| 1. |
- Juth, Niklas, 1973, et al.
(author)
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The Ethics of Screening in Health Care and Medicine: Serving Society or Serving the Patient?
- 2012
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Book (other academic/artistic)abstract
- Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs. This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs. It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise – both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole? These questions are addressed by applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to a large number of ongoing and proposed screening programs which makes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
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| 6. |
- Munthe, Christian, 1962, et al.
(author)
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Person centred care and shared decision making: Implications for ethics, public health and research
- 2012
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In: Health Care Analysis. - : Springer Science and Business Media LLC. - 1065-3058 .- 1573-3394. ; 20:3, s. 231-249
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Journal article (peer-reviewed)abstract
- This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.
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| 7. |
- Girma Kebede, Betlehem, et al.
(author)
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Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia
- 2020
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:3
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Journal article (peer-reviewed)abstract
- Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
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| 8. |
- Munthe, Christian, 1962, et al.
(author)
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Sustainability principle for the ethics of healthcare resource allocation
- 2021
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In: Journal of Medical Ethics. - : BMJ. - 0306-6800 .- 1473-4257. ; 47:2, s. 90-97
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Journal article (peer-reviewed)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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| 9. |
- Nijsingh, Niels, 1977, et al.
(author)
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Ethics of Screening
- 2017
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In: International Encyclopedia of Public Health, 2nd Edition, Volume 3. Stella R.Quah (ed.). - Oxford, U.K. : Academic Press (Elsevier). - 9780128037089 ; , s. 28-35
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Book chapter (peer-reviewed)
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| 10. |
- Munthe, Christian, 1962
(author)
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Pragmatic Challenges in Practical Ethics
- 2023
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In: In: Garcia, A., Gunnemyr, M. & Werkmäster, J. Value, Morality & Social Reality: Essays dedicated to Dan Egonsson, Björn Petersson & Toni Rønnow-Rasmussen.. - Lund : Department of Philosophy, Lund University. - 9789189415669 ; , s. 275-285
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Book chapter (peer-reviewed)abstract
- This brief essay traces a development of orthodox applied ethics into a present-day variant of practical ethics, where pragmatic reasons may upset ideal theoretically and empirically informed epistemically supported ethical prescriptions when these are to be implemented in a real context. This shift comes with a development where the applied ethicists of older days are nowadays aiming for much more specific and practically useful action-guidance, and for activist involvement to support feasible implementation of ethical prescriptions. This results in a strongly and moderately activist variant of practical ethics, both of which face specific challenges due to the necessity of considering pragmatic reasons. I argue that the radical variant has trouble managing these challenges. The moderate variant may manage them, but this may require substantial methodological development.
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| 11. |
- Cutas, Daniela, 1978, et al.
(author)
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Legal imperialism in the regulation of stem cell research and therapy: the problem of extraterritorial jurisdiction
- 2010
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In: Capps BJ & Campbell AV (eds.). CONTESTED CELLS: Global Perspectives on the Stem Cell Debate. - London : Imperial College Press. - 9781848164376 ; , s. 95-119
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Book chapter (other academic/artistic)abstract
- Countries worldwide have very different national regulations on human embryonic stem (ES) cell research, informed by a range of ethical values. Some countries find reason to extend the applicability of their regulations on such research to its citizens when they visit other countries. Extraterritorial jurisdiction has recently been identified as a potential challenge towards global regulation of ES cell research. This chapter explores the implications and impact of extraterritorial jurisdiction and global regulation of ES cell research on researchers, clinicians and national health systems, and how this may affect patients. The authors argue that it would make ethical sense for ES cell restrictive countries to extend its regulations on ES cell research beyond its borders, because, if these countries really consider embryo destruction to be objectionable on the basis on the status of the embryo, then they ought to count it morally on par with murder (and thus have a moral imperative to protect embryos from the actions of its own citizens). However, doing so could lead to a legal situation that would result in substantial harm to central values in areas besides research, such as health care, the job market, basic freedom of movement, and strategic international finance and politics. Thus, it seems that restrictive extraterritorial jurisdiction in respect to ES cell research would be deeply problematic, given that the ethical permissibility of ES cell research is characterised by deep and wide disagreement.
