Moral sensitivity and moral reasoning are essential competencies biomedical researchers have to develop to make ethical decisions in their daily practices. Previous research has shown that these competencies can be developed through ethics education. However, it is unclear which underlying mechanisms best support the development of these competencies. In this article we argue that the development of moral sensitivity and moral reasoning can be fostered through teaching strategies that tap into students’ moral imagination. We describe how moral imagination can stimulate (...) the development of these competencies through three different merits of moral imagination. Moral imagination can help students to 1) transfer and apply abstract moral concepts to concrete situations and contexts, 2) explore the perspective of others, 3) explore and foresee the moral consequences of different decisions and actions. We explain these three merits of moral imagination in the context of biomedical research and present a theoretical model for how these merits can be used to stimulate the development of moral sensitivity and moral reasoning. Furthermore, we describe multiple teaching strategies for biomedical curricula that tap into the three merits of moral imagination. These teaching strategies can inspire teachers to design ethics education that activates students’ moral imagination for the development of moral sensitivity and moral reasoning. (shrink)

This study investigates the prevalence of ‘Seeking God's Help’, its relation to time since diagnosis, and its association with Life Satisfaction for all cancer types. This study also investigates Disease-Specific Quality of Life for patients with breast, prostate, and colorectal cancers. Data were obtained from the third wave of the Nord-Trøndelag Health Study of Norway, with 2,086 cancer patients identified by the Cancer Registry of Norway and 6,258 cancer-free controls. Our results indicate a higher prevalence of ‘Seeking God's Help’ after (...) a shorter time since diagnosis among men. No association was observed in multivariate analyses between ‘Seeking God's Help’ and ‘Life Satisfaction’ or ‘Disease-Specific QoL’ in long-term cancer survivors. Longitudinal investigations are needed to elucidate the relationship between the ‘Seeking God's Help’ variable and Life Satisfaction and Disease-Specific QoL among cancer patients in a Norwegian context. (shrink)

Although there is a significant amount of research on organizational citizenship behavior and its importance to individual and organizational outcomes, relatively little research has explored the process by which such behavior emerges and is established within an organization. Against this backdrop, we combine the perspectives offered by contextualist inquiry and actor–network theory to propose an integrative framework for investigating how organizational citizenship behavior develops in a large, heterogeneous organization. In order to illustrate the framework, we present a detailed case study (...) of recycling at a large university. Like many other organizations, the university does not have a formal organizational structure to address sustainability concerns and the initiatives are therefore mainly voluntary and emerging in nature, and outcomes are, as a consequence, highly uncertain, and fragile. We argue that contextualist inquiry in combination with actor–network theory provides new and important insights into the emergence and establishment of organizational citizenship behaviors, and that outcomes are contingent upon interactions between the context, process, and content of the behaviors in question and the related networks of human and non-human actors. (shrink)

Limiting intensive care is paid increasing attention. In the echoing call for physicians’ ethical self‐restriction, it is easily overlooked, however, that ethics needs a critical epistemological analysis before it can suffice as an emergency brake to futile treatment. This analysis is provided by the present essay. The authors suggest that the difficulties of resolving moral dilemmas related to limiting intensive care may just be due to the unclarified epistemological status of moral claims. Even if normative ethics cannot prescribe right decisions, (...) but only draw conclusions from defined premises, the premises may or may not be true. Their intertwined descriptive and normative evidence is endorsed in an academic and political discourse. There will necessarily be various demands for rationality in prudent decisions between physicians, their patients and society. These demands are formulated dialogically through critical questions and justified answers. A good argument is the convincing one that, finally and ideally, leads to the absence of open objections. Thus, in the end the rightness of a given decision does not depend on axiomatic moral principles, but is comparative and conditional, as it is given in an omnilateral argument. Neither is it the democratic process of shared decision making that we should evaluate, but rather the argumentative state itself, when we judge the morality of health politics and clinical practice. (shrink)

