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  • 1.
    Friedrichsen, Maria
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Waldréus, Nana
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Milovanovic, Micha
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Karlsson, Marit
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Närvårdskliniken. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi.
    Milberg, Anna
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Jaarsma, Pier
    Linköpings universitet, Medicinska fakulteten.
    Schaller, Anne
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ethical challenges around thirst in end-of-life care –experiences of palliative care physicians.2023Ingår i: BMC Medical EthicsArtikel i tidskrift (Refereegranskat)
  • 2.
    Friedrichsen, Maria
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Lythell, Caroline
    Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Waldreus, Nana
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Ångström, Helene
    Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Milovanovic, Micha
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Karlsson, Marit
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Närvårdskliniken.
    Milberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Thulesius, Hans
    Linnaeus Univ, Sweden; Reg Kronoberg, Sweden.
    Hedman, Christel
    Karolinska Inst, Sweden; Stockholms Sjukhem Fdn, Sweden.
    Söderlund Schaller, Anne
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Jaarsma, Pier
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Ethical challenges around thirst in end-of-life care -experiences of palliative care physicians2023Ingår i: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 24, nr 1, artikel-id 61Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundThirst and dry mouth are common symptoms in terminally ill patients. In their day-to-day practice, palliative care physicians regularly encounter ethical dilemmas, especially regarding artificial hydration. Few studies have focused on thirst and the ethical dilemmas palliative care physicians encounter in relation to this, leading to a knowledge gap in this area.AimThe aim of this study was to explore palliative care physicians experiences of ethical challenges in relation to thirst in terminally ill patients.MethodsA qualitative interview study with an inductive approach was conducted. Sixteen physicians working in four different specialised palliative care units and one geriatric care unit in different hospitals in Sweden were interviewed. The interviews were transcribed verbatim and analysed with a reflexive thematic analysis.ResultsWhen presented with an ethical challenge relating to thirst, physicians attempted to balance benefits and harms while emphasizing respect for the patients autonomy. The ethical challenges in this study were: Starting, continuing or discontinuing drips; lack of evidence and traditions create doubt; and lack of interest and time may result in patient suffering.ConclusionsAll physicians in this study reported that "Starting, continuing or discontinuing drips" was the main ethical challenge they encountered, where some were so accustomed to the decision that they had a standard answer ready to offer patients and families. Physicians reported that drips were a symbol of thirst quenching, life and survival but were not necessary in end-of-life care. Others questioned the traditions regarding thirst and emphasised drips in particular.

  • 3.
    Friedrichsen, Maria
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Lythell, Caroline
    Linköpings universitet, Institutionen för hälsa, medicin och vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Pier
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Angstrom, Helene
    Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Milovanovic, Micha
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Karlsson, Marit
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Närvårdskliniken.
    Milberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Thulesius, Hans
    Linnaeus Univ, Sweden; Reg Kronoberg, Sweden.
    Hedman, Christel
    Karolinska Inst, Sweden; Stockholms Sjukhem Fdn, Sweden.
    Waldreus, Nana
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Söderlund Schaller, Anne
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Thirst or dry mouth in dying patients?-A qualitative study of palliative care physicians experiences2023Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 18, nr 8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IntroductionThirst and dry mouth are common symptoms among patients at the end of life. In palliative care today, there is a focus on mouth care to alleviate thirst. There are no qualitative studies on thirst from a physicians experience, which is why this study is needed. PurposeThis study aimed to explore palliative care physicians experiences and views of thirst in patients at the end of life. MethodsA qualitative interview study with an inductive approach was carried out. Sixteen physicians working in specialised palliative care units in Sweden were included. The interviews were analysed with a reflexive thematic analysis. ResultsThe analysis resulted in three basic assumptions regarding thirst: It is dry mouth, not thirst; patients are dry in their mouth and thirsty; and, I do not know if they are thirsty. Further, four different themes regarding how to relieve thirst appeared: drips will not help thirst but cause harm; the body takes care of thirst itself; drips might help thirst; and, mouth care to relieve thirst or dry mouth. ConclusionsThe palliative care physicians had different experiences regarding thirst, from thirst never arising, to a lack of awareness. They thought good mouth care worked well to alleviate the feeling of thirst and dry mouth. Most physicians did not want to give patients drips, while some did. This study indicates that there are many unanswered questions when it comes to thirst at end-of-life and that further research is needed.

