The Nordic countries aim to have a unique place within the European and global health data economy. They have extensive nationally maintained and centralized health data records, as well as numerous biobanks where data from individuals can be connected based on personal identification numbers. Much of this phenomenon can be attributed to the emergence and development of the Nordic welfare state, where Nordic countries sought to systematically collect large amounts of population data to guide decision making and improve the health (...) and living conditions of the population. Recently, however, the so-called Nordic gold mine of data is being re-imagined in a wholly other context, where data and its ever-increasing logic of accumulation is seen as a driver for economic growth and private business development. This article explores the development of policies and strategies for health data economy in Denmark and Finland. We ask how nation states try to adjust and benefit from new pressures and opportunities to utilize their data resources in data markets. This raises questions of social sustainability in terms of states being producers, providers, and consumers of data. The data imaginaries related to emerging health data markets also provide insight into how a broad range of different data sources, ranging from hospital records and pharmacy prescriptions to biobank sample data, are brought together to enable “full-scale utilization” of health and welfare data. (shrink)

How can we figure out what’s right or wrong, if moral truths are neither self-evident nor something we can perceive? Very roughly, the method of reflective equilibrium (RE) says that we should begin moral inquiry from what we already confidently think, seeking to find a a match between our initial convictions and general principles that are well-supported by background theories, mutually adjusting both until we reach a coherent outlook in which our beliefs are in harmony (the equilibrium part) and we (...) know why and how they support each other (the reflective part). It has been central to the self-understanding of normative ethics and other branches of philosophy in the last half a century. In this chapter, we examine the history of the idea of RE and introduce a schema for generating 256 variants. We explain why RE is subject to serious objections insofar as it purports to yield epistemic justification in virtue of achieving coherence. However, we also develop a new argument to the effect that RE is the best feasible method for us to achieve moral understanding and the ability to justify our judgments to others. It may thus be crucial for responsible moral inquiry, even if coherence among considered judgments and principles is neither sufficient nor necessary for justified moral belief. (shrink)

According to surveys and opinion polls, citizens in Nordic welfare societies have positive, supportive attitudes towards medical research and biobanking. In Finland, it was expected that this would result in the active biobank participation of patients and citizens. Indeed, public support has been rhetorically utilised as a unique societal factor and advantage in the promotion of Finnish biobanks, underlining the potential Finland offers for the international biomedical enterprise. In this paper, we critically analyse the use of notions such as ‘willing (...) population’ and ‘engaged people’ in the promotion and legitimation of biobanking. First, there is a seeming contradiction between positive attitudes and actual participation rates, as biobanks have faced unexpected challenges in participant recruitment during the first years of their operations. As a result, the concept of a willing population was redirected to problematise the necessity of informed consent. Second, we question whether it is even meaningful to assume the existence of an informed and engaged population with regard to biobanking. Therefore, we suggest that it is problematic to talk about a willing population at the same time as the relevance of the informed consent system is being questioned by biobank actors and policy makers. We analyse this tension in relation to existing data on Finnish people’s attitudes, pointing out that positive, supportive views do not directly transform into high participation rates; nor do they justify the claims of policy makers and biobank proponents that people are willing to participate, when in fact surveys report that people know very little about biobanks. (shrink)

In different countries responses to important bioethical issues are different, as exemplified by the attitudes towards the voluntary and active forms of medical euthanasia. But why is this the case? My suggestion is that the roots of the variety are, to a considerable degree, ideological. The most important present‐day political ideologies all have their roots in the prevailing doctrines of moral and social philosophy. In the paper these doctrines are outlined and the predicted response towards active voluntary euthanasia within each (...) model is sketched. The conclusion reached is that while it would in some countries be dangerous to allow euthanasia in the prevailing circumstances, the solution is not to hinder the legalization process but to alter the circumstances. (shrink)