Voluntary actions and their distal effects are intimately related in conscious awareness. When an expected effect follows a voluntary action, the experience of the interval between these events is compressed in time, a phenomenon known as ‘intentional binding’ . Current accounts of IB suggest that it serves to reinforce associations between our goals and our intention to attain these goals via action, and that IB only occurs for self-generated actions. We used a novel approach to study IB in the context (...) of shared intentions and actions. Pairs of participants judged the time of occurrence of actions and events attributed either to oneself or to another agent. We found that IB and subjective agency are not mutually predictive when an action can be attributed to only one of two ‘co-intending’ agents. Our results pose a complication for the prevailing view that IB and subjective agency reflect a common mechanism. (shrink)

Exploring Textual Action questions how we analyse works of art after the performative turn and shows how the interplay of performativity (textual action), space and topography, and the converging of genres and art forms is essential in modern drama, theatre, prose fiction, poetry and film. The volume also fosters a keen concern for the development of congenial theory. Its 14 detailed essays analyse works of art ranging from Balzac, Melville and George Eliot, to Breton, Kafka, Benjamin, Blixen and Woolf; and (...) from W.C. Williams, Bresson and Scorsese, to Sarraute, Duras, Reygadas, Dumont and Waltz. The approach of these studies discloses the art works as creative and dynamic utterances with active and shaping forces so powerful, and consequential, that they have the potential to transform human perception and blur clear distinctions between art and real life. Using an alternative and dynamic method and suggesting a direction towards the detailed analysis of literature, art, media and culture, Exploring Textual Action addresses current debates within the humanities. (shrink)

Background Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally. This is a review of the ethical considerations documented in the prehospital medical records (...) of patients in a Danish prehospital setting for whom the decision to resuscitate or not was made at the scene. Methods The study is based on discharge summaries of all patients subjected to crucial life-and-death decisions by the Mobile Emergency Care Unit in Odense in the years 2010 to 2014. The medical records with possible documentation of ethical issues were independently reviewed by two philosophers in order to identify explicit ethical or philosophical considerations pertaining to the decision to resuscitate or not. Results In total, 1275 patients were either declared dead at the scene without exhibiting layman’s reliable signs of death or admitted to hospital following resuscitation. In a total of 62 patients, 85 specific ethical issues related to resuscitation were documented. The expressions of the ethical considerations were generally vague or unclear and almost exclusively concerned the interests of the patient and not the relatives. In the vast majority of cases where an ethical content was identified, the ethical considerations led to a decision to terminate treatment. Conclusions A strengthened practice of documenting ethical considerations in prehospital life-and-death decision-making in the patient’s medical records is required. We suggest that a template be implemented in the prehospital medical records describing the basis for any ethical decisions. This template should contain information regarding the persons involved in the deliberations and notes on ethical considerations. The documentation should include considerations concerning the patient’s end-of-life wishes, the estimations of the quality of life before and after the incident, and a summary of other ethical concerns taken into account, such as the integrity of the patient and frame of mind of relatives. (shrink)

In a recent paper A. Tabarrok [Believe in Pascal’s Wager? Have I Got a Deal for You!, Theory and Decision 48, 123--128, 2000] argued that a believer who accepts Pascal’s Wager should in addition accept payment of any given fee in return for a given increase in the probability of reaching God. However the conclusion is obtained from manipulations of infinities which are not valid in an expected utility model. In this note, an alternative model is formulated in which Tabarrok’s (...) conclusion can be obtained. (shrink)

The “right to repair” movement highlights opportunities to reduce health care costs and promote public health resilience through increased competition in the way in which medical devices are serviced and updated over their lifespan. We review legislative and legal facets of third-party repair of medical devices, and conclude with specific recommendations to help this market function more efficiently to the benefit of patients and health care systems.

Certification marks are a type of trademark used to show that a product or service meets specific standards or qualities set by an independent organization (not by the manufacturer or seller). Certification marks could enhance the quality perception and oversight of generic drugs. Despite the FDA’s rigorous regulatory framework, skepticism about generic drug quality persists among patients and prescribers, partly due to the FDA’s limited ability to inspect manufacturing facilities. Independent certification marks — similar to USDA Organic or Energy Star (...) labels — could help communicate drug quality information more effectively to consumers, incentivize manufacturers to exceed baseline standards, and bolster trust in generics. Such a system could operate without legislative changes and offer a cost-effective supplement to existing FDA inspections, particularly given the challenges posed by an increasingly globalized drug supply chain and current FDA resource constraints. (shrink)

