We invite submissions that are rich in new information to fill the gap in knowledge in applied ethics. We also encourage more explicit normative discussions of the relevance of new knowledge to persisting ethical issues and questions that threaten social justice and equity. It is important that we address threats to the professional integrity of practitioners we engage both in traditional and as well as emerging practices and technologies.
Communication between healthcare professionals and patients typically concerns diagnoses, treatment options, and prognoses. In certain situations, however, not all relevant information is disclosed in order to prevent harm or to protect patient well-being. This practice is commonly referred to as therapeutic privilege. While therapeutic privilege has been widely discussed in relation to autonomy, beneficence, and non-maleficence, its implications for justice remain insufficiently explored. This article addresses this gap by examining therapeutic privilege through the lens of epistemic injustice. It argues that the selective withholding of information may undermine patients’ status as epistemic agents and thereby give rise to both hermeneutical and testimonial forms of injustice. The analysis focuses on three contexts in which such injustices arise: (1) the relationship between healthcare professionals and patients, (2) age-based differences in treatment, and (3) the role of family caregivers. Across these cases, the analysis argues that practices of information control can lead to forms of exclusion and unequal recognition. The article concludes that prevailing justifications of therapeutic privilege remain incomplete as long as they neglect considerations of epistemic injustice. The article therefore calls for greater attention to the conditions under which patients are recognized as epistemic participants within healthcare communication. Keywords: Therapeutic privilege; epistemic injustice; family caregivers; doctor-patient relationship; ageism
Book review of Ho, A. (2023). Live like nobody is watching: Relational autonomy in the age of artificial intelligence health monitoring. Oxford University Press. https://doi.org/10.1093/med/9780197556269.001.0001
How can peace negotiations be conducted in a way that is ethically viable, producing results that all parties to the negotiations will abide by and respect? This article discusses the importance of fairness in general and perceived fairness in particular as key parts of ethical and successful peace negotiations. Given the increase in protracted and brutal conflicts at the current moment in history, addressing key ethical aspects of peace negotiations is essential. Keywords: negotiations, peace, fairness, perceptions, recognition
Shortage of organs for transplantation leads to reduced quality of life and premature deaths among patients on waiting lists. One proposed policy response is the conscription of cadaveric organs, whereby all suitable organs are retrieved after death. Another proposal is to restrict access to transplantation for patients who have not themselves consented to donate. The ethical acceptability of both policies remains contested, and empirical evidence on public opinion is limited. Previous surveys suggest low support for conscription. We conducted a national survey of adults in Norway (N = 1000) to investigate public attitudes towards the badness of death (reported elsewhere), the conscription of organs for transplantation, and reciprocity, understood as the acceptance to be a potential donor as necessary for being a potential recipient of organs if in need. This last question did not elicit conclusive responses. It did, however, show a correlation between responses supportive of reciprocity (i.e., against free riding) and those supportive of conscription. The results suggest a slight majority in favor of conscription in Norway. Our survey shows that belief in an afterlife corresponds negatively with acceptance of conscription, but no other demographic data are influential. Keywords: Conscription of organs; Free riding; Public opinion; Reciprocity; Solidarity.
The Nordic Journal of Applied Ethics will celebrate its 20th year of publishing in November of the coming year 2026. In the last 10 years, the journal has published 229 articles that altogether have attracted 1.3 million views by 53,976 unique users. These articles cover around 126 discrete topics, converging methodologically on an applied ethics approach that articulates rigorous reasoning for adopting good practices, decisions or social policies. We invite researchers to contribute to this on-going discussion of questions in applied ethics by submitting their papers to the journal.
Some authors have advocated the creation of private citizenship markets, whereby individual citizens would be allowed to sell their citizenship to foreigners. There seems to be an inherent contradiction in this proposal. On the one hand, the right to sell citizenship presupposes the state’s right to exclude foreigners from citizenship, which, in turn, is grounded in citizens’ right to collective self-determination. On the other hand, private citizenship markets, by allowing each citizen to unilaterally decide on the admission of new members, would sidestep the democratic process by which members of the political community define who the collective is. This violates citizens’ right to collective self-determination, and therefore undermines the state’s right to exclude. This article aims to rescue private citizenship markets from the ‘self-defeating’ objection. In short, it argues that private citizenship markets do not necessarily violate citizens’ right to collective self-determination because they do not privatize the state’s right to exclude, but only its right to include. As long as the selling of citizenship by individual members of society is legally sanctioned by the state, it does not violate citizens’ right to collective self-determination, and therefore does not undermine the state’s right to exclude, any more than family reunification does. If anything, the objection shows that the right to exclude is not absolute, not that the privatization of the right to include undermines it. The argument has important implications for other cases of unilateral inclusion, especially sham marriages. Keywords: immigration; selling citizenship; private citizenship markets; right to include; right to exclude; self-determination.
