How should scarce healthcare resources be distributed? This is a contentious issue that became especially pressing during the pandemic. It is often emphasised that studies exploring public views about this question provide valuable input to the issue of healthcare priority setting. While there has been a vast number of such studies it is rarely articulated, more specifically, what the results from these studies would mean for the justification of principles for priority setting. On the one hand, it seems unreasonable that (...) public values would straightforwardly decide the ethical question of how resources should be distributed. On the other hand, in a democratic society, it seems equally unreasonable that they would be considered irrelevant for this question. In this paper we draw on the notion of reflective equilibrium and discuss the relevance and roles that empirical studies may plausibly have for justification in priority setting ethics. We develop a framework for analysing how different kinds of empirical results may have different kinds of implications for justification. (shrink)

A majority of South Africans agrees that when science and religion conflict, religion is always right. Is this an indication the public is anti-science or does the question wording hide a more complex relationship? We examined the relationship between science and religion in South Africa using quantitative data from the World Values Survey and qualitative data from face-to-face interviews. As research on the potential conflict between science and religion is predominantly focused on Western countries, the present study focuses on Africa (...) and compares results with those of two Western countries. Findings show that almost 76% South Africans agree that religion is always right and religious belief, social trust and education were significant predictors of this perception. Comparing findings with data from Zimbabwe, the United States and Germany, we found that while the influence of religiosity is significant across countries, comparatively, trust seems to be more of an African issue. The qualitative interviews, however, provided an elaboration of the relationship between science and religion in South Africa, indicating that choosing either science or religion is not always an outright rejection of the other. The relationships were classified as those informed by cognitive dissonance, often expressed in hierarchical associations, and those influenced by cognitive polyphasia, a complementary and transformative coexistence. (shrink)

Transparency has achieved a mythical status in society. Myths are not false accounts or understandings, but deep-seated and definitive descriptions of the world that ontologically ground the ways in which we frame and see the world around us. We explore the mythical nature of transparency from this perspective, explain its social-historical underpinnings and discuss its influence on contemporary organizations. In doing so, we also theorize in a more general sense about the relationship between myth, as a foundational understanding and description (...) of the world, and the constellation of metaphors, as specific ways of framing and seeing organizational reality, to which it gives rise. While observations and evidence can always be adduced to challenge a particular set of metaphors, the endogenous force of the myth may sustain the overall project. This process is explained with a detailed analysis of the transparency myth. (shrink)

Accounts of analogical inference are usually categorized into four broad groups: abductive, deductive, inductive and sui generis. The purpose of this paper is to defend a sui generis model of analogical inference. It focuses on the sui generis account, as developed by Juthe [2005, 2009, 2015, 2016] and Botting’s [2017] criticism of it. This paper uses the pragmadialectical theory of argumentation as the methodological framework for analyzing and reconstructing argumentation. The paper has two main points. First, that Juthe’s arguments against (...) a deductive interpretation of prima facie analogy argumentation remain unaffected by Botting’s criticism, which means that many of the reasons against deductive reformulation of analogy argumentation still stand. The additional argument, which Botting himself brings up, that a deductive interpretation cannot account for the cumulative effect of analogies, just provides further reason to reject deductivism. The second main point of this paper is that an inductive interpretation of analogical inference also fails. There are constitutional differences between inductive and analogical inference that cannot be bridged. The result is a firm defense of the sui generis view of analogical inference. (shrink)

The essays deal with the aesthetic and aesthetics; Bourdieu's critique of aesthetics form and content in the arts, musical formalism, the nature and value of literature, Heidegger's philosophy of art, postmodernism and history, Lyotard and the sublime, and the challenge of evolutionary psychology to the humanities.

During a pandemic, demand for intensive care often exceeds availability. Experts agree that allocation should maximize benefits and must not be based on whether patients could have taken preventive measures. However, intensive care units (ICUs) are often overburdened by individuals with severe COVID-19 who have chosen not to be vaccinated to prevent the disease. This article reports an experiment that investigated the German public's prioritization preferences during the fourth wave of the coronavirus pandemic ( N = 1014). In a series (...) of scenarios, participants were asked to decide on ICU admission for patients who differed in terms of health condition, expected treatment benefits, and vaccination status. The results reveal an in-group bias, as vaccinated individuals preferred to allocate more resources to the vaccinated than to the unvaccinated. Participants also favored admitting a heart attack patient rather than a COVID-19 patient with the same likelihood of benefiting from ICU admission, indicating a preference for maintaining regular ICU services rather than treating those with severe COVID-19. Finally, participants were more likely to admit a patient to intensive care when this meant withholding rather than withdrawing care from another patient. The results indicate that lay prioritizations violate established allocation principles, presaging potential conflicts between those in need of intensive care and those who provide and allocate it. It is therefore recommended that allocation principles should be explained to enhance public understanding. Additionally, vaccination rates should be increased to relieve ICUs and reduce the need for such triage decisions. (shrink)

