We do not know how much clinical physicians carrying out clinical trials in oncology and haematology struggle with ethical concerns. To our knowledge, no empirical research exists on these questions in a Nordic context. Therefore, this study aims to learn what kinds of ethical challenges physicians in Sweden, Denmark and Finland face when caring for patients in clinical trials; and what strategies, if any, they have developed to deal with them. The main findings were that clinical cancer trials pose ethical (...) challenges related to autonomy issues, unreasonable hope for benefits and the therapeutic misconception. Nevertheless, some physicians expressed that struggling with such challenges was not of great concern. This conveys a culture of hope where health care professionals and patients uphold hope and mutually support belief in clinical trials. This culture being implicit, physicians need opportunities to deliberately reflect over the characteristics that should constitute this culture. (shrink)

The purpose of retracting published papers is to maintain the integrity of academic research. Recent work in research ethics has devoted important attention to how to improve the system of paper retraction. In this context, the focus has primarily been on how to handle fraudulent or flawed research papers and how to encourage the retraction of papers based on honest mistakes. Less attention has been paid to whether papers that report unethical research—for example, research performed without appropriate concern for the (...) moral rights and interests of the research participants—should be retracted. The aim of this paper is to examine to what extent retraction policies of academic journals and publishers address retractions of unethical research and to discuss critically various policy options and the reasons for accepting them. The paper starts by reviewing retraction policies of academic publishers. The results show that many journals do not have explicit policies for how to handle unethical research. Against this background, we then discuss four normative arguments for why unethical research should be retracted. In conclusion, we suggest a retraction policy in light of our empirical and normative investigations. (shrink)

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection (...) from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient’s dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient’s wishes and needs are the starting point. (shrink)

Sometimes participants in research collaboration die before the paper is accepted for publication. The question we raise in this paper is how authorship should be handled in such situations. First, the outcome of a literature survey is presented. Taking this as our starting point, we then go on to discuss authorship of the dead in relation to the requirements of the Vancouver rules. We argue that in principle the deceased can meet the requirements laid down in these authorship guidelines. However, (...) to include a deceased researcher as author requires a strong justification. The more the person has been involved in the research and writing process before he or she passes away, the stronger the justification for inclusion. (shrink)

Due to the alarming rise of antibiotic resistance, medically unwarranted use of antibiotics has assumed new moral significance. In this paper, a thematic content analysis of focus group discussions was conducted to explore lay people’s views on the moral challenges posed by antibiotic resistance. The most important finding is that lay people are morally sensitive to the problems entailed by antibiotic resistance. Participants saw the decreasing availability of effective antibiotics as a problem of justice. This involves individual as well as (...) collective moral responsibility. Yet, holding agents responsible for their use of antibiotics involves varying degrees of demandingness. In our discussion, these findings are related to the contemporary ethical debate on antibiotic resistance and two proposals for the preservation of antibiotic effectiveness are compared to and evaluated against participants’ views. (shrink)

Background Research is crucial to improve treatment, survival and quality of life for children with cancer. However, recruitment of children for research raises ethical challenges. The aim of this study was to explore and describe ethical values and challenges related to the recruitment of children with cancer for research, from the perspectives and experiences of healthcare professionals in the Swedish context. Another aim was to explore their perceptions of research ethics competence in recruiting children for research. Methods An explorative qualitative (...) study using semi-structured interviews with key informants. Seven physicians and ten nurses were interviewed. Interviews were analysed using inductive qualitative content analysis. Results The respondents’ ethical challenges and values in recruitment mainly concerned establishing relationships and trust, meeting informational needs, acknowledging vulnerability, and balancing roles and interests. Ensuring ethical competence was raised as important, and interpersonal and communicative skills were highlighted. Conclusion This study provides empirical insight into recruitment of children with cancer, from the perspectives of healthcare professionals. It also contributes to the understanding of recruitment as a relational process, where aspects of vulnerability, trust and relationship building are important, alongside meeting informational needs. The results provide knowledge on the complexities raised by paediatric research and underpin the importance of building research ethics competence to ensure that the rights and interests of children with cancer are protected in research. (shrink)

Research ethics committees (RECs) have a crucial role in protecting children in research. However, studies on REC members’ perspectives on paediatric research are scarce. We conducted a qualitative study to explore Swedish scientific REC members’ perspectives on ethical aspects in applications involving children with severe health conditions. The REC members considered promoting participation, protecting children and regulatory adherence to be central aspects. The results underscored the importance of not neglecting ill children’s rights to adapted information and participation. REC members supported (...) a contextual and holistic approach to vulnerability and risk, which considers the child’s and parents’ psychological wellbeing and the child’s integrity, both short and long term. The ethical complexity of paediatric research requires continuous ethical competence development within RECs. (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)

