A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into (...) moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded ‘grey zone articles’, in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients’ and caregivers’ views on ethical challenges, is presented. (shrink)

Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.

Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics in such initiatives. This study adds to this subject by exploring health professionals’ descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices. Seven semi-structured telephone interviews were carried out in 2012 with (...) key informants in charge of central development projects and quality-assurance work in mental health services in Norway. No facilities used formal clinical ethics support. However, the informants described five areas in which ethics was of importance: moral concerns as implicit parts of local quality improvement initiatives; moral uneasiness and idealism as a motivational source of change; creating a normative basis for development work; value-based leadership; and increased staff reflexivity on coercive practices. The study shows that coercion entails both individual and institutional ethical aspects. Thus, various kinds of moral deliberation and ethics support could contribute to addressing coercion challenges by offering more systematic ways of dealing with moral concerns. However, more strategic use of implicit and institutional ethics is also needed. (shrink)

BackgroundNorway has extensive and detailed legal requirements and guidelines concerning involvement of next of kin during involuntary hospital treatment of seriously mentally ill patients. However, we have little knowledge about what happens in practice. This study explores NOK’s views and experiences of involvement during involuntary hospitalisation in Norway.MethodsWe performed qualitative interviews-focus groups and individual-with 36 adult NOK to adults and adolescents who had been involuntarily admitted once or several times. The semi-structured interview guide included questions on experiences with and views (...) on involvement during serious mental illness and coercion.ResultsMost of the NOK were heavily involved in the patient’s life and illness. Their conceptions of involvement during mental illness and coercion, included many important aspects adding to the traditional focus on substitute decision-making. The overall impression was, with a few exceptions, that the NOK had experienced lack of involvement or had negative experiences as NOK in their encounters with the health services. Not being seen and acknowledged as important caregivers and co sufferers were experienced as offensive and could add to their feelings of guilt. Lack of involvement had as a consequence that vital patient information which the NOK possessed was not shared with the patient’s therapists.ConclusionsDespite public initiatives to improve the involvement of NOK, the NOK in our study felt neglected, unappreciated and dismissed. The paper discusses possible reasons for the gap between public policies and practice which deserve more attention: 1. A strong and not always correct focus on legal matters. 2. Little emphasis on the role of NOK in professional ethics. 3. The organisation of health services and resource constraints. 4. A conservative culture regarding the role of next of kin in mental health care. Acknowledging these reasons may be helpful to understand deficient involvement of the NOK in voluntary mental health services. (shrink)

The aim of this study was to compare the acute effects of performing a lower body resistance training program in one long or two shorter sessions in 1 day on training volume and affective measures. Employing a randomized-crossover design, 23 resistance-trained women performed two training days consisting of one long or two short sessions separated by 3.5–5 h. Each training day was separated by 4-6 days and consisted of three sets to failure for six exercises. Training volume were recorded during (...) the sessions. Rating of perceived exertion for effort, rating of perceived exertion for discomfort, session displeasure/pleasure and exercise enjoyment were measured 10 min after each session. Participants also completed a readiness to train questionnaire, 24 h after each session, and which training protocol they preferred, 48 h after the last session. The long session led to higher RPE, RPD and sPDF compared to the short sessions. There was no difference in EES. The short sessions had 3% higher training volume than the long session. There were no differences in perceived readiness to train 24 h after the sessions. Twenty-two participants preferred the long session, while one preferred the short sessions. In conclusion, performing a longer, lower body, resistance training session led to greater perceptions of effort, discomfort and session pleasure than splitting the same program into two shorter sessions among resistance-trained women. However, two shorter sessions led to a greater training volume. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. (...) Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)

In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a (...) lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence. (shrink)