  • 4.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Gelhaus, Petra
    Linköpings universitet, Institutionen för hälsa, medicin och vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping.
    Eklund Saksberg, My
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Two cases of nursing older nursing home residents during COVID-192023Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Two ethical challenges of nursing home nurses during the COVID-19 pandemic in Sweden are discussed in this paper. Background Historically, the nurses primary concern is for the person who is ill, which is the core of nurses moral responsibility and identity. In Sweden, person-centered care is generally deemed important in nursing older nursing home residents. Objective To chart moral responsibilities of nursing home nurses in two cases involving older residents during the COVID-19 pandemic in Sweden. Methods We used Margaret Urban Walkers framework for moral responsibilities and the International Council of Nurses (ICN) code of ethics for nurses (2021) for our normative analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given that participation was entirely voluntary and possible to cancel at any time before the work was published. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to this research project (Dnr. 2020-05649). Findings Case #1: a palliative older nursing home resident who was coercively tested for COVID-19, and case #2: a COVID-19-infected resident with dementia who was isolated using sedation. The decision that was finally made in the respective case was analyzed in the light of either consequentialist/utilitarian or non-consequentialist/deontological reasons. Discussion Empowerment of nurses as moral agents is required for the application of practical wisdom in the balancing of different care relationships (responsibilities), moral identities (professional virtues), and competing moral values. This requires resources and opens possibilities for profound ethical reflection in nursing education and at work. Conclusion During the COVID-19 pandemic, the moral and professional responsibility of nursing home nurses to deliver person-centered care was sometimes problematically abandoned in favor of a more utilitarian manner of ethical decision-making.

  • 5.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Gelhaus, Petra
    Institute for Ethics, History and Philosophy of Medicine, University of Muenster, Muenster, Germany.
    Medium-Range Narratives as a Complementary Tool to Principle-Based Prioritization in Sweden: Test Case "ADHD"2019Ingår i: Journal of Bioethical Inquiry, ISSN 1176-7529, E-ISSN 1872-4353, Vol. 16, nr 1, s. 113-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this paper, for the benefit of reflection processes in clinical and in local, regional, and national priority-setting, we aim to develop an ethical theoretical framework that includes both ethical principles and medium-range narratives. We present our suggestion in the particular case of having to choose between treatment interventions for attention deficit hyperactivity disorder (ADHD) and treatment interventions for other conditions or diseases, under circumstances of scarcity. In order to arrive at our model, we compare two distinct ethical approaches: a generalist (principles) approach and a particularist (narratives) approach. Our focus is on Sweden, because in Sweden prioritization in healthcare is uniquely governmentally regulated by the “ethics platform.” We will present a (fictional) scenario to analyse the strengths and weaknesses of the generalist principled perspective of the ethics platform and the particularist perspective of narrative ethics. We will suggest an alternative (moderately particularist) approach to prioritization, which we dub a “principles plus medium-range narratives” approach. Notwithstanding the undeniably central role of principles in distributive justice, we claim that medium-range narratives concerning individuals or groups who stand to benefit or lose from ADHD prioritization practices should also be read or listened to and taken into account at all levels of priority-setting. These narratives are expected to ethically optimize clinical priority-setting, as well as that undertaken at local, regional, and national levels.

