Gilles Deleuze famously expressed distaste for the philosophy of Ludwig Wittgenstein and his followers. The two thinkers are here seen as irreconcilable. The critique of false problems and the refutation of scepticism found in Wittgenstein have no resonance in Deleuze, who was a systematic metaphysical philosopher in the tradition of pre-Kantian rationalism. Pragmatic-sceptical self-limitation of thought's capabilities on the grounds of existing practice flies in the face of aesthetic experience. Moreover Deleuze explicitly upholds modern literature as a locus of philosophical (...) innovation. The comparison between Deleuze and Wittgenstein is pursued in an examination of the questions of ‘rule following’, literary practice and semiotics. Deleuze was hostile to ‘pragmatism’, whereas Wittgenstein and his followers could often be described as pragmatists. (shrink)

This book provides a clear and concise introduction to the philosophy of Gilles Deleuze. It analyses his key theoretical concepts, such as difference and the body without organs, and covers all the different areas of his thought, including metaphysics, the history of philosophy, psychoanalysis, political theory, the philosophy of the social sciences and aesthetics. As the first book to offer a comprehensive analysis of Deleuze's writings, it reveals both the internal coherence of his philosophy and its development through a series (...) of distinct phases. Reidar Due offers an entirely new interpretation of Deleuze's philosophy, centred around the notion of thought as a capacity to form relations. These relations are embodied in nature, in language and in the unconscious; in art, science and social practice. With this concept of embodied thought, Deleuze challenges our most entrenched beliefs about the self and about signs whether linguistic or social. He develops an original theory of power and social systems and presents a method for understanding any signifying practice, from language and ritual to the unconscious, including cinema, literature and painting. Due analyses the different strands in this theoretical edifice and shows its implications for a wide range of human sciences, from history and psychology to political theory and cultural studies. (shrink)

This paper seeks to present a kind of skeptical, and, in an indirect way, Wittgensteinian perspective upon purpose and meaning in architecture. The argument presented here revolves around the two notions that, first, there are different categories, which we have available for making architecture seem intelligible to us, and, second, that there are distinct historical discourses in which architecture has been made intelligible in specific ways.

This book is about film's encounter with love throughout the medium's history. It is also about the philosophy of love... [it] outlines a new metaphysics and ontology of love as a reciprocal erotic relationship. This study argues that film's special narrative language is particularly well suited to depicting love in this way. It begins with early silent directors, such as Joseph von Sternberg, and concludes with contemporary filmmakers, such as Sophia Coppola; it also compares classical French and American love films (...) of the 1940s with modernist films by Luis Buñuel, François Truffaut, and Wong Kar Wai, amongst many others"--Page [4] of cover. (shrink)

L’article propose une analyse de la gestion politique de la pandémie, élaborant un concept de domination nouvelle qui, du côté de l’Etat comme du côté du citoyen, et des attitudes normatives que l’on attend de lui, aurait été caractérisé par un type de réflexion rationnelle à échelle temporelle brève. L’article analyse les implications temporelles et politiques de ce lien de domination nouveau en comparant la raison d’Etat des gouvernements occidentaux durant la pandémie à des conceptions du pouvoir défini en termes (...) d’idéologie ou de “biopolitique”. Ensuite, il cherche à déterminer la nature du citoyen-sujet qui entre dans cette nouvelle forme de domination par comparaison avec trois formes de subjectivité canoniques : le sujet kantien, l’individu sociologique et la subjectivité contingente et éthique théorisée par Hannah Arendt. Par ce biais, il définit la singularité du citoyen-sujet nouveau par sa réactivité. (shrink)

This essay raises some questions concerning the method and conceptual structure of Sartre's Being and Nothingness. Three substantially different types of interpretation of this text have been put forward. One of the main issues separating the three interpretative strategies is the relationship that they each establish between Sartre's three fundamental concepts: consciousness, nothingness and freedom—each of which can be seen to play the fundamental role in the argument. It therefore seems crucial for any interpretation of Being and Nothingness to determine (...) the exact relationship between these terms. However, Being and Nothingness presents a hybrid argument that interweaves metaphysical deduction, phenomenological description and moral-existential argument in a way that makes it almost impossible to decide which of the strands of the argument should be seen to dominate the others. It is therefore perhaps equally difficult to ascertain which of its principal concepts has the most central place in the system. One could therefore argue that a reading of Being and Nothingness should aim to account for (rather than dismiss) the hybridity of the argument and then seek to assign relative functions to its different strands. The following remarks are intended as a step in that direction. (shrink)