Recent developments in biology have made it possible to acquire more and more precise information concerning our genetic makeup. There are four groups of people who may want to know about our genes. First, we ourselves can have an interest in being aware of own health status. Second, there are people who are genetically linked with us, and who can have an interest in the knowledge. Third, individuals with whom we have contracts and economic arrangements may have an interest in (...) knowing about our genetic makeup. Fourth, society as a whole can have an interest in the composition of our genes. As regards the question of motivation, the term 'should' can be interpreted in three ways. Prudentially speaking, to say that individuals should act in a certain manner is to say that the actions in question promote the long-term self-interest of these individuals. From the viewpoint of morality, we should do what is right and avoid doing what is wrong. When it comes to legal thinking, it is held in most liberal societies that grave other-regarding harm should be the primary justification for the use of coercion and constraint. In the paper, all these aspects are examined in more detail. (shrink)

The article examines Barthes’s A Lover’s Discourse (1977) in conjunction with du Maurier’s Trilby (1894) in order to present an argument about the similarities they share with the male masochistic fantasy as theorised by Deleuze in his Coldness and Cruelty (1989). Barthes’s insistence on the connection between art and love directs my approach. Trilby deals with love and aesthetics in the contexts of art, music, and narrative. The discourses of Trilby’s competing lovers over the same woman serve as a point (...) of comparison against which I read Barthes’s dramatisation of a lover’s discourse. I argue that Barthes’s lover shares a number of central discursive figures with the Deleuzian masochistic lover. I examine Barthes’s suggestion about the tension between the non-narrative discourse of love and the metalanguage of conventional love stories. I focus on those figures in a lover’s discourse that Barthes identifies as keeping this discourse from turning into a love story. My argument is that many of these figures are among the hallmarks of the masochistic fantasy. In particular the formula of disavowal safeguards the lover’s discourse, hindering it from turning into a conventional narrative about love. (shrink)

_The Limits of Medical Paternalism_ defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

Dan Haybron has argued by counterexample that perfectionism fails as a theory of well-being. I respond by articulating two different versions of diachronic perfectionism, which takes into account the level of development and exercise of essential human capacities over the course of an entire lifetime.

In this article, the author discusses the methodology of the internalism debate and the role that neuroscience and related experimental methods can play in it. The author argues that findings in either actual or fictional experimental psychology or neuroscience have little relevance to the debate. He claims that the findings do not provide any independent support pro or con internalism. He also observes that the traditional view of the methodological autonomy of philosophical moral psychology remains well-grounded.

Stories and images of successful career women and support for women’s advancement in working life have become hallmarks of contemporary postfeminist media culture, and especially of women’s magazines such as Cosmopolitan. While in previous research these features have been seen as signs for a new, popular feminism, more recently they have also been connected to the growing hegemony of neoliberal governance, a mode of power that ultimately aims at the economization of the social and is fundamentally exercised in and through (...) discourse. The aim of this article is to investigate further the interconnectedness of these two phenomena, postfeminism and neoliberalism, in the domain of work, using the example of the German edition of Cosmopolitan. For a detailed and multilayered investigation the study draws on linguistically oriented discourse analysis, focusing on the operation of a ‘discourse of postfeminist self-management’. The examination shows how this discourse, while on the one hand evoking an ethos of feminist engagement, on the other seeks to guide readers to mould themselves into a version of the entrepreneurial self required by the neoliberalized world of work. (shrink)

Abstract.The legitimate impact of common morality on legal restrictions has been continuously discussed within the Western philosophy of law since Lord Patrick Devlin in the late 1950s presented his moralistic arguments against some liberal conclusions drawn by the English Committee on Homosexual Offences and Prostitution in their public report. Devlin's arguments were subsequently identified and refuted by Richard Wollheim, H. L. A. Hart and Ronald Dworkin, but in a way that later provoked further argument. In particular the attack against anti‐moralistic (...) principles set forth by Simon Lee (1986) owes much to the rather naive liberalism represented by the opponents of Devlin. The battle over liberalism and moralism from the Hart‐Devlin debate to the present day is reviewed. In addition to the discussion of the philosophers mentioned above, a potential flaw in the argumentation of Joel Feinberg (1986) is considered. (shrink)