The aim of the study was to compare the acute effects of traditional resistance training and superset training on training duration, training volume and different perceptive measures. Twenty-nine resistance-trained participants performed a whole-body workout traditionally and as supersets of exercises targeting different muscle groups, in a randomized-crossover design. Each session was separated by 4–7 days, and consisted of eight exercises and three sets to failure. Training duration and number of repetitions lifted were recorded during the sessions. Rate of perceived exertion (...) for effort, rate of perceived exertion for discomfort, session displeasure/pleasure, and exercise enjoyment were measured 15 min after each session. Forty-eight hours after the final session participants reported which session they preferred. The superset session led to significantly higher values for RPE and RPD and tended to be higher for sPDF, i.e., more pleasurable, compared to the traditional session. There was no difference in EES. The traditional session led to significantly increased training volume and lasted 23 min longer than the superset session. Eighteen of the participants preferred the superset session, while 11 preferred the traditional session. In conclusion, performing a whole-body workout as a superset session was more time-efficient, but reduced the training volume and was perceived with greater exertion for effort and discomfort than a traditional workout. (shrink)

This introduction to the Common Knowledge symposium titled “Comparative Relativism” outlines a variety of intellectual contexts where placing the unlikely companion terms comparison and relativism in conjunction offers analytical purchase. If comparison, in the most general sense, involves the investigation of discrete contexts in order to elucidate their similarities and differences, then relativism, as a tendency, stance, or working method, usually involves the assumption that contexts exhibit, or may exhibit, radically different, incomparable, or incommensurable traits. Comparative studies are required to (...) treat their objects as alike, at least in some crucial respects; relativism indicates the limits of this practice. Jensen argues that this seeming paradox is productive, as he moves across contexts, from Lévi-Strauss's analysis of comparison as an anthropological method to Peter Galison's history of physics, and on to the anthropological, philosophical, and historical examples offered in symposium contributions by Barbara Herrnstein Smith, Eduardo Viveiros de Castro, Marilyn Strathern, and Isabelle Stengers. Comparative relativism is understood by some to imply that relativism comes in various kinds and that these have multiple uses, functions, and effects, varying widely in different personal, historical, and institutional contexts that can be compared and contrasted. Comparative relativism is taken by others to encourage a “comparison of comparisons,” in order to relativize what different peoples—say, Western academics and Amerindian shamans—compare things “for.” Jensen concludes that what is compared and relativized in this symposium are the methods of comparison and relativization themselves. He ventures that the contributors all hope that treating these terms in juxtaposition may allow for new configurations of inquiry. (shrink)

In this article, I critically assess Hélène Landemore's new model of Open Democracy, asking whether it requires of citizens to blindly defer to the decisions of the mini-public. To address this question, I, first, discuss three institutional mechanisms in Open Democracy, all of which can be read to grant citizens democratic control. I argue that neither the capacity to authorize the selection mechanism (random sortition), nor the lottocratic conception of political equality, nor the self-selection mechanisms of Landemore's model deliver the (...) form of control that would insulate Open Democracy from the charge of blind deference. I then discuss the direct democracy mechanisms that Landemore incorporates into her model. Although these devices grant citizens control and, by extension, offer the resources for repudiating the charge of blind deference, they also, I argue, subvert the logic of Landemore's lottocratic model, rendering Open Democracy predictably unstable. Given the deliberative asymmetries between the mini-public and the citizenry, a high frequency of bottom-up challenges is to be expected that would throw the whole system into jeopardy. Thus, the challenge for lottocrats is to show how democratic control can be achieved in a lottocratic system without undermining the benefits of the legislature by lot. (shrink)

This is the introduction to Moretti, Luca and Nikolaj Pedersen (eds), Non-Evidentialist Epistemology. Brill. Contributors: N. Ashton, A. Coliva, J. Kim, K. McCain, A. Meylan, L. Moretti, S. Moruzzi, J. Ohlorst, N. Pedersen, T. Piazza, L. Zanetti.