In this paper, I present a nominalist ethics of intersubjectivity based on the principle of a discourse transcendent reality of the Other within an intersubjective relationship. Through a discussion of the authors Foucault, Sartre, and Hegel, and the film Drive My Car, the article presents a phenomenology of the appearance of one’s own body and of the body of the Other, according, either, to evaluative criteria or to existential criteria not accessible to discursive handling. The argument is nominalist in its (...) denial of a discursive purchase on the Other. It is realist in its exploration of the discourse transcendent reality of the Other. The argument moves between different orders of scale. (shrink)

Background Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees’ attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. Methods We used panel data in a longitudinal design study to measure (...) variation in survey scores from multidisciplinary employees from seven departments within three Norwegian mental health care institutions at three time points (T0–T1–T2). Mixed models were used to account for dependence of data in persons who participated more than once. Results In total, 1068 surveys (from 817 employees who did and did not participate in ERG) were included in the analyses. Of these, 7.6% (N = 62) responded at three points in time, 15.5% (N = 127) at two points, and 76.8% (N = 628) once. On average, over time, respondents who participated in ERG viewed coercion more strongly as offending (p < 0.05). Those who presented a case in the ERG sessions showed lower scores on User Involvement (p < 0.001), Team Cooperation (p < 0.01) and Constructive Disagreement (p < 0.01). We observed significant differences in outcomes between individuals from different departments, as well as between different professions. Initial significant changes due to frequency of participation in ERG and case presentation in ERG did not remain statistically significant after adjustment for Departments and Professions. Differences were generally small in absolute terms, possibly due to the low amount of longitudinal data. Conclusions This study measured specific intervention-related outcome parameters for describing the impact of clinical ethics support (CES). Structural implementation of ERGs or MCDs seems to contribute to employees reporting a more critical attitude towards coercion. Ethics support is a complex intervention and studying changes over time is complex in itself. Several recommendations for strengthening the outcomes of future CES evaluation studies are discussed. CES evaluation studies are important, since—despite the intrinsic value of participating in ERG or MCD—CES inherently aims, and should aim, at improving clinical practices. (shrink)

Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient’s best interest, assessment of capacity to consent, and on the patient’s own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. Using a questionnaire, we studied the (...) decision-making process for 299 nursing home patients who were treated for dehydration using intravenous fluids, or for bacterial infections using intravenous antibiotics. We compared the 215 patients treated in nursing homes to the 84 nursing home patients treated in the hospital. The patients’ capacity to consent was considered prior to treatment in 197 of the patients treated in nursing homes and 56 of the patients treated in hospitals. The answers indicate that capacity to consent can be difficult to assess. Patients that were considered capable to consent, were more often involved in the decision-making in nursing homes than in hospital. Next of kin and other health personnel were also more rarely involved when the nursing home patient was treated in hospital. Whether advance care planning had been carried out, was more often unknown in the hospital. Hospital doctors expressed more doubt about the decision to admit the patient to the hospital than about the treatment itself. This study indicates a potential for improvement in decision-making processes in general, and in particular when nursing home patients are treated in a hospital ward. The findings corroborate that nursing home patients should be treated locally if adequate health care and treatment is available. The communication between the different levels of health care when hospitalization is necessary, must be better. ClinicalTrials. gov NCT01023763 [The registration was delayed one month after study onset due to practical reasons]. (shrink)

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

This article presents a case study from the history of cardiology, namely, the development towards the acceptance of the coronary theory of angina pectoris. I show that the arguments which were considered decisive against the theory were not answered at the time the theory was accepted. I also point out that the experimental and practical success of the theory cannot be used to support the initial choice because, in the subsequent development, the field researchers became preoccupied with new questions and (...) problems. In spite of this, there is a sense in which the field of angina research has progressed, but it remains a challenge to exactly characterise in what sense this is the case. (shrink)

Like the French revolutionaries, Kant defended individual rights and a republican constitution. That he nonetheless rejected a right of revolution has puzzled scholars. In this article I give an overview of Kant’s rejection of a right of revolution, compare it to the German intellectual context, and use it to explain Kant’s view of the events in France. In Kant’s nuanced account of the revolution’s two central phases, he refined a distinction between legitimate political transition and lawless popular rebellion.

