Meanings of living at home on a ventilator Nine adults were interviewed in order to illuminate the meanings of being dependent on a ventilator and living at home. The data were analysed using a phenomenological‐hermeneutic method inspired by the philosophy of Ricoeur. Five main themes emerged through the analysis: experiencing home as a safe and comfortable space from which to reach out, experiencing the body as being frail, brave and resilient, striving to live in the present, surrendering oneself to and (...) trusting others, and experiencing technology as a burden and a relief to the lived body. Meanings of being home on a ventilator were interpreted as maintaining autonomy and persistence in interaction with the ventilator and other human beings and being able to rise above yourself and your personal boundaries in order to live a good life. These meanings indicate that aesthetic and ethical values impact on the lived body. They are bound up with experiencing a vital force and interdependency, bringing safety and courage into daily life. (shrink)

This article deals with science content “in the making” and in particular the role of the body in producing scientific phenomena. While accounts of scientists’ work have repeatedly demonstrated, how producing phenomena requires immense amounts of time and effort, involving tinkering and manual labor, this is a little empirically studied content in science education. Seeking to shed light on how the body is involved with materiality to produce physics phenomena, and in what terms this is learning physics content, the article (...) first examines how bodily tinkering is a necessary part of knowing physics through reviewing major accounts of science studies and research in science education. Secondly, drawing on phenomenology and pragmatist ideas, the article examines how students’ bodies need to be educated in the transactional process with material and artifacts to produce phenomena in the context of science learning in lower secondary physics education. Demonstrating that embodied phenomena production is an inescapable part of learning scientific inquiry, and that bodies are just as much a part of the subject physics as conceptual knowledge, we suggest that the education of students’ bodies needs to be made an explicit content. This is important not only for making tacit content accessible to all, but also for addressing epistemological understandings of what science and technology is about. (shrink)

New Jersey residents who tested their homes for radon and found more than four picocuries per liter were surveyed about their knowledge, emotions, attitudes, and intentions to take remedial action Respondents proved well informed, but radon levels were not highly correlated with any of the response variables. Overoptimism was more common than overreaction. The results suggest that active guidance is needed to ensure appropriate responses to environmental hazards, like radon, that require individual remediation. Simple information dissemination alone seems inadequate.

In recent years, the issue of accepting a higher cost per health improvement for orphan drugs has been the subject of discussion in health care policy agencies and the academic literature. This article aims to provide an analysis of broadly egalitarian arguments for and against accepting higher costs per health improvement. More specifically, we aim to investigate which arguments one should agree upon putting aside and where further explorations are needed. We identify three kinds of arguments in the literature: considerations (...) of substantial equality, formal equality, and opportunity cost. We argue that considerations of substantial equality do not support higher costs per health improvement orphan drugs, even if such considerations are considered valid. On the contrary, arguments of formal equality may support accepting a higher cost per health improvement for orphan drugs. However, in order to do so, a number of both normative and empirical issues must be resolved; these issues are identified in the article. For instance, it must be settled to what extent the opportunity cost in terms of foregone health for other patients is acceptable in order to uphold formal equality. We conclude that certain arguments can be set aside, and future focus should be put on the unresolved normative and empirical issues related to formal equality and opportunity cost. (shrink)

This five-volume edition of Aristotle's works in Greek is (with the exception of Vol. III) a photomechanical copy of the standard edition of Aristotle's works from 1831-1870. Vols. I And II contain Aristotle's works. VOlume III presents O. GIgon's revision and supplementation of Aristotle's fragments. VOl. IV Presents a selection of the most important sections of Classical commentaries on Aristotle, together with a concordance with the Commentaria in Aristotelem Graeca. VOl. V Contains a copy of H. BOnitz' Index Aristotelicus.