Dilation occurs when an interval probability estimate of some event E is properly included in the interval probability estimate of E conditional on every event F of some partition, which means that one’s initial estimate of E becomes less precise no matter how an experiment turns out. Critics maintain that dilation is a pathological feature of imprecise probability models, while others have thought the problem is with Bayesian updating. However, two points are often overlooked: (1) knowing that E is stochastically (...) independent of F (for all F in a partition of the underlying state space) is sufficient to avoid dilation, but (2) stochastic independence is not the only independence concept at play within imprecise probability models. In this paper we give a simple characterization of dilation formulated in terms of deviation from stochastic independence, propose a measure of dilation, and distinguish between proper and improper dilation. Through this we revisit the most sensational examples of dilation, which play up independence between dilator and dilatee, and find the sensationalism undermined by either fallacious reasoning with imprecise probabilities or improperly constructed imprecise probability models. (shrink)

I introduce a mathematical account of expectation based on a qualitative criterion of coherence for qualitative comparisons between gambles (or random quantities). The qualitative comparisons may be interpreted as an agent’s comparative preference judgments over options or more directly as an agent’s comparative expectation judgments over random quantities. The criterion of coherence is reminiscent of de Finetti’s quantitative criterion of coherence for betting, yet it does not impose an Archimedean condition on an agent’s comparative judgments, it does not require the (...) binary relation reflecting an agent’s comparative judgments to be reflexive, complete or even transitive, and it applies to an absolutely arbitrary collection of gambles, free of structural conditions (e.g., closure, measurability, etc.). Moreover, unlike de Finetti’s criterion of coherence, the qualitative criterion respects the principle of weak dominance, a standard of rational decision making that obliges an agent to reject a gamble that is possibly worse and certainly no better than another gamble available for choice. Despite these weak assumptions, I establish a qualitative analogue of de Finetti’s Fundamental Theorem of Prevision, from which it follows that any coherent system of comparative expectations can be extended to a weakly ordered coherent system of comparative expectations over any collection of gambles containing the initial set of gambles of interest. The extended weakly ordered coherent system of comparative expectations satisfies familiar additivity and scale invariance postulates (i.e., independence) when the extended collection forms a linear space. In the course of these developments, I recast de Finetti’s quantitative account of coherent prevision in the qualitative framework adopted in this article. I show that comparative previsions satisfy qualitative analogues of de Finetti’s famous bookmaking theorem and his Fundamental Theorem of Prevision.The results of this article complement those of another article (Pedersen, Strictly coherent preferences, no holds barred, Manuscript, 2013). I explain how those results entail that any coherent weakly ordered system of comparative expectations over a unital linear space can be represented by an expectation function taking values in a (possibly non-Archimedean) totally ordered field extension of the system of real numbers. The ordered field extension consists of formal power series in a single infinitesimal, a natural and economical representation that provides a relief map tracing numerical non-Archimedean features to qualitative non-Archimedean features. (shrink)

Helen Steward puts forward a radical critique of the foundations of contemporary philosophy of mind, arguing that it relies too heavily on insecure assumptions about the sorts of things there are in the mind--events, processes, and states. She offers a fresh investigation of these three categories, clarifying the distinctions between them, and argues that the category of state has been very widely and seriously misunderstood.

A common objection to paternalism concerns its expressive content. Many reject paternalistic policies and actions on the ground that they arguably involve insulting expressions of disrespect toward those subjected to them. The paper challenges this view. It argues that refraining from acting paternalistically can be disrespectful. Specifically, the paper argues that there is a relevant way in which A disregards the moral worth of B if A stands idly by when B is about to act very imprudently. If true, treating (...) others with equal respect and concern, as relational egalitarians and others rightly ask us to do, will somewhat surprisingly sometimes involve treating them paternalistically. (shrink)