The global shortage of transplantable organs is becoming increasingly acute, prompting intensified debates over the ethical acceptability and feasibility of various forms of financial compensation for donors. Although organ donation in exchange for payment is legally prohibited in most countries, the prospect of a regulated market has gained support—even among some Christian bioethicists. Among the most notable proponents is H. Tristram Engelhardt, Jr., arguably the only Orthodox Christian bioethicist who openly contends that there is no fundamental moral objection to receiving or even requesting monetary compensation for organ donation. This article explores the ethical implications of compensated organ donation through the lens of Engelhardt’s bioethical thought, examining the reasoning and consequences of his position. It further argues that his perspective represents a personal philosophical stance rather than a reflection of the broader Orthodox theological tradition. Finally, the article underscores the need for sustained moral vigilance and ideological awareness in resisting the commodification of the human body, calling for ethical safeguards that transcend legal prohibitions. Keywords: Bioethics, Medical Ethics, Organ Transplantation, Organ Donation, H. T. Engelhardt
This article examines ethical decision-making in military contexts from a longitudinal perspective, emphasising how cumulative risk factors, protective factors, and key decision points interact over time to shape outcomes. Drawing on normative ethical theories, classical social psychology, military doctrine, and historical case studies, the discussion moves beyond traditional cross-sectional approaches to consider the temporal and sequential nature of decisions. Particular attention is given to selection, training, organisational culture, and time in combat as determinants of ethical resilience or risk factors for ‘moral dead ends’. The My Lai massacre is used as an illustrative case, visualised through a timeline that highlights the interaction of multiple contributory factors. The analysis suggests that ethical decision-making is rarely the result of isolated choices; rather, it emerges from a chain of preceding decisions and contextual influences. The study concludes by arguing that military ethics education should incorporate longitudinal analysis to better prepare leaders for the cumulative pressures of operational environments. Keywords: Military ethics, Moral dead ends, Professional military education, Ethical resilience, Virtue ethics
A longitudinal perspective of military ethics highlights how a range of factors—from recruitment and selection to the cultivation of a healthy military culture—play a crucial role in building the resilience necessary to reduce the risk of moral failure in military contexts.
Ole Martin Moen and Aksel Braanen Sterri's book "Aktiv d & oslash;dshjelp. Etikk ved livets slutt" [ Assisted dying. Ethics at the end of life ] is the best and most thorough argument in Norwegian for the legalization of assisted dying to date. This article is based on a critical reading of the book. The criticism is structured by five thematic "tracks" that the assisted dying debate tends to follow. I argue that Moen and Sterri have not placed sufficient emphasis on the moral significance of the act of euthanasia itself. The argument that legalizing assisted dying can put "pressure on the weak" is an even stronger argument than what the authors present. Access to assisted dying can threaten professional ethical attitudes necessary for the doctor-patient relationship. With good palliation and a wise practice of timely limiting of treatment, the perceived need for assisted dying can be greatly reduced. Finally, there are weaknesses in the concrete model for legalization that Moen and Sterri propose; the model is close to the Dutch system, and is thus vulnerable to objections to this model.
Medical overactivity has been documented in a number of areas and consumes considerable resources. This article attempts to answer four questions: 1) What is medical overactivity? 2) What are the ethical aspects of overactivity? 3) What are the mechanisms behind and drivers of medical overactivity? 4) What can be done to reduce unwanted medical overactivity? What all medical overactivity has in common is that it is not necessary or justified in terms of a moral goal of reducing a person's pain, dysfunction or suffering. Medical overactivity thus lacks a moral justification and violates all four principles of biomedical ethics, but also specifically consequentialist ethics and deontology. There are many mechanisms behind and drivers of medical overactivity, which point to strategies to reduce medical overactivity. An overarching approach is to ensure that medical activity can be directly linked to the moral goal of reducing individuals' pain, loss of function and suffering. Reducing overactivity is key to preserving the moral justification of medicine, but also the quality of services, patient safety, trust in medicine and a sustainable health service.
