The aim of this study was to explore the ethical foundations for a caring conversation. The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown (...) to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to be asymmetrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible. (shrink)

Experts have been claimed to perceive risks in a different way than the general public. It is likely that experts often see risks in their own field of expertise as smaller than the public does, but that does not imply that their risk perception is also driven by other factors. Topical experts and general risk assessors are two quite different types of experts. Still, common assertions as to the simple structure of expert risk perception, said to be related only to (...) technical or statistical risk estimates, builds on a meager database consisting of 15 general risk assessors. Results from a study reported here show that the factors explaining experts’ risk perception are similar to those of a comparable group of nontopical experts with a similar level of technological literacy and to the general public, and that the level of explained variance is quite comparable for experts and the general public. (shrink)

One INTRODUCTION 1. Background The theory of the nature of health and disease, or of the concepts of health and disease, has been central in modem ...

It is part of our everyday experience that there is a reliable connection between moral opinions and motivation. Thinking that an act is right (wrong) tends to be accompanied by motivation to (avoid to) perform the act in question. This is mirrored in moral talk. We tend to think that someone who says that he thinks that it is right (wrong) to act in a certain way without being motivated, to some extent, will most likely be speaking insincerely. Moveover, moral (...) utterances have a dynamic function to exhort and guide conduct. This suggests that moral utterances involve a kind of attitudinal expressiveness that makes them very different from prosaically factual utterances. These commonsensical features of our moral practice represent the practicality of moral thought and talk. The main purpose of this essay is to investigate how the practicality of moral thought and talk is best represented and whether it supports either a cognitivist or noncognitivist analysis of moral judgments. I argue that sophisticated versions of internalism and externalism, the main competing explanations of the connection between moral judgments and motivation, represent the reliable connection equally good and that the relevant kind of attitudinal expression can be accomodated by both cognitivists and noncognitivists. The upshot is that considerations based on the practicality of moral thought and talk does not cut much philosophical ice. Hence, the rivalry between cognitivists and noncognitivists analyses must be settled beyond considerations based on practicality. Maybe the belief-like features of moral thought and talk can tilt things in favor of cognitivism. However, noncognitivists have different ways of accommodating the belief-like features. In fact, in the wake of different accommodation projects one wonders what remains of the traditional debate between cognitivist and noncognitivist analyses, a debate that shaped metaethics as we know it. (shrink)

Probabilism is committed to two theses: 1) Opinion comes in degrees—call them degrees of belief, or credences. 2) The degrees of belief of a rational agent obey the probability calculus. Correspondingly, a natural way to argue for probabilism is: i) to give an account of what degrees of belief are, and then ii) to show that those things should be probabilities, on pain of irrationality. Most of the action in the literature concerns stage ii). Assuming that stage i) has been (...) adequately discharged, various authors move on to stage ii) with varied and ingenious arguments. But an unsatisfactory response at stage i) clearly undermines any gains that might be accrued at stage ii) as far as probabilism is concerned: if those things are not degrees of belief, then it is irrelevant to probabilism whether they should be probabilities or not. In this paper we scrutinize the state of play regarding stage i). We critically examine several of the leading accounts of degrees of belief: reducing them to corresponding betting behavior (de Finetti); measuring them by that behavior (Jeffrey); and analyzing them in terms of preferences and their role in decision-making more generally (Ramsey, Lewis, Maher). We argue that the accounts fail, and so they are unfit to subserve arguments for probabilism. We conclude more positively: ‘degree of belief’ should be taken as a primitive concept that forms the basis of our best theory of rational belief and decision: probabilism. (shrink)

Bengt Brülde in his article ``The Goals of Medicine. Towards a Unified Theory'' has proposed a normative theory of the goals of medicine within which the concept of quality of life plays a crucial role. In Brülde's analysis, however, the very concept of medicine is deliberately left quite vague and it is therefore difficult to see how the goals of medicine are related to the goals of closely allied enterprises such as health promotion and social welfare. In this reply I (...) therefore propose an analysis of these related conceptual areas. I do this mainly in two respects. Following the nomenclature in a previously published article I propose a systematic conceptual framework for all varieties of health enhancement and distinguish different notions of medicine within this framework. A consequence of this analysis is, for instance, that the means and also the immediate goals of medicine in its broadest sense are more diversified than the means and immediate goals of medicine in its narrowest sense. From this position I expand the topic further by comparing medicine and health enhancement with social welfare and try to trace the basic features between – as well as the common properties of – these different enterprises. (shrink)