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| 12. |
- Munthe, Christian, 1962
(author)
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The Price of Precaution and the Ethics of Risk
- 2011
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Book (other academic/artistic)abstract
- Since a couple of decades, the notion of a precautionary principle plays a central and increasingly influential role in international as well as national policy and regulation regarding the environment and the use of technology. Urging society to take action in the face of potential risks of human activities in these areas, the recent focus on climate change has further sharpened the importance of this idea. However, the idea of a precautionary principle has also been problematised and criticised by scientists, scholars and policy activists, and been accused of almost every intellectual sin imaginable: unclarity, impracticality, arbitrariness and moral as well as political unsoundness. In that light, the very idea of precaution as an ideal for policy making rather comes out as a dead end. On the basis of these contrasting starting points, Christian Munthe undertakes an innovative, in-depth philosophical analysis of what the idea of a precautionary principle is and should be about. A novel theory of the ethics of imposing risks is developed and used as a foundation for defending the idea of precaution in environmental and technological policy making against its critics, while at the same time avoiding a number of identified flaws. The theory is shown to have far-reaching consequences for areas such as bio-, information- and nuclear technology, and global environmental policy in areas such as climate change. The author argues that, while the price we pay for precaution must not be too high, we have to be prepared to pay it in order to act ethically defensible. A number of practical suggestions for precautionary regulation and policy making are made on the basis of this, and some challenges to basic ethical theory as well as consumerist societies, the global political order and liberal democracy are identified
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| 13. |
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| 14. |
- Berbyuk Lindström, Nataliya, 1978, et al.
(author)
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Person- and Family-Centeredness in Ethiopian Cancer Care: Improving Communication, Ethics, Decision Making and Health
- 2020
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In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:5
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Journal article (peer-reviewed)abstract
- BACKGROUND: Cancer is a major burden in Ethiopia. The Oncology Department of Tikur Anbessa (Black Lion) Specialized Hospital (TASH) in Addis Ababa is the country's sole specialist unit for cancer care. With only a handful of oncologists, a lack of resources, and a huge patient load, the work is challenging, especially in terms of achieving effective and ethical patient consultations. Patients, usually accompanied by family members, often wait for a long time to receive medical attention and frequently depart without treatment. Handling consultations effectively is essential in order to help patients as much as possible within such limitations. OBJECTIVE: The project addresses three main aims: (1) to enhance and expand the understanding of communicative and associated ethical challenges in Ethiopian cancer care; (2) to enhance and expand the understanding of the implications and use of person- and family-centered solutions to address such communicative challenges in practice, and (3) to plan and evaluate interventions in this area. METHODS: This project develops and consolidates a research collaboration to better understand and mitigate the communicative challenges in Ethiopian cancer care, with a focus on the handling and sharing of decision making, and ethical tensions between patients, staff, and family. Using theoretical models from linguistics, health communication, and health care ethics, multiple sources of data will be analyzed. Data sources currently include semi-structured interviews with the Ethiopian staff, patients, and family caregivers (91), survey data on cancer awareness (150) and attitudes to breaking bad news (450), and video-recordings of medical consultations (45). In addition, we will also develop clinical and methodological solutions to formulate educational interventions. RESULTS: The project was awarded funding by the Swedish Research Council in December 2017 for the period 2018-2021. The research ethics board in Sweden and in Ethiopia approved the conduct of the project in May 2018. The results from the studies will be published in 2020 and 2021. CONCLUSIONS: The project is a first step towards producing unique and seminal knowledge for the specific context of Ethiopia in the area of physician-patient communication research and ethics. It contributes to an understanding of the complexity around the role of family and ethical challenges in relation to patient involvement and decision making in Ethiopia. Improved knowledge in this area can provide a fundamental model for ways to improve cancer care in many other low resource settings in Africa and the Middle East, which share central cultural prerequisites (such as a strong patriarchal family structure, combined with strong and devout religiosity). The project will also serve to develop greater understanding about current challenges in Western health systems associated with greater family and patient participation in decision making. In addition, the project will also contribute to improving the education of Ethiopian health professionals working in cancer care by developing a training program to help them better understand and respond to identified challenges associated with communication.