  • 6.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Welin, Stellan
    Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för kulturvetenskaper, KVA. Linköpings universitet, Filosofiska fakulteten.
    Autism, Accommodation and Treatment: A Rejoinder to Chong-Ming Lims Critique2015Ingår i: Bioethics, ISSN 0269-9702, E-ISSN 1467-8519, Vol. 29, nr 9, s. 684-685Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    We are very grateful to Chong-Ming Lim for his thoughtful reply published in this journal on one of our articles, which motivated us to think more carefully about accommodating autistic individuals and treating autism. However we believe there are some confusions in Lims argument. Lim uses the accommodation thesis, according to which we should accommodate autistic individuals rather than treat autism, as the starting point for his reasoning. He claims that if the accommodation thesis is right, then we should not treat autistic individuals for their autism, not even low-functioning (i.e. intellectually disabled) ones, because this would be disrespectful to all autistic individuals. We should instead limit ourselves to accommodate all autistic individuals. However, the opposition between accommodation and treatment is not valid in the case of autism, because of ambiguity in the concepts of accommodation and treatment. Moreover there is confusion in Lims reasoning caused by omitting important facts about the practice of treating autism.

  • 7. Beställ onlineKöp publikationen >>
    Jaarsma, Pier
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Reflections on Autism: Ethical Perspectives on Autism Spectrum Disorder in Health Care and Education2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    I de fyra artiklarna, som presenteras i denna avhandling, analyserar och diskuterar jag olika värdeuttalanden och moraliska ställningstaganden, vilka jag anser inte kan berättigas och är skadliga för personer med autism och utgör hinder för skapandet av ett autismvänligt samhälle. I artiklarna försöker jag visa att de ståndpunkter som ligger till grund för autism - fobiska moraliska ställningstaganden inte kan berättigas eller försvaras på ett rimligt sätt. På så sätt hoppas jag att omvandla de skadliga moraliska intuitioner som ligger bakom dessa positioner till autismvänliga sådana. Den första artikeln undersöker påståendet från förespråkare av neurodiversitet att ”autism är en naturlig variation”. Påståendet tolkas och utreds och ett argument ges att, i motsats till låg fungerande autism, kan högfungerande autism faktiskt ses som en naturlig variation, utan att nödvändigtvis ses som ett handikapp. Den andra artikeln fokuserar på problem för personer med autism för att anpassa sig till att ljuga prosocialt, nämligen att säga något som är osant men socialt lämpligt i en viss situation. Genom att jämföra en Kantiansk strategi med en omsorgsetisk strategi rekommenderar artikeln att undervisning i att ljuga på ett regelbaserat och empatiskt sätt bör ges till personer med autism. Den tredje artikeln behandlar moralen kring väljande av embryo i IVF. Baserat på en allmänt delad intuition om förekomsten och betydelsen av naturliga förmågor ges ett argument för att det är moraliskt legitimt att välja ett autistiskt embryo i stället för ett ”normalt”, i motsats till argument som ges av förespråkarna för ”varje barn ska få bästa chansen till det bästa livet”. Den fjärde artikeln handlar om hur barn ska bibringas moral genom utbildning. Ett argument ges att på grund av problem med kognitiv empati så bör barn med autism undervisas i pro - socialt beteende på ett regelbaserat sätt.

    Delarbeten
    1. Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement
    Öppna denna publikation i ny flik eller fönster >>Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement
    2012 (Engelska)Ingår i: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 20, nr 1, s. 20-30Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Neurodiversity has remained a controversial concept over the last decade. In its broadest sense the concept of neurodiversity regards atypical neurological development as a normal human difference. The neurodiversity claim contains at least two different aspects. The first aspect is that autism, among other neurological conditions, is first and foremost a natural variation. The other aspect is about conferring rights and in particular value to the neurodiversity condition, demanding recognition and acceptance. Autism can be seen as a natural variation on par with for example homosexuality. The broad version of the neurodiversity claim, covering low-functioning as well as high-functioning autism, is problematic. Only a narrow conception of neurodiversity, referring exclusively to high-functioning autists, is reasonable. We will discuss the effects of DSM categorization and the medical model for high functioning autists. After a discussion of autism as a culture we will analyze various possible strategies for the neurodiversity movement to claim extra resources for autists as members of an underprivileged culture without being labelled disabled or as having a disorder. We will discuss their vulnerable status as a group and what obligation that confers on the majority of neurotypicals.