The article discovers the multiple values of water as a key element of the Biosphere and a vital natural resource that sustains the equilibrium of the global ecosystem and human well-being. Different approaches to classifying and justifying values and various interpretations of the concepts of intrinsic, instrumental, and relational values in the context of the valuation of water are considered. Values are important for the efficient sustaining, management, and protection of water and water-related ecosystems globally and locally, and just access to water resources. Understanding the role of values and their respect or neglect is crucial in times of crisis, wars, and other conflicts that affect water. By accepting the consensus about three main classes of values (intrinsic, instrumental, and relational), water weaponization, and referring to some facts of the current Russo-Ukrainian war, it is shown that military actions exacerbate most of the challenges to environmental sustainability and human life. War also aggravates the conflict between water values. Water weaponization is considered one of the forms of instrumentalization of water that has multifaceted negative impacts on the environment, human rights to water, and human welfare. It is concluded that the way to reduce the negative environmental, economic, social, humanitarian, and cultural consequences of the weaponization of water is to stop the Russian aggression in Ukraine as soon as possible. Keywords: water and water-related resources, values, Russo-Ukrainian war, water weaponization.
After the revision of the Biotechnology Act in May 2020, egg donation in Norway became a reality. In the wake of the ‘biotechnology agreement’ – a result of the coalition between Ap (the Norwegian Labour party), Frp (the Progress Party) and SV (the Socialist Left Party) to secure a parliamentary majority for changes in the law – the amount of compensation was to be determined for women who wish to donate eggs. A public consultation was therefore held on the guidelines for egg donation, including alternatives for how much the donor should be financially compensated. In this article, I have analysed the consultation draft, the consultation responses and the final guidelines for compensation for egg donation. The purpose of the study was to examine the various arguments in the Norwegian debate about financial compensation for egg donation. Three recurring themes were identified in the consultation documents: the form and content of the motivation, fairness and donor store. A key finding in the consultation was a recurring concern about financially motivated donation. There was also broad agreement that egg donation should be altruistic. Altruism was understood as an absence of financial motivation on the part of the donor, but without other non-altruistic motives being problematised or the prerequisites for altruism being further discussed. The analysis also showed how similar arguments were framed differently in order to support both higher and lower compensation. For example, an emphasis on women's rights in some consultation responses ended up as a defence for the higher compensation proposed, while in other consultation responses it was used as an argument for a ban on any form of compensation. Overall, this study provides insight into the diversity of arguments that have been used in the Norwegian debate on financial compensation for egg donation, and it shows the importance of defining the relevant concepts – such as altruism, voluntariness and financial motivation – in order to better illuminate the agreements and disagreements between the parties in the debate. Keywords: altruism, biotechnology, oocyte donation, remuneration, motivation
Among the most contentious practices within a globalized and corporatized economy is allegations of so-called ‘biopiracy’. This refers to the taking of genetic resources and associated traditional knowledge without either free, prior and informed consent or any mechanisms for benefit-sharing with the community that provided the resource. Attempts to revise the TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights) to bring it more in compliance with the Convention on Biological Diversity (CBD) have not led to concrete results. The article analyzes CBD provisions, binding protocols and non-binding guiding documents, and two less known treaties of the United Nations. The World Intellectual Property Organization (WIPO), that joined the United Nations in 1974, has – after negotiating for almost 15 years – adopted the WIPO Treaty on Intellectual Property, Genetic Resources and Associated Traditional Knowledge. The article demonstrates how this WIPO Treaty is embedded in the ‘defensive strategy’ of traditional knowledge protection, enabling patent examiners to reject a patent as the alleged invention does not represent new and applicable knowledge. The alternative, termed ‘positive strategy’, is witnessed primarily in India’s Plant Variety and Farmers’ Rights Act, which has resulted in more grants of certificates for so-called ‘farmers’ varieties’ compared to all other varieties together. Other United Nations treaties include elements of such protection, but not on the level of specify and subsequent implementation as found in India. The negotiations of what became the WIPO Treaty has generated increased awareness of indigenous peoples’ traditional knowledge and should be easy to ratify as it aligns with existing legislation. Keywords: India’s Plant Variety and Farmers’ Rights Act, traditional knowledge, TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights), WIPO Treaty on Intellectual Property, Genetic Resources and Associated Traditional Knowledge