The relative merits and demerits of historically prominent views such as the correspondence theory, coherentism, pragmatism, verificationism, and instrumentalism have been subject to much attention in the truth literature and have fueled the long-lived debate over which of these views is the most plausible one. While diverging in their specific philosophical commitments, adherents of these historically prominent views agree in at least one fundamental respect. They are all alethic monists. They all endorse the thesis that there is only one property (...) in virtue of which propositions can be true, and so, in this sense, take truth to be one. The truth pluralist, on the other hand, rejects this idea. There are several properties in virtue of which propositions can be true. The literature on truth pluralism has been growing steadily for the past twenty years. This volume, however, is the first of its kind—the first collection of papers focused specifically on pluralism about truth. Part I is dedicated to the development, investigation, and critical discussion of different forms of pluralism. An additional reason to look at truth pluralism with interest is the significant connections it bears to other debates in the truth literature—the debates concerning traditional theories of truth and the deflationism/inflationism divide being cases in hand. Parts II and III of the volume connect truth pluralism to these two debates. (shrink)

This paper offers a discussion of metaphysical pluralism, alethic pluralism, and logical pluralism. According to the metaphysical pluralist, there are several ways of being. According to the alethic pluralist, there are several ways of being true, and according to the logical pluralist, there are several ways of being valid. Each of these three forms of pluralism will be considered on its own, but the ambition of the paper is to explore possible connections between them. My primary objective is to present (...) and develop a positive account according to which the different forms of pluralism are intimately related. I will proceed in two steps. First, I will investigate the connection between alethic pluralism and logical pluralism. I will argue that a certain version of alethic pluralism supports logical pluralism. Second, I will connect alethic pluralism and logical pluralism to metaphysical pluralism. I will suggest that the former two are at least partly founded on the latter. (shrink)

Alethic pluralism is the view that the nature of truth is not uniform across domains. There are several ways of bang true $(T_1 ...\,T_n )$ A simple argument, the 'instability challenge', purports to show that this view is inherently unstable. One can simply say that something is uniformly true if and only if it is T₁ or ... or $\,T_n $ . Being uniformly true is a single truth property that applies across the board, and so the nature of truth (...) is uniform across domains, contra pluralism. I defend pluralism against the instability challenge. I show that the challenge bifurcates: one Challenge is formulated in terms of predicates, and the other is formulated in terms of properties. Vie pluralist has the resources to defuse both of these. The sparse/abundant property distinction and considerations of explanatory asymmetry play a crucial role in my argument. (shrink)

Here is a well-known thought about truth: Truth consists in correspondence with reality. A sentence is true just in case what it says corresponds with how the world is. Theories of truth that incorporate this thought are naturally regarded as robust or “heavyweight”. Truth is to be understood in a realist fashion. The world decides what is true and what is not. A recent incarnation of the correspondence view is found in truth-maker theories, whose adherents maintain that truths are true (...) in virtue of there being something – a truth-maker – in the world that makes them so.2. (shrink)

Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. One important task for these committees is clinical ethics consultations. This qualitative study explores significant barriers confronting the ethics committees in providing such consultation services. The interviews with the committees indicate that there is a substantial need for clinical ethics support services and, in general, the committee members expressed a great deal of enthusiasm for the committee work. They also reported, however, that tendencies to evade moral disagreement, (...) conflict, and ‘outsiders’ are common in the hospitals. Sometimes even the committees comply with some of these tendencies. The committees agree that there is a need to improve their routines and procedures, clarify the committees' profile and field of responsibility, to make the committees well‐known, to secure adequate operating conditions, and to develop organizational integration and support. Various strategies to meet these challenges on a local, regional or national level are also explored in this paper. (shrink)

