This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)

BackgroundNon-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate.AimTo learn what ethical issues operating room nurses perceive as important regarding non-technical skills.Research designQualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke’s six phases for thematic analysis.Participants and research contextEleven experienced perioperative/operating room nurses working in an operating unit at a Norwegian (...) university hospital.Ethical considerationsApproval was given by The Norwegian Social Science Data Service in care of the hospital’s Data Protection Officer.FindingsThree main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety.DiscussionDefending the patient’s dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other’s tasks and responsibilities and to talk to one another in a friendly manner.ConclusionBeing respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good ‘flow’ within the operating room team. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1. Providing information about research integrity§ 2. Providing education, training and mentoring§ 3. Strengthening a research integrity culture§ 4. Facilitating open dialogue§ 5. Wise incentive management§ 6. Implementing quality assurance procedures§ 7. Improving the work environment and work satisfaction§ 8. Increasing transparency of misconduct cases§ 9. Opening up research§ 10. Implementing safe and effective whistle-blowing channels§ 11. Protecting the alleged perpetrators§ 12. Establishing a research integrity committee and appointing an ombudsperson§ 13. Making explicit the applicable standards for research integrity. (shrink)

The expansion of livestock production throughout the world has led to increased demand for high protein animal feed. This expansion has created economic benefits for livestock farmers and other actors in the chain, but also resulted in environmental and social side effects. This study aims to identify a set of sustainability issues that cover the environmental, economic and social dimensions of soymeal and beef production chains. The method applied combines the results of multiple studies, including a literature review and stakeholder (...) surveys. Stakeholder surveys were conducted for three different interest groups and two geographical regions . Our results reveal that the selection of issues in most sustainability assessment studies is a relatively arbitrary decision, while the literature also states that identifying issues is an important step in a sustainability assessment. Defining sustainability issues from a whole chain perspective is important, as issues of sustainability emerge at various stages along the production chain, and are found to vary across stakeholders’ interests. Business stakeholders, for example, perceived economic issues to be more important, whereas the majority of consumer stakeholders and other stakeholders perceived social and environmental issues, respectively, to be more important. Different education levels, knowledge, and living patterns in various geographical regions can affect the stakeholders’ perceptions. The combination of a heterogeneous group of stakeholders and the consideration of multiple chain stages constitutes a useful approach to identify sustainability issues along food chains. (shrink)

Artikkelen undersøker hvordan NIPT ble vedtatt implementert i det norske fosterdiagnostiske systemet gjennom en fagligpolitisk prosess mellom 2012 og 2017. Prosessen innebar at Nasjonalt kunnskapssenter for helsetjenesten, Helsedirektoratet, Bioteknologirådet og Helse- og Omsorgsdepartementet ga sine vurderinger av testen og sine råd omkring en eventuell innføring. Artikkelen viser at det i denne prosessen foregikk en forsiktig tilnærming eller sammensmelting mellom de tradisjonelt helt ulike måtene å forstå og å ramme inn fosterdiagnostikk på i Norge, dvs. i en ‘autonomi/ behandlingsramme’ og en (...) ‘sorteringsramme’. Artikkelen argumenterer videre for at denne tilnærmingen eller konvergensen var mulig fordi prosessen ble holdt innenfor de fagligpolitiske byråkratiene, og de ulike etatene var innstilt på å ‘samarbeide’ om å inkludere både kunnskap og verdier fra begge rammene i sine tilrådninger. Politikk for fosterdiagnostikk er imidlertid et svært politisk betent område i Norge, og denne konvergensen var et skjørt byggverk. Den sprakk da også opp i løpet av tre uker i mai 2020, da Fremskrittspartiet plutselig inngikk et ‘bioteknologiforlik’ med Arbeiderpartiet og SV etter at de hadde gått ut av Solbergregjeringen. Dermed endte spørsmålet om implementeringen av NIPT i Stortinget, hvor konvergensen i den fagpolitiske prosessen ble erstattet av de tradisjonelle frontene, og de gamle innrammingene igjen ble ‘satt i arbeid’. Artikkelen diskuterer avslutningsvis kort de bortimot uløselige dilemmaene disse innrammingene både representerer og produserer. Nøkkelord: NIPT, fosterdiagnostikk, humanmedisinsk bioteknologi, regulering English Title: Fetal diagnostics between medicine and ethics: Implementation of Prenatal Invasive Testing in a turbulent policy area: The article examines how the decision to implement Prenatal Invasive Testing in the Norwegian Fetal Diagnostic System was reached through a professional policy process between 2012 and 2017. The process involved the Norwegian Research Centre for Health Services, the Norwegian Directorate of Health, the Norwegian Biotechnology Advisory Board and the Ministry of Health and Care Services, which provided their individual assessments and advice regarding the potential implementation of the test. The article finds that a careful convergence took place between traditionally opposing ways to understand and frame fetal diagnostics in Norway – either as a ‘treatment frame’ or a ‘sorting frame’. The article further argues that this convergence was possible because the process was kept within these bureaucracies, and that the different agencies were willing to collaborate to include knowledge and values from both frames in their recommendations. However, policy for fetal diagnostics is a very turbulent political area in Norway, and this convergence was a fragile construction. During three weeks in May 2020, the convergence collapsed when the Norwegian Progress Party suddenly entered a “biotechnology settlement” with the Labour Party and the Socialist Left Party after exiting the conservative Government coalition. Hence, the question of implementing NIPT ended up in the Norwegian Parliament, where the convergence from the professional policy process was replaced by the traditional fronts, and the old framings were again set in motion. Lastly, the article briefly discusses the almost unsolvable dilemmas these framings both produce and represent. Keywords: NIPT, non-invasive prenatal testing, fetal diagnostics, medical biotechnology, regulation. (shrink)

