Purpose: To survey the attitudes of the general public in Sweden to biobank research and to discuss the findings in the light of some well-known ethical principles.Methods: A questionnaire was used to survey the opinions of the general public in Sweden, and an ethical analysis (using the principles of autonomy, non-maleficence, beneficence and justice) was performed to discuss the possible conditions of such research.Findings: Between 3 and 9% answered that they did not want their samples to be collected and stored (...) in a biobank. Many respondents required information about the purpose of the research and wanted to be able to consent or refuse. About one third of the respondents said they would have answered differently if financial gain was involved and those who commented indicated a more negative attitude. The principle of autonomy maintains that the right to self-determination should be respected, and the principles of non-maleficence and beneficence that the probable harms and benefits resulting from a particular project by using samples from a biobank should be balanced. The general public disagree about how these principles are to be balanced. Interpretation: In the light of the findings different interpretations of the situation as well as possible alternatives are discussed in this paper. (shrink)
The principle of proportionality is used in many different contexts. Some of these uses and contexts are first briefly indicated. This paper focusses on the use of this principle as a moral principle. I argue that under certain conditions the principle of proportionality is helpful as a guide in decision-making. But it needs to be clarified and to be used with some flexibility as a context-dependent principle. Several interpretations of the principle are distinguished, using three conditions as a starting point: (...) importance of objective, relevance of means, and most favourable option. The principle is then tested against an example, which suggests that a fourth condition, focusing on non-excessiveness, needs to be added. I will distinguish between three main interpretations of the principle, some primarily with uses in research ethics, others with uses in other areas of bioethics, for instance in comparisons of therapeutic means and ends. The relations between the principle of proportionality and the precautionary principle are explored in the following section. It is concluded that the principles are different and may even clash. In the next section the principle of proportionality is applied to some medical examples drawn from research ethics and bioethics. In concluding, the status of the principle of proportionality as a moral principle is discussed. What has been achieved so far and what remains to be done is finally summarized. (shrink)
Twenty-four children (aged 5 months to 18 years) who were admitted to a university hospital were observed for a total of 135 hours with the aim of describing their degree of participation in decisions concerning their own care. Grading of their participation was made by using a 5-point scale. An assessment was also made of what was considered as optimal participation in each situation. The results indicate that children are not always allowed to participate in decision making to the extent (...) that is considered optimal. In no case was it judged that a child participated in or was forced to make a decision that was too difficult for the child. The interactions between children, parents and staff were also described in connection with discussions and decision-making processes. This showed that parents do not always support their children in difficult situations and that health care staff often inform children about what is going to happen without presenting alternatives or asking for their views. Staff may, however, find themselves facing an ethical conflict in deciding between supporting a child’s view or following hospital routine. It is of great importance that children are looked upon as potentially autonomous individuals and that staff members realize that one of their core duties is to facilitate children’s participation in decision making concerning their health care. (shrink)
The paper discusses the concept of explanation in metaphysics. Different types of explanation are identified and explored. Scientific explanation is compared with metaphysical explanation. The comparison illustrates the difficulties with applying the concept of explanation in metaphysics.
The purpose of the present paper is: (1) to outline a conceptual framework useful for the analysis of ethical issues raised by goal-directed activities, (2) to apply this framework to nanoscale research, (3) identify some of the main challenges in the evaluation of such research, and (4) exemplify what is needed for a positive answer to the question “How can nanoscale research improve the quality of life?” A basic idea of the paper is that nanoscale research can improve the conditions (...) and quality of life of large groups in society, provided that: (a) this research is directed at certain generally accepted goals, (b) at least some of the opportunities are exploited for the good of mankind, (c) the key obstacles on the road are eliminated, reduced or circumvented, and (d) this is done in ethically acceptable ways. (shrink)
The aims of this article are to consider whether there are medical and societal differences among diseases regarding which patient groups should be asked to participate in first-in-human trials of stem-cell-based therapies; any differences in the light of values generally endorsed by different types of ethical theories, since the question in the title of this article is value laden, and its answer depends on which values one wants to promote and protect, and how they are ranked in importance; whether the (...) answer to that question is disease-specific, or whether it depends on factors common to several diseases. To illustrate these problems, we use Parkinson’s disease and Huntington’s disease , between which there are important medical and societal differences. Moreover, research on stem-cell-based therapies for these diseases is being translated from research to practice. This approach to the problem can be applied to decision making about similar problems raised by other diseases that exhibit the same types of differences. (shrink)
The purpose of this paper is first to discuss and criticize some general theses about interpretation. The concept of interpretation is shown to be more complex than these general theses indicate. Distinctions are suggested between different types o f interpretations, and an attempt is made to state criteria of interpretation and arguments which can be used to support or criticize proposed interpretations. The relations between the various types of interpretations and the criteria (arguments) are then explored. Can they be combined? (...) How? Can they comie into conflict with each other? How are such conflicts in that case to be solved? It is argued that at least partly different criteria and arguments are used, and ought to be used, when different types of interpretations are proposed, checked, and criticized. Sometimes a particular criterion is given, and ought to be given, different weight when different types of interpretations are considered. (shrink)
