Torbjörn Tännsjö

Why We Ought to Accept the Repugnant Conclusion

Derek Parfit has famously pointed out that ‘total’ utilitarian views, such as classical hedonistic utilitarianism, lead to the conclusion that, to each population of quite happy persons there corresponds a more extensive population with people living lives just worth living, which is (on the whole) better. In particular, for any possible population of at least ten billion people, all with a very high quality of life, there must be some much larger imaginable population whose existence, if other things are equal, would be better, even though its members have lives that are barely worth living. This world is better if the sum total of well-being is great enough, and it is great enough if only enough sentient beings inhabit it. This conclusion has been considered by Parfit and others to be ‘repugnant’.

Compulsory sterilisation in Sweden.

In the Fall of 1997 the leading Swedish newspaper, Dagens Nyheter, created a media hype over the Swedish policy of compulsory sterilisation that had been in operation between 1935 and 1975. In the discussion that followed, the moral condemnation of our medical past was unanimous. However, the reasons for rejecting what had gone on were varied and mutually inconsistent. Three strands of criticism were common: the argument from autonomy, the argument from caution, and the argument from biological scepticism. In the paper it is argued that what point of departure you choose in your criticism of the past should be of consequence also for your ideas about present and future medical practice. In particular, if you rely on the argument from autonomy, you should be prepared to accept a liberal (present and future) use of reproductive techniques.

Honour-related threats and human rights: A qualitative study of Swedish healthcare providers’ attitudes towards young women requesting a virginity certificate or hymen reconstruction

Abstract Objectives To investigate the preferred actions of healthcare staff, as well as their reasoning and attitudes about young females’ requests for a virginity certificate or hymen restoration. Method A qualitative study, consisting of semi-structured interviews of healthcare providers from different parts of Sweden and from different medical specialties and professions, who had experience of women who asked for a virginity certificate or a hymen repair. Results Using content analysis, ten themes emerged regarding healthcare personnels attitudes and reasoning about young female patients and their requests for demonstration of virginity. The themes logically were categorised as values, beliefs, and cultural affiliation. Conclusions Responders had a more pragmatic and permissive view than the restrictive, official Swedish policy opposing hymenoplasties within the public healthcare system. There were degrees of willingness to accommodate such requests, due, for example, to different moral beliefs and medical concerns. Responders expressed frustration over the difficulty of following up patients, a situation likely due to the restrictive policy. The patient-centred approach adopted by a Dutch team of health professionals would probably better enable quality assurance.

Chinese and Westerners Respond Differently to the Trolley Dilemmas

A set of moral problems known as The Trolley Dilemmas was presented to 3000 randomly selected inhabitants of the USA, Russia and China. It is shown that Chinese are significantly less prone to supp ...

The convention on human rights and biomedicine and the use of coercion in psychiatry

According to a recent convention on human rights and biomedicine, coercive treatment of psychiatric patients may only be given if, without such treatment, serious harm is likely to result to the health of the patient; it must not be given in the interest of other people. In the present article a discussion is undertaken about the implication of this stipulation for the use of coercion in psychiatry in general and in forensic psychiatry in particular.

The case of biobank with the law: between a legal and scientific fiction

According to estimates more than 400 biobanks currently operate across Europe. The term ‘biobank’ indicates a specific field of genetic study that has quietly developed without any significant critical reflection across European societies. Although scientists now routinely use this phrase, the wider public is still confused when the word ‘bank’ is being connected with the collection of their biological samples. There is a striking lack of knowledge of this field. In the recent Eurobarometer survey it was demonstrated that even in 2010 two-thirds of the respondents had never even heard about biobanks. The term gives the impression that a systematic collection of biological samples can constitute a ‘bank’ of considerable financial worth, where the biological samples, which are insignificant in isolation but are valuable as a collection, can be preserved, analysed and put to ‘profitable use’. By studying the practices of the numerous already existing biobanks, the authors address the following questions: to what extent does the term ‘biobank’ reflect the normative concept of using biological samples for the purposes of biomedical research? Furthermore, is it in harmony with the so far agreed legal–ethical consensus in Europe or does it deliberately pull science to the territory of a new, ambiguous commercial field? In other words, do biobanks constitute a medico-legal fiction or are they substantively different from other biomedical research protocols on human tissues?