    Ort, förlag, år, upplaga, sidor
    Dordrecht: Springer, 2012
    Nyckelord
    Autism, Disability, DSM-V, Equality, Neurodiversity, Vulnerability
    Nationell ämneskategori
    Etik
    Identifikatorer
    urn:nbn:se:liu:diva-72172 (URN)10.1007/s10728-011-0169-9 (DOI)000300252300002 ()
    Tillgänglig från: 2011-11-21 Skapad: 2011-11-21 Senast uppdaterad: 2017-12-08
    2. Living the Categorical Imperative: autistic perspectives on lying and truth telling-between Kant and care ethics
    Öppna denna publikation i ny flik eller fönster >>Living the Categorical Imperative: autistic perspectives on lying and truth telling-between Kant and care ethics
    2012 (Engelska)Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 15, nr 3, s. 271-277Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Lying is a common phenomenon amongst human beings. It seems to play a role in making social interactions run more smoothly. Too much honesty can be regarded as impolite or downright rude. Remarkably, lying is not a common phenomenon amongst normally intelligent human beings who are on the autism spectrum. They appear to be 'attractively morally innocent' and seem to have an above average moral conscientious objection against deception. In this paper, the behavior of persons with autism with regard to deception and truthfulness will be discussed in the light of two different ethical theories, illustrated by fragments from autobiographies of persons with autism. A systemizing 'Kantian' and an empathizing 'ethics of care' perspective reveal insights on high-functioning autism, truthfulness and moral behavior. Both perspectives are problematic from the point of view of a moral agent with autism. High-functioning persons with autism are, generally speaking, strong systemizes and weak empathizers. Particularly, they lack 'cognitive empathy' which would allow them to understand the position of the other person. Instead, some tend to invent a set of rules that makes their behavior compatible with the expectations of others. From a Kantian point of view, the autistic tendency to always tell the truth appears praiseworthy and should not be changed, though it creates problems in the social life of persons with autism. From a care ethics perspective, on the other hand, a way should be found to allow the high-functioning persons with autism to respect the feelings and needs of other persons as sometimes overruling the duty of truthfulness. We suggest this may even entail 'morally educating' children and adolescents with autism to become socially skilled empathic 'liars'.

    Ort, förlag, år, upplaga, sidor
    Dordrecht: Springer, 2012
    Nyckelord
    High-functioning autism, Autobiographies, Truthfulness, Moral responsibilities, Moral education, Kant, Ethics of care
    Nationell ämneskategori
    Etik
    Identifikatorer
    urn:nbn:se:liu:diva-72173 (URN)10.1007/s11019-011-9363-7 (DOI)
    Tillgänglig från: 2011-11-21 Skapad: 2011-11-21 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    3. Human capabilities, mild autism, deafness and the morality of embryo selection
    Öppna denna publikation i ny flik eller fönster >>Human capabilities, mild autism, deafness and the morality of embryo selection
    2013 (Engelska)Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, nr 4, s. 817-824Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    A preimplantation genetic test to discriminate between severe and mild autism spectrum disorder might be developed in the foreseeable future. Recently, the philosophers Julian Savulescu and Guy Kahane claimed that there are strong reasons for prospective parents to make use of such a test to prevent the birth of children who are disposed to autism or Asperger’s disorder. In this paper we will criticize this claim. We will discuss the morality of selection for mild autism in embryo selection in a hypothetical in vitro fertilization (IVF) situation where preimplantation genetic diagnosis is performed and compare this with a similar selection for congenital deafness. To do this we first discuss relevant human differences. We then introduce the principle of human capabilities (PC) and compare this principle with the principle of procreative beneficence (PB) introduced by Savulescu and Kahane. We apply the two principles to selection for mild autism and selection for congenital deafness. We argue that PC allows for the selection for mild autism but rules out selection for congenital deafness. PB will not give clear answers; the ruling of PB depends to a large extent on expected social, cultural and political developments. We will argue that PC is preferable to PB. We will discuss arguments for the value of mild autism for individuals who have this condition and argue that they are able to lead a life with human dignity provided autism-friendly social circumstances are present. Neither PC nor PB yields strong reasons for prospective parents to seek to prevent the birth of children who are disposed to mild autism spectrum disorder.