This paper examines some aspects of Mitchell Green’s account of self-expression. I argue that Green fails to address the distinction between success and evidential notions of expression properly, which prevents him from adequately discussing the relation between these notions. I then consider Green’s explanation of how a speech act shows what is within, i.e., because of the liabilities one incurs and argue that this is false. Rather, the norms governing speech acts and liabilities incurred give us reason to think that (...) the speaker is in a particular state of mind. It thus supports an evidential rather than success notion. Finally, I suggest that it is because of the sincerity of what is said, rather than the liabilities incurred, that you show what is within. (shrink)

We consider an infinite hierarchy of systems of Alethic Modal Logic with so-called Levels of Perfection, and add to them suitable definitions of such interesting deontic categories as those of supererogation, offence, conditional obligation and conditional permission. We then state three problems concerning the proper characterization of the resulting logic(s) for our defined notions, and discuss two of these problems in some detail.

As a part of a research project on Dignity and Older Europeans Programme) I explore in this paper a set of notions of human dignity. The general concept of dignity is introduced and characterized as a position on a value scale and it is further specified through its relations to the notions of right, respect and self-respect. I present four kinds of dignity and spell out their differences: the dignity of merit, the dignity of moral or existential stature, the dignity (...) of identity and the universal human dignity. Menschenwürde pertains to all human beings to the same extent and cannot be lost as long as the persons exist. The dignity of merit depends on social rank and position. There are many species of this kind of dignity and it is very unevenly distributed among human beings. The dignity of merit exists in degrees and it can come and go. The dignity of moral stature is the result of the moral deeds of the subject; likewise it can be reduced or lost through his or her immoral deeds. This kind of dignity is tied to the idea of a dignified character and of dignity as a virtue. The dignity of moral stature is a dignity of degree and it is also unevenly distributed. The dignity of identity is tied to the integrity of the subject's body and mind, and in many instances, although not always, also dependent on the subject's self-image. This dignity can come and go as a result of the deeds of fellow human beings and also as a result of changes in the subject's body and mind. (shrink)

ABSTRACTIt has been objected to moral non-cognitivism that it cannot account for fundamental moral uncertainty. A person is derivatively uncertain about whether an act is, say, morally wrong, when her certainty is at bottom due to uncertainty about whether the act has certain non-moral, descriptive, properties, which she takes to be wrong-making. She is fundamentally morally uncertain when her uncertainty directly concerns whether the properties of the act are wrong-making. In this paper we advance a new reply to the objection (...) to non-cognitivism, immune to the problems afflicting earlier replies. First, we argue that fundamental moral uncertainty is best understood as classificatory uncertainty, since the psychological factors behind fundamental moral uncertainty are analogous to the factors behind fundamental uncertainty regarding descriptive, non-moral, matters, and fundamental descriptive uncertainty is naturally understood as classificatory uncertainty. We call this the classification account... (shrink)

The aim of the paper is to explore and assess the process of responsibility, decoupling point, and disengagement of moral responsibility, in combination with business sustainability in supply chains. The research is based on a qualitative approach consisting of two multifaceted case studies, each including multiple case companies and different empirical research characteristics, and a review of BSus in supply chain literature. The case studies apply moral disengagement to propose how moral responsibility can deteriorate in supply chains, and the literature (...) review identifies elements of BSus in supply chain management. The contribution of this paper is to compare these two research streams and evaluate the efficacy of the concepts proposed in the case studies. Through this study, BSus gains an entirely different and complementary toolkit which should facilitate further and more effective research in SCM. The theory of MDis also provides a foundation for reinforcing explanatory and prescriptive aspects of ‘best practices’ in the SCM literature. The findings also establish a basis for organizing and monitoring supply chains so as to improve BSus efforts. Considering moral responsibility as a flow this research explains why and how certain practices may impede BSus efforts in supply chains. Original and/or innovative outcomes include explanatory and prescriptive insights that emerge from a combination of empirical findings from two case studies, including seven companies and a framework for improving BSus management in supply chains, based on a typology of moral disengagement. (shrink)

Norms are a pervasive yet mysterious feature of social life. In Explaining Norms, four philosophers and social scientists team up to grapple with some of the many mysteries, offering a comprehensive account of norms: what they are; how and why they emerge, persist and change; and how they work.

