The boundary problem in normative democratic theory is the problem of who should be entitled to participate in which democratic decision-making. The boundary problem is at the heart of many pressing political issues, including voting rights of resident aliens in their host countries and of expats in their home countries, the legitimacy of border regimes, the justifiability of global democracy, and the democratic representation of future generations. The two most popular answers to the boundary problem are the all-affected interests principle and the all-subjected principle. According to the all-affected interests principle, all (and only) persons whose interests are affected by a democratic decision should be entitled to participate in making that decision. According to the all-subjected principle, all (and only) persons who are subject to a democratic decision should be entitled to participate in making that decision, where being subject is spelled out either in terms of being legally bound or in terms of being exposed to coercion. A well-known challenge for the proposed solutions to the boundary problem is posed by tourists. Tourists seem to be affected in their interests and subject in the relevant sense by democratic decisions in their host countries. But we would not normally consider tourists entitled to participate in the making of such decisions. In this paper, I examine the most natural responses to the challenge of tourists and argue that both the all-affected interests principle and the all-subjected principle are on the horns of a dilemma. The dilemma arises because responses that yield intuitively plausible verdicts about tourists on the other hand commit their advocates to implausible verdicts about dying citizens.

We analyze a frequent but undertheorized form of structural injustice, one that arises due to the difficulty of reaching numerically equitable representation of underrepresented subgroups within a larger group. This form of structural injustice is significant because it could occur even if it were possible to completely eliminate bias and overt discrimination from hiring and recruitment practices. The conceptual toolkit we develop can be used to analyze such situations and propose remedies. Specifically, based on a simple mathematical model, we offer a new argument in favour of quotas, explore implications for policy-making, and consider the wider philosophical significance of the problem. We show that in order to reach more equitable representations, quota-based recruitment may often be practically unavoidable. Assuming that members of groups in statistical minority are more likely to quit due to their marginalization, their proportions can stabilize at a low level, preventing a shift towards more equal representation and conserving the minority status of the subgroup. We show that this argument has important implications for addressing, preventing, and remediating the structural injustice of unfair representation.

This is the first book exclusively devoted to phenomenology and quantum mechanics. By emphasizing the role of the subject’s experiences, QBism exhibits several interesting parallels with phenomenology. This book elaborates whether and specifies how phenomenology could serve as thephilosophical foundation of QBism. This objective is pursued from the perspective of QBists engaging with phenomenology as well as the perspective of phenomenologists engaging with QBism. These approaches enable us to realize a better understanding of quantum mechanics and the world we live in, achieve a better understanding of QBsim, and introduce the phenomenological foundations of quantum mechanics.

This is the first issue of the research environment for the Philosophy and Applied Ethics publication series. In this issue we see a selection of texts from the active researchers within the environment. In preparation for this first issue of our publication series, the authors were asked to write a text showing how philosophical research or philosophical competence is (or can be) expressed in society outside of academia. In these texts, one can not only see the breadth within our research environment but also how broad the subject of philosophy is and can be. It provides a good sampling of the various approaches and methodologies encompassed within the subject. One can clearly see how these texts represent various aspects of the activities encompassed in the research environment and the Department of Philosophy and Applied Ethics (FTE) within the Department of Culture and Society (IKOS) at Linköping University.

The opening text by Fredrik Stjernberg reflects on what makes philosophical questions specific, pointing out how it seems almost impossible to escape philosophy, no matter how many times it has been declared dead throughout history. Elin Palm’s text discusses the expertise that ethicists are said to possess and how this is expressed in various ethical councils in our society. Erik Gustavsson’s text is an example of how medical ethical considerations are made, in this case specifically how one can think about the concept of “cure” in relation to treatment methods in healthcare.

Another perspective is found in Martin Berzell’s text on the ancient philosopher Epicurus’ view of pleasure, which is related to modern consumer society. Here, it is about how a philosophical attitude can be used to improve mental well-being, which could be seen as a precursor to our self-help literature. Harald Wiltsche, on the other hand, has written a text about thought experiments in the sciences, and how one could consider science fiction literature as a parallel to how thought experiments are used in, for example, physics.