Eriarvoisuuspuheella voidaan viitata moniin eri asioihin. Usein sillä tarkoitetaan hyvien asioiden epätasaista jakautumista. Ei kuitenkaan ole itsessään huono asia, että joillakin menee paremmin kuin toisilla. Silloin kun taloudellinen eriarvoisuus on ongelma, kyse on sen syistä tai seurauksista. On kuitenkin myös itsessään moraalisesti ongelmallinen eriarvoisuuden muoto, jota kutsun erivertaisuudeksi. Siinä on kyse joidenkin herruudesta ja ylivallasta toisiin nähden tai siitä, että joitakin suositaan järjestelmällisesti toisten kustannuksella. Erivertaisuus ei sovi yhteen jokaisen yksilön moraalisen tasa-arvoisuuden kanssa, joten se on itsessään huono asia. Oikeudenmukaisuus (...) vaatii kansalaisten tasavertaisuutta, jota merkittävä taloudellinen eriarvoisuus uhkaa monella tavalla. (shrink)

This is a book review of Cheshire Calhoun's 2018 book, Doing Valuable Time.

One of the core issues in medical ethics has been and still is autonomy, people's right to make their own self-regarding choices in situations where more than one option is available. Depending on the case, these choices may be influenced by personal life history, one's ethical and other values, and one's future expectancies. A professional soccer player may risk an operation, which for a less athletic individual would represent an unnecessary risk that might jeopardize her ability to even walk. Saying (...) no to painkillers may sound irrational to those who do not see anything ennobling in avoidable suffering, and preferring homeopathic medicine to more evidence-based medicine may lead others to seriously doubt the logic of one's thinking. But although these situations may be difficult,1 they seldom lead to an impasse. Even if serious value conflicts emerge in these patient–medical personnel encounters, they can be overcome by the fact that, in Western countries, honoring patients' autonomy has been widely accepted as part of medical professionalism. (shrink)

ABSTRACT Public health authorities sometimes have to make decisions about the use of preventive medical measures—e.g. vaccination programmes—which could, if realised, save millions of lives, but could also kill a certain (small) number of those subjected to the measures. According to a rough‐and‐ready utilitarian calculation, such measures should be taken, but there are also possible objections to this view. A liberal objection to the use of mandatory preventive measures which might harm human beings is that people have a right to (...) decide for themselves whether or not they want to participate in the programme. A further objection is based on the claims that first, the authorities are directly killing those who die because of, say, vaccination programmes, and second, directly killing human beings is forbidden (since every human being has a right to live). The latter objection is discussed at length in the present paper. The validity of three doctrines, the doctrines of the double effect, of acts and omissions, and of killing and letting die, are considered with reference to the use of preventive measures, and found inapplicable. The objection is, however, refuted by comparing some hypothetical examples, and the initial utilitarian calculation is reinforced. (shrink)

It has been suggested that both performance and academic well-being play a role in adolescent students’ educational attainment and school dropout. In this study, we therefore examined, first, what kinds of academic well-being (i.e., school burnout, schoolwork engagement, and mathematics self-concept) and mathematics performance profiles can be identified among lower secondary school students ( N grade 7 = 583, N grade 9 = 497); second, how stable these profiles are across one school year during the seventh and ninth grades; and, (...) third, how students with different academic well-being and mathematics performance profiles differ with respect to their educational aspirations. By means of latent profile analyses, three groups of students in seventh grade: thriving (34%), average (51%), and negative academic well-being (15%) and four groups of students in ninth grade: thriving (25%), average (50%), negative academic well-being (18%), and low-performing (7%) with distinct well-being and mathematics performance profiles were identified. Configural frequency analyses revealed that the profiles were relatively stable across one school year; 60% of the students displayed identical profiles over time. The thriving students reported the highest educational aspirations compared to the other groups. In addition, the low-performing students in the ninth grade had the lowest educational aspirations just before the transition to upper secondary school. Practical implications as well as directions for future research are discussed. (shrink)