This article analyses 1,073 e-mails that were hacked from the Climatic Research Unit at the University of East Anglia in November 2009. The incident was popularly dubbed 'Climategate', indicating that the e-mails reveal a scientific scandal. Here we analyse them differently. Rather than objecting to the exchanges based on some idea about proper scientific conduct, we see them as a rare glimpse into a situation where scientists collectively prepare for participation in heated controversy, with much focus on methodology. This allows (...) us to study how scientists communicate informally about framing propositions of facts in the best possible way. Through the eyes of science and technology studies, the e-mails provide an opportunity to study communication as part of science in the making across disciplines and laboratories. Analysed as 'written conversation' the e-mails provide information about processes of consensus formation through 'agonistic evaluations' of other scientists' work and persuasion of others to support one's own work. Also, the e-mails contain judgements about other groups and individual scientists. Consensus-forming appeared as a precarious activity. Controversies could be quite resilient in the course of this decade-long exchange, probably reflecting the complexity of the methodological challenges involved. (shrink)

It is a common mistake, especially, perhaps, among students of the religions and philosophies of India, to assume that the word prak?ti, best known as the ultimate material principle in the S??khya and Yoga systems of religious thought, the material cause of the world in Hindu theologies and, as such, an epithet of the goddesses in Hinduism, always refers to an ultimate principle. Even in S??khya and Yoga texts the word prak?ti is used in various ways. Prak?ti does not always (...) refer to the ultimate principle. Translators often leave the word prak?ti untranslated and mislead the reader to assume that the ultimate principle is referred to, when it is not. This article discusses the use of prak?ti in the S??khya-Yoga texts the Yogas?tra and the Vy?sabh??ya and criticises some translation practices. (shrink)

