A frequent justification in the literature for using stated preference methods (SP) is that they are the only methods that can capture the so-called total economic value (TEV) of environmental changes to society. Based on follow-up interviews with SP survey respondents, this paper addresses the implications of that argument by shedding light on the construction of TEV, through respondents’ perspective. It illuminates the deficiencies of willingness to pay (WTP) as a measure of value presented as three aggregated themes considering respondents’ (...) unintentionality, their retraction once they understood that their WTP could be decisive in cost-benefit analysis and the inherent incompleteness of WTP. We discuss why the TEV discourse persists, how it conceals rather than reveals broader notions of value and in what ways our results support the development of alternative approaches that truly endorse plurality in environmental valuation and decision-making. (shrink)

A frequent justification in the literature for using stated preference methods (SP) is that they are the only methods that can capture the so-called total economic value (TEV) of environmental changes to society. Based on follow-up interviews with SP survey respondents, this paper addresses the implications of that argument by shedding light on the construction of TEV, through respondents' perspective. It illuminates the deficiencies of willingness to pay (WTP) as a measure of value presented as three aggregated themes considering respondents' (...) unintentionality, their retraction once they understood that their WTP could be decisive in cost-benefit analysis and the inherent incompleteness of WTP. We discuss why the TEV discourse persists, how it conceals rather than reveals broader notions of value and in what ways our results support the development of alternative approaches that truly endorse plurality in environmental valuation and decision-making. (shrink)

Background:Providing oncological care to children is demanding and ethical issues concerning what is best for the child can contribute to moral distress.Objectives:To explore healthcare professionals’ experiences of situations that generate moral distress in Swedish paediatric oncology.Research design:In this national study, data collection was conducted using the Swedish Moral Distress Scale-Revised. The data analysis included descriptive statistics and non-parametric analysis of differences between groups.Participants and research context:Healthcare professionals at all paediatric oncology centres in Sweden were invited to participate. A total of (...) 278 healthcare professionals participated. The response rate was 89%.Ethical considerations:In its advisory statement, the Regional Ethical Review Board decided that the study was of such a nature that the legislation concerning ethical reviews was not applicable. All participants received written information about the aim of the study and confidentiality. Participants demonstrated their consent by returning the survey.Findings:The two situations with the highest moral distress scores concerned lack of competence and continuity of personnel. All professional groups reported high levels of disturbance. Nurses rated significantly higher frequencies and higher total Moral Distress Scale scores compared to medical doctors and nursing assistants.Discussion:Lack of competence and continuity, as the two most morally distressing situations, confirms the findings of studies from other countries, where inadequate staffing was reported as being among the top five morally distressing situations. The levels of total Moral Distress Scale scores were more similar to those reported in intensive care units than in other paediatric care settings.Conclusion:The two most morally distressing situations, lack of competence and continuity, are both organisational in nature. Thus, clinical ethics support services need to be combined with organisational improvements in order to reduce moral distress, thereby maintaining job satisfaction, preventing a high turnover of staff and ensuring the quality of care. (shrink)

Sustainability discourse offers a plethora of perspectives on the type of change needed to ensure a just development within planetary boundaries, and how that change could come about. Calls for radical transformations nonetheless underline the need to examine prevalent discursive structures in society, including challenging the 'ideology of growth', in order to formulate new and transformative policy approaches. Based on empirical insights as to how different actors - including grassroots, planners, officials and politicians - in Sweden perceive the transformations needed (...) to reach sustainability goals, this paper explores how narratives of change reproduce, make use of or show cracks in the eco-modern sustainability paradigm. (shrink)

Recently, there have been attempts at offering new justifications of the Rawlsian idea of public reason. Blain Neufeld has suggested that the ideal of political autonomy justifies public reason, while R.J. Leland and Han van Wietmarschen have sought to justify the idea by appealing to the value of political community. In this paper, I show that both proposals are vulnerable to a common problem. In realistic circumstances, they will often turn into reasons to oppose, rather than support, public reason. However, (...) this counterintuitive result can be avoided if we conceive of autonomy and community differently. (shrink)

Truth-telling in healthcare practice can be regarded as a universal communicative virtue; however, there are different views on what consequence it has for giving or diminishing hope. The aim of this article is to explore the relationship between the concepts of truth-telling and hope from a relational ethics approach in the context of healthcare practice. Healthcare staff protect themselves and others to preserve hope in the care of seriously sick patients and in end-of-life care. This is done by balancing truth-telling (...) guided by different conditions such as the cultural norms of patients, family and staff. Our main conclusion is that the balancing of truth-telling needs to be decided in a mutual understanding in the caring relationship, but hope must always be inspired. Instead of focusing on autonomy as the only guiding principle, we would like to propose that relational ethics can serve as a meaningful perspective in balancing truth-telling. (shrink)