There are prominent resemblances between issues addressed by Simone de Beauvoir in her early essay on moral philosophy, Pyrrhus and Cineas (1944), and issues attracting the attention of contemporary feminist ethicists, especially those concerned with the ethics of care. They include a focus on relationships, interaction, and mutual dependency. Both emphasize concrete ethical challenges rooted in everyday life, such as those affecting parents and children. Both are critical of the level of abstraction and insensitivity to the situation of the moral (...) agent in utilitarianism and Kantian ethics. And both condemn the “moral point of view,” i.e. the assumption that it is possible to speak with a universal voice on behalf of humanity. These resemblances are explored in this article. (shrink)

Growing concern has been expressed that we have entered a “post-truth” era in which each of us willfully believes whatever we choose, aided and abetted by alternative and social media that spin alternative realities for boutique consumption. A prime example of the belief in alternative realities is said to be acceptance of “conspiracy theories”—a term that is often used as a pejorative to indict claims of conspiracy that are so obviously absurd that only the unhinged could believe them. The epistemological (...) standard often involved in this indictment, however—the standard of “obvious” falsity—invites subjectivity in its application, because what is obviously false to one person can be common sense to another. This is not just a truism; considerable research suggests that people’s political beliefs, in general, and their acceptance or rejection of conspiracy theories in particular, tends in large part to be determined by partisan, ideological, and other priors. (shrink)

The title of this paper reflects the fact truthmaking is quite frequently considered to be expressive of realism. What this means, exactly, will become clearer in the course of our discussion, but since we are interested in Armstrong’s work on truthmaking in particular, it is natural to start from a brief discussion of how truthmaking and realism appear to be associated in his work. In this paper, special attention is given to the supposed link between truthmaking and realism, but it (...) is argued that this link should not be taken too seriously, as truthmaking turns out to be, to a large extent, ontologically neutral. Some consequences of this are studied. (shrink)

It is now possible to have a child without sexual intercourse. The history of this apparently new statement has been breefly synthetised.The new perspectives open ethical problems for the scientific community and a new social context for single women.

The main aim of this paper is to introduce the logics of evidence and truth $$LET_{K}^+$$ and $$LET_{F}^+$$ together with sound, complete, and decidable six-valued deterministic semantics for them. These logics extend the logics $$LET_{K}$$ and $$LET_{F}^-$$ with rules of propagation of classicality, which are inferences that express how the classicality operator $${\circ }$$ is transmitted from less complex to more complex sentences, and vice-versa. The six-valued semantics here proposed extends the 4 values of Belnap-Dunn logic with 2 more values (...) that intend to represent (positive and negative) reliable information. A six-valued non-deterministic semantics for $$LET_{K}$$ is obtained by means of Nmatrices based on swap structures, and the six-valued semantics for $$LET_{K}^+$$ is then obtained by imposing restrictions on the semantics of $$LET_{K}$$. These restrictions correspond exactly to the rules of propagation of classicality that extend $$LET_{K}$$. The logic $$LET_{F}^+$$ is obtained as the implication-free fragment of $$LET_{K}^+$$. We also show that the 6 values of $$LET_{K}^+$$ and $$LET_{F}^+$$ define a lattice structure that extends the lattice L4 defined by the Belnap-Dunn four-valued logic with the 2 additional values mentioned above, intuitively interpreted as positive and negative reliable information. Finally, we also show that $$LET_{K}^+$$ is Blok-Pigozzi algebraizable and that its implication-free fragment $$LET_{F}^+$$ coincides with the degree-preserving logic of the involutive Stone algebras. (shrink)

Argues that there can be interaction without breaking physical laws: e.g. by basic psychic forces, or by varying physical constants, or especially by arranging fractal trees of physical causation leading to behavior.

Between 1873 and 1876, Felix Klein published a series of papers that he later placed under the rubric anschauliche Geometrie in the second volume of his collected works (1922). The present study attempts not only to follow the course of this work, but also to place it in a larger historical context. Methodologically, Klein’s approach had roots in Poncelet’s principle of continuity, though the more immediate influences on him came from his teachers, Plücker and Clebsch. In the 1860s, Clebsch reworked (...) some of the central ideas in Riemann’s theory of Abelian functions to obtain complicated results for systems of algebraic curves, most published earlier by Hesse and Steiner. These findings played a major role in enumerative geometry, whereas Plücker’s work had a strongly qualitative character that imbued Klein’s early studies. A leitmotif in these works can be seen in the interplay between real curves and surfaces as reflected by their transformational properties. During the early 1870s, Klein and Zeuthen began to explore the possibility of deriving all possible forms for real cubic surfaces as well as quartic curves. They did so using continuity methods reminiscent of Poncelet’s earlier approach. Both authors also relied on visual arguments, which Klein would later advance under the banner of intuitive geometry (anschauliche Geometrie). (shrink)