My dissertation, “Love, Self-Constitution, and Practical Necessity,” offers an interpretation of love between people. Love is puzzling because it appears to involve essentially both rational and non-rational phenomena. We are accountable to those we love, so love seems to participate in forms of necessity, commitment, and expectation, which are associated with morality. But non-rational attitudes—forms of desire, attraction, and feeling—are also central to love. Consequently, love is not obviously based in rationality or inclination. In contrast to views that attempt to (...) fit love into existing models of practical reasoning, I argue that love participates in a unique form of practical necessity, different from both moral and psychological necessity, yet bearing resemblances to each. Distinctive to this type of practical necessity is a direct appeal to another particular person that cannot be delivered in third-personal terms—that is, a non-moral yet normative type of expectation on another person. This type of expectation is predominant in loving relationships, but can also make better sense of the experiences of humor and beauty, as well as attitudes like forgiveness, gratitude, and agent-regret. I treat Immanuel Kant’s discussion of the experience of beauty in the Critique of Judgment and Christine Korsgaard’s work on self-constitution as fruitful starting points for this account of love. I conclude that our loving relationships enable us to have distinctive personal selves, and provide support for this account of love by offering a complementary theory of grief. In Part One of the dissertation, I focus on two prominent approaches to love characteristic of the sentimentalist and rationalist traditions. I begin with the work of David Hume, which treats desire (understood as something like a simple impulse or craving) as the paradigmatic mental state, and emphasizes our personal and affective dimensions. Hume has the valuable insight that loving someone affects our sense of ourselves. But Hume’s view becomes unsatisfying when he claims that love is essentially enfeebling, implying that to love is to be passive toward and readily overcome by another person. While this indicates Hume’s awareness that love involves being open and receptive to another person, the problem is that love is also a demanding attitude. Hume lacks the conceptual resources to offer a nuanced view of the self, in which we can—with one attitude—be both demanding of and vulnerable to another person. Hume’s model of a desire-based deliberative process has recently been revived in Harry Frankfurt’s discussions on love and rationality. Frankfurt, however, goes beyond Hume’s picture of the self by introducing a notion of “identification,” which he offers to make sense of our apparent ability to commit ourselves decisively to certain projects or people. I argue that active powers like identification and commitment cannot be accommodated within any basically Humean moral psychology. Such abilities, and with them the possibility of love, depend on something closer to a Kantian conception of rational agency. I next focus on the work of Kant, who provides the substantial counterpart to Humean-inspired moral theories, but is not known for his insight into our emotional lives. In the Metaphysics of Morals, Kant divides love into “practical love”—what we experience when we are morally motivated to help someone—and “pathological love”—what we experience when we feel fond of something. But in reality, we experience love neither as a mere preference for another person, nor as something that generates the kind of demands that would be binding on any rational creature. David Velleman attempts to remedy the deficiency of Kant’s dichotomy. Velleman offers a Kantian theory in which he describes love and respect as two ends of a continuum of attitudes that it is morally appropriate to have toward people. Velleman’s view has the peculiar implication that everyone deserves the love of everyone else, and I argue that this is a fatal flaw. Like Kant and Velleman, Korsgaard characterizes personal love as involving the treatment of other people as Kantian ends-in-themselves to a heightened degree. Korsgaard, though, also contends that our individual identities depend upon our personal relationships, and I take this position seriously for the remainder of the dissertation. Ultimately, however, characterizations of loving relations as subsets of moral relations can account for the authority of the demands of love, but not its particularity. The major conclusion of Part One is that any attempt to understand love primarily on a model of practical reasoning with which we are already familiar is doomed to fail. Our experience of love calls for a theory of a unique type of practical necessity. In Part Two I take seriously the possibility that love is simultaneously inescapable (in something like the way morality is supposed to be), and yet ineluctably personal. In love, we experience an engagement with a person as essentially particular, rather than as an instance of a rational agent in general. To make sense of this direct attachment to an individual, I argue that love involves distinctive forms of expectation and disappointment. When those we love let us down, they hurt our feelings, which is not a response to a failed prediction, but nor is it a reaction to a moral insult or offense. According to Peter Strawson and Stephen Darwall, second-personal moral reactive attitudes (such as resentment) always have third-personal analogues (such as indignation). In contrast, I argue that the type of hurt feelings associated with love is a second-personal reactive attitude that does not have a third-personal corollary. I take this as evidence that the expectations involved in love are not objective in the way that the moral is objective. Nor, however, is love a matter of mere preference. On my interpretation, Kant introduces this different type of expectation in the Critique of Judgment. Whereas he characterizes moral judgments as universally communicable, judgments of beauty implicitly involve only second-personal address: I appeal to your direct experience with a particular object. This provides the conceptual space for an account of love according to which it involves a uniquely second-personal form of practical necessity. I contend that the second-personal addresses we make in love are appeals to strengthen the intimacy implicit in the loving relationship, and I identify three interrelated dimensions of that intimacy. First, those we love have the standing to interpret us in a constitutive manner. We fine-tune and make determinate the character of our concerns and interests in part by accepting the interpretations provided by those we love. In that way, the people we love have the normative power to constitute who we are. Second, we share a perspective with those we love in a way that is not reducible to or derivative of our independent perspectives. Loving someone centrally involves the activity of forming concerns together, and we do this in a mode best understood on the model of playing a spontaneous game or improvising music. Finally, being loved enables us to see ourselves as distinctive and special, because the concern those who love us have for us does not track the objective merit of our characteristics. These dimensions of the intimacy that characterizes a loving relationship reveal what it is that we appeal for in love, and how we are hurt when our appeals are rebuffed. In broad terms, this dissertation advocates the recognition of a non-moral yet normative type of expectation, which is predominant in loving relationships. Humor and beauty, too, make more sense when understood in terms of this non-moral yet normative type of expectation, as they involve appeals to others that are more than mere predictions of, but less than rational demands for, a certain kind of response. Introducing this alternative notion of expectation into the discourse of moral philosophy can shed light on other common attitudes that are clearly normative, but defy translation into objective, third-personal terms. Such attitudes include certain experiences of pride and shame, apology and forgiveness, the bestowing of mercy, gratitude, agent-regret, and perhaps a basic sense of trust we have in others. Ultimately, I situate love in respect to grief, which demonstrates my theory’s ability to make sense of related dimensions of our emotional lives. The people we love and grieve over give us a sense of who we are as distinctive, particular individuals, as the three interrelated dimensions of intimacy in loving relationships reveal. Consequently, grief is best understood as a type of practical disorientation—namely, a disorientation that involves the loss of the personal self. I present my account of grief against the type of account that would draw philosophical conclusions about the nature of love and grief from empirical psychological data alone. In particular, these data indicate that we recover quickly from the deaths of loved ones, and Dan Moller draws the philosophical conclusion that those we love fulfill certain roles in our lives and are replaceable. In contrast, I contend that while we should acknowledge the truth of the objective judgment, made in the third-person, that we will likely recover after the deaths of those we love, it does not follow that we must affirm such a claim from the internal perspective of one person who loves another. As a result, the case of love and grief supports a general claim concerning the proper work of moral philosophy, which is that the understanding of ourselves gained through empirical data is not a substitute for the normative conclusions that are revealed through first-personal reflections on our relationships. (shrink)

