A monosexual configuration of sexuality assumes that sexual desire is directed at either men or women. Bisexuality resists a choice between oppositional categories and is often theorised as having a transgressive potential to destabilise binary logic, not only in relation to sexuality but also to gender. There is, however, a lack of empirical work exploring how this potential might be realised in the accounts of bisexual individuals. Drawing on interviews with South African bisexual women, we use a narrative-discursive lens to (...) examine the discursive resources employed by participants to trouble or resist hetero-gendered norms. Our findings demonstrate how resistance to the gender binary hinges on citational politics that are fundamentally gendered and linked to sexuality. Instead of entirely destabilising hetero-gendered norms, participants draw on gendered scripts that simultaneously expand norms to accommodate their sexual difference and, through processes of othering, function to reiterate hetero-gendered norms. While complete subversion of gender binaries is not possible in participants’ discursive contexts, what does occur is a ‘slow bending’ of norms. Theorising bisexuality as transgressing oppositional categories closes off opportunities to interrogate the pervasive influence of gender binaries in contexts that remain marked by pervasive heteronormativity and heterosexism. Significantly, it also obscures more modest improvisations of gender scripts that hold potential for destabilising gender binaries. (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.

CHAPTER 1 Narrative Psychology and Historical Consciousness Relationships and Perspectives DONALD E. POLKINGHORNE Postmodern theory has severely undercut ...

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

This essay examines the early reception of Scheler’s anthropological thought in Spain. The article traces the two main ways of reception of Scheler’s work in the School of Madrid and the School of Barcelona. I argue that, on the one hand, the Spanish translations of the works of the early phenomenologists – Scheler was a central figure among them – contributed to the diffusion of Scheler’s thought; and that, on the other hand, the Spanish authors subjected Scheler’s thought to a (...) critical assimilation and further developments. Scheler influenced the Spanish philosophy of the human affectivity, in which the capacity to feel, the values and love as a kernel of the human being occupy an exceptional position. This reception shows the originality of Spanish authors that incorporate Scheler’s ideas to their anthropological interest and develop these ideas in the direction of their own phenomenological anthropology. (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)

This article turns towards the spatial life of ‘digital infrastructures’, i.e. code, protocols, standards, and data formats that are hidden from view in everyday applications of computational technologies. It does so by drawing on the version control system Git as a case study, and telling the story of its initial development in order to reconstruct the circumstances and technical considerations surrounding its conception. This account engages with computational infrastructures on their own terms by adopting the figure of the ‘stack’ to (...) frame a technically informed analysis, and exploring its implications for a different kind of geographic inquiry. Drawing on topology as employed by Law and Mol, attention is given to the multiplicity of spatialities and temporalities enrolled in digital infrastructures in general, and Git specifically. Along the lines of the case study and by reading it against other literatures, this notion of topology is expanded to include the material performation of fundamentally arbitrary, more-than-human topologies, as well as their nested articulation, translation and negotiation within digital infrastructures. (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)

In the past decade, scholars such as Samuel Freeman, Martin O’Neill, Alan Thomas and others have argued that no matter how widely Rawls’s theory of justice (TJ) was understood as a defence of the welfare state (WS), the socio-economic system Rawls defends and always defended is property-owing democracy (POD). In this article I present the argument that Rawls did not defend POD in TJ. However, while the claim that it was POD the socio-economic system implied by the principle of difference (...) generated heated reactions by defenders of the WS, the argument I raise differs from most of them. In the article I maintain that, for Rawls, principles of justice underdetermine the choice of social systems, and that although this is true of both principles, it is especially true of the difference principle, whose ability to arbitrate between different social and economic policies is limited. I show how the attempt to uniquely determine the set of social and economic policies authorized by the difference principle clashes with what Rawls explicitly states in TJ and contrasts with central aspects of his sociological and political conception of socio-economic decision-making. Although my aim is to show that the difference principle itself does not discriminate among socio-economic systems, this does not preclude that additional reasons can help in narrowing the range of socio-economic systems allowed. With reference to the ideal of social union that Rawls expounds in the third part of TJ, I argue that TJ does, in fact, offer additional reasons to appraise the WS as preferable to POD. I maintain that the centrality Rawls attributes to the social unity of a just society provides the basis for an understanding of Rawls’s position towards POD after TJ. (shrink)

The efficient coding hypothesis posits that sensory systems are tuned to the regularities of their natural input. The statistics of natural image databases have been the topic of many studies, which have revealed biases in the distribution of orientations that are related to neural representations as well as behavior in psychophysical tasks. However, commonly used natural image databases contain images taken with a camera with a planar image sensor and limited field of view. Thus, these images do not incorporate the (...) physical properties of the visual system and its active use reflecting body and eye movements. Here, we investigate quantitatively, whether the active use of the visual system influences image statistics across the visual field by simulating visual behaviors in an avatar in a naturalistic virtual environment. Images with a field of view of 120° were generated during exploration of a virtual forest environment both for a human and cat avatar. The physical properties of the visual system were taken into account by projecting the images onto idealized retinas according to models of the eyes' geometrical optics. Crucially, different active gaze behaviors were simulated to obtain image ensembles that allow investigating the consequences of active visual behaviors on the statistics of the input to the visual system. In the central visual field, the statistics of the virtual images matched photographic images regarding their power spectra and a bias in edge orientations toward cardinal directions. At larger eccentricities, the cardinal bias was superimposed with a gradually increasing radial bias. The strength of this effect depends on the active visual behavior and the physical properties of the eye. There were also significant differences between the upper and lower visual field, which became stronger depending on how the environment was actively sampled. Taken together, the results show that quantitatively relating natural image statistics to neural representations and psychophysical behavior requires not only to take the structure of the environment into account, but also the physical properties of the visual system, and its active use in behavior. (shrink)