The Hospital Ethical Climate Survey was developed in the USA and later shortened. HECS has previously been translated into Swedish and the aim of this study was to describe a process of translating and culturally adapting HECS-S and to develop a Swedish multi-professional version, relevant for paediatrics. Another aim was to describe decisions about retaining versus modifying the questionnaire in order to keep the Swedish version as close as possible to the original while achieving a good functional level and trustworthiness. (...) In HECS-S, the respondents are asked to indicate the veracity of statements. In HECS and HECS-S the labels of the scale range from ‘almost never true’ to ‘almost always true’; while the Swedish HECS labels range from ‘never’ to ‘always’. The procedure of translating and culturally adapting the Swedish version followed the scientific structure of guidelines. Three focus group interviews and three cognitive interviews were conducted with healthcare professionals. Furthermore, descriptive data were used from a previous study with healthcare professionals, employing a modified Swedish HECS. Decisions on retaining or modifying items were made in a review group. The Swedish HECS-S consists of 21 items including all 14 items from HECS-S and items added to develop a multi-professional version, relevant for paediatrics. The descriptive data showed that few respondents selected ‘never’ and ‘always’. To obtain a more even distribution of responses and keep Swedish HECS-S close to HECS-S, the original labels were retained. Linguistic adjustments were made to retain the intended meaning of the original items. The word ‘respect’ was used in HECS-S with two different meanings and was replaced in one of these because participants were concerned that respecting patients’ wishes implied always complying with them. The process of developing a Swedish HECS-S included decisions on whether to retain or modify. Only minor adjustments were needed to achieve a good functional level and trustworthiness although some items needed to be added. Adjustments made could be used to also improve the English HECS-S. The results shed further light on the need to continuously evaluate even validated instruments and adapt them before use. (shrink)

The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington’s disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely (...) connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation. (shrink)

If the condemnation and crucifixion of Christ is interpreted in the key of Lutheran divine omniscience and absence of alternative possibilities, an apparent contradiction regarding the moral responsibility and duties of the Israelite executioners of Christ would arise. This contradiction would be the following: How can we sustain the moral responsibility of the executioners if they did not have alternative possibilities and, according to Christ’s first Saying on the cross, they did not know what they were doing? How could it (...) be possible to attribute duties to the executioners if they were not able to fulfill them? These problems can be addressed from a semicompatibilistic perspective of moral responsibility. It could be argued that: 1) the absence of alternative possibilities does not exclude the fact that the executioners could be considered morally responsible for Christ’s crucifixion, and that 2) the impossibility of fulfilling certain duties does not imply that the executioners would not have had these duties and cannot be considered morally responsible for their breach. (shrink)

BackgroundIn paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation, aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.MethodsIn this study, the perceptions held by healthcare professionals regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in Sweden. Healthcare professionals (...) answered the Euro-MCD instrument with 26 potential MCD outcomes using a scale from Not important to Very important. Descriptive and comparative statistical analyses were carried out.ResultsAll outcomes were rated high, i.e., between 3.12 and 3.78. More open communication, developing skills to analyse ethically difficult situations, better mutual understanding, and deciding on concrete actions were rated as most important. Understanding of ethical theories and critical examination of policies were rated less important. Most often nursing assistants rated higher and physicians lower than the other professions did. Women and participants without previous experience of MCDs perceived outcomes as more important. There were differences between centres as one centre had significantly higher, and one centre had significantly lower ratings compared to the others.ConclusionIt is clear that healthcare professionals want MCDs to improve teamwork and skills in order to analyse and manage ethically difficult situations. When comparing to previous research about important MCD outcomes, there were similarities in what healthcare professionals consider to be important when handling moral challenges regardless of country and potential differences in healthcare settings and systems, such as paediatric vs. adult care. (shrink)

We consider the expressive power of second - order generalized quantifiers on finite structures, especially with respect to the types of the quantifiers. We show that on finite structures with at most binary relations, there are very powerful second - order generalized quantifiers, even of the simplest possible type. More precisely, if a logic is countable and satisfies some weak closure conditions, then there is a generalized second - order quantifier which is monadic, unary and simple, and a uniformly obtained (...) sublogic of which is equivalent to. We show some other results of the above kind, relating other classes of quantifiers to other classes of structures. For example, if the quantifiers are of the simplest non-monadic type, then the result extends to finite structures of any arity. We further show that there are second - order generalized quantifiers which do not increase expressive power of first- order logic but do increase the power significantly when added to stronger logics. (shrink)

BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...) the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.MethodsThis study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation.ResultsData was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows:Interprofessional well-being in team interactionson a team level;Professional comfort when dealing with moral challengeson a personal level; andImproved quality of care for the child and the familyon a care level.ConclusionsHealthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support. (shrink)

It seems odd that in such a densely theological text that Augustine would bring up something like the KK-thesis, which is so epistemological. Yet, as one progresses through the book it does begin to make sense. In this paper, I aim to try to come to some understanding of how and why Augustine uses something like the KK-thesis in Book 11 of The City of God. The paper will progress in the following way: First, I discuss Jaakko Hintikka's work on (...) the KK-thesis in order to have a clear idea of what the KK-thesis is, and some associated problems with it. Next, since Augustine most explicitly deals with the KK-thesis in De Trinitate, with the help of Gareth Matthews work, I discuss Augustine's use of the KK-thesis there. Finally, I return to The City of God, in order come to an understanding of Augustine's use of the KK-thesis there. (shrink)

The procedures for structuring clinical ethics case reflections in a childhood cancer care setting are presented, including an eight-step model. Four notable characteristics of the procedures are: members of the inter-professional health care team, not external experts, taking a leading role in the reflections; patients or relatives not being directly involved; the model explicitly addressing values and moral principles instead of focussing exclusively on the interests of involved parties; using a case-based rather than principle-based method. By discusing the advantages and (...) disadvantages of the proposed procedures, our paper aims to contribute to the literature on models and procedures for ethical analysis that can be used in clinical settings. It is suggested that our proposed procedures have some advantageous features when it comes to promoting health care staff’s learning to structure their thinking about ethical issues. (shrink)

Evolutionary Transitions in Individuality have been responsible for the major transitions in levels of selection and individuality in natural history, such as the origins of prokaryotic and eukaryotic cells, multicellular organisms, and eusocial insects. The integrated hierarchical organization of life thereby emerged as groups of individuals repeatedly evolved into new and more complex kinds of individuals. The Social Protocell Hypothesis proposes that the integrated hierarchical organization of human culture can also be understood as the outcome of an ETI—one that produced (...) a “cultural organism” from a substrate of socially learned traditions that were contained in growing and dividing social communities. The SPH predicts that a threshold degree of evolutionary individuality would have been achieved by 2.0–2.5 Mya, followed by an increasing degree of evolutionary individuality as the ETI unfolded. We here assess the SPH by applying a battery of criteria—developed to assess evolutionary individuality in biological units—to cultural units across the evolutionary history of Homo. We find an increasing agreement with these criteria, which buttresses the claim that an ETI occurred in the cultural realm. (shrink)

BackgroundOrganizations worldwide increasingly adopt inclusive talent management, and this approach appears to rhyme particularly well with the Nordic welfare model. Questions about its value remain understudied, however. The inclusive approach is rooted in positive psychology and focuses on recognizing each employee's individual talents and assessing whether they fit the long-term needs of the organization, since a fit is assumed to be associated with employees' wellbeing. In the present study, we test this assumption focusing specifically on a key talent management practice, (...) talent identification, and the social dimension of employee wellbeing.MethodData were collected through an employee survey conducted within the Finnish units of four international manufacturing organizations and analyzed using logistic regression.ResultsWe found that the recognition of individual talents for long-term deployment by the organization is positively associated with social wellbeing in terms of supervisor support and social climate in the work unit, as perceived by the employees.ConclusionOur results tentatively suggest that inclusive talent management creates value through the identification of employees' individual talents as this practice can be associated with their enhanced wellbeing. (shrink)

Synthetic genomics is a new field of research in which small DNA pieces are assembled in a series of steps into whole genomes. The highly reduced genomes of host‐associated bacteria are now being used as models for de novo synthesis of small genomes in the laboratory. Bacteria with the smallest genomes identified in nature provide nutrients to their hosts, such as amino acids, co‐factors and vitamins. Comparative genomics of these bacteria enables predictions to be made about the gene sets required (...) for core cellular functions and the associated metabolic network for the biosynthesis of host‐selected compounds. Synthetic biology may ultimately enable researchers to make customized cell‐specific organelles for the production and delivery of drugs to humans and domestic animals. Synthetic genomics may also become the method of choice for functional analyses of genes and genomes from bacteria that cannot be cultivated in the laboratory. (shrink)