In his book The Principles of Art Robin George Collingwood presents a theory of art as the expression of emotion. The connection between his view and the theories of the Italian neo-idealists Benedetto Croce and Giovanni Gentile is both well known and well documented. What seems to be less known, however, is the intellectual link R. G. Collingwood’s father, William Gershom Collingwood, formed between his son and John Ruskin, the great Victorian essayist, critic and reformer. There are some references in (...) the literature to the fact that W. G. Collingwood was Ruskin’s friend, pupil, assistant and private secretary, later on his intellectual interpreter and biographer. It has also been argued that since R. G. Collingwood was until the age of thirteen exclusively educated by his father, there must have been an educational link between Ruskin and the younger Collingwood. But when it has come to pointing out theoretical similarities between the aesthetic theories of Ruskin and Collingwood, philosophers of art have, by and large, kept a remarkably low profile. (shrink)

The rapid spread of the Acquired Immune Deficiency Syndrome (AIDS) and its causative agent, the Human Immunodeficiency Virus (HIV), has posed people with difficult ethical questions. Philosophically, one of the most interesting problems is whether or not there is a right to remain in ignorance about one's own HIV infection.Being informed about a positive HIV test result has caused many people anguish and led some to suicidal thoughts. On these grounds a prima facte right not to know could be constructed. (...) Paternalistic arguments have been put forward to refute the alleged right, but these arguments are invalid, as is shown in the paper.However, by a utilitarian argument it can be shown that the prima facie right to remain in ignorance is overridden by other people's rights not to be infected. With certain qualifications, even a non-voluntary testing programme for HIV is justifiable. (shrink)

H. L. A. Hart in his Law, Liberty, and Morality (1963) defended the view that legal paternalism and legal moralism can be clearly distinguished from each other. Hart also stated that while legal moralism is always unacceptable, paternalistic laws are often justifiable. In this paper it is argued that Hart held the right view for the wrong reasons. Hart defended legal paternalism by claiming, against J. S. Mill, that for various psychological reasons individuals do not know their own interests best. (...) It will be shown in the paper that if this view is taken, it is impossible to reject legal moralism. The fact that paternalism is sometimes justifiable while moralism is not can be more firmly founded on a distinction made by C. L. Ten (1971). Ten's point is that in matters which concern only the individuals themselves, their actions cannot be legitimately restricted by appeals to the consequences of their action alone. Paternalistic control can be justified only if the decision-making abilities of the controlled individual are temporarily diminished. (shrink)

In disputes about conceptual analysis, each side typically appeals to pre-theoretical 'intuitions' about particular cases. Recently, many naturalistically oriented philosophers have suggested that these appeals should be understood as empirical hypotheses about what people would say when presented with descriptions of situations, and have consequently conducted surveys on non-specialists. I argue that this philosophical research programme, a key branch of what is known as 'experimental philosophy', rests on mistaken assumptions about the relation between people's concepts and their linguistic behaviour. The (...) conceptual claims that philosophers make imply predictions about the folk's responses only under certain demanding, counterfactual conditions. Because of the nature of these conditions, the claims cannot be tested with methods of positivist social science. We are, however, entitled to appeal to intuitions about folk concepts in virtue of possessing implicit normative knowledge acquired through reflective participation in everyday linguistic practices. (shrink)

Recent developments in biology have made it possible to acquire more and more precise information concerning our genetic makeup. There are four groups of people who may want to know about our genes. First, we ourselves can have an interest in being aware of own health status. Second, there are people who are genetically linked with us, and who can have an interest in the knowledge. Third, individuals with whom we have contracts and economic arrangements may have an interest in (...) knowing about our genetic makeup. Fourth, society as a whole can have an interest in the composition of our genes. As regards the question of motivation, the term ‘should’ can be interpreted in three ways. Prudentially speaking, to say that individuals should act in a certain manner is to say that the actions in question promote the longterm self-interest of these individuals. From the viewpoint of morality, we should do what is right and avoid doing what is wrong. When it comes to legal thinking, it is held in most liberal societies that grave other-regarding harm should be the primary justification for the use of coercion and constraint. In the paper, all these aspects are examined in more detail. (shrink)

