According to surveys and opinion polls, citizens in Nordic welfare societies have positive, supportive attitudes towards medical research and biobanking. In Finland, it was expected that this would result in the active biobank participation of patients and citizens. Indeed, public support has been rhetorically utilised as a unique societal factor and advantage in the promotion of Finnish biobanks, underlining the potential Finland offers for the international biomedical enterprise. In this paper, we critically analyse the use of notions such as ‘willing (...) population’ and ‘engaged people’ in the promotion and legitimation of biobanking. First, there is a seeming contradiction between positive attitudes and actual participation rates, as biobanks have faced unexpected challenges in participant recruitment during the first years of their operations. As a result, the concept of a willing population was redirected to problematise the necessity of informed consent. Second, we question whether it is even meaningful to assume the existence of an informed and engaged population with regard to biobanking. Therefore, we suggest that it is problematic to talk about a willing population at the same time as the relevance of the informed consent system is being questioned by biobank actors and policy makers. We analyse this tension in relation to existing data on Finnish people’s attitudes, pointing out that positive, supportive views do not directly transform into high participation rates; nor do they justify the claims of policy makers and biobank proponents that people are willing to participate, when in fact surveys report that people know very little about biobanks. (shrink)

The Nordic countries aim to have a unique place within the European and global health data economy. They have extensive nationally maintained and centralized health data records, as well as numerous biobanks where data from individuals can be connected based on personal identification numbers. Much of this phenomenon can be attributed to the emergence and development of the Nordic welfare state, where Nordic countries sought to systematically collect large amounts of population data to guide decision making and improve the health (...) and living conditions of the population. Recently, however, the so-called Nordic gold mine of data is being re-imagined in a wholly other context, where data and its ever-increasing logic of accumulation is seen as a driver for economic growth and private business development. This article explores the development of policies and strategies for health data economy in Denmark and Finland. We ask how nation states try to adjust and benefit from new pressures and opportunities to utilize their data resources in data markets. This raises questions of social sustainability in terms of states being producers, providers, and consumers of data. The data imaginaries related to emerging health data markets also provide insight into how a broad range of different data sources, ranging from hospital records and pharmacy prescriptions to biobank sample data, are brought together to enable “full-scale utilization” of health and welfare data. (shrink)

How can we figure out what’s right or wrong, if moral truths are neither self-evident nor something we can perceive? Very roughly, the method of reflective equilibrium (RE) says that we should begin moral inquiry from what we already confidently think, seeking to find a a match between our initial convictions and general principles that are well-supported by background theories, mutually adjusting both until we reach a coherent outlook in which our beliefs are in harmony (the equilibrium part) and we (...) know why and how they support each other (the reflective part). It has been central to the self-understanding of normative ethics and other branches of philosophy in the last half a century. In this chapter, we examine the history of the idea of RE and introduce a schema for generating 256 variants. We explain why RE is subject to serious objections insofar as it purports to yield epistemic justification in virtue of achieving coherence. However, we also develop a new argument to the effect that RE is the best feasible method for us to achieve moral understanding and the ability to justify our judgments to others. It may thus be crucial for responsible moral inquiry, even if coherence among considered judgments and principles is neither sufficient nor necessary for justified moral belief. (shrink)

The article examines Barthes’s A Lover’s Discourse (1977) in conjunction with du Maurier’s Trilby (1894) in order to present an argument about the similarities they share with the male masochistic fantasy as theorised by Deleuze in his Coldness and Cruelty (1989). Barthes’s insistence on the connection between art and love directs my approach. Trilby deals with love and aesthetics in the contexts of art, music, and narrative. The discourses of Trilby’s competing lovers over the same woman serve as a point (...) of comparison against which I read Barthes’s dramatisation of a lover’s discourse. I argue that Barthes’s lover shares a number of central discursive figures with the Deleuzian masochistic lover. I examine Barthes’s suggestion about the tension between the non-narrative discourse of love and the metalanguage of conventional love stories. I focus on those figures in a lover’s discourse that Barthes identifies as keeping this discourse from turning into a love story. My argument is that many of these figures are among the hallmarks of the masochistic fantasy. In particular the formula of disavowal safeguards the lover’s discourse, hindering it from turning into a conventional narrative about love. (shrink)