Patients in specialist mental healthcare services who are at risk of suicide may experience their struggles as existential in nature. Yet, research on meaning in life has been relatively scarce in suicidology. This qualitative study aimed to explore how patients at risk of suicide perceived their encounters with specialist healthcare professionals after a suicide attempt (SA), with special reference to meaning in life experiences. The study was conducted in specialised mental healthcare services in Norway. Data were collected via individual interviews (...) with eight patients aged 20–75 years. Using a four-step procedure, the interviews were analysed by systematic text condensation. The participants understood their feelings of shame, self-contempt and challenging life experiences as contributing factors to their SA. They perceived that existential themes in relation to financial difficulties, shame and trauma were resolved, while issues associated with the SA, such as death, loss and beliefs, were given less attention. The participants were either ambivalent about continuing to live or wished to rebuild a meaningful life. Overall, their experiences of meaningfulness were hampered. Assisting patients with meaning in life experiences may help them alter their life interpretations and increase their ability to rebuild their lives as meaningful. The present study should be seen as a contribution to meaning-informed approaches in specialist mental healthcare services. More research is needed to equip healthcare personnel in their overall aims of preventing suicide and supporting patients at risk in their efforts to live a meaningful life. (shrink)

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction and negative interpretation bias in a student sample screened for high and low social anxiety. Results support the hypothesis that group differences in negative interpretations (...) of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing. (shrink)

Three paradigms of legal positivism -- The pure theory of law : science or political theory? -- Kelsen's principles of legality -- Kelsen's theory of democracy : reconciliation with social order -- Democratic constitutionalism : Kelsen's theory of constitutional review -- Kelsen's legal cosmopolitanism -- Conclusions : the pure theory of law and contemporary positivism.

Focusing on the multi-dimensionality of interactional settings, this study analyzes how the material world is a significant factor in the sequential co-production of the video-taped doctor—patient interactions. The analysis shows how a material artifact, the patient's file, is relevant in two ways: a) as a device which is employed in the sequential organization of the interaction. The patient's file is being used in the contexts of topic development and topic change. b) The file with its specific physical and symbolic features (...) is being co-produced and contested by both actors as a knowledge reservoir. Further inspection of the interactions in concert with theoretical reflections of the role of space and materiality suggests that interactions should be interpreted as happening in spatially arranged constellations of material objects and actors. In these both rigid and flexible constellations boundaries are established, access is distributed, and meaning is solidified. (shrink)

The article examines Hannah Arendt’s analysis of ‘pan-nationalist Europeanism’ and anti-Americanism which may serve inherently problematic identity-generating functions for the European project. For Arendt, this specific form of Europeanism is often intimately linked to mobilizations of widely spread fears of global sociocultural and economic modernization, which is frequently perceived as ‘Americanization’. In addition, however, those fears may reflect self-referential politics of ‘Americanism’ abroad and also originate in ‘objective’ structural international imbalances. According to Arendt, then, Americanism on one side and Europeanism (...) on the other side of the Atlantic should be challenged as two ideologies facing, fighting and, above all, resembling each other as all seemingly opposed ideologies. In light of the current transatlantic cleavages, it is argued with Arendt that it is in the EU’s best interest to avoid binary, culturalized legitimizations of Europeanism and (anti-)Americanism. Instead, it is the eminent political task to positively resignify the EU as a new, truly post-national project and polity in its own right. Adapting and expanding Arendt’s framework, conceptual and normative implications for a self-reflexive, unique and future-oriented EU political identity and response to globalization are indicated and discussed. (shrink)

Brogaard's non-indexical version of moral contextualism has two related problems. It is unable to account for the function of truth-governed assertoric moral discourse, since it leaves two (semantically clearheaded) disputants without any incentive to resolve seemingly contradictory moral claims. The moral contextualist could explain why people do feel such an incentive by ascribing false beliefs about the semantic workings of their own language. But, secondly, this leaves Brogaard's moral contextualism looking weaker than a Mackie-style invariantist error theory about morals. The (...) latter is equally non-objectivist, but less revisionist, since it takes the semantics of moral discourse at face value, and can also explain all of Brogaard's other linguistic evidence. (shrink)