The proper nature of the relationship between people and their personal data is yet to be determined. Are personal data trivial to us like a piece of clothing, or more intimate and personal, like our thoughts and feelings? Does it matter how we view this relation? In this article, we present a philosophical critique of the unownability approach to personal data and outline some of its shortcomings. Menstruation data is an example of a particularly sensitive and personal type of data, and we argue that such data should be recognized as personal property, belonging to the data subject. In the following, we start by displaying how and why personal data ownership becomes such an intricate issue and conclude by suggesting that the personhood theory of ownership can provide a foundation for moral ownership, where other theories fall short. Keywords: Data ownership, Privacy, Ethics, Personhood, Alienation
Medisinsk overaktivitet er dokumentert på en rekke områder, og beslaglegger betydelige ressurser. Denne artikkelen forsøker å besvare fire spørsmål: 1) Hva er medisinsk overaktivitet? 2) Hva er de etiske aspektene ved overaktivitet? 3) Hva er mekanismene bak og driverne for medisinsk overaktivitet? 4) Hva kan gjøres for å redusere uønsket medisinsk overaktivitet? Felles for medisinsk overaktivitet er at aktiviteten ikke er nødvendig eller berettiget ut fra et moralsk mål om å være mer til nytte enn skade og redusere lidelse. Medisinsk overaktivitet mangler derved en moralsk begrunnelse og bryter med alle de fire prinsippene i biomedisinsk etikk, men også spesifikt med konsekvensetikk og pliktetikk. Det finnes en rekke mekanismer bak og drivere for medisinsk overaktivitet, som peker mot angrepspunkter og strategier for å redusere medisinsk overaktivitet. En overordnet strategi er å sikre at medisinsk aktivitet direkte kan knyttes til det moralske mål om å redusere individers smerte, funksjonstap og lidelse. Reduksjon av overaktivitet er sentralt for å bevare medisinens moralske begrunnelse, men også kvalitet på tjenestene, pasientsikkerhet, tillit til medisinen og en bærekraftig helsetjeneste. Nøkkelord: overaktivitet, overdiagnostikk, overundersøkelse, overbehandling, sykdomssalg English title: Medical overactivity: What is it, what are the ethical issues and what can we do about it? English summary: Medical overactivity has been documented in a number of areas and consumes considerable resources. This article attempts to answer four questions: 1) What is medical overactivity? 2) What are the ethical aspects of overactivity? 3) What are the mechanisms behind and drivers of medical overactivity? 4) What can be done to reduce unwanted medical overactivity? What all medical overactivity has in common is that it is not necessary or justified in terms of a moral goal of reducing a person's pain, dysfunction or suffering. Medical overactivity thus lacks a moral justification and violates all four principles of biomedical ethics, but also specifically consequentialist ethics and deontology. There are many mechanisms behind and drivers of medical overactivity, which point to strategies to reduce medical overactivity. An overarching approach is to ensure that medical activity can be directly linked to the moral goal of reducing individuals' pain, loss of function and suffering. Reducing overactivity is key to preserving the moral justification of medicine, but also the quality of services, patient safety, trust in medicine and a sustainable health service. Key words: overactivity, overdiagnosis, overdetection, overtreatment, disease mongering
Ole Martin Moen og Aksel Braanen Sterris bok «Aktiv dødshjelp. Etikk ved livets slutt» er den beste og grundigste argumentasjonen på norsk for legalisering av dødshjelp til nå. Denne artikkelen er basert på en kritisk lesning av boken. Kritikken struktureres av fem tematiske «spor» som dødshjelpsdebatten gjerne følger. Jeg argumenterer for at Moen og Sterri ikke har lagt tilstrekkelig vekt på den moralske betydningen av selve dødshjelpshandlingen. Argumentet om at legalisering av dødshjelp kan legge «press på de svake» er et enda sterkere argument enn hva forfatterne får frem. Adgang til dødshjelp kan true profesjonsetiske holdninger nødvendige for lege-pasientrelasjonen. Ved god palliasjon samt klok praktisering av behandlingsbegrensning kan det opplevde behovet for dødshjelp reduseres sterkt. Til sist er det svakheter ved den konkrete modellen for legalisering som Moen og Sterri foreslår; modellen ligger tett opp mot det nederlandske systemet, og er dermed sårbar for innvendinger mot dette.
I boken Aktiv dødshjelp - etikk ved livets slutt (2019) tar vi til orde for at vi bør legalisere dødshjelp i Norge. Personer som lider uutholdelig, ikke har utsikter til bedring og har tatt et kompetent, konsistent og ikke presset valg om å avslutte livet, bør bli tilbudt hjelp til å en trygg, skånsom og verdig måte. I artikkelen "Bør dødshjelp legaliseres i Norge?" kritiserer Morten Magelssen argumentasjonen i vår bok. Han er ikke den første til å kritisere oss. Vi har tidligere svart på Lars Johan Materstvedts (2022) kritikk av boken (Sterri og Moen 2023). I denne artikkelen svarer vi på Magelssens kritikk. Magelssen skriver at han har to formål med artikkelen. I tillegg til å ville vise hvor vår argumentasjon kommer til kort, vil han også demonstrere hvordan en ny fremgangsmåte for å diskutere dødshjelp. Vi vil begynne med å diskutere Magelssens metode.