People taking part in research vary in the extent to which they understand information concerning their participation. Since they may choose to limit the time and effort spent on such information, lack of understanding is not necessarily an ethical problem. Researchers who notice a lack of understanding are in the quandary of not knowing whether this is due to flaws in the information process or to participants’ deliberate choices. We argue that the two explanations call for different responses.A tool for (...) identifying those research participants who want limited information is presented. This consists of a restricted number of questions about trust in and appraisal of research, priority of time and privacy, and perception of a duty to participate. It is argued that an important group of participants who purposely lack understanding of the study can be identified with this tool. Some limitations to this approach are also discussed. (shrink)

We first deal with a few preliminary matters and discuss what-if any-distinct impact belief in moral error theory should have on our moral practice. Second, we describe what is involved in giving an answer to our leading question and take notice of some factors that are relevant to what an adequate answer might look like. We also argue that the specific details of adequate answers to our leading question will depend largely on context. Third, we consider three extant answers to (...) our leading question: fictionalism, conservationism, and abolitionism. Of these three, conservationism seems most promising. However, conservationism leaves pertinent questions unanswered. In order to provide answers to these questions, and ultimately to provide an answer to our leading question, conservationism needs to be supplemented, yielding an account we call “negotiationism.” This final proposal is not neat and tidy, but it might work reasonably well in the moral environment in which error theorists are likely to find themselves. (shrink)

The paper presents an infinite hierarchy of sound and complete axiomatic systems for Two-Dimensional Modal Tense Logic with Historical Necessity, Agents and Acts. A main novelty of these logics is their capacity to represent formally (i) basic action-sentences asserting that such and such an act is performed/omitted by an agent, as well as (ii) causative action-sentences asserting that by performing/omitting a certain act, an agent causes that such and such a state-of-affairs is realized (e.g. comes about/ceases/remains/remains absent). We illustrate how (...) the formal machinery of our systems can be used to reconstruct a number of interesting ideas in the Logic of Agency and Action that have been proposed by authors like von Wright, von Kutschera, Belnap and Segerberg. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Concepts and Theories of AddictionLennart Nordenfelt (bio)Keywordsaddiction, disease, will power, autonomy, holistic view of healthThe article "A Liberal Account of Addiction" is a good piece of analytic philosophy applied to psychiatry. It is well-informed both with regard to empirical matters and philosophical conceptualization. The arguments are often—but, as I will show, not always—quite convincing. The conclusions of the paper also have crucial consequences for practice, for the treatment (...) of patients, and for social policy.The authors argue that current scientific understandings of the problem of addiction are fundamentally flawed. They distinguish between two main positions in science: The Disease View and the Willpower View. According to the Disease View, drug-seeking behavior is the direct result of some physiological change in the drug seeker's brain. According to the Willpower View, the addict is no longer rational; he or she uses drugs as a result of a fundamentally non-voluntary process.The authors dismiss the Disease View in the following way. They first note that drug addicts are in many ways rational planners. The addicts may have to think a lot to find the best ways to find the heroin, cigarettes, or alcohol, and they normally act according to this planning. They are not in any simple sense "caused" to act in a particular way. Moreover, referring to recent neurological literature, the authors note that the changes caused by drug addiction—which have to do with activating reward pathways in the brain—are identical with the outcomes of many other human activities that we do not call addiction. "In fact, any pleasurable experience causes dopamine to be released within the brain, activating these reward pathways" (Foddy and Savulescu 2010, 4). These experiences can be the result of coffee drinking, sexual activity, and physical exercise. Thus, the physical changes in the brain are not effects peculiar to the pharmacology of the drugs; they are instead the effects of the pleasure that the subject has experienced.The argument against the Willpower View is lengthy and more involved. The proponent of the Willpower View must argue that there is some flaw in the subject's autonomy. The drug addict is in some sense unable to avoid taking the drug. The authors of the present article scrutinize this idea on the basis of distinguishing between different senses of autonomy: Substantive autonomy and procedural autonomy. They state that we must here be talking about procedural autonomy, namely, autonomy regarded as dependent only on our capacity to process information and make choices in accordance with our preferences. We cannot, as in the case of substantive autonomy, require that the preferences themselves be reasonable. [End Page 27] In such a case, many of our ordinary actions would be judged non-autonomous.The most reasonable Willpower accounts rely on the idea that addicted people in some sense lack self-control. The authors cite different interpretations of the concept of lacking self- control and they conclude that "none of these … theories can say that addicts are necessarily lacking in self-control unless they also make unreasonable normative or false factual claims about the nature of drug- or pleasure-oriented choices" (Foddy and Savulescu 2010, 10). For instance, according to one interpretation the subject does not endorse his own desire for drugs, but takes the drug anyway. According to another interpretation, the addict regrets taking the drug after having done so. Against such claims the authors claim that many addicts indeed endorse their desires for drugs and many addicts do not regret their addictive behavior.So what is the positive account proposed by the authors? They put forward what they call a Liberal View. It contains three claims about addiction: First, we do not know whether an addict values anything more than the satisfaction of his addictive desires; second, we do not know whether an addict behaves autonomously when he uses drugs; and third, addictive desires are just strong regular desires.According to the Liberal View, one has to accept that the addicts may have drug taking as their highest priority and that they do not have any reduced procedural autonomy. The authors say: "Once we abandon normative bias, we must accept... (shrink)

Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atom, metal and rain are value-free and descriptive. To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person. On (...) the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory. Other philosophers claim that the concept of health, together with the other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. A statement that he or she is healthy does not merely imply certain scientific facts regarding the person’s body or mind but implies also a (positive) evaluation of the person’s bodily and mental state. My task in this paper will be, first, to present the two principal rival types of theories and present what I take to be the main kind of reasoning by which we could assess these theories, and second, to present a deeper characterization of the principal rival theories of health and illness. (shrink)

A great number of constructive suggestions for the analysis of the concepts and models treated are presented in this book, which mirrors a current debate within the theory of medicine by covering three central topics: the concepts of health and disease; definition and classification in medicine; and causal explanation in medicine. Among the issues dealt with are: How should the concepts of health and disease be characterized in order to be of relevance to clinical practice? Should we try to define (...) particular diseases in explicit terms? What should be the criteria for selecting causes when explaining disease or death? These problems are treated from various points of view, the contributors being drawn from the fields of clinical medicine, epidemiology, psychiatry, social medicine, philosophy, and history of medicine. (shrink)

The basic work for this book was carried out during the spring of 1989 in Edinburgh, where I had been granted a research position at The Institute for Advanced Studies in the Humanities. I should like to express here my indebtedness to the Institute for the opportunity thus afforded me. I should also like to say how very grateful I am for the stimulating conversations I had there with Professor Timothy Sprigge and Dr. Elizabeth Telfer. Dr. Telfers’s own treatise Happiness (...) has been a major influence on my view of the questions involved. The basic view of health and illness presented in this book is more fully set out in my On the Nature of Health. As in the case of my previous larger projects, I have received a great amount of support and may wise comments from Professor Ingmar Pörn, Helsinki. Three Danish experts – Anton Aggernaes, Erik Ostenfeld and Peter Sandøe – have made valuable comments. Professor Heng ten Have, Nijmegen, has improved my reading of the philosophy of Jeremy Bentham. I should also like to thank my colleagues at the Department of Health and Society, University of Linköping, for helping me to avoid a number of the pitfalls that can so easily stumble into when it comes to a treatise like this. Especially I should like to mentioned Per-Erik Liss, Ingemar Nordin and Bo Petersson, all three of whom have read and commented on the entire manuscript. A Swedish version of this book, Livskvalitet och hälsa, came out in 1991. I have been made quite a number of corrections and additions, one type of addition being replies to critical points made in reviews of the Swedish version. I should like to thank Malcolm Forbes for valuable help putting my English into publishable condition. Linköping, May 1993 Lennart Noredenfelt. (shrink)

This book contains scholarly contributions to several current debates in the philosophy of medicine and health care regarding the nature of health and health promotion, concepts and measurements of mental illness, phenomenological conceptions of health and illness, allocation of health care resources, criteria for proper medical science, the clinical meeting, and ethical constraints in such a meeting. With one exception, the authors in this book are or have been teachers or graduate students at the interdisciplinary Department of Health and Society (...) (Tema H) at Linköping University, Sweden. While all the texts have a philosophical focus, many other disciplines have influenced the choice of specific perspectives. The university backgrounds of the authors range from medicine, psychology, sociology, and religion to philosophy. What binds the authors together is their deep interest in the theory of medicine and in the pursuit of a philosophy of humanistic medicine and health care. (shrink)

In policy-making the consumption of specially labelled products, and its role in improving the welfare of livestock, has attracted considerable attention. There is in many countries a diverse market for animal welfare-friendly products which is potentially confusing and may lack transparency. We ask whether special quality labels that involve medium levels of animal welfare, as compared with labels promoting premium levels of animal welfare, have a role to play in promoting improvements in animal welfare. The Danish pork market is our (...) reference case, but we also widen the context by comparing the markets for pork in three other European countries. Our findings suggest that in order to improve animal welfare through demand for welfare-friendly products it is important to maintain separate the market for products with strong animal welfare profiles from markets for products with medium levels of animal welfare where, often, animal welfare is bundled together with other food quality attributes. We conclude that such quality labels may indeed play an important role in promoting higher animal welfare standards provided that they offer real improvements in animal welfare as compared with standard products. They will be attractive to consumers with a positive, but not especially strong interest in animal welfare as an individual food attribute who would otherwise be inclined to purchase standard products. (shrink)

Kierkegaard's view of time and eternity.

