| 51. |
- Munthe, Christian, 1962, et al.
(författare)
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The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening
- 2015
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Ingår i: Public Health Ethics. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 8:3, s. 270-283
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Tidskriftsartikel (refereegranskat)abstract
- The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.
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| 52. |
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| 53. |
- Munthe, Christian, 1962
(författare)
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Etiska aspekter på regenerativ medicin : Ethical aspects on regenerative medicine
- 2003
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Ingår i: SNIB-konferensen 2003, Chalmers tekniska högskola, Göteborg, 16-18 maj 2003.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Inom den regenerativa medicinen strävar man efter att ersätta skadat eller sjukligt biologiskt mänskligt material (celler, organ, kroppsdelar) med nya biologiska komponenter. Området aktualiserar en rad etiska frågeställningar vad gäller (1) produktionen av ersättningsmaterialet (t.ex. embryonala stamceller eller införskaffande av transplantationsvävnad från donatorer), (2) risker i samband med försök på människa (genmodifierat material, material från djur), samt (3) gränserna för hur långt man bör gå i denna slags försök att förlänga människans livsspann. Föredraget ger en kort översikt över dessa frågeställningar, ståndpunkter och argument i debatten kring dem.
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| 54. |
- Grünloh, Christiane, 1980-, et al.
(författare)
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"why do they need to check me?" patient participation through ehealth and the doctor-patient relationship : Qualitative study
- 2018
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Ingår i: Journal of Medical Internet Research. - : J M I R Publications, Inc.. - 1438-8871. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Roles in the doctor-patient relationship are changing and patient participation in health care is increasingly emphasized. Electronic health (eHealth) services such as patient accessible electronic health records (PAEHRs) have been implemented to support patient participation. Little is known about practical use of PAEHR and its effect on roles of doctors and patients. Objective: This qualitative study aimed to investigate how physicians view the idea of patient participation, in particular in relation to the PAEHR system. Hereby, the paper aims to contribute to a deeper understanding of physicians' constructions of PAEHR, roles in the doctor-patient relationship, and levels and limits of involvement. Methods: A total of 12 semistructured interviews were conducted with physicians in different fields. Interviews were transcribed, translated, and a theoretically informed thematic analysis was performed. Results: Two important aspects were identified that are related to the doctor-patient relationship: roles and involvement. The physicians viewed their role as being the ones to take on the responsibility, determining treatment options, and to be someone who should be trusted. In relation to the patient's role, lack of skills (technical or regarding medical jargon), motives to read, and patients' characteristics were aspects identified in the interviews. Patients were often referred to as static entities disregarding their potential to develop skills and knowledge over time. Involvement captures aspects that support or hinder patients to take an active role in their care. Conclusions: Literature of at least two decades suggests an overall agreement that the paternalistic approach in health care is inappropriate, and a collaborative process with patients should be adopted. Although the physicians in this study stated that they, in principle, were in favor of patient participation, the analysis found little support in their descriptions of their daily practice that participation is actualized. As seen from the results, paternalistic practices are still present, even if professionals might not be aware of this. This can create a conflict between patients who strive to become more informed and their questions being interpreted as signs of critique and mistrust toward the physician. We thus believe that the full potential of PAEHRs is not reached yet and argue that the concept of patient empowerment is problematic as it triggers an interpretation of "power" in health care as a zero-sum, which is not helpful for the maintenance of the relationship between the actors. Patient involvement is often discussed merely in relation to decision making; however, this study emphasizes the need to include also sensemaking and learning activities. This would provide an alternative understanding of patients asking questions, not in terms of "monitoring the doctor" but to make sense of the situation.
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| 55. |
- Munthe, Christian, 1962, et al.
(författare)
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Sustainability principle for the ethics of healthcare resource allocation
- 2021
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Ingår i: Journal of Medical Ethics. - : BMJ. - 0306-6800 .- 1473-4257. ; 47:2, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We demonstrate how this principle may take different forms, and show that a commitment to sustainability is supported by considerations internal to the ethical principles already guiding healthcare resource allocation. We also consider two objections. The first of these, we argue, is either based on implausible assumptions or begs the question, whereas the second can be adequately accommodated by the principle we propose.
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| 56. |
- Andersson, Anders-Petter, 1969-, et al.
