuscript
    While health care goals are usually formulated in terms of the securing of good health for the population, the goal of public health is to an increasing extent, at least in Western countries, being formulated in terms of the provision of societal preconditions for securing of good health. This goal may be attained although no one enjoys good health as a result, namely if people choose not to make use of the preconditions provided. However, reaching this goal may still seem (...)
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  36.  25
    The Goals of Public Health and the Value of Autonomy.Christian Munthe - manuscript
    Public health is often distinguished from heaslth care in that it is said to serve more 'collective' goals, such as 'the common good' rather than the good of individual people. However, it is not clear what this good is supposed to be (although it is supposed to be 'common'). In regular health care we see in the West a gradual expansion of traditional goals exclusively in terms of length and quality of life to goals having to do more with autonomy (...)
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  37.  21
    Ethical Aspects of Controlling Genetic Doping.Christian Munthe - manuscript
    The IOC and WADA have announced their ambition to develop control program in order to detect athletes' illegitimate use of genetic technology for enhancing performance. Although it is far from clear what such uses should be counted as illegitimate, as well as to what extent the idea of control programs for such things is a feasible idea, I will assume that such programs will concern so-called somatic genetic modifications that aims at altering the athlete's initial bodily biochemistry in a way (...)
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  38.  15
    Selected Champions.Christian Munthe - 2007 - In William J. Morgan (ed.), Ethics in Sport. Human Kinetics. pp. 273.
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  39. Review of Lennart Nordenfeldt's Talking About Health. [REVIEW]Christian Munthe - 2000 - Theoria 66 (3):293-298.
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  40.  29
    Part I: Introduction to the Philosophy of Hate Crime.David Brax & Christian Munthe - 2013 - In The Philosophy of Hate Crime Anthology. University of Gothenburg.
  41. The Philosophy of Hate Crime Anthology.David Brax & Christian Munthe - 2013 - University of Gothenburg.
    Introductory anthology to the philosophy of hate crime, written in the EU project "When Law and Hate Collide".
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  42. Abortion: From Ethics to Politics.Christian Munthe - manuscript
    This article is not about abortion, but rather about how one can reflect on abortion - in particular its moral and political status. My aim, however, is not to defend any particular position regarding such status, rather, I will try to say something comprehensible about how one can (and cannot) reason one's way from a stand regarding the morality of abortion to a stand on the issue of abortion policy.
     
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  43.  16
    Are Unwanted Risks Ethically Worse Than Wanted Ones?Christian Munthe - manuscript
    Societal decisions regarding the possible granting of permission for industrial and power plants, waste disposals, traffic routes and other facilities implementing modern science and technology (here simply called technology-decisions) often provoke debates regarding the risks involved. A main theme in these debates concerns the magnitudes of these risks and whether or not they are worth taking to reach some aim. This is also a main theme in traditional risk-analysis and critical discussions of risk-management. However, sometimes the fact that some people (...)
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  44. Challenges for Empirical Study of Patient Autonomy, Self-Determination and Co-Decision Making.Christian Munthe - forthcoming - Thinking Ahead: Bioethics for the Future, the Future of Bioethics–Challenges, Changes, Concepts. 11th World Congress of the International Association of Bioethics. Rotterdam, June 26-29, 2012.
     
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  45.  6
    Controlled Medical Research or Routine Medical Procedure? The Ethics and Politics of Drawing a Line.Christian Munthe - unknown
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  46. David B. Resnik. Environmental Health Ethics.Christian Munthe - 2013 - Public Health Ethics (3):pht016.
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  47.  6
    Disputing with Patients in Person-Centered Care.Christian Munthe, Leila El-Alti, Thomas Hartvigsson & Niels Nijsingh - 2018 - Journal of Argumentation in Context 7 (2):231-244.
    This article explores ethical aspects of using open argumentation in person-centered care, where health professionals openly criticize or contradict factual claims, assumptions, preferences, or value commitments of patients. We argue that such disputing may be claimed to have an important place in advanced versions of PCC, but that it actualizes important clinical ethical aspects of doing such disputation well. This may prompt caution in the implementation of PCC, but also inspire educational and organizational reform. We also probe the notion of (...)
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  48.  16
    Editorial: New Media and Risky Behavior of Children and Young People: Ethics and Policy Implications. Introducing the Themes and Pushing for More.Christian Munthe & Karl Persson - 2014 - Public Health Ethics 7 (1):1-4.
    Guest editorial to a special symposium on New Media and Risky Behavior of Children and Young People: Ethics and Policy Implications.
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  49.  21
    Ethical Problems of Precautionarity.Christian Munthe - manuscript
    In recent years a principle for responsible risk-taking called "The Precautionarity Principle" (PP) has been put forward in several policy documents regarding risk-management of technological and environmental issues. PP involves two claims: 1. An ethical claim according to which it is irresponsible to, for example, use new technologies, regdless of how large benefits these are known to bring, unless it has been proven that they will not give rise to unacceptable long term risks. 2. An administrative/political claim according to which (...)
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  50. Handlingsfrihet och straff.Christian Munthe - 1989 - Norsk Filosofisk Tidsskrift 10 (4):21.
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