The aim of this article is to contribute to responsible innovation by developing a conceptual framework for the processes of creativity and innovation. The hypothesis is that creative and innovative processes are similar in that both are affective in nature. I develop this conceptual framework through an interpretation of the insights of Henri Poincaré’s notion of the ‘four stages’ in the creative process and Joseph Schumpeter’s notion of the entrepreneur. Building on this framework, I analyze the creative and innovative practices (...) of the film director Lars von Trier and the entrepreneur Steve Jobs. The interpretation and analysis suggest that the processes of creativity and innovation are similar in nature in that both are based on the moods of disturbance and enthusiasm; but that they differ in that creativity is based on the feelings of interest and irritation, whereas innovation is based on the feelings of desire and anger. In the conclusion I discuss the implications of this for responsible innovation with regard to the social aspect of resistance towards innovation and the ethical aspects of anger in entrepreneurial leadership. (shrink)

This article is a response to Thomas David Riisfeldt’s paper entitled ‘Weakening the ethical distinction between euthanasia, palliative opioid use and palliative sedation’. It is shown that as far as euthanasia and palliative sedation are concerned, Riisfeldt has not established that a common ground, or a similarity, between the two is the relief of suffering. Quite the contrary, this is not characteristic of euthanasia, neither by definition nor from a clinical point of view. Hence, the argument hinges on a conceptually (...) and empirically erroneous premise and is accordingly a non-starter. (shrink)

In this article we explore how Swedish welfare politics within health‐care and rehabilitation has opened up a space for nurses’ and occupational therapists’ professional projects. Using historical data, an analysis of the policy‐making process behind welfare programs central to the professionalization of nursing and occupational therapy is presented. The time period covered is, in the case of nurses, the larger part of the twentieth century, while the modern history of occupational therapists first began in the 1940s. Special emphasis is placed (...) on the corporative nature of the Swedish welfare state and the professional strategies utilized by nurses and occupational therapists in their struggle for jurisdiction. In the article, politicization is identified as a core strategy by which female‐dominated welfare state occupations in Sweden have tried to gain influence over the welfare policy‐making process and their occupations’ jurisdiction. (shrink)

According to Niklas Luhmann, causality is both an impossibility and a necessity in education. On the one hand, the task of the teacher is an impossible one, because teaching as communication is a closed system that cannot determine the learning of pupils' psychical system in any causal sense. On the other hand, one cannot practice as a teacher without a belief in causality, i.e., in a causal connection between teaching and learning. In his article “The Child as the Medium of (...) Education,” Luhmann focuses on the enablement of education, despite its impossibility. His answer is that one thing that makes education possible is the emergence of the symbolically generalized medium “the child.” In this article, Lars Qvortrup focuses on Luhmann's understanding of causality. According to Luhmann, causality is not a simple, ontological fact, but the result of the attribution of certain causes to certain effects. The conclusion is that causality as an attribution category — and not causality as an ontological fact — is another thing that makes education possible. Qvortrup also concludes, however, that Luhmann is not alone in criticizing the traditional, mechanical concept of causality. Other contemporary philosophers and sociologists have pointed out that in order to analyze causality in complex social systems, one has to select some causal factors and ignore others. While others do this based on seemingly pure scientific and statistical criteria, Luhmann focuses on attribution as a social construction of causality. (shrink)

The task of this paper is to clarify the notion of pluralism and religious pluralism against the background of disputations on the globalized challenges of religious pluralism, for example the incompatibility between different conceptions of religious pluralism, especially from the lens of a possible conversation on religious pluralism between Jürgen Habermas and Emmanuel Levinas. With a detailed reading into the development of the conceptualization of religious pluralism in each author, addressing the questions such as what is genuine pluralism and on (...) what ground the conflicts within religious pluralism can be re-accounted, we make our passage from challenging the total reliance on political unification by the effort of Habermas, towards adopting a Levinasian alternative path that prioritizes ethical relation over individual ways of plurality in the realization of each one’s good life. Even though it can be acknowledged that Habermas raised the right question against the relativism way of seeing pluralism, it is by Levinas, the ontological ground of pluralism and the universal dimension of the plural are thought not only through justice and politics but more importantly, through a way of responding to the non-familiar tradition with love, where human religion has a single dimension that is the transcendental notion of charity and love. (shrink)