Reidar Thomte's Kierkegaard's Philosophy of Religion is an excellent read for students beginning their study of one of the greats of nineteenth and twentieth century philosophy. Thomte directly appropriates Kierkegaard's insightful language and discussion of the theological and philosophical issues that stimulated him, all of which are still alive and well today. This approach has the happy result that readers seeking an introduction do not have to be led through technical debates in order to approach Kierkegaard's thought. Thomte is (...) a master of incisive summary; his presentations of crucial distinctions are level-headed and to the point. Kierkegaard's categories such as the stages on life's way (the aesthetic, the ethical, Religiousness A, and Religiousness B), the individual, subjectivity, the Paradox, the varieties of love, faith and knowledge, etc., are provocative and illuminating. Not only is this book a good a starter, it is also a comprehensive review of the principal issues in Kierkegaard's philosophy of religion. (by Robert L. Perkins, Editor, International Kierkegaard Commentary). (shrink)

BackgroundCase consultation performed by clinical ethics committees (CECs) is a complex activity which should be evaluated. Several evaluation studies have reported stakeholder satisfaction in single institutions. The present study was conducted nationwide and compares clinicians’ evaluations on a range of aspects with the CEC’s own evaluation.MethodsProspective questionnaire study involving case consultations at 19 Norwegian CECs for 1 year, where consultations were evaluated by CECs and clinicians who had participated.ResultsEvaluations of 64 case consultations were received. Cases were complex with multiple ethical (...) problems intertwined. Clinicians rated the average CEC consult highly, being both satisfied with the process and perceiving it to be useful across a number of aspects. CEC evaluations corresponded well with those of clinicians in a large majority of cases. Having next of kin/patients present was experienced as predominantly positive, though practised by only half of the CECs. The educational function of the consult was evaluated more positively when the CEC used a systematic deliberation method.ConclusionsCEC case consultation was found to be a useful service. The study is also a favourable evaluation of the Norwegian CEC system, implying that it is feasible to implement well-functioning CECs on a large scale. There are good reasons to involve the stakeholders in the consultations as a main rule. (shrink)

This paper gives an account of theory structure in the biomedical sciences with particular emphasis on cardiology. Rather than regarding theories as axiomatizable sets of statements (the so-called received view), theories are regarded as answers to questions which are accepted as legitimate and interesting by scientists within a field of investigation at a given time. This account of theory structure is used to distinguish between theories which are quite liable to be revised during the course of scientific investigation, here called (...) theories within the field, and theories which are more securely established, here called theories of the field. These latter theories can also be regarded as patterns of reasoning which are applied again and again to answer the questions of the field. It is argued that the distinction proposed in this paper fits our intuitive understanding of what it means for a theory to be securely established within a field of research. Several examples are given which show the problems of justifying clinical intervention solely on the basis of theories within the field. (shrink)

In this issue, Alex London and Kevin Zollman provide an analysis of an influential approach to the ethics of international research, known as the “fair benefits” approach. According to them, the fair benefits approach suffers from a fatal flaw: it is either too vague to be useful, or worse, is internally inconsistent. The fair benefits approach was developed based on a presentation I gave at a workshop organized in Malawi in March 2001 by the National Institutes of Health Clinical Center’s (...) Department of Bioethics. In this presentation, I made what I still think is a valid point, which was accepted by the diverse group of participants and formed the basis of the subsequent publications: One should not .. (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)

An introduction to the political philosophy of Kant, exploring how he developed his views in a context shaped by controversies following the French revolution. It provides new information on his followers and critics as they engaged in high stakes political debates on freedom's relation to the state at this key turning point in history.