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Amundin, Mats, et al.
(author)
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A proposal to use distributional models to analyse dolphin vocalisation
- 2017
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In: Proceedings of the 1st International Workshop on Vocal Interactivity in-and-between Humans, Animals and Robots, VIHAR 2017. - 9782956202905 ; , s. 31-32
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Conference paper (peer-reviewed)abstract
- This paper gives a brief introduction to the starting points of an experimental project to study dolphin communicative behaviour using distributional semantics, with methods implemented for the large scale study of human language.
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| 19. |
- Petersson, Jesper, 1974
(author)
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Medicine At A Distance In Sweden: Spatiotemporal Matters In Accomplishing Working Telemedicine
- 2011
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In: Science Studies. - 0786-3012. ; 24:2, s. 43-62
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Journal article (peer-reviewed)abstract
- This paper examines the accomplishment of making technology work, using the discourse around telemedicine in Swedish healthcare during 1994-2003. The paper will compare four projects launched in the mid-1990s and policymakers’ visions of healthcare through telemedicine. I will employ a sociotechnical approach developed within Actor-Network Theory that understands functioning technology not as something intrinsic but as an outcome of an ongoing process of negotiations. In the paper, I will extend the sociotechnical approach of what constitutes working technology to include spatiotemporal matters. I will also approach the closely related issue of space that has become a concern of Actor-Network Theory scholars interested in the accomplishment and continued workings of technology as it travels. In this discussion, an emphasis on fixed relations (network space) has been challenged by investigations into changing relations (fluid space). This paper suggests that in order to travel well, technology must be both fixed and fluid.⁰
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| 20. |
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| 21. |
- Nijsingh, Niels, 1977, et al.
(author)
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Managing pollution from antibiotics manufacturing: charting actors, incentives and disincentives
- 2019
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In: Environmental health. - : Springer Science and Business Media LLC. - 1476-069X. ; 18
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Journal article (peer-reviewed)abstract
- Background Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An attempt to assess and reduce such discharges, however, quickly meets with complex realities that need to be understood to identify effective ways to move forward. This paper charts relevant key actor-types, their main stakes and interests, incentives that can motivate them to act to improve the situation, as well as disincentives that may undermine such motivation. Methods The actor types and their respective interests have been identified using research literature, publicly available documents, websites, and the knowledge of the authors. Results Thirty-three different actor-types were identified, representing e.g. commercial actors, public agencies, states and international institutions. These are in complex ways connected by interests that sometimes may conflict and sometimes pull in the same direction. Some actor types can act to create incentives and disincentives for others in this area. Conclusions The analysis demonstrates and clarifies the challenges in addressing industrial emissions of antibiotics, notably the complexity of the relations between different types of actors, their international dependency and the need for transparency. The analysis however also suggests possible ways of initiating incentive-chains to eventually improve the prospects of motivating industry to reduce emissions. High-resource consumer states, especially in multinational cooperation, hold a key position to initiate such chains.
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| 22. |
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| 23. |
- Munthe, Christian, 1962, et al.
(author)
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Questioning the patient in person centred care: ethical aspects: children, forensic psychiatry, and public health
- 2017
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In: Medical Argumentation and Patient Centred Care, University of Amsterdam, October 26-27, 2017..
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Conference paper (other academic/artistic)abstract
- The paper explores the room, both conceptually and ethically, for questioning, contradicting and adapting positions to patients in three specific areas: care of patients with vulnerable cpapcities for taking responsibility (adolescents and psychiatry), contexts of constrained autonomy (forensic care), and public health (antobiotic resistance stewardship and vaccination). These areas in various ethically relevant ways exhibit non-standard settings, compared to usual assumptions about the nature of patients and institutional contexts made when person centredness and shared decision-making are held out as primarily emancipating concepts. The paper probes to what extent that ethical idea may be maintained also in such non-standard settings.