Student behavioural disengagement is a problem in many schools. This paper aims to explain why students’ behavioural disengagement occurs and reoccurs in Swedish classrooms in terms of two mechanisms. Mechanisms that explain student disengagement are tested quantitatively and illustrated qualitatively with primary data consisting of 74 video-recorded classroom lessons from three compulsory schools in Sweden. The regressions suggest that peer encouragement and the school subject curriculum are central for explaining student behavioural disengagement. Qualitative analysis decomposes how the mechanisms of peer (...) encouragement and school subject curriculum increase the risk of behavioural disengagement in real time using transcripts and images. In conclusion, this study shows how both mechanisms provide complementary explanations for students’ behavioural disengagement. (shrink)

This book explores the ethical dimensions surrounding the development of education for sustainable development within schools, and examines these issues through the lens of ethical literacy. The book argues that teaching children to engage with nature is crucial if they are to develop a true understanding of sustainability and climate issues, and claims that sustainability education is much more successful when pupils are treated as moral agents rather than being passive subjects of testing and assessment. The collection brings together a (...) range of fresh and creative perspectives on how issues around ethical literacies can be elaborated and expanded with regard to democratic sustainability education. The use of children's books in teaching about sustainability is carefully explored, as are the ethical and aesthetic dimensions of environmental education. Including an afterword by Arjen Wals, Professor of Transformative Learning for Socio-Ecological Sustainability, the book will be of great interest to students and researchers in the field of sustainability education. (shrink)

This book presents a number of fundamentally challenging perspectives that have been brought to the fore by the national tests on religious education (RE) in Sweden. It particularly focuses on the content under the heading Ethics. It is common knowledge that many teachers find these parts difficult to handle within RE. Further, ethics is a field that addresses a range of moral and existential issues that are not easily treated. Many of these issues may be said to belong to the (...) philosophical context, in which "eternal questions" are gathered and reflected upon. The first chapters highlight the concepts of ethical competence and critical thinking. In the following chapters the concept of ethical competence is analyzed with regard to teachers' objectives and to students' texts, respectively. These chapters pursue a more practice-related approach and highlight specific challenges identified from both teacher and student perspectives. Next, the book raises the issue of global responsibility. What kind of critical issues arise when handling such matters at school? Further, can contemporary moral philosophers contribute to such a discussion? In turn, the book discusses the role of statistical analyses with regard to national tests, while the closing chapters present international perspectives on the book's main themes and concluding remarks. The book's critical yet constructive approach to issues regarding assessment in ethics education makes a valuable contribution to an ongoing debate among researchers as well as to the everyday communication on testing in schools and classrooms. As such, it will appeal to scholars in ethics education and researchers in the field of assessment, as well as educators and teachers interested and engaged in the task of testing ethics in school contexts where curricular demands for valid and authoritative evaluation may provide important guidelines, but may also pose challenges of their own. (shrink)

Nästan alla bekänner sig till idealet om oberoende forskning. Men i praktiken är den vetenskapliga friheten begränsad av både politiken och marknaden. Vilken är egentligen vetenskapens roll i det öppna samhället?

In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM (...) are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship. (shrink)

The Swedish Jewish historian Hugo Valentin (1888–1963) founded the field of Swedish Jewish history in the 1920s. Valentin was also a prominent and public figure in Swedish Jewish affairs, as a writer, Zionist and refugee activist. This article focuses on Valentin’s analysis of antisemitism, from the 1920s to the early 1950s. It pays equal attention to the continuity and change of his writings on the topic, analysed in relation to such political contexts as the ‘Jewish question’, Zionism and anti-Nazi responses, (...) and advances within scholarly research on antisemitism. It shows that Valen­tin staked out a new approach to the topic of antisemitism, in which Jewish characteristics and the so-called Jewish question, while not completely absent, were placed within parentheses. Instead, he presented antisemitism and individual antisemites as problems in their own right, which, given Nazi German expansionism and the outbreak of the Second World War, seemed to be a greater and more urgent issue than whatever questions might have pertained to Jews and their place in modern society. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being (...) in the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (...) (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice. (shrink)