In the three concluding texts, we can see how practical philosophy and applied ethics provide us with concepts to describe and tools to handle various phenomena in our modern society. Vuko Andrić writes about the boundary problem in democracy issues, which addresses the question of who should be allowed to participate in democratic decision-making. András Szigeti writes in his text about exploitation and what the relationship between exploitation and structural injustices looks like. Lastly, Lars Lindblom’s text on justice and trade unions, where he takes inspiration from Rawls’ theory of justice to demonstrate the role of trade unions in achieving a fairer labor market.

Parents of a child with chronic kidney disease (CKD) must safely perform advanced care and treatment while at the same time allowing the child some freedom and maintaining everyday parenting and family tasks. Drawing on interviews with primary caregivers of children with CKD in Portugal, we examine the context of raising a child with CKD and how the parents practise their parenthood. The study takes inspiration from parenting studies and child studies and explores how good parenthood is constructed. Based on thematic analysis, three core themes emerged: protecting the child, involving the child in their treatment, and transferring responsibility. The transformation of life-limiting circumstances into a life that worked well for both parents and their child represents what we call ‘readiness parenting’. Assessing risks, supporting the child’s autonomy, and relating to social norms required constant vigilance and readjustments as well as negotiations about parental responsibility.

Caring for a child with chronic kidney disease (CKD) requires parents to reorganise mundane routines and develop advanced technical skills. Parents’ strategies used to meet these challenges need greater understanding. This article takes inspiration from phenomenology of practice and material culture studies to analyse interviews with parents in Portugal. It shows that, although home-based care leads to worsened social inequities, parents use the available financial and human resources to manage the situation and create normality. While they experience becoming confined and close relationships are strained, the mundane practices and social relations of care bring hope and meaning to the family.  

It is widely known that criminal punishment, especially imprisonment, has negative effects for innocent persons, most notably the families of prisoners. This is an issue attracting increasing attention from penal theorists and philosophers. Adding to this literature, this article examines the extent to which incarceration of a parent is consistent with fundamental rights that are often ascribed to children. In particular, we focus on children's rights against being separated from their parents. To this end, we begin with a discussion of the philosophical basis for children's rights against being separated from their parents against their will. Drawing from recent work by Kimberley Brownlee and Matthew Liao, we argue that children have such a right and that it is grounded in children's welfare interest and the importance of parent-child relationships for children to develop adequately into autonomous agents. We then examine three arguments why imprisoning a parent is justified despite the fact that children have a right against being separated from their parents. For each of these arguments, we argue that while they may show the imprisonment of a particular parent to be sometimes compatible with respecting the right against parent-child separation, an extensive use of imprisonment as punishment of the sort that persists in many states is not.

Is it possible to communicate ethics across cultural borders? Not according to representativesof “the incommensurability thesis”, who claim that values and norms are culturally bounded.This article argues against this thesis. A first problem is that cultures and traditions are seenas comprehensive, delimited, and exclusive. Normally, however, a culture develops from andis in dialogue with other cultures. Further, the inner diversity of cultures and traditions opensthe possibility of communication and shared understandings across cultural borders. Finally, theteaching and discussion of cross-cultural ethics provide practical evidence of the possibility ofdialogue and mutual understanding.

In 2013, the heads of the governments of the Caribbean community (CARICOM) issued a deklaration demanding reparation for the genocide of the Indigenous population, the enslavement, the trade and trafficking of enslaved Africans and people of African descent during colonialism.

In 2020, the world faced a new pandemic. The corona infection hit an unprepared world, and there were no medicines and no vaccines against it. Research to develop vaccines started immediately and in a remarkably short time several vaccines became available. However, despite initiatives for global equitable access to COVID-19 vaccines, vaccines have so far become accessible only to a minor part of the world population. In this article, I discuss the global distribution of COVID-19 vaccines from an ethical point of view. I reflect on what ethical principles should guide the global distribution of vaccines and what global justice and international solidarity imply for vaccine distribution and I analyse the reasons for states to prioritize their own citizens. My focus is on ethical reasons for and against ‘vaccine nationalism’ and ‘vaccine cosmopolitanism.’ My point of departure is the appeal for international solidarity from several world leaders, arguing that ‘Where you live should not determine whether you live’. I discuss the COVAX initiative to enable a global vaccination and the proposal from India and South Africa to the World Trade Organization to temporarily waive patent rights for vaccines. In the final section, I argue for global vaccine sufficientarianism, which is a modified version of vaccine cosmopolitanism. 