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| 24. |
- Nijsingh, Niels, 1977, et al.
(author)
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Justifying Antibiotic Resistance Interventions: Uncertainty, Precaution and Ethics
- 2020
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In: Jamrozik E., Selgelid M.J. (eds) Ethics and Drug-Resistance: Collective Responsibility for Global Public Health. - Cham, Switzerland : Springer. - 2211-6680. - 9783030278731
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Book chapter (peer-reviewed)abstract
- This chapter charts and critically analyses the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response antibiotic resistance (ABR), as well as other major public health threats. Our ambition here is to identify and briefly discuss main issues, and point to ways in which these need to be further advanced in future research. This will result in a tentative map of complications, underlying problems and possible challenges. This map illustrates that the ethical challenges in this area are much more complex and profound than is usually acknowledged, leaving no tentatively plausible intervention package free of downsides. This creates potentially overwhelming theoretical conundrums when trying to justify what to do. We therefore end by pointing out two general features of the complexity we find to be of particular importance, and a tentative suggestion for how to create a theoretical basis for further analysis.
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| 25. |
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| 26. |
- Petersson, Jesper, 1974
(author)
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Technospatialities and telehealthcare: Unfolding new spaces of visibility
- 2016
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In: Information, Communication & Society. - 1369-118X .- 1468-4462. ; 19:6, s. 824-842
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Journal article (peer-reviewed)abstract
- The umbrella term ‘telehealthcare’ denotes an array of information and communication technology-based solutions for digitally connecting citizens with healthcare services. Guided by the conviction that bodies can be translated into digital data which may serve as the basis for clinical decisions made elsewhere, these designs are widely assumed to enable a mode of healthcare delivery which is independent of space and time. Addressing the increasing use of telehealthcare for personalized health monitoring targeting the growing populations of elderly and chronic-care patients, this paper suggests that such designs invariably unfold new spaces of visibility. Based on an analysis of articles published in a leading telehealthcare journal, I argue that these new visibilities do not provide a window onto something that is already there. Instead, such visibilities are shaped by the way techno-medical practices and knowledge production processes are intertwined with a specific politico-economic agenda. The paper explores differences with respect to the positioning of older people and chronic-care patients in relation to two versions of health monitoring. While each version represents an attempt to promote individual freedom, improve health outcomes and ensure a functioning healthcare system, contrasting rationales are involved and different types of spaces are being unfolded.
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| 27. |
- Munthe, Christian, 1962
(author)
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How drug resistance challenges medical ethics
- 2018
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In: Ethikforum "public health ethics”, Ludwig-Maximilians Universität, München, Germany, February 6, 2018.
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Conference paper (other academic/artistic)
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| 28. |
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| 29. |
- Herlitz, Anders, 1981, et al.
(author)
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‘Green’ bioethics widens the scope of eligible values and overrides patient demand: comment on Parker
- 2023
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In: Journal of Medical Ethics. - : BMJ. - 0306-6800 .- 1473-4257. ; 49:2, s. 100-101
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Journal article (other academic/artistic)abstract
- It is welcome to have concrete attempts to analyse the implications of environmental sustainability in clinical ethics. We discuss two interrelated weaknesses of Parker's article. These relate to the need in "green" bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways of framing central decision problems.
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| 30. |
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| 31. |
- Schötz, Susanne, et al.
