In lieu of an abstract, here is a brief excerpt of the content:Medicine-Based Values?Åge Wifstad (bio)KeywordsEthics committees, judgment, common moralityToulmin's DiagnosisIn his classical article with the unforgettable title "How medicine saved the life of ethics" (Toulmin 1982), Stephen Toulmin claims that medicine saved ethics by giving the philosophers a positive reality check through medical challenges: (1) Ethics in medicine is a serious topic, not just something to discuss at seminars. If, for example, both A and B need treatment and there (...) are only enough resources for one, the fundamental interests of these two people compete against each other. (2) In clinical medicine, the individual case might demand a different approach than that suggested by theory. Similarly, an ethicist who is confronted by a diversity of medical cases becomes aware of the fact that solutions drawn from ethical theory can be irrelevant in practice. (3) The moral philosopher has often focused on the individual and his or her universal commitments. The fact that ethical dilemmas can have deep roots in practical challenges and must be understood within a certain context has been "forgotten." (4) In clinically relevant ethics, it is important to find solutions that all involved parties find reasonable. This revitalizes central Aristotelian schools of thought on, for example, ethical judgment and situational understanding.Today, there is a common understanding that in both the education of doctors and in the implementation of medical knowledge and technology there needs to be ethical guidelines and control. Toulmin wants us to see that the background for this agreement is multifaceted. It was not just the ethicists who saved the doctors. The doctors helped the ethicists to escape their academic isolation.Ethics CommitteesThe establishment of ethics committees is perhaps the most interesting example of this. Here it is especially clear how ethical judgment establishes a basis for decision making: Each case presented to an ethics committee is special because one cannot reference decisions made in similar cases. At the same time, we are expected to handle similar cases equally. Consideration of the concrete, individual case must be balanced with the principle of similar treatment. Second, as a committee member, one must interpret and respect ethical principles that cannot be easily defined. Every principle must be interpreted and implemented within a specific and concrete context. Third, one must consider the law, but seen isolated, the implications of relevant rules can be difficult to determine. Fourth, the status of principles and rules are open for interpretation. The most important example of this is the Declaration of Helsinki, which was established through cooperation between the worlds' doctors unions. The strength and end result of such a document can be discussed. Fifth, multiple but partly conflicting juridical and ethical considerations can be [End Page 179] relevant at the same time. An example: Decisions about confidentiality can prevent data gathering that is crucial in ensuring that a research project is scientifically acceptable. Two important ethical considerations are then put up against one another. As a sixth and final point, it can be mentioned that the ethics committee is expected to make a qualitative, scientific judgment. But what kind of quality judgment and how detailed it should be is up for discussion.Two Definitions of Ethical JudgmentThe fact that the committee must base their holistic decision on ethical judgment means that the committee, in an important sense of the word, stands freely: It can be difficult to refer to specific ethical rules or laws when making an external review of the committee's decision. Unless the committee has clearly not followed known principles and rules, then the committee is able to confront criticism by replying that the decision is based on holistic considerations, where many views have been taken into account. In this way, the usage of ethical judgment makes sure that the committee has freedom to act. The catch here is that the committee's responsibility becomes even more obvious. One cannot simply say that the decision is made based on rules and principles formulated by others, such as the state. The committee must, as a unit, be able to defend their decision.The complexity of the work of the committee can, however, make it more tempting to think about ethics in... (shrink)

A certain kind of externalism—"the view from nowhere"—lies at the heart of evidence-based medicine (EBM). As a consequence, the individual case glides out of focus. However, to judge to what extent external knowledge is applicable to an individual case, the clinician has to rely on some sort of knowledge of the case at hand. The article focuses on the tension between the externalism of EBM and the "internal evidence" one has to presuppose when making clinical judgments.