I boken Political Liberalism försöker den amerikanske filosofen John Rawls besvara frågan hur människor trots att de håller sig med vitt skilda livsåskådningar ska kunna leva tillsammans i ett stabilt och rättvist demokratiskt samhälle. En del av Rawls svar på denna fråga innebär att samhälleliga institutioner och offentliga tjänstemän måste agera inom ramen för ett offentligt förnuft när de fattar beslut som rör fundamentala politiska frågor. Men vad är ett offentligt förnuft?

Denna artikel presenterar en tolkning av Rawls teori om det offentliga förnuftet och diskuterar tre olika invändningar mot detta som mynnar ut i en reviderad uppfattning om detta offentliga förnuft.

In this paper we discuss some recent and widely debated views of belief, comparingthem with Ramsey's, as it was developed in his classic papers (Ramsey 1926, 1927) and the posthumously published work On Truth (Ramsey 1991). This paper is not purely historical. Modern views of belief, especially the theory of Shah and Velleman (2005) are examined, and it is shown that Ramsey's views are relevant to the current discussion. Ramsey's theory of belief and judgement satisfies conditions stressed in modern theories, and even goes beyond them. As it can be reconstructed from his writings, his theory still has much to offer.

This paper focuses on medical neutrality as impartiality as a ground for rationing medical care in the context of armed conflict. Impartiality is often taken to entail that medical professionals should not discriminate between patients on “morally irrelevant grounds”. Common examples of such grounds are age, gender, nationality, and political affiliation. This, in turn, is an idea akin to a principle of formal justice. Accordingly, medical neutrality as impartiality says something about how medical care should be distributed in armed conflict, or more specifically, it specifies grounds on which such care should not be distributed. However, it is unclear what this implies for rationing more specifically. The aim of this paper is to explore the concept of medical neutrality as impartiality, more specifically, to spell out the implications of medical neutrality as impartiality for the distribution of medical care in armed conflict. The paper argues that medical neutrality as impartiality must be understood as a mid-level ethical principle, rather than a high-level principle, to be applicable in practice. However, when ideas about formal justice are taken from high-level ethical theory and are applied on a mid-level, several questions arise. The paper then discusses two such questions.

Preexposure prophylaxis for HIV is a drug that reduces the risk for an HIV-negative person to acquire HIV if taken prior to sex. It has been suggested that it is important for resource allocation decisions that there are alternatives (such as abstinence, masturbation, etc.) for individuals potentially benefitted by this prophylaxis. In this paper we explore this idea from an ethical perspective in relation to three notions often discussed in priority setting ethics, namely responsibility, outcomes, and severity of disease. While the relevance of alternatives may be explained in terms by responsibility-sensitive priority setting, such a view comes with several challenges. We then discuss two other ways in which this intuition could be better explained: (a) in terms of total outcome of health, and (b) in terms of severity of the condition.

It is uncontroversial to claim that the extent to which health care interventions benefit patients is a relevant consideration for health care priority setting. However, when effects accrue to the individual patient, effects of a more indirect kind may accrue to other individuals as well, such as the patients children, friends, or partner. If, and if so how, such relational effects should be considered relevant in priority setting is contentious. In this paper, we illustrate this question by using disease-modifying drugs for Alzheimers disease as a case in point. The ethical analysis begins by sketching the so-called prima facie case for ascribing moral weight to relational effects and then moves on to consider a number of objections to it. We argue that, whereas one set of objections may be dismissed, there is another set of arguments that poses more serious challenges for including relational effects in priority setting.