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction and negative interpretation bias in a student sample screened for high and low social anxiety. Results support the hypothesis that group differences in negative interpretations (...) of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing. (shrink)

This collection illuminates the concept of Bildung in the works of Fichte, Schiller, Humboldt, and Nietzsche. Besides seeking to work out the theoretical contour of aesthetic education in the 18th and 19th centuries, the contributions attempt to make reason known to itself in the interdisciplinary study of Bildung, a concept important in fields as diverse as pedagogy, philosophy, and art. Moreover, a detailed examination of the concept of aesthetic education opens new perspectives on education debates in the present. ".

In 2015, the United Nations Sustainable Development Goals set an ethical imperative: end extreme poverty and hunger by 2030. Microfranchising can contribute to this critical effort by offering nonprofit organizations and businesses an opportunity to rapidly scale entrepreneurship within Base of the Pyramid markets. However, while abundant literature exists on traditional franchising, we know little about how to leverage microfranchising in resource-scarce contexts to alleviate poverty. To address this gap, we report a longitudinal case study of a microfranchise network aimed (...) at providing timely access to quality, affordable agricultural input, and services for millions of small-scale farmers in Bangladesh. Anchored in the BOP and microfranchise literature and drawing on innovation theory as an analytical lens, we provide a detailed account of how CARE—a global humanitarian and development non-governmental organization—developed and managed the network. We found that context played a strong role and that adaptability therefore was key to successfully recruiting and engaging BOP entrepreneurs and other business partners in the network. Moreover, as members joined the network with past ties and established practices, managing these path dependencies had important implications for network performance. Network sustainability in terms of financial and social impact was also a key theme that required careful consideration throughout network development. We combine these empirical findings with extant literature to discuss contributions to the theory and practice of microfranchising and innovation networking in the BOP context. (shrink)

It is not unusual in real-life that one has to choose among finitely many alternatives when the merit of each alternative is not perfectly known. Instead of observing the actual utilities of the alternatives at hand, one typically observes more or less precise signals that are positively correlated with these utilities. In addition, the decision-maker may, at some cost or disutility of effort, choose to increase the precision of these signals, for example by way of a careful study or the (...) hiring of expertise. We here develop a model of such decision problems. We begin by showing that a version of the monotone likelihood-ratio property is sufficient, and also essentially necessary, for the optimality of the heuristic decision rule to always choose the alternative with the highest signal. Second, we show that it is not always advantageous to face alternatives with higher utilities, a non-monotonicity result that holds even if the decision-maker optimally chooses the signal precision. We finally establish an operational first-order condition for the optimal precision level in a canonical class of decision-problems, and we show that the optimal precision level may be discontinuous in the precision cost. (shrink)

It is argued that the so‐called principles of “strong centering” and “weak centering” central to the traditional Lewis‐Stalnaker semantics for counterfactuals are both fallacious. A foundation for an alternative semantics without these prinsciples is outlined. The core idea is that the statistically normal worlds – rather than those worlds most qualitatively similar to the actual world – should serve as the semantical fulcrum.

The aim of this article is to contribute to responsible innovation by developing a conceptual framework for the processes of creativity and innovation. The hypothesis is that creative and innovative processes are similar in that both are affective in nature. I develop this conceptual framework through an interpretation of the insights of Henri Poincaré’s notion of the ‘four stages’ in the creative process and Joseph Schumpeter’s notion of the entrepreneur. Building on this framework, I analyze the creative and innovative practices (...) of the film director Lars von Trier and the entrepreneur Steve Jobs. The interpretation and analysis suggest that the processes of creativity and innovation are similar in nature in that both are based on the moods of disturbance and enthusiasm; but that they differ in that creativity is based on the feelings of interest and irritation, whereas innovation is based on the feelings of desire and anger. In the conclusion I discuss the implications of this for responsible innovation with regard to the social aspect of resistance towards innovation and the ethical aspects of anger in entrepreneurial leadership. (shrink)

Hannah Arendt and Theodor W. Adorno, two of the most influential political philosophers and theorists of the twentieth century, were contemporaries with similar interests, backgrounds, and a shared experience of exile. Yet until now, no book has brought them together. In this first comparative study of their work, leading scholars discuss divergences, disclose surprising affinities, and find common ground between the two thinkers. This pioneering work recovers the relevance of Arendt and Adorno for contemporary political theory and philosophy and lays (...) the foundation for a critical understanding of political modernity: from universalistic claims for political freedom to the abyss of genocidal politics. (shrink)

