Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, the decision that ought to be made for the incompetent patient is the decision the patient would have made, had he or she been competent. Although the merits of this standard have been extensively debated, some important issues have not been sufficiently explored. One fundamental problem is that the substituted judgment standard, as commonly formulated, is indeterminate in content (...) and thus offers the surrogate little or no guidance. What the standard does not specify is just how competent one should imagine the patient to be, and what else one ought to envision about the patient’s hypothetical outlook and the circumstances surrounding his or her decision making. The article discusses this problem of underdetermined decision conditions. (shrink)

We present results from a study about women and employee-elected board members, and fill some of the gaps in the literature about their contribution to board effectiveness. The empirical data are from a unique data set of Norwegian firms. Board effectiveness is evaluated in relation to board control tasks, including board corporate social responsibility (CSR) involvement. We found that the contributions of women and employee-elected board members varied depending on the board tasks studied. In the article we also explored the (...) effects of the esteem of the women and employee-elected board members, and we used creative discussions in the boardroom as a mediating variable. Previous board research, including research about women and employee-elected directors, questions if the board members contribute to board effectiveness. The main message from this study is that it may be more important to ask how, rather than if, women and employee-elected board members contribute, and we need to open the black box of actual board behavior to explore how they may contribute. (shrink)

Requirement‐sensitive legal moralism is a species of legal moralism in which the legitimacy of turning moral into legal demands depends on the existence of a legitimate moral requirement, producing a legitimate social requirement, which can then ground a legitimate legal requirement. Crucially, each step is defeasible by contingent or instrumental, but not intrinsic moral factors. There is no genuinely moral sphere in which the law is not to interfere; only contingent, non‐moral factors can defeat this. Using William A. Edmundson's Three (...) Anarchical Fallacies as a foil, this idea is spelled out; it is shown why considerations based on the harm principle, consent, and the fact of pluralism do not immediately defeat it, but several problems with Edmundson's account are examined to point out where the idea could be further developed. (shrink)

Does multiculturalism imply that certain cultural minorities – nomos groups, whose cultural conceptions extend in important ways into views about the law – should have forms of legal autonomy that go beyond normal multicultural accommodations such as exemptions and special protection? In other words: should we allow «minority jurisdictions» for multicultural reasons and give certain minorities powers of legislation and adjudication on certain issues? The paper sketches how one might arrive at such a conclusion given some standard multicultural reasoning, and (...) then proceeds by examining eight key rejoinders to such a proposal. None of these rejoinders provide by themselves knockdown arguments against extending multicultural rights to forms of legal autonomy, but together they do provide a basis for some skepticism about the cogency and desirability of at least more ambitious forms of legal autonomy for cultural minorities within a liberal framework. (shrink)

In recent literature, there has been much debate about whether and how luck egalitarianism, given its focus on personal responsibility, can justify universal health care. In this paper we argue that, whether or not this is so, and in fact whether or not egalitarianism should be sensitive to responsibility at all, the question of personal responsibilization for health is not settled. This is the case because whether or not individuals are responsible for their own health condition is not all that (...) is relevant when considering whether we should somehow hold them responsible for their own health condition, e.g. cost-wise. There may also be efficiency-based reasons to hold them responsible, and there may even be egalitarian reasons. Defining universal health care as an insurance system where everyone’s deductible and premium is 0, we will argue that efficiency-based reasons for cost-responsibilization are not convincing, but that there are egalitarian reasons for cost-responsibilization. Luck egalitarianism, therefore, cannot, at least not on its own term, justify universal health care. (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal (...) influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)

In “The Pecking Order,” Dalton Conley argues that inequalities between siblings are larger than inequalities at the level of the overall society. Our article discusses the normative implications for institutions of this observation. We show that the question of state intervention for curbing intra-family inequality reveals an internal tension within liberalism between autonomy and toleration, which bears on the forms that the intervention of institutions may take. Despite the pros and cons of both commitments, autonomy-based liberalism appears more compatible with (...) the involvement of the state for egalitarian reasons within the family than toleration-based liberalism.Export citation Request permission. (shrink)

The likely adverse effects of climate change call for political action. In this paper, we argue that the public reason framework—with its insistence on justifiability to all reasonable citizens, in spite of their profound disagreements—despite initial misgivings recommends itself as a framework for debate and decisions pertaining to climate change. We address two possible stumbling blocks: the exclusion of non-anthropocentric points of view, and the controversy over intergenerational justice. We argue that public reason can deal with these problems. Moreover, we (...) argue that both strongly idealized and moderately idealized versions are able to address these issues. Moreover, public reason, as a family of views emphasizing disagreement and justifiability to all reasonable citizens, can help secure the stability of political orders, and hence contribute to sustained and demanding efforts to combat the adverse effects of climate change. (shrink)