Decision analysts sometimes use the results of clinical trials in order to evaluate treatment alternatives. I discuss some problems associated with this, and in particular I point out that it is not valid to use the estimates from clinical trials as the probabilities of events which are needed for decision analysis. I also attempt to show that an approach based on objective statistical theory may have advantages over commonly used methods based on decision theory. These advantages include the recognition of (...) uncertain data, the introduction of a third alternative, namely suspension of judgement, and the possibility of modifying the choice of probabilities based on a clinical trial with reference to other available knowledge. I have not, however, shown in detail how this modification is done, but I think the concept is sufficiently promising to be applied to an actual clinical decision problem. (shrink)

To Kant, the French revolution's central events were the transfer of sovereignty to the people in 1789 and the trial and execution of the monarch in 1792-1793. Through a contextual study, this Element argues that while both events manifested the principle of popular sovereignty, the first did so in lawful ways, whereas the latter was a perversion of the principle. Kant was convinced that historical examples can help us understand political philosophy, and this Element seeks to show this in practice.

ABSTRACTCan there be a legal or a moral right to resist the government? Scholarly interest in the right of resistance has rarely focused on German philosophy, which has often been considered unusually committed to authority. Yet, during the Enlightenment German philosophers regularly attempted to justify not just conscientious refusal but also revolution. This essay explores the two dominant justifications, which were based in Wolffian perfectionism and Kantian relational theory. It argues that we can best understand the complexity of these theories (...) of resistance by exploring their contrasting views on the state’s purpose: providing material and spiritual welfare, or establishing freedom as independence. (shrink)

When Kant in 1793 rejected a right of revolution, he was immediately criticized by a group of radical followers who argued that he had betrayed his own principles of justice. Jakob, Erhard, Fichte, Bergk and Schlegel proceeded to defend a right of resistance and revolution based on what they took to be his true principles. I argue that we must understand Kant's Metaphysics of Morals, which came in 1797, partly as a response to these radical democratic writings. Exploring this forgotten (...) controversy reveals that Kant did not betray his own principles when he denied a right of revolution, because he did not mean that persons have an unconditional duty to obey. This becomes clear when we read the final developments of Kant's thinking on individual liberty and republican government in light of the radical critique. (shrink)

It is a remarkable fact about the development of medical ethics from the 1960s until today that there has been a dramatic shift from a position where it was taken for granted that the physician knows best, to a position where much greater emphasis is put on the patient’s treatment preferences. This shift is evident with regard to physician attitudes towards disclosing a cancer diagnosis. For example, in 1961, a survey of cancer physicians showed that almost 90% of the physicians (...) reported that their usual policy was not to tell their patients that they had cancer . The survey was repeated in 1979, and it showed a complete reversal in attitudes over this 20-year period. 90% reported that their usual policy was to tell their patients that they had cancer .One common way of justifying the new approach is to claim that patients have a right to make their own treatment decisions, referring to the basic value of patient autonomy. However, it is immediately obvious that physicians should not respect all choices made by patients. Consider the following case: A thirty-eight-year-old man with mild upper respiratory infection suddenly developed severe headache, stiff neck, and high fever. He went to an emergency room for help. The diagnosis was pneumococcal meningitis, a bacterial meningitis almost always fatal if not treated. If treatment is delayed, permanent neurological damage is likely. A physician told the patient that urgent treatment was needed to save his life and forestall brain damage. The patient refused to consent to treatment saying he wanted to be allowed to die .Very few, if any, physicians would respect this person’s treatment choice. The reason is that this patient is not competent to make his own decisions. Respect for autonomy only requires that the choices of patients who are competent to make their own decisions are honoured. Judgements about which patients are competent to make their own decisions therefore become crucial. (shrink)

The main idea of this article is to present various perspectives in order to analyze the recent crisis concerning the agriculture-based rural societies in the developed capitalist communities. In all of these countries there is a production crisis, resulting in too much food. But this is also an ideological crisis, because the consumer thinks that the food is produced at too high a price. And it is a political crisis as well because a major part of the voters think subsidies (...) and trade barriers are too high. The paper argues that beneath the present agricultural and rural policy crisis lies the failure of three great projects of our time: 1) The project of natural science; 2) The project of liberal capitalism; and 3) The project of scientific socialism. The failure of these three projects has to do with the breakdown of the positivist idea of modernization. Modernization theory was partly wrong because it overlooked the persistence of locally based life modes. Those life modes must be understood before a sustainable rural development is found. The article reviews some contemporary social science perspectives that have recently been developed to grasp the fundamental changes of today's rural societies. Based on those perspectives and primarily the life mode perspective, five key elements that are essential to analyze if we want to understand future development are isolated: food production, resources, space, social diversity, and culture. (shrink)