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

Paradoxically, the practical necessity of love seems to combine the personal character of psychological necessity with the inescapable and authoritative quality of moral necessity. Traditionally, philosophers have avoided this paradox by treating love as an amalgam of impersonal evaluative judgments and affective responses. On my account, love participates in a different form of practical necessity, one characterized by a non-moral yet normative type of expectation. This expectation is best understood as a kind of second-personal address that does not support derivative (...) third-personal demands. It is revealed when we react with hurt feelings instead of resentment upon its disappointment. (shrink)

People who make graveside promises consider themselves bound by them, which raises the question of whether a promise can morally obligate a promisor directly to a promisee who cannot acknowledge the promise. I show that it can by using the theoretical framework provided by “transaction accounts” of promising. Paradigmatically, these accounts maintain that the creation of a promissory obligation requires that the promisee consent to the promise. I extend these accounts to capture promises made by proxy and self-promises, and conclude (...) that we can make promises to absent promisees when we bear responsibility for their moral and personal development. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

Choosing a compassionate lifestyle that makes you feel good and positively impacts on the environment and on animals has never been easier. In this practical and accessible handbook, loaded with resources for all products that are mentioned, Ingrid Newkirk presents fabulous options that will not only enhance your life, but those of your neighbors, your community, animals, and the earth itself. From comfortable home furnishings, to delicious foods, to fashionable clothing there are a myriad of choices to be made (...) that can have a lasting positive effect on the well-being of animals and the environment, including: - recognizing hidden animal ingredients in cosmetics and household products - raising ecologically aware and animal-friendly kids - creating healthy, environmentally-friendly meals for everyday and special occasions - dressing with style without using leather or other animal products - dealing kindly with mice, insects, and other 'pests' in home or garden - adopting the right animal companion for you - volunteering and investing in eco- and animal-friendly companies - traveling with Eco-consciousness. (shrink)

With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)

Mental time travel is the ability to mentally project oneself backward in time to relive past experiences and forward in time to pre-live possible future experiences. Previous work has focused on MTT in its voluntary form. Here, we introduce the notion of involuntary MTT. We examined involuntary versus voluntary and past versus future MTT in a diary study. We found that involuntary future event representations—defined as representations of possible personal future events that come to mind with no preceding search attempts—were (...) as common as involuntary autobiographical memories and similar to them regarding cuing and subjective qualities. Future MTT involved more positive and idyllic representations than past MTT. MTT into the distant future/past involved more representations of cultural life script events than MTT into the immediate past/future. The findings are discussed in relation to cultural learning and MTT considered as a higher mental process. (shrink)

____Remembering Anna O.__ offers a devastating examination of the very foundations of psychoanalytic theory and practice, which was born with the publication of Breuer and Freud's ____Studies on Hysteria__ in 1895. Breuer described the case of Anna O., a young woman afflicted with a severe hysteria whom he had cured of her symptoms by having her recount under hypnosis the traumatic events that precipitated her illness. Drawing on the most recent Freud scholarship and on long-secret documents, Borch-Jacobsen demonstrates, however, (...) that Anna O. was never cured by Breuer's "talking cure" and that both Breuer and Freud knowingly falsified the historical record. Borch-Jacobsen points out the numerous inconsistencies in Breuer's account that suggests that Anna O.'s symptoms were simulated to meet Breuer's theoretical expectations and that her famed "reminiscences" were in fact fictitious memories induced by Breuer in the course of a hypnotic treatment. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