(author)
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Phonetic Characteristics of Domestic Cat Vocalisations
- 2017
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In: Proceedings of the 1st International Workshop on Vocal Interactivity in-and-between Humans, Animals and Robots, VIHAR 2017. - 9782956202905 ; , s. 5-6
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Conference paper (peer-reviewed)abstract
- The cat (Felis catus, Linneaus 1758) has lived around or with humans for at least 10,000 years, and is now one of the most popular pets of the world with more than 600 millionindividuals. Domestic cats have developed a more extensive, variable and complex vocal repertoire than most other members of the Carnivora, which may be explained by their social organisation, their nocturnal activity and the long period of association between mother and young. Still, we know surprisingly little about the phonetic characteristics of these sounds, and about the interaction between cats and humans.Members of the research project Melody in human–cat communication (Meowsic) investigate the prosodic characteristics of cat vocalisations as well as the communication between human and cat. The first step includes a categorisation of cat vocalisations. In the next step it will be investigated how humans perceive the vocal signals of domestic cats. This paper presents an outline of the project which has only recently started.
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| 32. |
-
Coloniality and Decolonisation in the Nordic region
- 2023
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Editorial collection (other academic/artistic)abstract
- This book advances critical discussions about what coloniality, decoloniality and decolonization mean and imply in the Nordic region. It brings together analysis of complex realities from the perspectives of the Nordic peoples, a region that are often overlooked in current research, and explores the processes of decolonization that are taking place in this region. The book offers a variety of perspectives that engage with issues such as Islamic feminism and the progressive left; racialization and agency among Muslim youths; indigenizing distance language education for Sami; extractivism and resistance among the Sami; the Nordic international development endeavour through education; Swedish TV-reporting on Venezuela; creolizing subjectivities across Roma and non-Roma worlds and hierarchies; and the whitewashing and sanitization of decoloniality in the Nordic region. As such, this book extends much of the productive dialogue that has recently occurred internationally in decolonial thinking but also in the areas of critical race theory, whiteness studies, and postcolonial studies to concrete and critical problems in the Nordic region. This should make the book of considerable interest to scholars of history of ideas, anthropology, sociology, cultural studies, postcolonial studies, international development studies, legal sociology and (intercultural) philosophy with an interest in coloniality and decolonial social change.
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| 33. |
- Munthe, Christian, 1962
(author)
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Reproductive liberty through a public health ethics lens: from individual rights to the public good of procreating populations
- 2016
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In: 13th World Congress of Bioethics, Edinburgh, June 14-17, 2016.
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Conference paper (other academic/artistic)abstract
- Reproductive bioethics has almost entirely proceeded within an individualist paradigm, where rights of parties are set against each other or societal interests. This paper takes some steps to analyse what happens if the ethical analysis of reproductive medicine and policy is instead approached based on public health ethical assumptions. That is, the general issues are about how society should organise itself with regard to the procreation of its population, and particular issues regarding, e.g., abortion, ART, contraception, pregnancy care, prenatal testing, etc. are analysed from that standpoint. Albeit there has been some public health ethical attention to sexual health issues, this way of approaching reproductive ethics has been ignored almost entirely, with a handful of exceptions the last few years taking account of, e.g., public expenditure on ART and environmental concerns linked to population policy. This presentation aims to sketch a preliminary theoretical framework for a general theory of reproductive public health ethics, within which such and further attempts may be placed and critically analysed, and to compare it to the traditional formats of reproductive bioethics. A general theory of reproductive public health ethics will view reproductition as a social rather than biological process, taking place at a collective level, and its values will hence be public goods and aggregates, while notions of individual rights will not be primary. This view also means that there is no basic relevant distinction to be made between procreating a population through migration and through biological reproduction.