The article ‘Understanding Racism’ by Kwame Anthony Appiah is a revised version of The Annual Examen Philosophicum Lecture held on 29 September 2023 at the University of Oslo, with comments by Anna...

The first clinical ethics committees in Norway were established in 1996. This started as an initiative from hospital clinicians, the Norwegian Medical Association, and health authorities and politicians. Norwegian hospitals are, by and large, publicly funded through taxation, and all inpatient treatment is free of charge. Today, all the 23 hospital trusts have established at least one committee. Center for Medical Ethics , University of Oslo, receives an annual amount of US$335,000 from the Ministry of Health and Care Services to (...) coordinate the committees and to facilitate competency building for committee members. (shrink)

This paper argues that, although no resistance or revolution is permitted in the Kantian state, very tyrannical regimes must not be obeyed because they do not qualify as states. The essay shows how a state ceases to be a state, argues that persons have a moral responsibility to judge about it and defends the compatibility of this with Kantian authority. The reconstructed Kantian view has implications for how we conceive authority and obligation. It calls for a morally demanding definition of (...) the state and asserts that the primary personal responsibility is not to evaluate the morality of every single law but to evaluate the moral standing of the polity.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

Volume 20, Issue 3, March 2020, Page 42-44.

Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. Rather, we should (...) focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

Empathy is generally regarded as important and positive. However, descriptions of empathy are often inadequate and deceptive. Furthermore, there is a widespread lack of critical attention to such deficiencies. This critical review of the medical discourse of empathy shows that tendencies to evade and misrepresent the understanding subject are common. The understanding subject’s contributions to the empathic process are often neglected or described as something that can and should be avoided or controlled. Furthermore, the intrinsic and closely interwoven relationship between (...) medical understanding and empathy is generally not explored. Instead of challenging objectivistic and instrumental ideals, the medical discourse of empathy tends to accommodate to inadequate ideals of objectivity and instrumentalism. Thus, important aspects of physician’s rationality, understanding, and morality are neglected and important opportunities for reflection, dialogue, and critique are forfeited. Both the critical and constructive parts of this paper are heavily inspired by philosophical hermeneutic insights, e.g. that physician’s empathy is always historically situated and part of a moral commitment. At the end of this paper, an alternative description of empathy - i.e. appropriate understanding of another human being - is outlined to facilitate the inclusion of hermeneutic insights and accentuate the inherent relationship between empathy and morality. (shrink)

Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...) challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices. (shrink)

This article raises the issue of the extent to which a single nation can develop a “national agricultural policy,” pursuing internal goals in agrarian development, goals that vary significantly from those of other industrialized countries. What are the conflicts arising from such a policy and how do these conflicts interfere with the general agricultural crisis of these countries? The Norwegian case is explored as an example of a blend of social-democratic and center-populist agricultural policies. The decision in 1975 by the (...) Norwegian Parliament to establish the income level of farmers at the same level as workers is seen as an experiment. As agricultural policy, this new departure represented a deviation from the earlier policies of rationalization. The Social Democrats developed their new position as a result of internal and external pressure. A series of reforms financed by the new state incomes from oil production were undertaken, of which income equalization and a farm relief service were the most important. Most Norwegian farmers speak of the reform years as “the good years of escalation.” Equity was reached in 1982, but nevertheless several problems emerged: 1) the escalation of subsidized incomes led to overproduction and decreasing incomes from the market (after 1982), 2) the large budgetary transfers to agriculture caused a legitimation crisis, fueling the constituency of the right-wing Progress Party, 3) the large subsidies to agriculture contributed to the fiscal crisis of the state, 4) the problems mentioned above, contributed to the general crisis of the Norwegian Social Democracy which finds itself with dwindling support. The likely outcome of the present Norwegian farm crisis is the implementation of an agricultural policy that will protect the most vulnerable sector and open the more competitive sector to market forces. (shrink)

