Different ideas of the normative relevance of autonomy can give rise to profoundly different action-guiding principles in healthcare. If autonomy is seen as a value rather than as a right, it can be argued that patients’ decisions should sometimes be overruled in order to protect or promote their own autonomy. We refer to this as paternalism in the name of autonomy. In this paper, we discuss different elements of autonomy (decision-making capacity, efficiency, and authenticity) and arguments in favor of paternalism (...) for the sake of autonomy that have been proposed in the bioethical debate. We argue that if autonomy is valuable, then paternalism for the sake of autonomy may be justified. However, policies allowing paternalism in the name of autonomy may be self-defeating. (shrink)

Contrary to Vaesen's argument that humans are unique with respect to nine cognitive capacities essential for tool use, we suggest that although such cognitive processes contribute to variation in tool use, it does not follow that these capacities arenecessaryfor tool use, nor that tool use shaped cognition per se, given the available data in cognitive neuroscience and behavioral biology.

Recent advances in medical and information technologies, the availability of new types of medical data, the requirement of increasing numbers of study participants, as well as difficulties in recruitment and retention, all present serious problems for traditional models of specific and informed consent to medical research. However, these advances also enable novel ways to securely share and analyse data. This paper introduces one of these advances—blockchain technologies—and argues that they can be used to share medical data in a secure and (...) auditable fashion. In addition, some aspects of consent and data collection, as well as data access management and analysis, can be automated using blockchain-based smart contracts. This paper demonstrates how blockchain technologies can be used to further all three of the bioethical principles underlying consent requirements: the autonomy of patients, by giving them much greater control over their data; beneficence, by greatly facilitating medical research efficiency and by reducing biases and opportunities for errors; and justice, by enabling patients with rare or under-researched conditions to pseudonymously aggregate their data for analysis. Finally, we coin and describe the novel concept of prosent, by which we mean the blockchain-enabled ability of all stakeholders in the research process to pseudonymously and proactively consent to data release or exchange under specific conditions, such as trial completion. (shrink)

There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly (...) rational grounds.We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views. (shrink)

Stellt sich beispielsweise in Ermittlungsverfahren heraus, dass es sich bei solchen Terroristen und gewalttätigen Radikalen, die für schwere Gewalt- und Hassverbrechen zur Verantwortung gezogen werden, zugleich um formal hoch gebildete und qualifizierte Menschen handelt, dann reagiert die Öffentlichkeit oftmals besonders irritiert darauf. Unschwer ließe sich das auf eine weitverbreitete Auffassung zurückführen, wonach Bildung und Gewalt einander ausschlössen. Der vorliegende Essay geht hingegen von einer anderslautenden These aus. Diese besagt: Auch Radikalisierungsprozesse lassen sich als Bildungsprozesse beschreiben – und individuelle Radikalisierungsprozesse ließen (...) sich auf diese Weise an vielleicht entscheidenden Punkten besser verstehen, als wenn man sie sich über Bezugsideologien, Gruppenstrukturen oder kritische Sozialisationsverläufe zu erklären versucht. Zwar greifen nur die wenigsten Radikalen auch zu gewaltsamen Mitteln, um ihre Ziele durchzusetzen. Doch selbst in solchen Fällen, argumentiert der Essay, wo es zur Gewaltanwendung kommt, widerspricht dies nicht zwingend der hier vertretenen These. Die Annahme, dass sich Radikalisierungsprozesse genauer noch als transformatorische Bildungsprozesse rekonstruieren lassen, könnte nicht nur eine Erklärung für das unausgesetzte Attraktionspotenzial bedeuten, über das die Radikalität selbst in Gesellschaften verfügt, die nicht vorrangig von gewaltsamen Konflikten oder materieller Not gezeichnet sind. Sie lässt sich zudem als produktiver Beitrag zu einer grundlagentheoretischen Debatte in der Extremismus- und politischen Gewaltforschung aufgreifen, in der das Konzept der Radikalisierung wegen seiner Gewaltgebundenheit, Subjektferne und seiner sicherheitspolitischen Agenda grundlegend in Frage gestellt wird. Doch vor allem möchte der Essay dazu anregen, sich vermehrt mit bildungstheoretischen Zugängen zum Phänomen der Radikalität auseinanderzusetzen; und zwar insbesondere auch dann, wenn dies selbst gewaltsame Formen mit einschließt. Auf diese Weise ließen sich womöglich neue und weiterführende Erklärungsansätze zur Genese von radikaler Gewalt entwickeln. (shrink)

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why it was justifiable (...) to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.

Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month (...) or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed. (shrink)

While organizations today make extensive use of complex algorithms, the notion of algorithmic accountability remains an elusive ideal due to the opacity and fluidity of algorithms. In this article, we develop a framework for managing algorithmic accountability that highlights three interrelated dimensions: reputational concerns, engagement strategies, and discourse principles. The framework clarifies that accountability processes for algorithms are driven by reputational concerns about the epistemic setup, opacity, and outcomes of algorithms; that the way in which organizations practically engage with emergent (...) expectations about algorithms may be manipulative, adaptive, or moral; and that when accountability relationships are heavily burdened by the opacity and fluidity of complex algorithmic systems, the emphasis of engagement should shift to a rational communication process through which a continuous and tentative assessment of the development, workings, and consequences of algorithms can be achieved over time. The degree to which such engagement is, in fact, rational can be assessed based on four discourse-ethical principles of participation, comprehension, multivocality, and responsiveness. We conclude that the framework may help organizations and their environments to jointly work toward greater accountability for complex algorithms. It may further help organizations in reputational positioning surrounding accountability issues. The discourse-ethical principles introduced in this article are meant to elevate these positioning contests to extend beyond mere adaption or compliance and help guide organizations to find moral and forward-looking solutions to accountability issues. (shrink)

Are we responsible for our misdeeds in dreams? The obvious answer would seem to be ‘No’. Dreams catch us with our defences down: just those critical and discriminative abilities which are distinctive of our waking lives as responsible moral agents seem out of play when we dream; el sueño de la razón produce monstruos . Moreover, if we are responsible for our dreamt misdeeds, then parity of reasoning demands that we be praised for dreaming noble dreams. But that is absurd. (...) Moral credit should not come that easily, and so neither should moral blame. (shrink)

In this paper I will revisit the debate over pornography by doing three things: (a) I will suggest a more sophisticated, two‐dimensional set of distinctions between positons in the debate; (b) I will then go on to attack both libertarians and the group I call “repressive feminists”; and (c) I will conclude by suggesting that by means of Hume's theory of sympathy we could support a limited form of censorship to bring women more fully into our moral and political community. (...) I turn first to the labors of definition. (shrink)

After briefly considering Plato’s objections to rhetoric—it disregards the truth, aiming only to persuade, and it manipulates our emotions rather than instructing us—I turn to the historical Gorgias. The ‘Encomium of Helen’ ascribes to logos virtually all-powerful capacities for persuasion, seduction, and even bewitchment. Here Gorgias celebrates the very things Plato rejects. Yet in the ‘Defense of Palamedes’ considerable anxieties about whether logos actually does possess such strength are voiced: the weakness, not the power, of logos comes to occupy center (...) stage. Gorgias’ own views thus are likely more complex than Plato allows. (shrink)

We critically discuss the impact of sustainable development initiatives in Kerala, India, on biodiversity and on women farmers in the matrilineal Adivasi community of the Kurichya-tribe in Wayanad. By contextualizing development programs regarding the specifically gendered access to land, division of labor, distribution of knowledge and decision-making power, we situate our analysis within the theoretical framework of feminist political ecology. We first outline women’s gaining of social and political space in local self-government institutions and then critically discuss the impacts of (...) women’s farming groups. Decentralization and development programs have aimed at empowering women and reducing poverty through improved food security. However, little success has materialized, as patriarchal power structures concerning decision-making processes as well as control over the most valuable resources and traditional knowledge have been maintained. Whereas women’s self-help groups in Kerala have enhanced their position, women’s farming groups, by contrast, have brought little betterment. In some cases they have even downsized women’s management and knowledge of resources related to agriculture and do not integrate or enhance Kurichya women’s knowledge. As some women are now introducing high-yielding rice seeds and fertilizer and as it is impossible for them to control land and get access to traditional rice seeds—the domain of men—we contest the notion of women being considered the preservers of agrobiodiversity. We argue, rather, that the construction and transformation of ecological traditional knowledge is highly dependent on the gendered multi-scaled power structures of state and community. (shrink)

The science underlying global warming, climate change, and the connections between these phenomena are reviewed. Projected future climate changes under various plausible scenarios of future human behavior are explored, as are the potential impacts of projected climate changes on society, ecosystems, and our environment. The economic, security, and ethical considerations relevant to determining the threat posed by climate change are subsequently assessed. The article then discusses the various means available for climate change mitigation, focusing on the relative strengths and weaknesses (...) of various societal alternatives including ‘geoengineering’ and transitioning to less carbon intensive energy sources. The article concludes with the author's views as to what steps might most profitably be taken to avert dangerous anthropogenic interference with Earth's climate, and the ramifications if such steps are not taken. (shrink)

Moving away from the strong body of critique of pervasive ‘bad data’ practices by both governments and private actors in the globalized digital economy, this book aims to paint an alternative, more optimistic but still pragmatic picture of the datafied future. The authors examine and propose ‘good data’ practices, values and principles from an interdisciplinary, international perspective. From ideas of data sovereignty and justice, to manifestos for change and calls for activism, this collection opens a multifaceted conversation on the kinds (...) of futures we want to see, and presents concrete steps on how we can start realizing good data in practice. (shrink)