Stakeholder participation is an increasingly popular ingredient within environmental management and decision-making. While much has been written about its purported benefits, a question that has been largely neglected is whether decision-making informed through stakeholder participation is actually likely to yield decisions that are morally justified in their own right. Using moral methodology as a starting point, we argue that stakeholder participation in environmental decision-making may indeed be an appropriate means to produce morally justified decisions, the reason being that such participation (...) may constitute an efficient way to satisfy the standard requirements on moral reasoning and moral justification. This finding also emphasizes the importance of identifying those settings most conducive to allowing different stakeholders to both challenge each other’s arguments and to adopt each other’s perspectives in order to make effective use of participation in environmenta... (shrink)

There are two dominant schools of thought addressing problems of cosmopolitanism and conflict: democratic national sovereigntism, inspired by Hegel, and global constitutionalism, inspired by Kant and reformulated by Habermas. This paper develops a third position by reading Adorno's critique of both theoretical traditions. Rather than compromising between these camps, Adorno triangulates between them. Critically illuminating their respective deficiencies in view of the changing conditions of a globalized modern world has critical implications for cosmopolitics. Although largely negative, Adorno's critique provides an (...) important framework for a contestatory reformulation of cosmopolitanism, one that is better equipped to confront societal and political global conflicts insufficiently reflected in sovereigntist and global constitutionalist models. (shrink)

Martin Heidegger’s Sein und Zeit presents one of the most striking reflexions on human facticity, i.e. the fact that Dasein fundamentally exists in a world letting Dasein and world be co-extensive. By quoting two central personages in theology, Pascal and Augustine, Heidegger refers to a concept of love that is constitutive for Dasein’s facticity to truth and to knowledge. By investigating the claim that love is as good as absent from Sein und Zeit, the article intends to show that the (...) scanty references to love nevertheless have a central role in Heidegger’s early work and, furthermore, why Heidegger returns to it in his later thinking. Interesting in this regard is the connection between the theological concept of love and Heidegger’s concept of ‘world’. The article places Heidegger’s Destruktion of the metaphysical tradition in the realms of his Dasein analysis focussing on facticity. Taking its methodological cues from Giorgio Agamben and Jacques Derrida, the article shows how the concepts of possibility and impotentiality (Ohnmacht) become essential in Heidegger via his reference to love. Lastly, the article examines to what extent Heidegger’s Sein und Zeit paraphrases the old angelology letting the Dasein concept become its secularisation. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2015 Heft: 207 Seiten: 327-368.

Aim:The purpose of this study was to explore how adolescent patients displaying developmental trauma experience and describe meaning in life. Schnell’s model of meaning in life is applied to explore meaningfulness, crises of meaning and sources of meaning. Method: The study has a qualitative design based on individual interviews with eight adolescents aged 14–18 years in treatment in an outpatient clinic for mental health care for children and adolescents. The interviews were transcribed and analyzed using systematic text condensation. Results: The (...) adolescents related meaning in life to the experience of coherence, intrinsic values, progress and belonging, or the absence of these. Examples of sources of meaning among the informants were positive relations with meaningful others, structure and routines, moments of well-being, achieving goals related to education, work and family, and seeking something else outside oneself such as playing computer games, being engaged in politics, being with animals, having a belief in a god or being outdoors in natural surroundings. Conclusion: Although the topic of meaning in life was unknown to this group, they used sources of meaning intuitively. This group seems to have similar preferences to the general population. More knowledge is needed on how the topic of meaning in life can be useful in therapy for adolescents with development trauma. (shrink)

A common way of analyzing the statistical relation between two tests of memory is to use contingency analyses. A potential problem with such analyses is known as Simpson’s paradox. The paradox is that collapsing two or more contingency tables may have the effect that the relationship expressed in the overall contingency table differs from the relationships expressed in the original tables. The paradox arises when covariates are correlated with each of the tests. It has been claimed that the paradox has (...) implications for the analysis of memory retrieval, and ways of solving the problem have been called for (Hintzman, 1980). In this paper, partial gamma (Davis, 1967) is suggested as one possible solution. This method can be used to compute a weighted average of the results in the original tables. The use of partial gamma is exemplified by applying it to hypothetical instances of Simpson’s paradox. (shrink)