Combining information from two or possibly several blocks of data is gaining increased attention and importance in several areas of science and industry. Typical examples can be found in chemistry, spectroscopy, metabolomics, genomics, systems biology and sensory science. Many methods and procedures have been proposed and used in practice. The area goes under different names: data integration, data fusion, multiblock analyses, multiset analyses and a few more. This book is an attempt to give an up-to-date treatment of the most used (...) and important methods within an important branch of the area; namely methods based on so-called components or latent variables. These methods have already obtained an enormous attention in for instance chemometrics, bioinformatics, machine learning and sensometrics and have proved to be important both for prediction and interpretation. The book is primarily a description of methodologies, but most of the methods will be illustrated by examples from the above-mentioned areas. The book is written such that both users of the methods as well as method developers will hopefully find sections of interest. In the end of the book there is a description of a software package developed particularly for the book. This package is freely available in R and covers many of the methods discussed. To distinguish the different type of methods from each other, the book is divided into five parts. Part I is introduction and preliminary concepts. Part II is the core of the book containing the main unsupervised and supervised methods. Part III deals with more complex structures and, finally, Part IV discusses alternative unsupervised and supervised methods. The book ends with Part V discussing the available software. Our recommendation for reading the book are as follows. A minimum read of the book would involve chapters 1, 2, 3, 5 and 7. Chapters 4, 6 and 8 are more specialized and chapters 9 and 10 contain methods we think are more advanced or less obvious to use. We feel privileged to have so many friendly colleagues who were willing to spend their time on helping us to improve the book by reading separate chapters. We would like to express our thanks to: Rasmus Bro, Margriet Hendriks, Ulf Indahl, Henk Kiers, Ingrid MaÌ⁽ge, Federico Marini, AÌ⁽smund Rinnan, Rosaria Romano, Lars Erik Solberg, Marieke Timmerman, Oliver Tomic, Johan Westerhuis and Barry Wise. Of course, the correctness of the final text is fully our responsibility! (shrink)

Efforts at demarcating pseudoscience from science have in the last four decades been fueled by claims of a substantial extensional consensus. Most philosophers, as well as scientists, reportedly have a knack for recognizing pseudoscience, and they agree on what counts as cases of pseudoscience. It is also believed that this extensional consensus will facilitate an intensional consensus on the defining criteria of pseudoscience. The extensional consensus, however, is undocumented, as is the existence of an acute pseudoscience perceptiveness. In this paper, (...) we survey PhD-holding philosophers to assess whether there is consensus on what are examples of paradigmatic pseudosciences. While we do record an initial agreement on examples that can be called “pseudoscientific”, we find no agreement that any of these are paradigmatic. Furthermore, philosophers with a PhD do not categorize pseudosciences markedly differently from respondents with lower or no degrees, suggesting that philosophers are no better at identifying pseudosciences than others. If these findings are correct, addressing the demarcation between science and nonscience via the pseudoscience – science divide will offer no clear advantage for solving the demarcation problem. (shrink)

Change can be difficult to achieve, and system inertia may be considered relevant. There is a tendency for dynamic systems to enter into specific states characterized by stabilizing factors. The present work attempts to define inertia processes and explores these with regard to pro-environmental behaviour and decision-making. Inertia processes can be considered both within an organizational context and from the level of the individual, and may involve a number of psychological processes and aspects of the decision-making process. A few suggestions (...) for research are also presented. (shrink)

The main aim of this study is to test the validity of the Motivation, Engagement, and Thriving in User Experience (METUX) model (Peters et al., 2018) in higher education. We propose a process model in which we investigate how the need-satisfaction of digital learning tools within the interface sphere and task sphere accounts for engagement, learning, and well-being. A total of 426 higher education students drawn from two subsamples participated in this cross-sectional study. A structural equation model shows that interface (...) autonomy and competence satisfaction positively predict task autonomy and competence. Task competence, in turn, negatively predicts focused attention and positively predicts perceived usability and well-being. Task autonomy positively predicts perceived usability and reward. Based on our results, we provide some initial support for the METUX model in higher education. However, more validation work is needed to improve the scale that measures need-satisfaction in the interface and task spheres. Moreover, we find no support for the effect of task sphere on learning. Further investigations are needed into how METUX can be used in domain- and situation-specific contexts to account for increases in engagement, learning, and well-being. Finally, future studies need to include all aspects of the METUX model in order to fully test its validity. (shrink)