Public reason demands that policies are justified to all reasonable citizens. Public health aims at protecting or improving aggregated health outcomes. Since health is not an uncontroversial value, an insurmountable chasm between public reason and public health seems to preclude any viable synthesis between the two outlooks. For any given public health policy, some reasonable citizen seems to have a reason to support ‘no policy’ over ‘some policy’, meaning that the policy cannot be justified to all. The paper first spells (...) out what exactly this conflict is about. Then, using smoking as a case, the paper outlines a model of reconciliation between public reason and public health that should give us some optimism if we want to have public health policies that are compatible with treating citizens as free and equal in the public reason sense. (shrink)

The article analyses the role and moral force of consent in BDSM (Sado-masochistic and related practice). The view defended accepts consent as a key feature in sexual morality, and explains in detail the relation between consent and autonomy. In brief, it is argued that consent as a genuine extension of personal autonomy both justifies and draws limits to justifiable BDSM-practices: autonomy-undermining practices cannot be justified by appealing to autonomy. The paper discusses in detail the necessary conditions for consent with an (...) emphasis on relevant pitfalls in the context of BDSM and moves to an analysis of the prevalent “official” morality of the BDSM-community, expressed in the slogan “safe, sane, and consensual.” Finally, it draws attention to an un-discussed parallel between sexual morality and the concept of exit-rights as it is known from political philosophy. (shrink)

It is a common belief that obesity is wholly or partially a question of personal choice and personal responsibility. It is also widely assumed that when individuals are responsible for some unfortunate state of affairs, society bears no burden to compensate them. This article focuses on two conceptualizations of responsibility: backward-looking and forward-looking conceptualizations. When ascertaining responsibility in a backward-looking sense, one has to determine how that state of affairs came into being or where the agent stood in relation to (...) it. In contrast, a forward-looking conceptualization of responsibility puts aside questions of the past and holds a person responsible by reference to some desirable future state of affairs and will typically mean that he or she is subjected to criticism, censure, or other negative appraisals or that he or she is held cost-responsible in some form, for example, in terms of demanded compensation, loss of privileges, or similar. One example of this view is the debate as to whether the obese should be denied, wholly or partially, free and equal access to healthcare, not because they are somehow personally responsible in the backward-looking sense but simply because holding the obese responsible will have positive consequences. Taking these two conceptions of responsibility into account, the authors turn their analysis toward examining the relevant moral considerations to be taken into account when public policies regarding obesity rely on such a conception of responsibility. (shrink)

To claim that companies should not discriminate on the basis of race, gender or religion seems almost as trivial as stating that they should not use forced labor or dump radioactive waste into the local river. Among other things, non-discrimination seems to imply that companies recognize and respect a range of religious preferences, including allowing religious clothing, e.g., by allowing Muslim women to wear headscarves. However, many companies do not believe that employees generally should be allowed to wear the kind (...) of clothes they please. In this paper, we discuss the asymmetry between the status of religious and secular clothing. We conclude that religious exemptions to dress codes can discriminate wrongfully. To solve this problem, companies should not ban religious clothing. Instead, companies should liberalize their dress codes, so that employees would be allowed to wear secular and religious types of clothing on an equal footing. (shrink)

Status inequalities seem to play a fairly big role in creating inequalities in health. This article assumes that there can be good reasons to fight status inequalities in order to reduce inequalities in health. It examines whether the neorepublican ideal of non-dominance does a better job as a theoretical foil for this as compared to a liberal notion of non-interference. The article concludes that there is a prima facie case for incorporating non-dominance into our thinking about public health, but that (...) it needs to go hand in hand with a more traditional liberal ideal of non-interference. (shrink)

Abstract2020 saw the rapid onset of a global pandemic caused by the SARS-CoV-2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to (...) “being a nurse” during the COVID-19 pandemic was experienced and understood by Danish hospital-based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