The article examines Barthes’s A Lover’s Discourse (1977) in conjunction with du Maurier’s Trilby (1894) in order to present an argument about the similarities they share with the male masochistic fantasy as theorised by Deleuze in his Coldness and Cruelty (1989). Barthes’s insistence on the connection between art and love directs my approach. Trilby deals with love and aesthetics in the contexts of art, music, and narrative. The discourses of Trilby’s competing lovers over the same woman serve as a point (...) of comparison against which I read Barthes’s dramatisation of a lover’s discourse. I argue that Barthes’s lover shares a number of central discursive figures with the Deleuzian masochistic lover. I examine Barthes’s suggestion about the tension between the non-narrative discourse of love and the metalanguage of conventional love stories. I focus on those figures in a lover’s discourse that Barthes identifies as keeping this discourse from turning into a love story. My argument is that many of these figures are among the hallmarks of the masochistic fantasy. In particular the formula of disavowal safeguards the lover’s discourse, hindering it from turning into a conventional narrative about love. (shrink)

ABSTRACT Public health authorities sometimes have to make decisions about the use of preventive medical measures—e.g. vaccination programmes—which could, if realised, save millions of lives, but could also kill a certain (small) number of those subjected to the measures. According to a rough‐and‐ready utilitarian calculation, such measures should be taken, but there are also possible objections to this view. A liberal objection to the use of mandatory preventive measures which might harm human beings is that people have a right to (...) decide for themselves whether or not they want to participate in the programme. A further objection is based on the claims that first, the authorities are directly killing those who die because of, say, vaccination programmes, and second, directly killing human beings is forbidden (since every human being has a right to live). The latter objection is discussed at length in the present paper. The validity of three doctrines, the doctrines of the double effect, of acts and omissions, and of killing and letting die, are considered with reference to the use of preventive measures, and found inapplicable. The objection is, however, refuted by comparing some hypothetical examples, and the initial utilitarian calculation is reinforced. (shrink)

ABSTRACTIn this paper, our purpose is to show what George Berkeley really said about ethics and the background conditions of religious life. The point is that true happiness is only possible in a religious sense; it means happiness in afterlife. The major threat to this is freethinking, or what we see as emerging enlightened modernism. His rather quixotic fix against freethinking shows the man as he is behind all the conventional panegyrics. He is a real Anglican soldier who anticipated but (...) never admitted a critical defeat in the most important of all battles. Interest in George Berkeley’s life’s work has been exceptionally selective. Yet his revolutionary immaterialism is only an early episode in his struggles towards a better society and religious life for all the people, regardless of their denomination. From this point of view, Alciphron is central. But he also develops his ethical ideas in his various minor writings, which have been largely overlooked. (shrink)

_The Limits of Medical Paternalism_ defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

In disputes about conceptual analysis, each side typically appeals to pre-theoretical 'intuitions' about particular cases. Recently, many naturalistically oriented philosophers have suggested that these appeals should be understood as empirical hypotheses about what people would say when presented with descriptions of situations, and have consequently conducted surveys on non-specialists. I argue that this philosophical research programme, a key branch of what is known as 'experimental philosophy', rests on mistaken assumptions about the relation between people's concepts and their linguistic behaviour. The (...) conceptual claims that philosophers make imply predictions about the folk's responses only under certain demanding, counterfactual conditions. Because of the nature of these conditions, the claims cannot be tested with methods of positivist social science. We are, however, entitled to appeal to intuitions about folk concepts in virtue of possessing implicit normative knowledge acquired through reflective participation in everyday linguistic practices. (shrink)

One of the core issues in medical ethics has been and still is autonomy, people's right to make their own self-regarding choices in situations where more than one option is available. Depending on the case, these choices may be influenced by personal life history, one's ethical and other values, and one's future expectancies. A professional soccer player may risk an operation, which for a less athletic individual would represent an unnecessary risk that might jeopardize her ability to even walk. Saying (...) no to painkillers may sound irrational to those who do not see anything ennobling in avoidable suffering, and preferring homeopathic medicine to more evidence-based medicine may lead others to seriously doubt the logic of one's thinking. But although these situations may be difficult,1 they seldom lead to an impasse. Even if serious value conflicts emerge in these patient–medical personnel encounters, they can be overcome by the fact that, in Western countries, honoring patients' autonomy has been widely accepted as part of medical professionalism. (shrink)