    Ort, förlag, år, upplaga, sidor
    Springer Netherlands, 2013
    Nyckelord
    autism, reproduction, genetic selection, ethics, human capabilities, procreative beneficence, quality of life
    Nationell ämneskategori
    Etik
    Identifikatorer
    urn:nbn:se:liu:diva-89704 (URN)10.1007/s11019-013-9464-6 (DOI)000327128500021 ()
    Tillgänglig från: 2013-03-04 Skapad: 2013-03-04 Senast uppdaterad: 2017-12-06
    4. Cultivation of empathy in individuals with high-functioning autism spectrum disorder
    Öppna denna publikation i ny flik eller fönster >>Cultivation of empathy in individuals with high-functioning autism spectrum disorder
    2013 (Engelska)Ingår i: Ethics and Education, ISSN 1744-9642, E-ISSN 1744-9650, Vol. 8, nr 3, s. 290-300Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    High-functioning individuals with autism spectrum disorder (HF-ASD) typically lack cognitive empathy, compromising their moral agency from both a Kantian and a Humean perspective. Nevertheless, they are capable of exhibiting moral behavior, and sometimes, they exhibit what may be deemed ‘super-moral’ behavior. The empathy deficit poses, to varying degrees, limitations with respect to their moral motivation and moral agency. To compensate for this deficit, individuals with HF-ASD rely primarily, and justifiably, on the formation and application of moral rules. Educators who focus predominantly on empathy, however, may be less effective in the moral education of individuals with HF-ASD because they neglect the preference for rules of the latter. In this article, I argue that an individualized balance of empathy-based and rule-based strategies in the context of moral education is needed to assist individuals with HF-ASD in their challenges with moral motivation and moral agency.

    Ort, förlag, år, upplaga, sidor
    Taylor & Francis, 2013
    Nyckelord
    Autism spectrum disorder, empathy, rules, education, Kant, Hume
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-104417 (URN)10.1080/17449642.2013.878514 (DOI)
    Tillgänglig från: 2014-02-17 Skapad: 2014-02-17 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
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    Reflections on Autism: Ethical Perspectives on Autism Spectrum Disorder in Health Care and Education
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    omslag
  • 8.
    Jaarsma, Pier
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Cultivation of empathy in individuals with high-functioning autism spectrum disorder2013Ingår i: Ethics and Education, ISSN 1744-9642, E-ISSN 1744-9650, Vol. 8, nr 3, s. 290-300Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    High-functioning individuals with autism spectrum disorder (HF-ASD) typically lack cognitive empathy, compromising their moral agency from both a Kantian and a Humean perspective. Nevertheless, they are capable of exhibiting moral behavior, and sometimes, they exhibit what may be deemed ‘super-moral’ behavior. The empathy deficit poses, to varying degrees, limitations with respect to their moral motivation and moral agency. To compensate for this deficit, individuals with HF-ASD rely primarily, and justifiably, on the formation and application of moral rules. Educators who focus predominantly on empathy, however, may be less effective in the moral education of individuals with HF-ASD because they neglect the preference for rules of the latter. In this article, I argue that an individualized balance of empathy-based and rule-based strategies in the context of moral education is needed to assist individuals with HF-ASD in their challenges with moral motivation and moral agency.