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient’s self-determination, the patient’s best interest, the carer’s professional ideals, the carer’s professional (...) role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context. (shrink)

What is privacy? What does privacy mean in relation to biobanking, in what way do the participants have an interest in privacy, (why) is there a right to privacy, and how should the privacy issue be regulated when it comes to biobank research? A relational view of privacy is argued for in this article, which takes as its basis a general discussion of several concepts of privacy and attempts at grounding privacy rights. In promoting and protecting the rights that participants (...) in biobank research might have to privacy, it is argued that their interests should be related to the specific context of the provision and reception of health care that participation in biobank research is connected with. Rather than just granting participants an exclusive right to or ownership of their health information, which must be waived in order to make biobank research possible, the privacy aspect of health information should be viewed in light of the moral rights and duties that accompany any involvement in a research based system of health services. (shrink)

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2018 Heft: 224 Seiten: 269-293.

This paper explores moral sensitivity in a learning perspective, and a framework is developed for the understanding of how moral sensitivity can be developed through reiterative problem solving in the face of diverse ethical problems. Factors that may inhibit the individual's ability to conceive of moral issues are discussed, and perspectives from moral psychology are integrated with theory on problem formulation. It is argued that (1) the individual's moral sensitivity is pivotal for ethical problem solving, because problem formulation is paramount (...) for further reflection and behaviour; (2) ethical behaviour must be understood both (a) in terms of the individual's psychological make‐up that determines psychological response to moral features and (b) in terms of external constraints on the individual's moral sensitivity; and (3) the development of moral sensitivity can be promoted by actively and consciously pursuing disciplined imagination in multi‐perspective formulations of problems. (shrink)

Background Neonatologists, legal experts and ethicists extensively discuss the ethical challenges of decision-making when a child is born at the limit of viability. The voices of parents are less heard in this discussion. In Norway, parents are actively shielded from the burden of decision-making responsibility. In an era of increasing patient autonomy, is this position still defendable? Research question In this article, we discuss the role of parents in neonatal decision-making, based on the following research question: Should parents decide whether (...) to provide lifesaving treatment when their child is born at the limit of viability? Research design We conducted eight interviews with 12 parents, 4 individuals and 4 couples, all having experienced prenatal counselling at the limit of viability. The interviews took place at different university locations in Norway in the years 2014–2018. Ethical considerations All study participants gave their written informed consent. The Regional Committee for Medical Research Ethics approved the study. Findings We identified six main themes in parents’ responses to the research question. Parents (1) experienced an emotional turmoil confronted with birth at the border of viability, (2) emphasized the importance of being involved in decision-making, (3) described and reflected on the need to balance the parental instinct of saving, (4) were concerned about the dilemmas involved in protecting the family, (5) were worried about the burden of overwhelming responsibility and (6) called for guideline relief. Conclusion The perceived parental instinct of saving the life of their child makes it hard for parents to step away from a call for ‘everything to be done’. Involvement of an interprofessional periviability team drawing on the experiences and viewpoints of nurses and neonatologists in decision-making is needed to protect both infants and parents against undue parental push for treatment and enable parents to make good decisions regarding their child. (shrink)

In health care priority setting different criteria are used to reflect the relevant values that should guide decision-making. During recent years there has been a development of value frameworks implying the use of multiple criteria, a development that has not been accompanied by a structured conceptual and normative analysis of how different criteria relate to each other and to underlying normative considerations. Examples of such criteria are unmet need and severity. In this article these crucial criteria are conceptually clarified and (...) analyzed in relation to each other. We argue that disease-severity and condition-severity should be distinguished and we find the latter concept better reflects underlying normative values. We further argue that unmet need does not fulfil an independent and relevant role in relation to condition-severity except for in some limited situations when having to distinguish between conditions of equal severity. (shrink)

The primary human rights documents of the United Nations claim that every human has a right to development, a right that also includes continuous improvement of each person's living conditions. On one interpretation, this implies a right to a never-ending improvement of living conditions. According to the author, this interpretation faces several counterintuitive implications. First, it seems reasonable that we cannot have a right to improvement without regard to environmental sustainability; improvements must instead focus on well-being, a concept that is (...) partially unrelated to material improvements. Second, if development is a human right, there are several distributional problems with this right. The paper discusses three different responses to the idea that everybody has a right to continuous improvement and concludes that the best solution is to reject the idea that everyone has such a right. This does not imply that we must reject a right to a certain minimum level of well-being; it just means that this right cannot include claims for never-ending improvement. (shrink)

In this book Lars Svendsen examines the nature of boredom, how it originated, its history, how and why it afflicts us, and why we cannot seem to overcome it by any act of will.