The Limits of Medical Paternalism defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

Everyone agrees that not all norms that govern belief and assertion are epistemic. But not enough attention has been paid to distinguishing epistemic norms from others. Norms in general differ from merely evaluative standards in virtue of the fact that it is fitting to hold subjects accountable for violating them, provided they lack an excuse. Different kinds of norm are most readily distinguished by their distinctive mode of accountability. My thesis is roughly that a norm is epistemic if and only (...) if its violation makes it fitting to reduce epistemic trust in the subject, even if there is no doubt about their sincerity, honesty, or other moral virtues. That is, violations of epistemic norms don’t merit resentment or other forms of blame, but rather deduction of credibility points in internal scorekeeping and related attitudinal and behavioral changes. As Fricker’s work on epistemic injustice shows, such distrust is undesirable from the point of view of an epistemic agent. Consequently, when one manifests epistemic distrust towards a subject in suitable circumstances, it amounts a way of holding her accountable. Since this form of accountability involves no opprobrium, there is good reason to think it is not linked to voluntary control in the same way as moral accountability. Finally, I make use of this account of what makes epistemic norms distinctive to point out some faulty diagnostics in debates about norms of assertion. My aim is not to defend any substantive view, however, but only to offer tools for identifying the right kind of evidence for epistemic norms. (shrink)

(Pdf updated to final, slightly revised version of November 2010) -/- Almost everyone would prefer to lead a meaningful life. But what is meaning in life and what makes a life meaningful? I argue, first, for a new analysis of the concept of meaningfulness in terms of the appropriateness of feelings of fulfilment and admiration. Second, I argue that while the best current conceptions of meaningfulness, such as Susan Wolf’s view that in a meaningful life ‘subjective attraction meets objective attractiveness’, (...) do a fairly good job capturing meaningfulness at a time, we need an account that makes sense of the intimate connection between meaningfulness and having a direction in one’s life. According to the Teleological View I propose, what makes a single chapter of a life most meaningful is success in reaching central, objectively valuable goals as a result of exercising essential human capacities. Life as a whole is most meaningful when past efforts increase the success of future goal-setting, goal-seeking, and goal-reaching, so that the life forms a coherent whole without being dedicated to a single aim. Since coherence in this sense is a holistic property of a life, global prudential value is not a function of local prudential values. I suggest that just as pleasure is the final good of human beings as subjects of experience, meaningfulness is the final good of human beings as active agents. (shrink)

In different countries responses to important bioethical issues are different, as exemplified by the attitudes towards the voluntary and active forms of medical euthanasia. But why is this the case? My suggestion is that the roots of the variety are, to a considerable degree, ideological. The most important present‐day political ideologies all have their roots in the prevailing doctrines of moral and social philosophy. In the paper these doctrines are outlined and the predicted response towards active voluntary euthanasia within each (...) model is sketched. The conclusion reached is that while it would in some countries be dangerous to allow euthanasia in the prevailing circumstances, the solution is not to hinder the legalization process but to alter the circumstances. (shrink)

What should we believe if epistemic and practical reasons for belief point in different directions? I argue that there’s no single answer, but rather a Dualism of Theoretical and Practical Reason is true: what we epistemically ought to believe and what we practically ought to believe may come apart, and both are independently authoritative. I argue in particular against recently popular views that subordinate the epistemic to the practical: it’s not the case that epistemic reasons bear on what we ‘just (...) plain ought’ to believe just to the extent we have practical reason to believe epistemically correctly. Why? Because epistemic reasons give rise to authoritative demands independently of the practical pay-off of believing accordingly. This is shown in particular by the fact that it can be fitting to epistemically ‘blame’ us just because we fail to believe as we epistemically ought, even if we don’t have sufficient practical reason to believe so. I also argue that we don’t need to come up with what we ‘just plain ought’ to believe, because contrary epistemic and practical responsibility responses can be simultaneously fitting in conflict cases, and because epistemic and practical ought judgments give rise to different enkrasia requirements, among other things. (shrink)

Sentimentalism comes in many varieties: explanatory sentimentalism, judgment sentimentalism, metaphysical sentimentalism, and epistemic sentimentalism. This encyclopedia entry gives an overview of the positions and main arguments pro and con.