  • 9.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Human capabilities, mild autism, deafness and the morality of embryo selection2013Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, nr 4, s. 817-824Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A preimplantation genetic test to discriminate between severe and mild autism spectrum disorder might be developed in the foreseeable future. Recently, the philosophers Julian Savulescu and Guy Kahane claimed that there are strong reasons for prospective parents to make use of such a test to prevent the birth of children who are disposed to autism or Asperger’s disorder. In this paper we will criticize this claim. We will discuss the morality of selection for mild autism in embryo selection in a hypothetical in vitro fertilization (IVF) situation where preimplantation genetic diagnosis is performed and compare this with a similar selection for congenital deafness. To do this we first discuss relevant human differences. We then introduce the principle of human capabilities (PC) and compare this principle with the principle of procreative beneficence (PB) introduced by Savulescu and Kahane. We apply the two principles to selection for mild autism and selection for congenital deafness. We argue that PC allows for the selection for mild autism but rules out selection for congenital deafness. PB will not give clear answers; the ruling of PB depends to a large extent on expected social, cultural and political developments. We will argue that PC is preferable to PB. We will discuss arguments for the value of mild autism for individuals who have this condition and argue that they are able to lead a life with human dignity provided autism-friendly social circumstances are present. Neither PC nor PB yields strong reasons for prospective parents to seek to prevent the birth of children who are disposed to mild autism spectrum disorder.

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  • 10.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement2012Ingår i: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 20, nr 1, s. 20-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Neurodiversity has remained a controversial concept over the last decade. In its broadest sense the concept of neurodiversity regards atypical neurological development as a normal human difference. The neurodiversity claim contains at least two different aspects. The first aspect is that autism, among other neurological conditions, is first and foremost a natural variation. The other aspect is about conferring rights and in particular value to the neurodiversity condition, demanding recognition and acceptance. Autism can be seen as a natural variation on par with for example homosexuality. The broad version of the neurodiversity claim, covering low-functioning as well as high-functioning autism, is problematic. Only a narrow conception of neurodiversity, referring exclusively to high-functioning autists, is reasonable. We will discuss the effects of DSM categorization and the medical model for high functioning autists. After a discussion of autism as a culture we will analyze various possible strategies for the neurodiversity movement to claim extra resources for autists as members of an underprivileged culture without being labelled disabled or as having a disorder. We will discuss their vulnerable status as a group and what obligation that confers on the majority of neurotypicals.

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  • 11.
    Jaarsma, Pier
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Gelhaus, Petra
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Psykiatri- och habiliteringsenheten.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Living the Categorical Imperative: autistic perspectives on lying and truth telling-between Kant and care ethics2012Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 15, nr 3, s. 271-277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Lying is a common phenomenon amongst human beings. It seems to play a role in making social interactions run more smoothly. Too much honesty can be regarded as impolite or downright rude. Remarkably, lying is not a common phenomenon amongst normally intelligent human beings who are on the autism spectrum. They appear to be 'attractively morally innocent' and seem to have an above average moral conscientious objection against deception. In this paper, the behavior of persons with autism with regard to deception and truthfulness will be discussed in the light of two different ethical theories, illustrated by fragments from autobiographies of persons with autism. A systemizing 'Kantian' and an empathizing 'ethics of care' perspective reveal insights on high-functioning autism, truthfulness and moral behavior. Both perspectives are problematic from the point of view of a moral agent with autism. High-functioning persons with autism are, generally speaking, strong systemizes and weak empathizers. Particularly, they lack 'cognitive empathy' which would allow them to understand the position of the other person. Instead, some tend to invent a set of rules that makes their behavior compatible with the expectations of others. From a Kantian point of view, the autistic tendency to always tell the truth appears praiseworthy and should not be changed, though it creates problems in the social life of persons with autism. From a care ethics perspective, on the other hand, a way should be found to allow the high-functioning persons with autism to respect the feelings and needs of other persons as sometimes overruling the duty of truthfulness. We suggest this may even entail 'morally educating' children and adolescents with autism to become socially skilled empathic 'liars'.

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