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| 34. |
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| 35. |
-
Posthumanistiska nyckelstexter
- 2012. - 1
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Editorial collection (peer-reviewed)abstract
- Den här boken introducerar några viktiga författare på samtidsaktuella teoriområden. Donna Haraway, Karen Barad, Rosi Braidotti, Michel Callon, Gilles Deleuze, Félix Guattari, Michel Serres och Annemarie Mol presenteras i boken, som också innehåller översatta texter av dessa namn. Boken ger en bakgrund till och en överblick över ett område i intensiv teoriutveckling. Här presenteras den så kallade materiella, posthumana eller ontologiska vändningen. Här kartläggs grunderna för olika posthumanistiska förhållningssätt till de både mänskliga och icke-mänskliga (djur, miljö, teknik) krafterna i vår värld så som de begreppsliggjorts inom filosofi, feministisk teori, kulturstudier och samhällsvetenskapliga studier av naturvetenskap, medicin och teknik. Genom lästips och en omfattande litteraturlista öppnar boken för fortsatta studier och vidare diskussioner. Avslutningsvis finns också en omfattande ordlista med viktiga nyckelbegrepp som i sig ger en introduktion till ett heterogent forskningsfält. Boken riktar sig till studenter, doktorander och andra nyfikna forskare inom olika tvärvetenskapliga eller disciplinära former av humaniora och samhällsvetenskap.POSTHUMANISTISKA NYCKELTEXTER ger i de inledande kapitlen en överblick och en introduktion till posthumanistiska studier och till materiell-semiotik. Här behandlas tankeströmningar som rör det humanas natur, humanismens etik och humanvetenskapernas framtid. Boken ger en introduktion till det som inom genusvetenskap och tekniksociologi kommit att kallas den ontologiska vändningen mot de materiaaliteter och världsliga relationer som både gör och förgör oss. Här kartläggs grunderna för posthumanistiska förhållningssätt till de både mänskliga och icke-mänskliga (djur, miljö, teknik) dimensionerna av vår värld så som de begreppsliggjorts inom filosofi, feministisk teori, kulturstudier och sociala studier av vetenskap och teknik. POSTHUMANISTISKA NYCKELTEXTER erbjuder introduktioner till viktiga författare och översättningar av nyckeltexter skrivna av Donna Haraway, Karen Barad, Rosi Braidotti, Michel Callon, Gilles Deleuze med Felix Guattari, Michel Serres och Annemarie Mol. Boken innehåller även en omfattande ordlista med viktiga nyckelbegrepp som i sig ger en introduktion till ett mångfaldigt forskningsfält.
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| 36. |
- Munthe, Christian, 1962
(author)
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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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In: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 29:1, s. 36-45
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Journal article (peer-reviewed)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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| 37. |
- Munthe, Christian, 1962, et al.
(author)
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The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening
- 2015
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In: Public Health Ethics. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 8:3, s. 270-283
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Journal article (peer-reviewed)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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| 38. |
- Malmqvist, Erik, et al.
(author)
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Pharmaceutical Pollution from Human use and the Polluter Pays Principle
- 2023
-
In: Public Health Ethics. - 1754-9973 .- 1754-9981. ; 16:2, s. 152-164
-
Journal article (peer-reviewed)abstract
- Human consumption of pharmaceuticals often leads to environmental release of residues via urine and faeces, creating environmental and public health risks. Policy responses must consider the normative question how responsibilities for managing such risks, and costs and burdens associated with that management, should be distributed between actors. Recently, the Polluter Pays Principle (PPP) has been advanced as rationale for such distribution. While recognizing some advantages of PPP, we highlight important ethical and practical limitations with applying it in this context: PPP gives ambiguous and arbitrary guidance due to difficulties in identifying the salient polluter. Moreover, when PPP does identify responsible actors, these may be unable to avoid or mitigate their contribution to the pollution, only able to avoid/mitigate it at excessive cost to themselves or others, or excusably ignorant of contributing. These limitations motivate a hybrid framework where PPP, which emphasizes holding those causing large-scale problems accountable, is balanced by the Ability to Pay Principle (APP), which emphasizes efficiently managing such problems. In this framework, improving wastewater treatment and distributing associated financial costs across water consumers or taxpayers stand out as promising responses to pharmaceutical pollution from human use. However, sound policy depends on empirical considerations requiring further study.
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| 39. |
- Ranisch, Robert, et al.
(author)
-
Ethics of digital contact tracing apps for the Covid-19 pandemic response
- 2020
-
Reports (other academic/artistic)abstract
- There is a growing interest in contact tracing apps (CT apps) for pandemic man- agement. These apps raise significant moral concerns. It is therefore crucial to consider ethical requirements before and while implementing such apps. Public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely under- mine public trust, and as such, risk impeding general effectiveness. In response to these demands, to meet ethical requirements and find a basis for justified trust, this background introduces an ethical framework for a responsible design and implementation of CT apps. However, even prudently chosen measures of digital contact tracing carry moral costs, which makes it necessary address different trade-offs. This background paper aims to inform developers, researchers and decision-makers be- fore and throughout the process of implementing contact tracing apps.