How should scarce healthcare resources be distributed? This is a contentious issue that became especially pressing during the pandemic. It is often emphasised that studies exploring public views about this question provide valuable input to the issue of healthcare priority setting. While there has been a vast number of such studies it is rarely articulated, more specifically, what the results from these studies would mean for the justification of principles for priority setting. On the one hand, it seems unreasonable that public values would straightforwardly decide the ethical question of how resources should be distributed. On the other hand, in a democratic society, it seems equally unreasonable that they would be considered irrelevant for this question. In this paper we draw on the notion of reflective equilibrium and discuss the relevance and roles that empirical studies may plausibly have for justification in priority setting ethics. We develop a framework for analysing how different kinds of empirical results may have different kinds of implications for justification.

This thesis explores Friedrich Nietzsche's use of history for philosophical purposes, focusing on two central themes in Nietzsche's writings: the genealogical methodology, and perspectival epistemology. My aim is to demonstrate how Nietzsche's concept of "historical philosophizing" is intricately connected to his moral philosophy. Using a genealogical methodology, Nietzsche traces the historical development of moral concepts back to their foundations, unveiling the underlying power structures and complex mechanisms that underpin moral discourse. Additionally, perspectival epistemology challenges conventional notions of truth and objectivity, serving as a critique of moral semantics. I argue that these elements are interconnected and should be studied as parts of a unified whole. By providing insights into an overlooked theme in Nietzschean methodology, this essay may enrich our understanding of his philosophy as well as contribute to broader debates within contemporary philosophy.

Thomas Hobbes first law of nature states that 'each rational man shall and ought to endeavor peace'. Simultaneously, Hobbes first law of nature is perhaps the antithesis of his conception of man in nature (homo naturalis), where man is simply defined as an animal residing in an amoral and arbitrary environment in which every notion of "right and wrong" are connected to the individual's capacity for self-maximizing rationality. In turn, the social creature - zoon politikon - is the contradiction of Hobbes' homo naturalis: he is the impersonated restraint of the impulses and passions that leads him away from a life of an unending state of war into a moral and social community. Hobbes' social and moral creature is the result of a transition involving the creation of a social contract between an arbiter and the masses, binding them together in a shared fate: the excommunication of war and fear into the installment of peace and security. This essay addresses the transition of Hobbes conception of homo naturalis to his implicit understanding of zoon politikon; the transition from the amoral to the moral man. What implications does such a transition have for the egoistic-rational creature? What political and moral obligations are to be found between man and man, and between man and state? Finally, what is rational for the social creature to demand of the state? 

Fair priority setting is based on morally sound criteria. Still, there will be cases when these criteria, our primary considerations, are tied and therefore do not help us in choosing one allocation over another. It is sometimes suggested that such cases can be handled by tiebreakers. In this paper, we discuss two versions of tiebreakers suggested in the literature. One version is to preserve fairness or impartiality by holding a lottery. The other version is to allow secondary considerations, considerations that are not part of our primary priority setting criteria, to be decisive. We argue that the argument for preserving impartiality by holding a lottery is sound, while the argument for using tiebreakers as secondary considerations is not. Finally, we argue that the instances where a tiebreaker seems necessary are precisely the situations where we have strong reasons for preferring a lottery. We conclude that factors that we consider valuable should all be included among the primary considerations, while ties should be settled by lotteries.

Preface to the Special Issue on Free Will and Epistemology written by Robert Lockie

BACKGROUND: Breast cancer survivors' (BCS) attitudes toward eMental Health (eMH) are largely unknown, and adoption predictors and their interrelationships remain unclear. This study aimed to explore BCS' attitudes toward eMH and investigate associated variables.

METHODS: A cross-sectional study involving 336 Portuguese BCS was conducted. Attitudes toward eMH, depression and anxiety symptoms, health-related quality of life, and sociodemographic, clinical, and internet-related variables were assessed using validated questionnaires. Spearman-ranked correlations, χ², and multiple regression analyses were computed to explore associations between attitudes and collected variables.

RESULTS: BCS held a neutral stance toward eMH. In models adjusted for age and education, positive attitudes were statistically significantly associated with increased depressive symptoms and worse emotional, cognitive, and body image functioning. Social network use, online health information and mental healthcare seeking, higher self-reported knowledge of eMH, and previous use of remote healthcare were positively associated with better attitudes toward eMH.