In his book The Principles of Art Robin George Collingwood presents a theory of art as the expression of emotion. The connection between his view and the theories of the Italian neo-idealists Benedetto Croce and Giovanni Gentile is both well known and well documented. What seems to be less known, however, is the intellectual link R. G. Collingwood’s father, William Gershom Collingwood, formed between his son and John Ruskin, the great Victorian essayist, critic and reformer. There are some references in (...) the literature to the fact that W. G. Collingwood was Ruskin’s friend, pupil, assistant and private secretary, later on his intellectual interpreter and biographer. It has also been argued that since R. G. Collingwood was until the age of thirteen exclusively educated by his father, there must have been an educational link between Ruskin and the younger Collingwood. But when it has come to pointing out theoretical similarities between the aesthetic theories of Ruskin and Collingwood, philosophers of art have, by and large, kept a remarkably low profile. (shrink)

Moral philosophy is one of the core areas of philosophy. It is a fruitful research project in which ethicists investigate a range of different kinds of questions from the abstract metaethical puzzles concerning the meaning of moral language to the concrete ethical problems such as how much we should do to help other people. Yet, even if different answers to all these questions are intensively debated in moral philosophy, there is surprising little explicit reflection of what the appropriate ways of (...) doing moral philosophy are. -/- What are we entitled to assume as the starting-points of our ethical inquiry? What is the role of empirical sciences in ethics? Is there just one general method for doing moral philosophy or should different questions in moral philosophy be answered in different ways? Are there argumentative structures and strategies that we should be encouraged to use or common problematic argumentative patterns that we should avoid? -/- This volume brings together leading moral philosophers to consider these questions systematically. The chapters investigate the prospects of empirical ethics, outline new methods of ethics, evaluate recent methodological advances, and explore whether different areas of moral philosophy are methodologically continuous or independent of one another. (shrink)

According to the quasi-perceptualist account of philosophical intuitions, they are intellectual appearances that are psychologically and epistemically analogous to perceptual appearances. Moral intuitions share the key characteristics of other intuitions, but can also have a distinctive phenomenology and motivational role. This paper develops the Humean claim that the shared and distinctive features of substantive moral intuitions are best explained by their being constituted by moral emotions. This is supported by an independently plausible non-Humean, quasi-perceptualist theory of emotion, according to which (...) the phenomenal feel of emotions is crucial for their intentional content. (shrink)

The demands of rationality are linked both to our subjective normative perspective (given that rationality is a person-level concept) and to objective reasons or favoring relations (given that rationality is non-contingently authoritative for us). In this paper, I propose a new way of reconciling the tension between these two aspects: roughly, what rationality requires of us is having the attitudes that correspond to our take on reasons in the light of our evidence, but only if it is competent. I show (...) how this view can account for structural rationality on the assumption that intentions and beliefs as such involve competent perceptions of downstream reasons, and explore various implications of the account. (shrink)

This chapter is concerned with the use of conceptual analysis, particularly intuitions, in solving various philosophical problems such as the concepts of knowledge, free will, moral judgment, and intentional action, among others. Experimentalists make use of the Survey Model in conducting their studies since survey feedbacks produce data about which philosophical perspectives can be analyzed. An alternative model is the Dialogue Model of inquiry, which has proven to be more efficient as the philosopher can directly present alternate interpretations and varying (...) examples for the subject to choose from, yielding even more fruitful results. (shrink)

What is the relationship between meaning in life and happiness? In psychological research, subjective meaning and happiness are often contrasted with each other. I argue that while the objective meaningfulness of a life is distinct from happiness, subjective or felt meaning is a key constituent of happiness, which is best understood as a multidimensional affective condition. Measures of felt meaning should consequently be included in empirical studies of the causes and correlates of happiness.