This paper treats the problem of which type of units, individuals or whole societies, should be used when explaining societal phenomena. It is argued that factors operating at the individual level in principle form societies, and that societal phenomena therefore should ideally be explained at this level. However, it is also argued that many societal phenomena cannot in practice be analyzed at the individual level in a clear and strict way, but rather must be analyzed holistically, because it is not (...) known how they are related to individual factors due to the complexity of societies. For societies to be described and analyzed in a clear and strict way, they must as a rule be much simplified, and such simplification is often made easier by abandoning the individualistic perspective. If researchers still wish to describe a connection between individual factors and a societal phenomenon, they often must do so in vague terms. There are also other problems with the individualistic perspective that make it difficult to use. However, using the holistic perspective may be risky, as shown by two hypothetical examples. (shrink)

This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view (...) of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective. (shrink)

Constitutivism explains norms in terms of their being constitutive of agency, actions, or certain propositional attitudes. However, the shmagency objection says that if we can be shmagents – like agents, minus the norm-explaining features of agency – we can avoid the norms, so the explanation fails. This paper extends this objection, arguing that constitutivists about practical norms suffer from it despite their recent attempts to solve it. The standard response to the objection is that it is self-defeating for agents to (...) become shmagents. I agree, but the response ignores the possibility of shmagents who consider whether to be agents while already standing outside agency. Another response says that we ought to be agents because agency is, in some sense, normatively valuable, and if so, we can explain norms in terms of this valuable form of agency. But then the norms that our constitutions are supposed to explain are underdetermined because it is unclear how much we ought to care about this value. I conclude that the shmagency objection has yet to be answered. (shrink)

In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined (...) or if they conflict at fundamental or pragmatic levels. This paper reviews existing literature in both medicine and related philosophy to analyze closer the meaning of the two notions, and to explore the extent to which they overlap or oppose each other, in theory or in practice, in particular regarding ethical assumptions and their respective practical implications. (shrink)

In recent discussions of the Humean Theory of Motivation (HTM), several authors – not to mention other philosophers around the proverbial water cooler – have appealed to the simplicity of the theory to defend it. But the argument from simplicity has rarely been explicated or received much critical attention – until now. I begin by reconstructing the argument and then argue that it suffers from a number of problems. Most importantly, first, I argue that HTM is unlikely to be simpler (...) than even close competing theories, and second, it is unlikely that a plausible version of the theory will be very simple. Moreover, I argue that a convincing case for HTM is likely to have to show that it is more virtuous than defenders have done so far. (shrink)

In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What (...) this implies in terms of the importance that we have reason to attach to (non-)adherence and how has, however, not been explained. In this article, we explore the relationship between different forms of shared decision-making, patient autonomy and adherence. Distinguishing between dynamically and statically framed adherence we show how the version of shared decision-making advocated will have consequences for whether one should be interested in a dynamically or statically framed adherence and in what way patient adherence should be assessed. In contrast to the former compliance paradigm (where non-compliance was necessarily seen as a problem), using observations about (non-)adherence to assess the success of health care decision making and professional-patient interaction turns out to be a much less straightforward matter. (shrink)

Realists about group agency, according to whom corporate agents may have mental states and perform actions over and above those of their individual members, think that individual agents may switch between participating in individual and corporate agency. My aim is, however, to argue that the inescapability of individual agency spells out a difficulty for this kind of switching – and, therefore, for realism about corporate agency. To do so, I develop Korsgaard's notion of plight inescapability. On my take, it suggests (...) that individual agents are continuously faced with fully exercising their own individual agency (absent external limits at the time of its exercise). But then individual agents may not switch to acting as members of corporate agents, in the sense of taking on irreducible mental states that differ from their own. As it nevertheless is possible to participate fully in the action of a corporate entity, this incompatibility between individual and corporate mental states suggests a challenge for group agent realism. (shrink)

It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of (...) futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field. (shrink)