The Capability Approach is in the first place an approach to the evaluation of individual well-being and social welfare. Many disciplines refer to the CA, first and foremost welfare economics, development studies and political philosophy. Educational theory was not among the first disciplines that took notice of the CA, but has a rising interest in it. This paper argues that the CA would also profit from looking into educational theory. The first part of the paper shows why and where educational (...) theory—or more precisely: a theory of learning—is missing in the CA. This is done in three steps: the first section gives a brief overview of the core concepts of Sen’s CA. Section “Capability and Choosing” focuses on the role of choosing in the CA. It states the views of Sen and Nussbaum on choosing and shows the shortcomings in their appreciation of choosing. In consequence, the third section derives some demands on a theory of learning in the CA. The second part of the paper presents Dewey’s educational theory on experience as a possible starting point when looking for a learning theory that lends itself to the integration in the CA. Section “Opportunity of Choosing, Experience and Education” introduces Dewey’s conception of experience, freedom of the learner, conditions of experience and education. Section “Capability and Experience” discusses how Dewey’s concepts fit into the CA. On the first glance, there are three points in which the CA and Dewey’s concepts match: the importance of freedom for human life, the role of participation in education and the need to take internal and external factors as well as their interaction into account in assessing choice situations. This establishes a basis for linking both theories. Yet, more research is needed to explore the issue further. Section “Conclusion and Outlook” concludes and sketches the lines for future research. (shrink)

When discussing the morality of gonad transplantation for procreative purposes, it can be tempting to examine the act solely qua reproductive technology. This paper, instead, compares the gonad to the kidney and evaluates the act qua organ transplantation. First, the author expounds a hierarchy of organs in relation to personal identity. Next, after considering an organ’s subjective effect on identity, the author elucidates an organ’s objective effect by ranking the powers of the soul and the goods of the human person. (...) The hierarchy of organs shows the gonad to be among the highest organs and most perfective of the human person. Because of the gonad’s highly personal nature, it cannot licitly be directed to another’s good. (shrink)

In this paper I comment on Gareth B. Matthews's “The Socratic Augustine” and Peter King's “Augustine on the Impossibility of Teaching.” Matthews's paper adduces several instances of Augustine's apparent willingness to accept Socratic perplexity in some philosophical matters. Matthews suggests that these cases are compatible with Augustine's dogmatism because Augustine presupposes that the phenomena in question, although perplexing, are actual. I suggest instead that Augustine can be viewed as taking a neutral stance toward many of his examples, because they arise (...) in areas of philosophical inquiry where it is not important to the tenets of his faith that he hold the right opinion. King defends the Augustinian thesis that teaching, construed as the causal transmission of knowledge from teacher to learner, is, if not impossible, at least mysterious. I suggest that much of the alleged mystery may rest on a confusion between epistemological dependency and metaphysical dependency. (shrink)

Down Girl is a broad, original, and far ranging analysis of what misogyny really is, how it works, its purpose, and how to fight it. The philosopher Kate Manne argues that modern society's failure to recognize women's full humanity and autonomy is not actually the problem. She argues instead that it is women's manifestations of human capacities -- autonomy, agency, political engagement -- is what engenders misogynist hostility.

In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where issues related (...) to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)

The Durkheim Test. Remarks on Susan Leigh Star’s Boundary Objects. The article reconstructs Susan Leigh Star’s conceptual work on the notion of ‘boundary objects’. It traces the emergence of the concept, beginning with her PhD thesis and its publication as Regions of the Mind in 1989. ‘Boundary objects’ attempt to represent the distributed, multifold nature of scientific work and its mediations between different ‘social worlds’. Being addressed to several ‘communities of practice’, the term responded to questions from Distributed Artificial Intelligence (...) in Computer Science, Workplace Studies and Computer Supported Cooperative Work (CSCW), and microhistorical approaches inside the growing Science and Technology Studies. Yet the interdisciplinary character and interpretive flexibility of Star’s invention has rarely been noticed as a conceptual tool for media theory. I therefore propose to reconsider Star’s ‘Durkheim test’ for sociotechnical media practices. (shrink)

Die Arbeit verfolgt die Entwicklung einer Theorie der Wirtschaftskrisen bei Marx und in der politischen Ökonomie des 19. Jahrhunderts. Marx hat die großen Krisen seiner Zeit und ihre Verläufe in umfangreichen, erst jüngst veröffentlichten Studienheften erforscht und in ökonomischen Manuskripten theoretisch verarbeitet. Er wollte die Wiederkehr der Krisen erklären und auch verstehen, wie sie die Welt verändern und was sie über diese aussagen.

Das Jahrbuch versteht sich als akademisches Forum der wissenschaftlichen Marx-Debatte und will zur Erschließung des enzyklopädischen Oeuvres der beiden Autoren beitragen; es wird in Verbindung mit der Marx-Engels-Gesamtausgabe herausgegeben. Neben Beiträgen aus der internationalen Forschung enthält der aktuelle Doppelband anlässlich des 200. Geburtstags einen Schwerpunkt zu Engels.