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| 40. |
- Munthe, Christian, 1962
(author)
-
Pure Selection. The Ethics of Preimplantation Genetic Diagnosis and Choosing Children without Abortion
- 1999
-
Book (other academic/artistic)abstract
- Preimplantation ge¬netic diagnosis (PGD) is taken to mark the starting-point of a new phase in human reproduction, where the possibility of choosing children on genetic grounds without having to resort to ethi¬cally controversial procedures (such as abortion) will grad¬ually increase. Ethical and political issues actu¬alised by this develop¬ment are addressed. The discussion touches upon issues regarding the moral status of em¬bryos and gametes, the moral import of respecting individual auton¬omy and its implications for the requirement of informed consent in health-care, the connec¬tion between sickness, dis¬ability and the value of life, the moral status of possible future people, and the connection between choosing children and eugenic policies of the past. Practical policy issues are adressed on the basis of this, as well as an empirical case-study of the intro¬duction of PGD in Sweden. The book ends up in a set of recommendations regarding the management of re¬search on, introduction and routine use of procedures for pure se¬lection, both within health care and from the point of view of society as a whole. It is argued that research on such procedures should be allowed and supported by society. However, tight restrictions regarding the clinical introduction of new procedures in this area is highly desirable. A rough model for implementing such re¬strictions is also pre¬sented. It is further asserted that, although reasons of economy and safety should limit the access to pure se¬lection, society should not apply any explicit restrictions based on ideasregarding how different traits affect a person’s quality of life. It is stressed that, in order to to avoid a re¬sur¬rection of eugenic policies of the past, the development in this field un¬der¬lines the need for continued and strengthen public support to the sick, dis¬abled and mentally retarded.
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| 41. |
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| 42. |
- Ahlgren, Jennie, et al.
(author)
-
Ethical considerations in relation to personalised nutrition : An overview of Work Package 5, with respect to ethics
- 2015
-
Reports (other academic/artistic)abstract
- The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.
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| 43. |
- Ranisch, Robert, et al.
(author)
-
Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management
- 2021
-
In: Ethics and Information Technology. - : Springer Science and Business Media LLC. - 1388-1957 .- 1572-8439. ; 23, s. 285-294
-
Journal article (peer-reviewed)abstract
- There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness.
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| 44. |
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| 45. |
- Wild, Verina, et al.
(author)
-
Covid-19: Eine Ad hoc Public-Health-Ethikberatung : Covid-19: An ad hoc public health ethics consultation
- 2020
-
In: Das Gesundheitswesen. - : Georg Thieme Verlag KG. - 0941-3790 .- 1439-4421. ; 82:6, s. 507-513
-
Journal article (peer-reviewed)abstract
- In diesem Dokument beschreiben wir den Prozess und den Inhalt einer ad hoc Public-Health-Ethikberatung vom 22. März 2020 für eine regionale Gesundheitsbehörde (Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit) zu Entscheidungen im Zusammenhang mit Covid-19. In this paper we describe the process and content of our ad hoc public health ethics consultation for a Bavarian health authority in relation to Covid-19.
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| 46. |
- Munthe, Christian, 1962, et al.
(author)
-
Person centredness and shared decision-making in forensic care, social services and public health
- 2016
-
In: 30th European Conference of the Philosophy of Medicine and Healthcare, Zagreb, August 17-20, 2016.