The thought that empathy plays an important role in moral motivation is almost a platitude of contemporary folk psychology. Parallel themes were mooted in German moral philosophy and aesthetics in the 1700s, and versions of the empathy construct remained prominent in continental accounts of moral motivation through the nineteenth century and early twentieth centuries. This chapter elucidates the Empathic Motivation Hypothesis (EMH) and sets out some of the conceptual and empirical challenges it faces. It distinguishes empathic concern from other dimensions (...) of empathy (e.g., resonance, attunement, distress, and non-empathic concern) and examines the merits of EMH as a developmental thesis, focusing on evidence from psychopathology and attachment theory. (shrink)

Discusses the rationality of the Christian religion and examines the philosophical arguments for the existence of God.

This original and lively book explores Greek ideas about health and disease and their influence on Greek thought. Fundamental issues such as causation and responsibility, purification and pollution, mind-body relations and gender differences, authority and the expert and who can challenge them, reality and appearances, good government, happiness, and good and evil themselves are deeply implicated. Using the evidence not just from Greek medical theory and practice but also from epic, lyric, tragedy, historiography, philosophy, and religion, G. E. R. Lloyd (...) offers the first comprehensive account of the influence of Greek thought about health and disease on the Greek imagination. (shrink)

The main scientific problems of chemical bonding were solved half a century ago, but adequate philosophical understanding of chemical combination is yet to be achieved. Chemists routinely use important terms ("element," "atom," "molecule," "substance") with more than one meaning. This can lead to misunderstandings. Eliminativists claim that what seems to be a baseball breaking a window is merely the action of "atoms, acting in concert." They argue that statues, baseballs, and similar macroscopic things "do not exist." When macroscopic objects like (...) baseballs move, exceedingly large numbers (1025) of microscopic components coordinate their activities. Understanding how this happens requires attention to the interactions that link parts into larger units. Eliminativists say that everything that truly exists has causal relationships in addition to those of its components—"nonredundant causality." This paper holds that if a number of entities interact in such a way that the effect of that collection on test objects is different than it would have been in the absence of the interaction, then identification of that collection as a single composite agent is warranted, for purposes to which that difference is relevant. Ordinary "chemical substances" (both elementary materials such as dihydrogen and compounds such as water) fulfill this version of the requirement of nonredundant causality. Other sorts of chemical coherences, including chemical dissipative structures (e.g., flames), also fulfill that criterion. All these types of coherences qualify as "substances" (as that term is used in philosophy) even though they are not all "chemical substances.". (shrink)

This review shows the various tools used to implemente the food quality system in food establishments. Presenting the various laws that subsidize this process, establishing criteria and instrumentes for a correct implementation of the quality system in order to offer adequate hygiene processes in the production of safe food, in addition to favoring the maintenance of companies in the consumer market. The implementation of food safety management systems such as Good Manufacturing Practices (GMP), Standard Operating Procedures (SOP) e Hazard Analysis (...) and Critical Control Points (HACCP), in order to guarantee the safety of the food served and portray the organization of the company. It is essential to implement these systems ensuring the quality of the servisse (planning, control and improvement). In order to achieve healthy criteria related to foodstuffs, it is necessary to implement quality programs as prerequisites of the Hazard Analysis System and Critical Control Points in food services. Regulating and inspecting are just a few points that guarantee food security, since food that does not pose a health hazard to consumers is considered safe. (shrink)

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all (...) involved. Also attended to is the embeddedness of care in wider cultural and political contexts. (shrink)

In October 2021, the Inclusive Framework of the Organisation for Economic Co-operation and Development (OECD) adopted a new international tax deal, which has been hailed as a major step towards a fair and effective global corporate tax system. In this article, we question this verdict. We analyse this deal on the basis of three complementary fairness principles: preventing free riding by multinational corporations (MNCs), respect for and promotion of the fiscal autonomy of countries, and the limitation of distributive and relational (...) inequalities. We argue that the tax deal is unlikely to lead to a substantial improvement in fairness. We do, however, welcome the deal’s recognition of the need to tax multinational corporations as unitary entities subject to a global minimum effective tax rate. We argue that this recognition creates opportunities for fairer reforms that should be pursued through a more inclusive global decision-making process. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)