The nub of the following argument is that there is a conflict between the idea of (liberal) neutrality on the one hand, and an intuitively plausible idea of political representation on the other. The conflict arises when neutrality is seen as a condition for political legitimacy: neutralist political representation is only legitimate insofar as the representative does not advance political ideas based on conceptions of the good that are not endorsed by the whole of the (reasonable) polity. However, we often (...) encounter examples of political representation that do not live up to this demand but nevertheless seem legitimate. Hence, neutralists should explain either why this counterintuitive notion of representation does not follow from neutrality or explain what representatives are meant and allowed to do in such a political arrangement. A plausible neutralist rejoinder to this is to say that legitimacy is not dependent on neutrality for all political decisions. Neutrality is important (only or predominantly) regarding a certain body of political decisions, viz., using the Rawlsian idiom, 'constitutional essentials and matters of basic justice.' However, such a two-levelled approach is not without its problems. I argue that a skein of theoretical and practical challenges to the two-levelled approach undermines, or at least weakens, this attempt to solve the problem about representation and neutrality, and that the two-levelled approach is unclear in certain key aspects. The aim of the article is, however, quite modest. It is not to challenge neutrality per se ; rather, it is a call for further clarification of the issues pertaining to the relationship between neutrality and representation. (shrink)

This article opens with the questions, What is on the inside of a relation? Might we imagine the inner workings of a relational form detached from the elements that it connects? Then, through an ethnographic examination of ancestral interventions among residents in a neighborhood on the outskirts of Maputo, the article challenges conventional understandings of relational forms as the connective “glue” holding together exterior and, to a certain extent, autonomous elements. In southern Mozambique, ancestral spirits intervene in the lives of (...) their descendants as interior agentive forces that enable the latter to assimilate seemingly exterior elements that are nevertheless configured as being already “inside” the living person. Conventional distinctions between exterior and interior are consequently dissolved through a peculiar process of “interior swelling” that occurs when an inside is extended outward. The article shows how it is the fuzziness of relational forms that gives to ancestral interventions their expansive qualities. (shrink)

This study investigates the role of perceived power relation between target and perpetrator regarding victimization and turnover intent following exposure to bullying behavior at the workplace. We hypothesized that targets of bullying behavior who self-label as victims experiences a larger power imbalance with the perpetrator compared to targets who do not self-label as victims, and that the association between exposure to bullying behavior and intent to leave the job is stronger when there is power balance between target and perpetrator than (...) when there is a power imbalance. The hypotheses were tested in a probability sample of employees working in the child welfare service in Oslo municipality, Norway, and that had been exposed to at least one instance of mistreatment from a colleague at their workplace. Targets of bullying behavior whom self-labeled as victims reported a larger power imbalance with the perpetrator. Supporting the study hypothesis, and representing a reverse buffering effect, exposure to bullying behavior was most strongly associated with intent to leave among targets in power balance with the perpetrator. For targets in a perceived power imbalance, both low and high exposure to bullying behavior were associated with higher levels of intent to leave. These findings highlight the importance of implementing measures directed at preventing bullying and other forms of mistreatment, irrespective of the power relation between the two parties. (shrink)

This two-part study examined if the buffering effect of transformational leadership on the association between work-related ambiguity and job satisfaction is contingent upon whether a follower holds a formal leadership position him/herself. Data from two separate surveys were employed: Study 1: A sample of 845 respondents from Belgium. Study 2: A national probability sample of 1,608 Norwegian employees. Study 1 showed that task ambiguity had a significant negative relation with job satisfaction, but that transformational leadership did only buffer the association (...) between task ambiguity and job satisfaction among employees holding a formal position as a supervisor or manager. Study 2 extended Study 1 by adjusting for age and job tenure of subordinates as a confounding variable. Study 2 confirmed that transformational leadership had a significantly stronger impact on the observed association between role ambiguity and job satisfaction among respondents holding a supervisor or manager position. In conclusion, when considering job satisfaction as an outcome of work-related ambiguity, transformational leadership is mainly beneficial for followers holding a formal supervisor or manager position themselves. Our findings thereby question assumptions about the general effectiveness of transformational leadership. (shrink)

Do we have a “duty to recognize culture”? The aim of this paper is to examine the following question: assuming we have reasons to respect or valuerecognition per se, do we on that background also have reasons to recognize culture? More specifically, does “culture” furnish a particular morally relevant fact with pro tanto force, providing the basis for a duty to recognize culture? The paper first examines the concept of recognition and then proceeds to analyze “the recognition thesis”, a general (...) argument for why or how culture can be a salient part of what should be recognized. On that basis, the more specific theories of recognition proposed by Axel Honneth and Charles Taylor are examined, and it is argued that neither of these theories support a general duty to recognize culture. (shrink)