Everyone agrees that not all norms that govern belief and assertion are epistemic. But not enough attention has been paid to distinguishing epistemic norms from others. Norms in general differ from merely evaluative standards in virtue of the fact that it is fitting to hold subjects accountable for violating them, provided they lack an excuse. Different kinds of norm are most readily distinguished by their distinctive mode of accountability. My thesis is roughly that a norm is epistemic if and only (...) if its violation makes it fitting to reduce epistemic trust in the subject, even if there is no doubt about their sincerity, honesty, or other moral virtues. That is, violations of epistemic norms don’t merit resentment or other forms of blame, but rather deduction of credibility points in internal scorekeeping and related attitudinal and behavioral changes. As Fricker’s work on epistemic injustice shows, such distrust is undesirable from the point of view of an epistemic agent. Consequently, when one manifests epistemic distrust towards a subject in suitable circumstances, it amounts a way of holding her accountable. Since this form of accountability involves no opprobrium, there is good reason to think it is not linked to voluntary control in the same way as moral accountability. Finally, I make use of this account of what makes epistemic norms distinctive to point out some faulty diagnostics in debates about norms of assertion. My aim is not to defend any substantive view, however, but only to offer tools for identifying the right kind of evidence for epistemic norms. (shrink)

ABSTRACTIn this paper, our purpose is to show what George Berkeley really said about ethics and the background conditions of religious life. The point is that true happiness is only possible in a religious sense; it means happiness in afterlife. The major threat to this is freethinking, or what we see as emerging enlightened modernism. His rather quixotic fix against freethinking shows the man as he is behind all the conventional panegyrics. He is a real Anglican soldier who anticipated but (...) never admitted a critical defeat in the most important of all battles. Interest in George Berkeley’s life’s work has been exceptionally selective. Yet his revolutionary immaterialism is only an early episode in his struggles towards a better society and religious life for all the people, regardless of their denomination. From this point of view, Alciphron is central. But he also develops his ethical ideas in his various minor writings, which have been largely overlooked. (shrink)

(Pdf updated to final, slightly revised version of November 2010) -/- Almost everyone would prefer to lead a meaningful life. But what is meaning in life and what makes a life meaningful? I argue, first, for a new analysis of the concept of meaningfulness in terms of the appropriateness of feelings of fulfilment and admiration. Second, I argue that while the best current conceptions of meaningfulness, such as Susan Wolf’s view that in a meaningful life ‘subjective attraction meets objective attractiveness’, (...) do a fairly good job capturing meaningfulness at a time, we need an account that makes sense of the intimate connection between meaningfulness and having a direction in one’s life. According to the Teleological View I propose, what makes a single chapter of a life most meaningful is success in reaching central, objectively valuable goals as a result of exercising essential human capacities. Life as a whole is most meaningful when past efforts increase the success of future goal-setting, goal-seeking, and goal-reaching, so that the life forms a coherent whole without being dedicated to a single aim. Since coherence in this sense is a holistic property of a life, global prudential value is not a function of local prudential values. I suggest that just as pleasure is the final good of human beings as subjects of experience, meaningfulness is the final good of human beings as active agents. (shrink)

The Limits of Medical Paternalism defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

There is a growing feeling in many Western countries that every human being has a right to health, or a right to health care. This feeling is reflected in a declaration of the World Health Organization (WHO) from 1976, which states: The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Our intention in the following is to use the WHO (...) declaration as a basis for considering the allocation of resources in health care. We shall first argue that most of the criteria suggested as grounds for fair allocation of scarce medical resources have their difficulties if one tries to apply them one by one to medical practices. We shall then go on to claim that, if we take the right of all human beings to health or health care even moderately seriously, increasing the resources would in most cases be more ethical than attempting to allocate them ‘fairly’. (shrink)