-
Conference paper (other academic/artistic)abstract
- Shared decision-making and person centred care (PCC/SDM) are increasingly embraced framework conceptions on how to organise health care's interaction with patients. Although underlying ethical motivation may vary, PCC/SDM holds ideals of a greater adaption of health care to individual circumstances, and of recognising patients as collaborators in clinical decision-making. The PCC/SDM notion has migrated quickly across many areas where it is less clear how it applies, due to patients being in non-standard conditions with regard to personal capacities or care context, and detected to offer a number of peculiar ethical and practical challenges. But the migration has also reached areas with even less similarity to the original PCC/SDM landscape of somatic hospital care. In this presentation, we describe – based on comissioned and work in a Swedish context and ongoing research studies – three examples of this expansion and survey these for extra ethical complications: forensic care, social services and public health (outside of health care institutions). Each area offers peculiar extra ethical challenges for PCC/SDM, as they depart extensively from standard assumptions by, in various ways, embracing goals not built on the standard individualist assumptions of health care ethics. It is possible to implement adapted forms of PCC/SDM to these areas, but these cannot be assumed to serve ideals of emancipating, empowering or recognising individuals as persons. Rather, they have to be viewed though a lens of public goods aimed for in the respective areas. Clients and patients are entitled to be made aware of this fact, but regardless of this, the mentioned perspective-shift will pose particular challenges for health professionals. At the same time, PCC/SDM strategies may also open up for approaches to resolving these tensions and meet typical challenges that would otherwise have remained out of reach.
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| 47. |
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| 48. |
- El-Alti, Leila, 1986, et al.
(author)
-
Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?
- 2019
-
In: Health Care Analysis. - : Springer Science and Business Media LLC. - 1065-3058 .- 1573-3394. ; 27:1, s. 45-59
-
Journal article (peer-reviewed)abstract
- In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined or if they conflict at fundamental or pragmatic levels. This paper reviews existing literature in both medicine and related philosophy to analyze closer the meaning of the two notions, and to explore the extent to which they overlap or oppose each other, in theory or in practice, in particular regarding ethical assumptions and their respective practical implications.
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| 49. |
- Munthe, Christian, 1962
(author)
-
Precaution, bioethics and normative justification
- 2015
-
In: Monash Bioethics Review. - : Springer Science and Business Media LLC. - 1321-2753 .- 1836-6716. ; 33:2, s. 219-225
-
Review (other academic/artistic)abstract
- Daniel Steel’s new book on the precautionary principle illustrates the need to work ahead to fuse perspectives of epistemology and philosophy of science with those of ethics to accomplish progress in the debate on the proper role of precaution in a broad selection of bioethical areas. Steel advances the territory greatly with regard to conceptual clarity and epistemology, but from a bioethics standpoint he is mistaken in discounting the need for ethical underpinnings of a sound theory of the precautionary principle.
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| 50. |
- Munthe, Christian, 1962, et al.
(author)
-
Testing Interventions for Drastic Public Health Threats: "Social Value”, Pragmatic Risks and the Challenge of ”Health-related Research” Ethics – The Case of drug Resistance
- 2017
-
In: Matariki Research Ethics Workshop, Bader International Study Center, Herstmonceux Castle, East Sussex, UK, August 14-17, 2017.
-
Conference paper (other academic/artistic)abstract
- The recently revised CIOMS guidelines radically broaden both that scope of the guidelines from medical to all kinds of health research), and the basis on which such research may be assessed ethically, not least what is called ”social value” of research. This makes these guidelines less on a par with the WMA’s Declaration of Helsinki principles for biomedical research, e.g. with regard to what kind of benefits may justify risks to research subjects and others, and ethical requirements regarding the management of such risks. While DoH still mostly expresses an orthodox individualist research ethical perspective of a sort that has enjoys traditional support in bioethics, but has attracted some criticism from a public health ethical perspective, the new CIOMS guidelines seem to open up for more consideration of collective, institutional and public goods, and possibility of having these traded off against risks to individuals. This paper uses interventions meant to prevent or mitigate problems due to antibiotic resistance as a case in point, to discuss how a sound research ethical regulation should position itself with regard to research regarding health interventions of great importance for (global) public health. A particular focus will be the balancing of individual and collective goods/bads in face of threats of having core institutions and central public goods undermined.
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