In Defence of Science

In a talk to this conference2 Lars Bergstrom has put forward the somewhat surprising thesis that, in a conventional sense, the more “useful” a given field of research is considered to be, the more dangerous it is, and the less money should be invested in it. At least this is a reasonable “rule of thumb”, according to Bergstrom. The rationale of this thesis is a thoroughgoing scepticism concerning the (positive) value of science, considered both in terms of its possible intrinsic value (according to Bergstrom, knowledge as such does not have any value) and in terms of instrumental, extrinsic, value (probably, according to Bergstrom who quotes Wittgenstein and Michael Dummett for support, on balance, science does more harm than good). In this paper I want to question the thesis put forward by Bergstrom. However, for the sake of argument, I will accept many of the premisses upon which his argument is based. My disagreement with Bergstrom concerns a difficult problem within ethics. It might be of some interest to learn that, even among people who share a common view of the facts of the matter, rather subtle differences of ethical outlook may engender very different evaluations of a phenomenon such as science.

Should we change the human genome

Should we change the human genome? The most general arguments against changing the human genome are here in focus. Distinctions are made between positive and negative gene therapy, between germ-line and somatic therapy, and between therapy where the intention is to benefit a particular individual (a future child) and where the intention is to benefit the human gene-pool.Some standard arguments against gene-therapy are dismissed. Negative somatic therapy is not controversial. Even negative, germ-line therapy is endorsed, if the intention is to cure a certain individual (a future child). In rare cases, positive therapy on somatic cells may be warranted. Germ-line therapy may become a valuable method of preventing harm, through ‘genetic vaccination’. If safe methods evolve, it is harmless (though vain), to try to achieve more ambitious goals. Prospective parents should not be prevented from exercising this harmless kind of parental authority.The paper concludes: Thereis a moral limit to how much we ought to manipulate the human genome, however. We ought not to jeopardize the continued existence of mankind. We ought not to develop methods of germ-line therapy intended in a radical manner to improve human nature, and we ought to leave to prospective parents to decide in individual cases what kind of intervention shall take place.

Conservatism for our time

An examination of conservative doctrine as applied to the pressing political and social problems of our time. Torbjorn Tannsjo argues that conservatism no longer necessarily has any neat alignment with right-wing politics, and that the political right has no exclusive claim to conservative thought. Many political problems now facing us fall outside the traditional political spectrum, notably issues to do with the environment and nuclear power, where green attitudes are in a sense conservative ones. Tannsjo defines the concept of conservatism in terms of two tenets: one, whatever exists as a well-established fact ought to continue to exist; and two, the reason it ought to continue to exist is that it is well-established. Tannsjo distinguishes and clarifies general conservative positions, and looks critically at classical and modern arguments such as those put forward by Burke, Hume, Oakeshott, and Scruton. Applying his conclusions to practical matters, he considers the relevance of conservative arguments to current political and social problems such as nuclear policy, genetic engineering and real socialism.

Duelling with doctors, restoring honour and avoiding shame? A cross-sectional study of sick-listed patients’ experiences of negative healthcare encounters with special reference to feeling wronged and shame

Aims The aim of this study was to examine if it is plausible to interpret the appearance of shame in a Swedish healthcare setting as a reaction to having ones honour wronged. Methods Using a questionnaire, we studied answers from a sample of long-term sick-listed patients who had experienced negative encounters (n=1628) and of these 64% also felt wronged. We used feeling wronged to examine emotional reactions such as feeling ashamed and made the assumption that feeling shame could be associated with having ones honour wronged. In statistical analyses relative risks (RRs) were computed, adjusting for age, sex, disease-labelling, educational levels, as well as their 95% CI. Results Approximately half of those who had been wronged stated that they also felt shame and of those who felt shame, 93% (CI 91 to 95) felt that they had been wronged. The RR was 4.5 (CI 3.0 to 6.8) for shame when wronged. This can be compared with the other emotional reactions where the RRs were between 1.1 (CI 0.9 to 1.3)–1.4 (CI 1.2 to 1.7). We found no association between country of birth and feeling shame after having experienced negative encounters. Conclusions We found that the RR of feeling shame when wronged was significantly higher compared with other feelings. Along with theoretical considerations, and the specific types of negative encounters associated with shame, the results indicate that our research hypothesis might be plausible. We think that the results deserve to be used as point of departure for future research.