The DNA hypomethylating agents (HMA) azacitidine (AZA) and decitabine (DAC) improve survival and transfusion independence in myelodysplastic syndrome (MDS) and enable a low intensity cytotoxic treatment for aged AML patients unsuitable for intensive chemotherapy, particularly in combination with novel agents. The proposed mechanism of AZA and DAC relies on active DNA replication and therefore patient responses are only observed after multiple cycles of treatment. Although extended dosing may provide the optimal scheduling, the reliance of injectable formulation of the drug limits (...) it to intermittent treatment. Recently, an oral formulation of AZA demonstrated significantly improved patient relapse free survival (RFS) and overall survival (OS) when used as maintenance after chemotherapy for AML. In addition, both DAC and AZA were found to be highly effective to improve survival in elderly patients with AML through combination with other drugs. These recent exciting results have changed the therapeutic paradigm for elderly patients with AML. In light of this, we review current knowledge on HMA mechanism of action, clinical trials exploring dosing and scheduling, and recent HMA combination therapies to enhance efficacy. (shrink)

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

This paper proposes a view, called limitarianism, which suggests that there should be upper limits to the amount of income and wealth a person can hold. One argument for limitarianism is that superriches can undermine political equality. The other reason is that it would be better if the surplus money that superrich households have were to be used to meet unmet urgent needs and local and global collective action problems. A particular urgent case of the latter is climate change. The (...) paper discusses one objection to limitarianism, and draws some conclusions for society, as well as for the human development paradigm and the capability approach. (shrink)

Journal of Economic Methodology, Volume 19, Issue 2, Page 159-163, June 2012.

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)

Yetta Howard's queer-radical monograph Ugly Differences: Queer Female Sexuality in the Underground presents in its four chapters and conclusion a critical discussion of queer radicality in underground art productions. The chapters engage with Slava Tsukerman's camp cult movie Liquid Sky, Sapphire's poetry, Roberta Gregory's and Erika Lopez's comics, A. L. Steiner and Narcissister's collaborative art installation Winter/Spring Collection, and New Queer Cinema's High Art. In this volume, Howard unearths a spectrum of aesthetic pleasure derived from survival and self-destruction, to tragic (...) romance and kink intimacies. In all the material that Howard chooses for her discussions, “ugliness” enacts a powerful, political premise, which makes this book not only a captivating manifesto of queer punk aesthetics but also a thoughtful exploration of the importance of subcultural, queer-feminist politics antagonizing the norms of mainstream LGBT inclusion politics and homonormative pink-washing tendencies. Ultimately, as the key term of this volume, “ugliness” unfolds in the chapters, specifically in the analogy of three textual elements: as the “disagreeable and pejorative traits” conventionally attributed to queerness (2); a critique of the abjection and stigmatization of all bodies outside of the Western norms of white, able-bodied, cis masculinity (2); and third, as the angry, creative, punk, and anti-aesthetic textual practices of subcultural queer life (2). (shrink)

Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (shrink)

From the co-founder and president of PETA, Ingrid Newkirk, and bestselling author Gene Stone comes Animalkind, a book that offers both a tour of the wonderful world of animals and a guide to simple ways in which we can reduce the harm we cause them in our everyday lives.

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)

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)

People with dementia have previously not been active participants in research, with ethical difficulties often being cited as the reason for this. A wider inclusion of people with dementia in research raises several ethical and methodological challenges. This article adds to the emerging debate by reflecting on the ethical and methodological issues raised during an interview study involving people with dementia and their spouses. The study sought to explore the impact of living with dementia. We argue that there is support (...) for the inclusion of people with dementia in research and that the benefits of participation usually far outweigh the risks, particularly when a `safe context' has been created. The role of gatekeepers as potentially responsible for excluding people with dementia needs further consideration, with particular reference to the appropriateness of viewing consent as a primarily cognitive, universalistic and exclusionary event as opposed to a more particularistic, inclusive and context relevant process. (shrink)

Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

'Tener demasiado' es el primer volumen académico dedicado al limitarismo: la idea de que el uso de los recursos económicos o de los ecosistemas no sobrepasen ciertos límites. Se trata de un concepto profundamente arraigado en el pensamiento económico y político, por lo que es posible encontrar premisas similares en pensadores como Platón, Aquino o Spinoza. No obstante, 'Tener demasiado' es el primer ejemplar en el campo de la filosofía política contemporánea en el que el limitarismo se explora en profundidad (...) y con detalle. Asimismo, este estudio reúne por primera vez los mejores escritos de los principales teóricos del limitarismo, lo que le convierte en una contribución esencial al campo de la filosofía política, en general, y de las teorías sobre la justicia distributiva, en particular. Incluye tanto artículos seminales ya publicados como nuevos capítulos y se presenta como lectura indispensable para académicos y estudiantes de teoría política y filosofía, así como para todos aquellos interesados en cuestiones relacionadas con la justicia distributiva. (shrink)

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)

In this paper, we show that non-well-founded sets can be defined constructively by formalizing Hallnäs' limit definition of these within Martin-Löf's theory of types. A system is a type W together with an assignment of ᾱ ∈ U and α̃ ∈ ᾱ → W to each α ∈ W. We show that for any system W we can define an equivalence relation = w such that α = w β ∈ U and = w is the maximal bisimulation. Aczel's proof (...) that CZF can be interpreted in the type V of iterative sets shows that if the system W satisfies an additional condition (*), then we can interpret CZF minus the set induction scheme in W. W is then extended to a complete system W * by taking limits of approximation chains. We show that in W * the antifoundation axiom AFA holds as well as the axioms of CFZ -. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)