Animal models of human diseases are often used in biomedical research in place of human subjects. However, results obtained by animal models may fail to hold true for humans. One way of addressing this problem is to make animal models more similar to humans by placing human tissue into animal models, rendering them chimeric. Since technical and ethical limitations make neurological disorders difficult to study in humans, chimeric models with human neural tissue could help advance our understanding of neuropathophysiology. In (...) this article, we examine whether the introduction of human neural tissue and any consequent cognitive change is relevant to the way we ought to treat chimeras. We argue that changes in cognitive abilities are morally relevant to the extent that they increase the capacities that affect the moral status of any entity, including awareness, autonomy, and sociability. We posit that no being, regardless of species, should be treated in a way that is incommensurate with its moral status. Finally, we propose a framework that can be used to guide ethical assessment of research involving chimeras with advanced cognitive capacities. We advance this framework as a useful tool for bringing relevant considerations to the forefront for those considering the ethical merit of proposed chimeric research. In doing so, we examine concepts relevant to the question of how any entity may be treated, including moral status, dignity, and capacities. (shrink)
It is well known that close relatives of terminally ill patients endure great emotional stress. Many factors, such as existential concerns, contribute to the distress of these relatives. In this study, interviews were conducted to explore experiences concerning life restrictions, emotional distress, and limited support, in a group of close relatives of patients with amyotrophic lateral sclerosis (ALS). The purpose was to identify, illuminate and clarify ethical problems related to these experiences. The results indicate that close relatives of patients with (...) ALS need someone to talk to, as well as more information about the disease and its process. Furthermore, the study illustrates how ethical problems are related to choices and conflicts, and that a process including shared decision making is often an ideal when trying to find a solution to ethical problems. (shrink)
in Undetermined Table d’Hôte Ingar Brinck: Investigating the development of creativity: The Sahlin hypothesis 7 Linus Broström: Known unknowns and proto-second-personal address in photographic art 25 Johan Brännmark: Critical moral thinking without moral theory 33 Martin Edman: Vad är ett missförhållande? 43 Pascal Engel: Rambling on the value of truth 51 Peter Gärdenfors: Ambiguity in decision making and the fear of being fooled 75 Göran Hermerén: NIPT: Ethical aspects 89 Mats Johansson: Roboethics: What problems should be addressed and why? 103 (...) Johan Laserna: Ambivalenta bilder 113 Anna-Sofia Maurin: Metaphysical explanation 161 Kevin Mulligan: Is preference primitive? 169 John D. Norton: How does your garden grow? 181 Johannes Persson & Annika Wallin: The distinction between internal and external validity 187 Johanna Seibt: Becoming our selves 197 Paul Slovic, Robin Gregory, David Frank, and Daniel Vastfjall: Confronting the collapse of humanitarian values in foreignpolicy decision making 209 Peter Sylwan: Det eviga livet 215 Claudine Tiercelin: Chance, love and logic: Ramsey and Peirce on norms, rationality and the conduct of life 221 Epilog 257 Frank Ramsey. (shrink)
The Fregean distinction between Sinn ("sense") and Bedeutung ("reference") can be applied also to pictures. As to pictorial representation, one may distinguish between what a picture refers to and the properties of the picture that make it possible to tell what it refers to. It is tempting to try to define or elucidate notions like depiction in terms of the Sinn of pictures. But to avoid certain obvious objections to such an approach, the properties of the picture must be construed (...) broadly; they should not only include patches of colors and light, but also complex relational properties. This paper tries to pave the way for such an analysis of pictorial representation in terms of certain combinations of intentions, seeing as, and traditions of representation. An attempt is also made to explore the relations between pictorial representation and structural similarity, and to outline distinctions between some relevant senses of "see-as". Applications to different kinds of art are briefly discussed. (shrink)
The achievement of optimal therapeutic results presupposes the use of appropriate treatment combined with maximal utilization of placebo effects. These aims may sometimes be difficult to satisfy in randomized clinical trials (RCTs). The question thus arises whether there is a conflict between the goals of therapy and those of experimental research; and if so, to what extent, and how is it handled in practice by clinicians and researchers. Various ethical problems have been discussed in several reports connected with RCTs. But (...) we have found no discussion concerning the conflict between obtaining informed consent and promoting optimal placebo effects. Information about RCTs can be given in various ways. Sometimes appropriate information about RCTs to patients involves non-optimal utilization of placebo effects. This gives rise to ethical and methodological problems, which are discussed in this article. (shrink)
The first main purpose of this paper is to identify and to distinguish between a number of problems and conflicts of interest in the area where medical personal registers are used in research, particularly when the registers are computerized. The second main purpose is to suggest and comment upon a method for solving or minimizing such conflicts of interest.
The purpose of this paper is first to discuss and criticize some general theses about interpretation. The concept of interpretation is shown to be more complex than these general theses indicate. Distinctions are suggested between different types o f interpretations, and an attempt is made to state criteria of interpretation and arguments which can be used to support or criticize proposed interpretations. The relations between the various types of interpretations and the criteria are then explored. Can they be combined? How? (...) Can they comie into conflict with each other? How are such conflicts in that case to be solved? It is argued that at least partly different criteria and arguments are used, and ought to be used, when different types of interpretations are proposed, checked, and criticized. Sometimes a particular criterion is given, and ought to be given, different weight when different types of interpretations are considered. (shrink)
The Fregean distinction between Sinn and Bedeutung can be applied also to pictures. As to pictorial representation, one may distinguish between what a picture refers to and the properties of the picture that make it possible to tell what it refers to. It is tempting to try to define or elucidate notions like depiction in terms of the Sinn of pictures. But to avoid certain obvious objections to such an approach, the properties of the picture must be construed broadly; they (...) should not only include patches of colors and light, but also complex relational properties. This paper tries to pave the way for such an analysis of pictorial representation in terms of certain combinations of intentions, seeing as, and traditions of representation. An attempt is also made to explore the relations between pictorial representation and structural similarity, and to outline distinctions between some relevant senses of "see-as". Applications to different kinds of art are briefly discussed. (shrink)