The aim of this paper is to provide an overview of various forms of alethic pluralism. Along the way we will draw a number of distinctions that, hopefully, will be useful in mapping the pluralist landscape. Finally, we will argue that a commitment to alethic disjunctivism, a certain brand of pluralism, might be difficult to avoid for adherents of the other pluralist views to be discussed. We will proceed as follows: Section 1 introduces alethic monism and alethic pluralism. Section 2 (...) presents a distinction between strong and moderate versions of monism and pluralism, understood as theses about the existence of truth properties. Section 3 introduces four pluralist positions: strong alethic pluralism, alethic disjunctivism, second-order functionalism and manifestation functionalism. These positions are classified using the basic framework from Section 2, and a further distinction between pure and mixed versions of pluralism is drawn. Interestingly, alethic disjunctivism and the two kinds of functionalism—i.e. three out of four positions— have a mixed character. They incorporate a monist thesis. The only pure form of pluralism is strong alethic pluralism. Section 4 adds another distinction to the stock: one-level and two-level views. Each of the mixed positions operates with two levels, locating certain “alethically potent”—or grounding—properties at a lower level and others at a higher level. We briefly discuss the nature of grounding. In Section 5, we answer a question about mixed, two-level views, viz. whether they are as much monist as pluralist in nature, or more. They are not. Section 6 is devoted to the task of arguing that the strong pluralist, the second-order functionalist, and the manifestation functionalist will find it hard to deny a commitment to alethic disjunctivism. (shrink)

In this paper I discuss two fundamental challenges concerning Crispin Wright's notion of entitlement of cognitive project: firstly, whether entitlement is an epistemic kind of warrant since, seemingly, it is not underwritten by epistemic reasons, and, secondly, whether, in the absence of such reasons, the kind of rationality associated with entitlement is epistemic in nature. The paper investigates three possible lines of response to these challenges. According to the first line of response, entitlement of cognitive project is underwritten by epistemic (...) reasons – and thus supports epistemic rationality – because, when P is an entitlement, trust in P is a dominant strategy with respect to promotion of epistemic value. The second line of response replaces dominance with maximization of expected utility. I argue that both of these proposals are flawed and develop an alternative line of response. (shrink)

The objective of this paper is to examine the relationship between business model innovation, corporate sustainability, and the underlying organisational values. Moreover, the paper examines how the three dimensions correlate with corporate financial performance. It is concluded that companies with innovative business models are more likely to address corporate sustainability and that business model innovation and corporate sustainability alike are typically found in organisations rooted in values of flexibility and discretion. Business model innovation and corporate sustainability thus seem to have (...) their origin in the fundamental principles guiding the organisation. In addition, the study also finds a positive relationship between the core organisational values and financial performance. The analysis of the paper is based on survey responses from 492 managers within the Swedish fashion industry. (shrink)

This article has two objectives. In the first part, I present a critical overview of the extensive anthropological literature that may be deemed “phenomenological.” Following this critique, which is built up around a classification into four different varieties of phenomenological anthropology, I discuss the relationship between phenomenological anthropology and the ontological turn (OT). Contrary to received wisdom within the anthropological discipline, I suggest that OT has several things in common with the phenomenological project. For the same reason, I argue, it (...) is not accurate to posit OT and phenomenology as opposing or antagonistic projects, as they are often depicted among critics and advocates of OT alike. On the contrary, I go as far as suggesting, OT may be understood as one of the most concerted attempts anthropology has produced to realize a distinctly anthropological version of Husserl’s method of phenomenological bracketing, namely what could be called the ontological epoché. (shrink)

There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...) was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting and discussing 10 case consultations are summarized. The tool facilitated understanding of the details of clinical ethics case consultations across individuals and institutions with various experiences and cultures, and comparison between various practices. (shrink)

Sustainability challenges typically occur across sectoral boundaries, calling the state, market, and civil society to action. Although consensus exists on the merits of cross-sector collaboration, our understanding of whether and how it can create value for various, collaborating stakeholders is still limited. This special issue focuses on how new combined knowledge on cross-sector collaboration and business models for sustainability can inform the academic and practitioner debates about sustainability challenges and solutions. We discuss how cross-sector collaboration can play an important role (...) for the transition to new and potentially sustainability-driven business models given that value creation, delivery, and capture of organizations are intimately related to the collaborative ties with their stakeholders. Sustainable alternatives to conventional business models tend to adopt a more holistic perspective of business by broadening the spectrum of solutions and stakeholders and, when aligned with cross-sector collaboration, can contribute new ways of addressing the wicked sustainability problems humanity faces. (shrink)

In Balanced Wonder, Jan B. W. Pedersen digs deep into the alluring topic of wonder, in dialogue with Neo-Aristotelian philosophers, arguing that the experience of wonder, when balanced, serves as a strong contributor to human flourishing.