Human perception is often believed to function holistically, especially in the tradition of Gestalt psychology, involving a focused item and its surrounding. This holistic approach can allow us to explain something that is not directly experienced in our perception, meaning that the absence as well as the presence of something can have a significant impact on how we perceive the world. The way we perceive the presence is more or less the same cross-culturally, but the prominence of the absence, or (...) what is termed emptiness in this volume, varies considerably from one culture to another. The aim of this volume is to identify what emptiness is like and how different cultures incorporate this concept from various perspectives. It turns out that emptiness plays a key role in identifying socio-cultural diversity in a broader sense, including arts and languages. This volume consists of contributions from different fields covering a wide range of topics such as history, literary studies, mythology, film studies, architecture, linguistics, social-anthropology, ethnology and cognitive science. Due to the range covered in this volume, studies presented here are highly interdisciplinary, but all chapters deal with the sense of emptiness, which suggest that the underlying idea of the significance of emptiness is pervasive. Yet, this topic has not previously been systematically compared across different disciplines. It is hoped that this volume will offer a first overview of the pervasiveness and integration of disciplines concerning the sense of emptiness. (shrink)

How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion we (...) suggest a new classification of comparability problems that focuses on the problems they cause for practical reasoning. (shrink)

Childhood cancers are life-threatening diseases that affect not only the child but the whole family. Although rates of survival are high with modern therapy, childhood cancers are still serious and...

When should nudging be deemed as permissible and when should it be deemed as intrusive to individuals’ freedom of choice? Should all types of nudges be judged the same? To date the debate concerning these issues has largely proceeded without much input from the general public. The main objective of this study is to elicit public views on the use of nudges in policy. In particular we investigate attitudes toward two broad categories of nudges that we label pro-self and pro-social (...) nudges. In addition we explore how individual differences in thinking and feeling influence attitudes toward nudges. General population samples in Sweden and the United States were presented with vignettes describing nudge-policies and rated acceptability and intrusiveness on freedom of choice. To test for individual differences, measures on cultural cognition and analytical thinking were included. Results show that the level of acceptance toward nudge-policies was generally high in both countries, but were slightly higher among Swedes than Americans. Somewhat paradoxically a majority of the respondents also perceived the presented nudge-policies as intrusive to freedom of choice. Nudge-polices classified as pro-social had a significantly lower acceptance rate compared to pro-self nudges. Individuals with a more individualistic worldview were less likely to perceive nudges as acceptable, while individuals more prone to analytical thinking were less likely to perceive nudges as intrusive to freedom of choice. To conclude, our findings suggest that the notion of “one-nudge- fits-all” is not tenable. Recognizing this is an important aspect both for successfully implementing nudges as well as nuancing nudge theory. (shrink)

This paper examines a struggle over the future use of Nordic forests, which took place from 2009 to 2012 within a major research program, Future Forests—Sustainable Strategies under Uncertainty and Risk, organized and funded by Mistra, The Swedish Foundation for Strategic Environmental Research. We explore the role of strategic environmental research in societal constructions of long-term challenges and future risks. Specifically, we draw attention to the role played by environmental research in the creation of future images that become dominant for (...) how societies structure action for the long term. We also show that this process is on several accounts problematic. Research labeled “strategic” or “relevant” is intended to manage long-term risks and challenges in a sustainable way, by taking into account the “open” and “plural” nature of the future. The case of Future Forests suggests, rather, that by contributing to the emergence of dominant future images, environmental research is entangled with a process of gradual consensus creation around what may be highly selective or biased narratives of the long term, which may conceal or postpone key forms of future conflict. (shrink)

Six case studies on nursing home staff attitudes to patient autonomy have been analysed. The case studies are based on six polarities within autonomy, as developed by Collopy. In total, 189 professional caregivers, comprising the staff of 13 nursing homes in the county of Stockholm, Sweden, responded to questions based on the case studies. Results show that the attitudes within each professional category had a high level of internal correspondence. Nurses consistently supported patient preferences to the highest degree, followed by (...) assistant nurses and auxiliary staff. Nurses' aides ranked lowest in supporting patient preferences. In only one of the cases were background variables of significance. (shrink)

Chief executive officers (CEOs) are typically paid great amounts of money in wages and bonuses by commercial companies. This is sometimes defended with an argument from peer comparison; roughly that “our” CEO has to be paid in accordance with what other CEOs at comparable companies get. At first glance this seems like a poor excuse for morally outrageous pay schemes and, consequently, the argument has been ignored in the previous philosophical literature. In contrast, however, this article provides a partial defence (...) of the argument from peer comparison. Moreover, it is demonstrated how a serious consideration of this argument sheds further light on both incentive- and desert-based theories of just pay. (shrink)

The main assumptions on which the tidal wave hypothesis rests will be questioned. First, since focal synchronous mossy fibre input is sufficient to ensure spread of activity along the parallel fibres, the tidal wave is redundant. Second, spatial and temporal characteristics of mossy fibre input make spatio-temporal sequences appropriate for setting up a tidal wave unlikely in the behaving animal.

This book reflects the growing influence of corpus linguistics in a variety of areas such as lexicography, translation studies, genre analysis, and language ...