The aging process involves changes in immune regulation, i.e. adaptive immunity declines whereas innate immunity becomes activated. NF‐κB signaling is the master regulator of the both immune systems. Two recent articles highlight the role of the NF‐κB system in aging and immune responses. Adler et al1 showed that the NF‐κB binding domain is the genetic regulatory motif which is most strongly associated with the aging process. Kwon et al2 studying HIV‐1 infection and subsequent immune deficiency process demonstrated that HIV‐1 Tat (...) protein binds to SIRT1 protein, a well‐known longevity factor, and inhibits the SIRT1‐mediated deacetylation of the p65 component of the NF‐κB complex. As a consequence, the transactivation efficiency of the NF‐κB factor was greatly potentiated, leading to the activation of immune system and later to the decline of adaptive immunity. These observations support the scenario where immune responses and aging process can be enforced by the potentiation of NF‐κB transactivation efficiency. Longevity factors, such as SIRT1 and its activators, might regulate the efficiency of the NF‐κB signaling, the major outcome of which is inflamm‐aging via proinflammatory responses. BioEssays 30:939–942, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Very plausibly, there is something important missing in our lives if we are thoroughly ignorant or misled about reality – even if, as in a kind of Truman Show scenario, intervention or fantastic luck prevents unhappiness and practical failure. But why? I argue that perfectionism about well-being offers the most promising explanation. My version says, roughly, that we flourish when we exercise our self-defining capacities successfully according to their constitutive standards. One of these self-defining capacities, or capacities whose exercise reveals (...) who we are, is Reason, our capacity for normative self-governance. I argue that in its practical use, Reason formally aims at competently realizing self-chosen valuable ends that are in harmony with each other, or valuable achievements. In its theoretical use, it formally aims at competently grasping fundamental enough subject matters, or a kind of understanding. Because success by reason’s own standards requires many things to go right, there are many different ways in which we can fall short. Some of them amount to partial success. But some, like incompetent inquiry that fails to yield understanding of its target, or taking inefficient means to a worthless end, are robust failures that amount to epistemic or agential unflourishing, and thus to a form of ill-being. (shrink)

When we admire a person, we don’t just have a wow-response towards them, as we might towards a painting or a sunset. Rather, we construe them as realizing an ideal of the person in their lives to a conspicuous degree. To merit admiration, it is not enough simply to do something valuable or to possess desirable character traits. Rather, one’s achievements must manifest commitments and character traits that define a worthwhile ideal. Agential admiration, I argue, is a person-focused attitude like (...) shame, contempt, and hubristic pride, not an act-focused one like gratitude or guilt, not to mention mere evaluation as excellent. Given its holistic focus, its motivational effects permeate our interactions with its target, who is construed as an exemplar. Consequently, even if someone is admirable in some way, admiring them may be all-things-considered inappropriate, if they fall short of other ideals that we ought to care about. (shrink)

Most of us are hedonically future-biased: other things being equal, we prefer pains to be in the past and pleasures to be in the future. Recently, various authors have argued that future bias is irrational, and that we should be temporally neutral instead. I argue that instead of temporal neutrality, the putative counterexamples and the rationales offered for them only motivate a more narrow principle I call Only Action Fixes Utility: it is only when you act on the basis of (...) assigning a utility to an outcome that rationality requires you to give it the same value retrospectively and prospectively, other things being equal. When hedonic experiences are untethered from action, hedonic future bias is rationally permissible. I support this principle by appeal to additional scenarios and more general asymmetries between agential and experiential goods. (shrink)

It is widely acknowledged that susceptibility to suitable emotional responses is part of what it is to value something. Indeed, the value of at least some things calls for such emotional responses – if we lack them, we don’t respond appropriately to their value. In this paper, I argue that susceptibility to anger is an essential component of valuing other people, ourselves, and our relationships. The main reason is that various modes of valuing, such as respect, self-respect, and love, ground (...) normative expectations towards others and ourselves. And holding someone accountable for violating legitimate normative expectations involves emotions from the anger family, such as resentment and indignation. I hold that such forms of anger, which aim at getting the target to conform to expectations or lower their unduly elevated status, are neither inherently problematic or dispensable parts of the package of attitudes involved in valuing. Finally, thinking about anger’s role in valuing also helps see when it is out of place or immature – roughly, it is often excessive, because we easily exaggerate the magnitude of the value involved, the harm or threat to it, or the degree of the target’s moral responsibility. (shrink)