Background: Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce. Objectives: To explore clinical ethics committees’ deliberations and to identify areas for improvement. Design: A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data. Participants: Nine hospital ethics committees in Norway. Results and interpretations: Key elements (...) of the deliberations included identifying the ethical problems; exploring moral values and principles; clarifying key concepts and relevant legal regulation; exploring medical facts, the patient’s situation, the therapists’ perspective, analogous clinical situations, professional uncertainties, the patient’s and relatives’ perspective, and clinical communication; identifying the involved parties and how to involve them; identifying possible courses of action, and possible conclusion and follow-up. The various elements were closely interwoven. The content and conclusions varied and seemed to be contingent on the committee members’ interpretations, experience and knowledge. Important aspects of a clinical ethics deliberation were sometimes neglected. When the committees used a deliberation procedure and a blackboard, the deliberations tended to become more systematic and transparent. Many of the committees were insecure about how to include the involved parties and how to document the deliberations. Conclusion: Clinical ethics committees may provide an important arena for multidisciplinary discussions of complex clinical ethics challenges. However, this seems to require adequate composition, adoption of transparent deliberation procedures, and targeted training. (shrink)

While historically prominent theories of truth such as the correspondence theory, coherentism, pragmatism, verificationism, and instrumentalism diverge in many ways, they converge in at least one fundamental respect. They are all monist theories of truth. They incorporate the thesis that there is one property—and one property only—in virtue of which propositions can be true. The truth pluralist, on the other hand, rejects this idea. There are several properties in virtue of which propositions can be true. This article offers a survey (...) of recent work on alethic pluralism—presenting various incarnations of the view, objections leveled against them, and various lines of response available to pluralists. (shrink)

From Stoicism to Platonism describes the change in philosophy from around 100 BCE, when monistic Stoicism was the strongest dogmatic school in philosophy, to around 100 CE, when dualistic Platonism began to gain the upper hand - with huge consequences for all later Western philosophy and for Christianity. It is distinguished by querying traditional categories like 'eclecticism' and 'harmonization' as means of describing the period. Instead, it highlights different strategies of 'appropriation' of one school's doctrines by philosophers from the other (...) school, with all philosophers being highly conscious of their own identity. The book also sets out to break down the traditional boundaries between, on the one hand, the study of Greco-Roman philosophy in the period and, on the other hand, that of contemporary Hellenistic Jewish and early Christian writings with a philosophical profile. In these ways, the book opens up an immensely fruitful period in the history of philosophy. (shrink)

This second volume in the series "Studies in Hellenistic Civilization", published for the Danish Research Council for the Humanities, offers a comprehensive analysis of the Stoic theory of Oikeiosis.

Friedrich Schleiermacher is often considered the Father of Modern Theology, known for his attempt to reconcile traditional Christian doctrines with philosophical criticisms and scientific discoveries. Despite the influence of his work on significant figures like Karl Barth, he has been largely ignored by contemporary theologians. Focussing on Schleiermacher's doctrine of sin, this book demonstrates how Schleiermacher has not only been misinterpreted, but also underestimated, and deserves a critical re-examination. The book approaches Schleiermacher on sin with respect to three themes: one, (...) its power to transcend an intractable metaethical dilemma at the heart of modern debates over sin; two, its intended compatibility with natural science; and three, to re-evaluating its place, and so Schleiermacher's place, in the history of theology. It solves and dissolves problems arising simultaneously from natural science, confessional theology, ethics, and metaphysics in a single, integrated account using Schleiermacher's understudied thought from his dogmatics The Christian Faith. In contrast to the account sometimes given of modern theology as marked by a break with "Greek metaphysics," Schleiermacher's account is shown to stand in stark contrast by retrieving, not excising, ancient thought in service of an account of sin adequate to natural science. This is a vital rediscovery of a foundational voice in theology. As such, it will greatly appeal to scholars of Modern Theology, theological ethics, and the history of Modern Christianity. (shrink)