Introduction Stored human samples and the establishment of biobanks are increasing in the world. Along with this there are the questions of ethics that arise such as the correct method of obtaining informed consent for research on stored samples and the policies involved in collaborative research using collected samples. This study is an attempt to evaluate the researchers, academics and policy makers' views on these ethical aspects. Methods This was an anonymised study involving a Sri Lankan population of researchers, ethics (...) committee members, and policy makers. A self administered questionnaire was utilised as the study instrument. The questionnaire captured four major areas of interest: demographic characteristics of respondents, their attitudes on informed consent policy, their opinion on rights of collaborating researchers, their attitudes on dealing with international differences in regulatory frameworks. Results The study included 55 responders with 40/55 agreeing that donors should receive the option of giving informed consent for future research, with 31/55 considering multiple- type consent options most appropriate. Regarding the issue of shared samples in collaborative research majority agreed that source country ethics review committee approval was necessary 53/55. Conclusion The study concludes that sample donors should be given the option of giving advance consent to unspecified future research provided that future research is approved by an ethics committee. In collaborative research, it is necessary to involve ethics committees from donor countries in the research approval process. (shrink)

This article argues that Kant's republicanism provides a foundation for democratic procedures. The conclusion is reached through an investigation of Critique of the Power of Judgment, which allows us to interpret Kant's notion of the state as a self-determining organic community, and not merely an aggregate of individuals. The article rejects Isaiah Berlin's interpretation of Kant as an authoritarian thinker, and reveals a republican theory centered on liberal freedom expressed within a self-organizing political community.

This book, edited by a team of leading European bioethicists, is in all respects an innovative publication.

In recent years, political philosophers have debated whether human rights are a special class of moral rights we all possess simply by virtue of our common humanity and which are universal in time and space, or whether they are essentially modern political constructs defined by the role they play in an international legal-political practice that regulates the relationship between the governments of sovereign states and their citizens. This edited volume sets out to further this debate and move it ahead by (...) rethinking some of its fundamental premises and by applying it to new and challenging domains, such as socio-economic rights, indigenous rights, the rights of immigrants and the human rights responsibilities of corporations. Beyond the philosophy of human rights, the book has a broader relevance by contributing to key themes in the methodology of political philosophy and by addressing urgent issues in contemporary global policy making. (shrink)

Background/Objective The act of surgery involves harming vulnerable patients with the intent that the results will improve their health and, ultimately, help the patients. Such activities will inevitably entail moral decisions, yet the ethics of surgery has only recently developed as a field of medical ethics. Within this field, it is striking how few accounts there are of actions within the operating room. The aim of this systematic review was to investigate how much of the scientific publications on surgical ethics (...) focus on what take place inside the operating room and to explore the ethical issues included in the publications that focus on medical ethics in the operating room. Methods We conducted a systematic search of the Medline and Embase databases using a PICO model and the search terms “surgery”, “ethics” and “operating room”. Papers were included if they focused on doctors, entailed activities inside the operating room and contained some ethical analysis. Thematic synthesis was used for data extraction and analysis. Findings Fewer than 2% of the scientific publications on surgical ethics included activities inside the operating room. A total of 108 studies were included in the full-text analysis and reported according to the RESERVE guidelines. Eight content areas covered 2/3 of the included papers: DNR orders in the OR, overlapping surgery, donation of organs, broadcasting live surgery, video recordings in the OR, communication/teamwork, implementing new surgical technology, and denying blood to Jehovah’s Witness. Discussion/Conclusions This systematic review indicates that only a small fraction of scientific publications on the ethics of surgery focus on issues inside the operating room, accentuating the need for further research to close this gap. The ethical issues that repeatedly arose in the included papers included the meaning of patient autonomy inside the operating room, the consequences of technological advances in surgery, the balancing of legitimate interests, the dehumanising potential of the OR, and the strong notion of surgeon responsibility. (shrink)

An amendment to this paper has been published and can be accessed via the original article.