This paper examines systematically which features of a life story (or history) make it good for the subject herself - not aesthetically or morally good, but prudentially good. The tentative narrative calculus presented claims that the prudential narrative value of an event is a function of the extent to which it contributes to her concurrent and non-concurrent goals, the value of those goals, and the degree to which success in reaching the goals is deserved in virtue of exercising agency. The (...) narrative value of a life is a simple sum of the values of individual events that comprise it. I claim that this view best explains and support common intuitions about the significance of the shape of a life. (shrink)

On a widely accepted view, what gives meaning to our lives is success in valuable ground projects. However, philosophers like Kieran Setiya have recently challenged the value of such orientation towards the future, and argued that meaningful living is instead a matter of engaging in atelic activities that are complete in themselves at each moment. This chapter argues that insofar as what is at issue is meaningfulness in its primary existential sense, strongly atelic activities do not suffice for meaning. Instead, (...) finding one’s life meaningful is warranted both by sustainable success in valuable prospective (future-oriented) projects, and by success in reflexive projects that aim to promote or realize a practice-dependent value that can be realized at each moment, but never for good. The latter kind of activities are only weakly atelic, since their aim remains distinct from the activity, and individual actions gain significance from serving a long-term commitment. Thus, whether our ground projects are prospective or reflexive, what we do at each moment contributes to leading a meaningful life only when it’s connected in the right way to what we do at other moments. (shrink)

The moral importance of liability to harm has so far been ignored in the lively debate about what self-driving vehicles should be programmed to do when an accident is inevitable. But liability matters a great deal to just distribution of risk of harm. While morality sometimes requires simply minimizing relevant harms, this is not so when one party is liable to harm in virtue of voluntarily engaging in activity that foreseeably creates a risky situation, while having reasonable alternatives. On plausible (...) assumptions, merely choosing to use a self-driving vehicle typically gives rise to a degree of liability, so that such vehicles should be programmed to shift the risk from bystanders to users, other things being equal. Insofar vehicles cannot be programmed to take all the factors affecting liability into account, there is a pro tanto moral reason not to introduce them, or restrict their use. (shrink)

Normative political philosophy always refers to a standard against which a society's institutions are judged. In the first, analytical part of the article, the different possible forms of normative criticism are examined according to whether the standards it appeals to are external or internal to the society in question. In the tradition of Socrates and Hegel, it is argued that reconstructing the kind of norms that are implicit in practices enables a critique that does not force the critic's particular views (...) on the addressee and can also be motivationally effective. In the second part of the article, Axel Honneth's theory of recognition is examined as a form of such reconstructive internal critique . It is argued that while the implicit norms of recognition made explicit in Honneth's philosophical anthropology help explain progressive social struggles as moral ones, his theory faces two challenges in justifying internal critique. The Priority Challenge asks for the reasons why the implicit norms of recognition should be taken as the standard against which other implicit and explicit norms are to be judged. The Application Challenge asks why a social group should, by its own lights, extend equal recognition to all its members and even non-members. The kind of functional, prudential, conceptual, and moral considerations that could serve to answer these challenges are sketched. (shrink)

On the face of it, suffering from the loss of a loved one and suffering from intense pain are very different things. What makes them both experiences of suffering? I argue it’s neither their unpleasantness nor the fact that we desire not to have such experiences. Rather, what we suffer from negatively transforms the way our situation as a whole appears to us. To cash this out, I introduce the notion of negative affective construal, which involves practically perceiving our situation (...) as calling for change, registering this perception with a felt desire for change, and believing that the change is not within our power. We (attitudinally) suffer when negative affective construal is pervasive, either because it colours a large swath of possibilities, as in the case of anxiety, or because it narrows our attention to what hurts, as in the case of grief. On this view, sensory or bodily suffering is a special case of attitudinal suffering: the unpleasantness of pain causes pervasive negative affective construal. Pain that doesn’t negatively transform our world doesn’t make for suffering. (shrink)