This article provides a survey of key topics on just inheritance taxation. It does so by first presenting the main arguments in the debate. Here, I distinguish between arguments in the academic literature and the various arguments which have proven important in the public debate. Secondly, I outline four influential proposals when it comes to how inheritance should be taxed. Finally, I examine a recent controversy and point towards a number of themes that have not been sufficiently discussed.

Given the prominent position Habermas' philosophy has gained, it is surprising that his method, rational reconstruction, has not caused more debate. This article clarifies what this method consists of, and shows how it is used in two of Habermas' research programs. The method is an interesting, but problematic way of confronting some of the basic epistemological questions in the social sciences. It represents an alternative to both the empirical-analytical and the hermeneutic tradition. On the basis of this methodology, Habermas' work (...) is situated between the transcendental and the empirical approach. A fundamental problem is that it remains unclear how to test the hypothesis put forward through rational reconstruction. (shrink)

This chapter examines age discrimination from the perspective of age-differentiated paternalism. Many people share the intuition that paternalism is less problematic when applied to children than to the elderly. The chapter examines this intuition by considering not only the dimensions of competence and voluntariness but also the magnitude of the good promoted by paternalistic interventions. While this dual account does not generally challenge common-sense intuitions about paternalism, it introduces additional complexity when evaluating paternalistic interventions in a wide range of cases (...) where age plays a part. The chapter considers many examples, from age-differentiated rules for access to sterilization, through age-differentiated fines for not using a helmet, to age-differentiated prices for cigarettes. (shrink)

Both dilation and non-conglomerability have been alleged to conflict with a fundamental principle of Bayesian methodology that we call \textit{Good's Principle}: one should always delay making a terminal decision between alternative courses of action if given the opportunity to first learn, at zero cost, the outcome of an experiment relevant to the decision. In particular, both dilation and non-conglomerability have been alleged to permit or even mandate choosing to make a terminal decision in deliberate ignorance of relevant, cost-free information. Although (...) dilation and non-conglomerability share some similarities, some authors maintain that there are important differences between the two that warrant endorsing different normative positions regarding dilation and non-conglomerability. This article reassesses the grounds for treating dilation and non-conglomerability differently. Our analysis exploits a new and general characterization result for dilation to draw a closer connection between dilation and non-conglomerability. (shrink)

At the top of his ethical system Aristotle placed, as the supreme value, eudai- monia (happiness). But what does this really mean? ...

This article examines the place of human and animal subjectivity in two autobiographically informed texts by Hélène Cixous. It takes her view on the word ‘human’ and the figure of Fips, the dog of the Cixous family, as a point of departure. By thinking through this figure, I argue, Cixous analyses the dehumanizing logic of colonialism and anti-Semitism in Algeria and develops her own response to such kinds of political evils, arguing for human relationality and animal corporeality. The article shows (...) that Cixous’ meeting with Fips creates a stigma that, belatedly, breaks through the barrier between herself and the dog; the reopening of the wound takes place in a poetical writing that reveals an intense ‘animal humanity’ formed by communal suffering, finiteness, and love. The lesson Cixous learns from the memory of Fips the dog is how to become ‘better human’. This becoming is also an assault on the false humanism of the colonial project and on racialized social exclusion. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

International Journal of Philosophical Studies, Volume 20, Issue 1, Page 125-133, February 2012.