The mobility restrictions related to COVID-19 pandemic have resulted in the biggest disruption to individual mobilities in modern times. The crisis is clearly spatial in nature, and examining the geographical aspect is important in understanding the broad implications of the pandemic. The avalanche of mobile Big Data makes it possible to study the spatial effects of the crisis with spatiotemporal detail at the national and global scales. However, the current crisis also highlights serious limitations in the readiness to take the (...) advantage of mobile Big Data for social good, both within and beyond the interests of health sector. We propose two strategical pathways for the future use of mobile Big Data for societal impact assessment, addressing access to both raw mobile Big Data as well as aggregated data products. Both pathways require careful considerations of privacy issues, harmonized and transparent methodologies, and attention to the representativeness, reliability and continuity of data. The goal is to be better prepared to use mobile Big Data in future crises. (shrink)

Next SectionThe principle of respect for autonomy has shaped much of the bioethics' discourse over the last 50 years, and is now most commonly used in the meaning of respecting autonomous choice. This is probably related to the influential concept of informed consent, which originated in research ethics and was soon also applied to the field of clinical medicine. But while available choices in medical research are well defined, this is rarely the case in healthcare. Consideration of ordinary medical practice (...) reveals that the focus on patient choice does not properly grasp the moral aspects involved in healthcare. Medical decisions are often portrayed as if doctors and patients in confidence confront specific decisions about examinations or treatment, yet the reality often involves many different participants, with decisions being made over time and space. Indeed, most of the decisions are never even presented to patients, as it would be unethical to suggest something that is not medically justifiable. The options patients do confront are somewhat arbitrarily constructed within the narrow framework of both what is deemed to be medically appropriate and how the healthcare system is organised practically. While the autonomy discourse has proven valuable, a failure to distinguish between the fields of medical research and clinical medicine has generated a focus on patient choice that does not reflect what is really at stake in healthcare settings. This is alarming, because the current discourse misrepresents medical practice in a way that actually contributes to bioethical self-delusion. (shrink)

BackgroundBurnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors.MethodsA cross-sectional survey was conducted among 879 teachers (...) in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory, during April 2021. Multistage cluster random sampling was used.ResultsThe mean age of the participants was 41.4 years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms. Consequences of burnout were observed, such as using psychotropic medications, absenteeism, lack of job satisfaction, and changing schools. Using the MBI scale, most teachers showed medium or high emotional exhaustion, low depersonalization, and low personal accomplishment.ConclusionMost teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences. (shrink)

Volume 23, Issue 3-4, November - December 2024, Page 251-263.

Volume 23, Issue 3-4, November - December 2024, Page 245-250.

Game Transfer Phenomena refers to a cluster of involuntary phenomena related to playing videogames, including sensory and cognitive intrusions, transient changes in perception and self-agency. The Game Transfer Phenomena Scale has been used to measure the frequency of GTP with respect to five factors. The present study aimed to validate an instrument for assessing the multiple dimensions of GTP that helps clarify the distinction between GTP experiences. GTP were contextualized onto the spectrum of intrusive cognitions, perceptual distortions, and dissociations. The (...) relationship between GTP, involuntary phenomena without game content in terms of, e.g., hallucinations and perceptual distortions, and game-biased perceptions, as well as the positive and negative impact of GTP and level of distress were also examined. The data were collected using a survey. Separate confirmatory factor analyses of the dimensions of “inner intrusions/misperceptions,” “outer intrusions/distortions,” and “dissociations/mix-ups” produced acceptable fit indices. The findings show that phenomena manifesting as internal experiences are more common, while those manifesting as externalized intrusions are less common. Correlations between the GTP dimensions, INVWG, and GBPA, such as the insertion of game elements in thoughts, perceptions, and dreams, supported convergent validity. The correlations between the GTP dimensions and hours played supported criterion validity. Distress was correlated with outer intrusions and dissociations/mix-ups, but not with inner intrusions. Taken together, these results support the validity and reliability of the proposed assessment of GTP constructs. (shrink)