Clinical ethics committees have existed in Norway since 1996. By now all hospital trusts have one. An evaluation of these committees’ work was started in 2004. This paper presents results from an interview study of eight clinicians who evaluated six committees’ deliberations on 10 clinical cases. The study indicates that the clinicians found the clinical ethics consultations useful and worth while doing. However, a systematic approach to case consultations is vital. Procedures and mandate of the committees should be known to (...) clinicians in advance to ensure that they know what to expect. Equally important is bringing all relevant facts, medical as well as psychosocial, into the discussion. A written report from the deliberation is also important for the committees to be taken seriously by the clinicians. This study indicates that the clinicians want to be included in the deliberation, and not only in the preparation or follow-up. Obstacles for referring a case to the committee are the medical culture’s conflict aversion and its anxiety of being judged by outsiders. The committees were described as a court by some of the clinicians. This is a challenge for the committees in their attempt to balance support and critique in their consultation services. (shrink)

This article tries to present a broad view on the values and ethicalissues that are at stake in efforts to rationalize health policy on thebasis of economic evaluations (like cost-effectiveness analysis) andrandomly controlled clinical trials. Though such a rationalization isgenerally seen as an objective and `value free' process, moral valuesoften play a hidden role, not only in the production of `evidence', butalso in the way this evidence is used in policy making. For example, thedefinition of effectiveness of medical treatment or (...) health care serviceis heavily dependent on dominant individual or social views about thegoals of the particular treatment or service. There is also a concernthat a reliance on EBM in health policy will occur at the expense ofwidely shared social values like equity and solidarity. Moreover, thereis a concern that when economic considerations and rational proceduresbecome more influential, various `outside' groups third parties likeinsurance companies and policy makers will get a stronger influence onmedical practice which may lead to a change in the patient-providerrelationship. The authors conclude that social values and patientpreference should be explicitly addressed when health policy making isbased on economic and other scientific evidence. (shrink)

The ethical issues associated with germline gene modification and embryo research are some of the most contentious in current international science policy debates. In this paper, we argue that new genetic techniques, such as CRISPR, demonstrate that there is an urgent need for China to develop its own regulatory and ethical framework governing new developments in genetic and embryo research. While China has in place a regulatory framework, it needs to be strengthened to include better compliance oversight and explicit criteria (...) for how different types of research should be reviewed by regulatory authorities. We also document a variety of opinions about the new technologies among the public, scholars, and policy makers. China needs to develop its own regulations in coordination with other countries; but it is unlikely that an international consensus will be achieved in this area, given the existing differences in regulations between countries. We should aim at harmonization, not necessarily complete consensus, and the perspective from China is vital when international norms are developed and harmonized. Chinese policy makers and researchers need to be aware of the international discussions, at the same time as the international community is aware of, and accommodates, Chinese positions on important policy options. (shrink)

Democratic theorists are usually dismissive about the idea that citizens act “through” their representatives and often hold persons to exercise true political agency only at intervals in elections. Yet, if we want to understand representative government as a proper form of democracy and not just a periodical selection of elites, continuous popular agency must be a feature of representation. This article explores the Kantian attempt to justify that people can act “through” representatives. I call this the “exercise view” of representation (...) and defend its superiority to the “opportunity view,” which I attribute to Locke. It is superior because it has a robust conception of rationality and collective action, allowing us to understand how representation can mediate public reason. (shrink)

BackgroundEthically challenging critical events and decisions are common in nursing homes. This paper presents nursing home doctors’ descriptions of how they include the patient and next of kin in end-of-life decisions.MethodsWe performed ten focus groups with 30 nursing home doctors. Advance care planning; aspects of decisions on life-prolonging treatment, and conflict with next of kin were subject to in-depth analysis and condensation.ResultsThe doctors described large variations in attitudes and practices in all aspects of end-of-life decisions. In conflict situations, many doctors (...) were more concerned about the opinion of next of kin than ensuring the patient’s best interest.ConclusionsMany end-of-life decisions appear arbitrary or influenced by factors independent of the individual patient’s values and interests and are not based on systematic ethical reflections. To protect patient autonomy in nursing homes, stronger emphasis on legal and ethical knowledge among nursing home doctors is needed. (shrink)