(författare)
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Musical interaction for health improvement
- 2014
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Ingår i: Oxford handbook of interactive audio. - Oxford : Oxford University Press. - 9780199797226 ; , s. 247-262
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Bokkapitel (refereegranskat)abstract
- During the past decade, tangible sensor technologies have matured and become less expensive and easier to use, leading to an explosion of innovative musical designs within video games, smartphone applications, and interactive art installations. Interactive audio has become an important design quality in commercially successful games like Guitar Hero , and a range of mobile phone applications motivating people to interact, play, dance, and collaborate with music. Parallel to the game, phone, and art scenes, an area of music and health research has grown, showing the positive results of using music to promote health and wellbeing in everyday situations and for a broad range of people, from children and elderly to people with psychological and physiological disabilities. Both quantitative medical and ecological humanistic research show that interaction with music can improve health, through music’s ability to evoke feelings, motivate people to interact, master, and cope with difficult situations, create social relations and experience shared meaning. Only recently, however, the music and health field has started to take interest in interactive audio, based on computer-mediated technologies’ potential for health improvement. Here, we show the potential of using interactive audio in what we call interactive musicking in the computer-based interactive environment Wave. Interactive musicking is based on musicologist Christopher Small’s concept “musicking”, meaning any form of relation-building that occurs between people, and people and things, related to activities that include music. For instance, musicking includes dancing, listening, and playing with music (in professional contexts and in amateur, everyday contexts). We have adapted the concept of "musicking" on the design of computer-based musical devices. The context for this chapter is the research project RHYME. RHYME is a multidisciplinary collaboration between the Centre for Music and Health at the Norwegian Academy of Music, the Oslo School of Architecture and Design (AHO), and Informatics at the University of Oslo. Our target group is families with children with severe disabilities. Our goal is to improve health and wellbeing in the families through everyday musicking activities in interactive environments. Our research approach is to use knowledge from music and health research, musical composition and improvisation, musical action research, musicology, music sociology, and soundscape studies, when designing the tangible interactive environments. Our focus here is interaction design and composition strategies, following research-by-design methodology, creating interactive musicking environments. We describe the research and design of the interactive musicking environment Wave, based on video documentation, during a sequence of actions. Our findings suggest some interactive audio design strategies to improve health. We base the design strategies on musical actions performed while playing an instrument, such as impulsive or iterative hitting, or sustainable stroking of an instrument. Musical actions like these can also be used for musicking in everyday contexts, creating direct sound responses to evoke feelings that create expectations and confirm interactions. In opposition to a more control-oriented, instrument and interface perspective, we argue that musical variation and narrative models can be used to design interactive audio, where the audio is seen as an actor taking many different roles, as instrument, co-musician, toy, etc. In this way, the audio and the interactive musicking environments will change over time, answering with direct response, as well as nose-thumbing and changing response, motivating creation, play, and social interaction. Musical variation can also be used to design musical backgrounds and soundscapes that can be used for creating layers of ambience. These models create a safe environment and contribute to shared meaning.
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| 57. |
- Håman, Linn, 1982-, et al.
(författare)
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Orthorexia nervosa : An integrative literature review of a lifestyle syndrome
- 2015
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 10:1
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Forskningsöversikt (refereegranskat)abstract
- Bratman first proposed orthorexia nervosa in the late 1990s, defining it an obsession with eating healthy food to achieve, for instance, improved health. Today, in the Swedish media, excessive exercising plays a central role in relation to orthorexia. A few review articles on orthorexia have been conducted; however, these have not focused on aspects of food and eating, sport, exercise, or a societal perspective. The overall aim of this study was to provide an overview and synthesis of what philosophies of science approaches form the current academic framework of orthorexia. Key questions were: What aspects of food and eating are related to orthorexia? What role do exercise and sports play in relation to orthorexia? In what ways are orthorexia contextualized? Consequently, the concept of healthism was used to discuss and contextualize orthorexia. The method used was an integrative literature review; the material covered 19 empirical and theoretical articles published in peer-reviewed journals. This review demonstrates a multifaceted nature of orthorexia research; this field has been examined from four different philosophies of science approaches (i.e., empirical-atomistic, empirical-atomistic with elements of empirical-holistic, empirical-holistic, and rational-holistic) on individual, social, and societal levels. The majority of the articles followed an empirical-atomistic approach that focused on orthorexia as an individual issue, which was discussed using healthism. Our analysis indicates a need for (a) more empirical-holistic research that applies interpretive qualitative methods and uses a social perspective of health, e.g., healthism and (b) examining the role of sports and exercise in relation to orthorexia that takes the problematizing of "orthorexic behaviours" within the sports context into account.
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| 58. |
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| 59. |
- Lundh Hagelin, Carina, et al.
(författare)
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Factors influencing attitude toward care of dying patients in first-year nursing students.
- 2016
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Ingår i: International journal of palliative nursing. - : Mark Allen Group. - 1357-6321 .- 2052-286X. ; 22:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated.
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| 60. |
- Munthe, Christian, 1962
(författare)
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A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal
- 2015
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Ingår i: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 29:1, s. 36-45
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Tidskriftsartikel (refereegranskat)abstract
- A new landscape of prenatal testing (PNT) is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development supports a radical individualization of how PNT screening is organized. This reformation is, at the same time, difficult to reconcile with responsible spending of resources in a publicly funded healthcare context. Thus, while the ethical imperative of individualization holds and applies to PNT, the new landscape of PNT provides reasons to start rolling back the type of mass-screening programmes currently established in many countries. Instead, more limited offers are suggested, based on considerations of severity of conditions and optimized to simultaneously serve reproductive autonomy and public health within an acceptable frame of priorities. The new landscape of PNT furthermore underscores the ethical importance of supporting and including people with disabilities. For the very same reason, no ban on what may be analysed using PNT in the new landscape should be applied, although private offers must, of course, conform to strict requirements of respecting reproductive autonomy and what that means in terms of counselling.
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