While certain substantial moral dilemmas in health care have been given much attention, like abortion, euthanasia or gene testing, doctors rarely reflect on the moral implications of their daily clinical work. Yet, with its aim to help patients and relieve suffering, medicine is replete with moral decisions. In this qualitative study we analyse how doctors handle the moral aspects of everyday clinical practice. About one hundred consultations were observed, and interviews conducted with fifteen clinical doctors from different practices. It turned (...) out that the doctors’ approach to clinical cases followed a rather strict pattern across specialities, which implied transforming patients’ diverse concerns into specific medical questions through a process of ‘essentialising’: Doctors broke the patient’s story down, concretised the patient’s complaints and categorised the symptoms into a medical sense. Patients’ existential meanings were removed, and the focus placed on the patients’ functioning. By essentialising, doctors were able to handle a complex and ambiguous reality, and establish a medically relevant problem. However, the process involved a moral as well as a practical simplification. Overlooking existential meanings and focusing on purely functional aspects of patients was an integral part of clinical practice and not an individual flaw. The study thus questions the value of addressing doctors’ conscious moral evaluations. Yet doctors should be aware that their daily clinical work systematically emphasises beneficence at the expense of others—that might be more important to the patient. (shrink)

Technological approaches are increasingly discussed as a solution for the provision of support in activities of daily living as well as in medical and nursing care for older people. The development and implementation of such assistive technologies for eldercare raise manifold ethical, legal, and social questions. The discussion of these questions is influenced by theoretical perspectives and approaches from medical and nursing ethics, especially the principlist framework of autonomy, non-maleficence, beneficence, and justice. Tying in with previous criticism, the present contribution (...) is taking these principles as a starting point and as a frame of reference to be critically re-examined. It thus aims to outline how existing ethical frameworks need to be extended or reconsidered to capture the ethical issues posed by technological developments regarding care for older people. In a first step, we provide a brief overview of assistive technologies in eldercare according to their purposes and functions. In the next step, we discuss how the questions and problems raised by new technologies in eldercare call for an expansion, re-interpretation, and revision of the principlist framework. We underline that the inclusion of ethical perspectives from engineering and computer science as well as a closer consideration of socio-political dimensions and fundamental anthropological and praxeological questions are needed. (shrink)

Ageing populations are a major consideration for socio-economic development in the early twenty first century. This demographic change is mainly seen as a threat rather than as an opportunity to improve the quality of human life, especially in Europe, where ageing has resulted in a reduction in economic competitiveness. Economic Foundations for Creative Ageing Policy mixes the silver economy, the creative economy, and the social economy to construct positive solutions for an ageing population. Klimczuk covers theoretical analyses and case study (...) descriptions of good practices to suggest strategies that could be internationally popularized. Contents: Foreword by Harry R. Moody Foreword by Kathrin Komp Introduction 1. Old Age as a Stage in the Life Course and the Life Cycle 2. Forms of Older People’s Capital 3. Creativity and Ageing: Concepts and Controversies 4. Mixed Economy and Multisectoral Approach to Population Ageing 5. Silver, Creative, and Social Economies as Positive Responses to Population Ageing 6. Benefits at the Interface Between Economic Systems Conclusion Afterword by Lukasz Tomczyk. (shrink)

Slowing the aging process would be one of the most dramatic and momentous ways of enhancing human beings. It is also one that mainstream science is on the brink of pursuing. The state of the science, together with its possible impact, make it an important example for how to think about research into all enhancement technologies.

Previous studies found similarities in adults’ disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7–9 years), late childhood (10–12 years), adolescence (13–17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (1) (...) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children’s disgust responses whereas adolescents and adult responses considered cognitive cues. (shrink)

What does it mean to be an adult? In this original and compelling work, John Russon answers that question by leading us through a series of rich reflections on the psychological and social dimensions of adulthood and by exploring some of the deepest ethical and existential issues that confront human life: intimacy, responsibility, aging, and death. Using his knowledge of the history of philosophy along with the combined resources of psychology, sociology, and anthropology, he explores the behavioral challenges of (...) becoming an adult and examines the intimate relationships that are integral to healthy development. He also studies our experiences of time and space, which address both aging and the crucial role that our material environments play in the formation of our personalities. Of special note is Russon's provocative assessment of the economic and political contexts of contemporary adult life and the distinctive problems they pose. Engaging and accessible, Adult Life is for anyone seeking the profound lessons our human culture has learned about living well. (shrink)