The category of “former friend” is familiar, yet the nature of this relationship type remains underexplored. Aristotle, for example, poses but does not answer the question of what constitute appropriate relations between former friends. To elucidate post-friendship expectations, I promote an account of friendship according to which some of our most significant friendships participate in a type of intimacy characterized by having normative standing to interpret each other in a constitutive manner, which I call the “co-interpretation view” of friendship. Unchecked (...) powers of co-interpretation, however, invite and allow for violations of each friend’s personhood, so I draw on Kantian resources to guide the co-interpretation view and render it more plausible. These Kantian resources help to establish relevant expectations for co-interpretation between friends. This positions me to provide an account of appropriate expectations between former friends, which I analyze in three types of post-friendship circumstance: when the friendship has faded but the parties still share a general outlook; when the friendship has become damaging for the friends but not due to viciousness; and, when the friendship ruptures due to vicious behaviors. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used and the (...) responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)

Why do 'maladies of the soul' such as hysteria, anxiety disorders, or depression wax and wane over time? Through a study of the history of psychiatry, Mikkel Borch-Jacobsen provocatively argues that most mental illnesses are not, in fact, diseases but the product of varying expectations shared and negotiated by therapists and patients. With a series of fascinating historical vignettes, stretching from Freud's creation of false memories of sexual abuse in his early hysterical patients to today's promotion and marketing of (...) depression by drug companies, Making Minds and Madness offers a powerful critique of all the theories, such as psychoanalysis and biomedical psychiatry, that claim to discover facts about the human psyche while, in reality, producing them. Borch-Jacobsen proposes such objectivizing approaches should be abandoned in favor of a constructionist and relativist psychology that recognizes the artifactual and interactive character of psychic productions instead of attempting to deny or control it. (shrink)

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

For many, the Holocaust made thinking about ethics in traditional ways impossible. It called into question the predominance of speculative ontology in Western thought, and left many arguing that Western political, cultural and philosophical inattention to universal ethics were both a cause and an effect of European civilization's collapse in the twentieth century. Emmanuel Levinas, Elie Wiesel and Richard Rubenstein respond to this problem by insisting that ethics must be Western thought's first concern. Unlike previous thinkers, they locate humanity's source (...) of universal ethical obligation in the temporal world of experience, where human suffering, rather than metaphysics, provides the ground for ethical engagement. All three thinkers contend that Judaism’s key lesson is that our fellow human is our responsibility, and use Judaism to develop a contemporary ethics that could operate with or without God. _Ethics and Suffering since the Holocaust_ explores selected works of Levinas, Wiesel, and Rubenstein for practical applications of their ethics, analyzing the role of suffering and examining the use each thinker makes of Jewish sources and the advantages and disadvantages of this use. Finally, it suggests how the work of Jewish thinkers living in the wake of the Holocaust can be of unique value to those interested in the problem of ethics in the twentieth and twenty-first centuries. Presenting a thorough investigation of the work of Levinas, Wiesel and Rubinstein, this book is of key interest to students and scholars of Jewish studies, as well as Jewish ethics and philosophy. (shrink)

In this article we introduce an argument developed in Borch-Jacobsen and Shamdasani (2006). We attempt to draw some consequences from several decades of work in Freud history. We argue that such work has had the cumulative effect of showing up the legendary nature of Freud's epistemology, and has demonstrated the direct linkages between his interpretive procedures and rewriting of history. The Freud legend was by no means a supplementary accessory which accompanied substantive advances, akin to the legend of Newton's (...) apple: rather, it was constitutive of the very identity of psychoanalysis, and enabled its differentiation from rival psychologies and psychotherapies, and promoted the claim that it formed the only viable science of mind and the most advanced form of psychotherapy. Historical research enables one to grasp the legendary nature of Freud's achievement. (shrink)

"An astutely argued and elegantly written (and translated) book on the philosophical genealogy and logical implications of the work of Jacques Lacan."Choice.

A IDENTIFICAÇÃO DO DIREITO AMBIENTAL MARÍTIMO.

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

A IMPORTÂNCIA DE TRATAMENTO DE ÁGUAS RESIDUAIS ATRAVÉS DA BIORREMEDIAÇÃO: UMA ANÁLISE PRINCIPIOLÓGICA.