It is argued that utilitarianism should be reformulated as a scalar theory admitting of degrees of wrongdoing. It is also argued that the degree of wrongness of an action should be sensitive both to the relative valueloss the action results in and to the difficulty of having acted better. A version of utilitarianism meeting these specifications is forumalted.

The main purpose of this paper is to clarify some senses of dignity that are particularly relevant for the treatment and care of the elderly. I make a distinction between two quite different ideas of dignity, on the one hand the basic kind of dignity possessed by every human being, and on the other hand the dignity which is the result of a person's merits, whether these be inherited or achieved. Common to both these ideas is that having a dignity (...) entails having a set of rights, in the case of basic dignity the set of rights which we call human rights, the rights which the United Nations, among others, has tried to determine. The dignities of merit also provide some rights, although normally rights with limited scope covering, for instance, a professional area. This observation gives my preliminary answer to the fundamental question of what distinguishes dignity from other high values that could be attached to humans. I discuss further a kind of value that might be mistaken for a kind of dignity, viz. what I call public status. This status is to be distinguished from social status (the status of e.g. kings, governors, and officials) that I take to be a proper dignity of merit. The public status is the status gained solely via public perception and not directly via any merits on the part of the dignified. Finally, I turn to the topic of the dignity of the elderly and try to determine whether there is some dignity peculiar to the elderly, and which is over and above the basicMenschenwrde. My two preliminary proposals are the following: the elderly have a dignity of wisdom and they have a highly general dignity of merit, which results from their life-long efforts and achievements, and for this they deserve our gratitude. (shrink)

In some cases of disagreement it seems that neither party is at fault or making a mistake. This phenomenon, so-called faultless disagreement, has recently been invoked as a key motivation for relativist treatments of domains prone to such disagreements. The conceivability of faultless disagreement therefore appears incompatible with traditional realists semantics. This paper examines recent attempts to accommodate faultless disagreement without giving up on realism. We argue that the accommodation is unsatisfactory. However, the examination highlights that “faultless” is multiply ambiguous. (...) The more overarching purpose is to examine the consequences of this—more generally, how to think about faultless disagreement. (shrink)

According to an infinite frequency principle, it is rational, under certain conditions, to set your credence in an outcome to the limiting frequency of that outcome if the experiment were repeated indefinitely. I argue that most infinite frequency principles are undesirable in at least one of the following ways: accepting the principle would lead you to accept bets with sure losses, the principle gives no guidance in the case of deterministic experiments like coin tosses and the principle relies on a (...) metaphysical property, ‘chanciness’, whose necessary and sufficient conditions are unknown. I show that a frequency principle that is based on the principal principle suffers from problems related to the definition of ‘chance’ or ‘chanciness’, which could lead to all three of the above problems. I introduce a version of the infinite frequency principle that does not rely on a notion of chance or chanciness and does not suffer from any of these problems. (shrink)

In this article I provide an analysis of some salient concepts of dignity. The text is a development of a work which was initiated in the year 2000 in the research programme Dignity and Older Europeans supported by the European Union. The programme was both theoretical and empirical. The empirical part, which was the most comprehensive, consisted of focus-group interviews with health care and social care personnel, elderly persons within health care or social care, and representatives from the general public. (...) The interviews concerned the care of the elderly and attitudes towards the elderly. Some questions concerned how the interviewees conceived the concept of dignity and what they meant by behaviour respectful of dignity in the care of the elderly. Altogether around 1000 focus-group interviews were conducted in seven of the countries involved. The theoretical part of the programme consisted of an analysis of the concepts of dignity based on studies of dictionary entries in six languages as well as previous philosophical analyses of the concept. In the theoretical part of the study there emerged four different concepts of dignity: dignity of merit, dignity of moral standing, dignity of identity and human dignity. Characterizations of these concepts have been presented and developed in several publications, for example Nordenfelt and. In the present article this analysis is taken a step further. I take as a starting point some previous studies, including Schroeder, Sulmasy and my earlier ones, and propose an improvement and clarification of my earlier classification of dignities. At the same time I enlarge the analysis to concern worths in general and how these are attached to entities in general, not just human beings. The four kinds of dignities which I now propose are called: attributed dignity, dignity of inflorescence, dignity of identity and human dignity. (shrink)