Do we have a “duty to recognize culture”? The aim of this paper is to examine the following question: assuming we have reasons to respect or valuerecognition per se, do we on that background also have reasons to recognize culture? More specifically, does “culture” furnish a particular morally relevant fact with pro tanto force, providing the basis for a duty to recognize culture? The paper first examines the concept of recognition and then proceeds to analyze “the recognition thesis”, a general (...) argument for why or how culture can be a salient part of what should be recognized. On that basis, the more specific theories of recognition proposed by Axel Honneth and Charles Taylor are examined, and it is argued that neither of these theories support a general duty to recognize culture. (shrink)

This article examines two current debates in Denmark—assisted suicide and the prioritization of health resources—and proposes that such controversial bioethical issues call for distinct philosophical analyses: first-order examinations, or an applied philosophy approach, and second-order examinations, what might be called a political philosophical approach. The authors argue that although first-order examination plays an important role in teasing out different moral points of view, in contemporary democratic societies, few, if any, bioethical questions can be resolved satisfactorily by means of first-order analyses (...) alone, and that bioethics needs to engage more closely with second-order enquiries and the question of legitimacy in general. (shrink)

Obtaining human genetic samples is vital for many biobank research purposes, yet, the ethics of obtainment seems to many fraught with difficulties. One key issue is consent: it is by many considered ethically vital that consent must be fully informed (at least ideally speaking) in order to be legitimate. In this paper, we argue for a more liberal approach to consent: a donor need not know all the specifics of future uses of the sample. We argue that blanket consent is (...) ethically defensible, and that this is buttressed by considerations of (justified) trust-relations. Given robust institutional oversight, blanket consent is a permissible form of consent in the bio-banking context. (shrink)

To claim that companies should not discriminate on the basis of race, gender or religion seems almost as trivial as stating that they should not use forced labor or dump radioactive waste into the local river. Among other things, non-discrimination seems to imply that companies recognize and respect a range of religious preferences, including allowing religious clothing, e.g., by allowing Muslim women to wear headscarves. However, many companies do not believe that employees generally should be allowed to wear the kind (...) of clothes they please. In this paper, we discuss the asymmetry between the status of religious and secular clothing. We conclude that religious exemptions to dress codes can discriminate wrongfully. To solve this problem, companies should not ban religious clothing. Instead, companies should liberalize their dress codes, so that employees would be allowed to wear secular and religious types of clothing on an equal footing. (shrink)

This book deals with the role of international standards for corporate governance in the context of corporate social responsibility. Based on the fundamentals of moral theory, the book examines governance and CSR in general, addressing questions such as: Is "good governance" not affected by moral concerns? How do the principles and practices of CSR standards adhere to or conflict with insights from business ethics and moral theory? To what extent do the standards and governance models provide normative guidance? Do the (...) standards and governance guidelines provide an adequate means of benchmarking and auditing? Are these standards a help or a hindrance to stakeholder engagement and transparency? The book provides insightful and thought-provoking answers to these and many other important questions concerning CSR standards, and offers a valuable resource for practitioners, academics and students at business schools and other institutions. (shrink)

Several lines of evidence show that systematic exposure to negative social acts at the workplace i.e., workplace bullying, results in symptoms of depression and anxiety among those targeted. However, little is known about the association between bullying, inflammatory genes and sleep problems. In the present study, we examined the indirect association between exposure to negative social acts and sleep through distress, as moderated by the miR-146a genotype. The study was based on a nationally representative survey of 1179 Norwegian employees drawn (...) from the Norwegian Central Employee Register by Statistics Norway. Exposure to workplace bullying was measured with the 9-item version of Negative Acts Questionnaire – Revised (NAQ-R) inventory. Seventeen items from Hopkins Symptom Checklist (HSCL-25) was used to measure distress. Insomnia was assessed with three items reflecting problems with sleep onset, maintenance of sleep and early morning awakening. Genotyping with regard to miR-146a rs2910164, previously linked to inflammatory processes, was carried out using Taqman assay. The data revealed that individuals systematically exposed to negative social acts at the workplace reported higher levels of sleep problems than non-exposed individuals. Moreover, the relationship between distress induced by exposure to negative social acts and insomnia was significantly stronger for individuals with the miR-146a GG genotype. Thus, the miR-146a genotype moderated the association between distress and insomnia among individuals exposed to negative social acts. The present report support the hypothesis that inflammation could play a role in stress-induced insomnia among individuals exposed to workplace bullying. (shrink)