CONCLUSIONS: eMH programs targeting BCS seem to be a promising strategy for providing supportive psychosocial care to BCS. However, increasing awareness about eMH efficacy and security may be necessary to improve its acceptance and use among BCS. Additional research is necessary to understand how BCS' unmet care needs, and specifically their psychological distress severity, may impact BCS' acceptance and use of eMH.

Background: Despite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices. Objective: This study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices. Methods: A qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)-psychologists and psychiatrists-was conducted. The transcribed interviews were thematically analyzed. Results: Mental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals. Conclusions: The publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.

Purpose

The purpose of this paper is to pinpoint and analyse ethical issues raised by the dual role of artificial intelligence (AI) in relation to climate change, that is, AI as a contributor to climate change and AI as a contributor to fighting climate change.

Design/methodology/approach

This paper consists of three main parts. The first part provides a short background on AI and climate change respectively, followed by a presentation of empirical findings on the contribution of AI to climate change. The second part presents proposals by various AI researchers and commentators on how AI companies may contribute to fighting climate change by reducing greenhouse gas emissions from training and use of AI and by providing AI assistance to various mitigation and adaptation measures. The final part investigates ethical issues raised by some of the options presented in the second part.

Findings

AI applications may lead to substantial emissions but may also play an important role in mitigation and adaptation. Given this dual role of AI, ethical considerations by AI companies and governments are of vital importance.

Practical implications

This paper pinpoints practical ethical issues that AI companies and governments should take into account.

Social implications

Given the potential impact of AI on society, it is vital that AI companies and governments take seriously the ethical issues raised by the dual role of AI in relation to climate change.

Originality/value

AI has been the subject of substantial ethical investigation, and even more so has climate change. However, the relationship between AI and climate change has received only limited attention from an ethical perspective. This paper provides such considerations.

In the initial phase of the COVID-19 pandemic, Sweden’s response stood out as an exception. For example, Sweden did not introduce any lockdowns, while many other countries did. In this paper I take the Swedish Corona Commission’s critique of the initial Swedish response as a point of departure for a general analysis of precaution in relation to pandemics. The Commission points out that in contrast to many other countries Sweden did not follow ‘the precautionary principle’. Based on this critique, the Commission proposes that the precautionary principle should be included among Sweden’s guiding principles for crisis management. However, as the debate on this principle during the last 30 years indicates, the principle is loaded with problems. I discuss one of these problems, namely its lack of clarity. I argue, however, that this problem is not unsurmountable. A principle is lacking clarity precisely by being a principle and not a rule with a well-defined meaning. As a principle it indicates a direction but does not prescribe a specific action. However, to be action-guiding its content needs to be specified by rational deliberation. With this in mind, I propose a framework for specification of the precautionary principle as applied to pandemics. The framework focuses on the principle’s four key elements: threat, uncertainty, action and responsibility. I also suggest certain general ethical restrictions on specification.

Science is a collective endeavor highly dependent on public acceptance and trust. Research findings must be reliable to serve the surrounding society as well as the research community itself. Evidence-based practice and policy recommendations may become ineffective or even dangerous if based on fraudulent research findings. Research persons directly involved in research projects and stakeholders affected by the research outcome should be able to trust in researchers´ integrity and rest assured that their rights and interests are duly respected within academic research. As David B Resnik notes, those who produce knowledge bear responsibility for the effects of the knowledge that they produce (Resnik, 1998:147). However, good research practice is not only about individual responsibility-taking and compliance. It is also a matter of conditions for good research practice within the organizations where academic research is conducted. Being the entities responsible for research, universities and higher education institutions are obligated to foster and maintain scientific integrity (Högskolelagen 1992:1434) and good research practice (Higher education ordinance/Högskoleförordningen (1993:100) chapter 1, 3 a §). They must also ensure that co-workers can get advice and support in questions regarding good research practice and deviations from such conduct (Chapter 1, 16 §).

Syftet med denna studie är att undersöka gymnasieelevers attityder till användningen av ChatGPT i skolan utifrån följande frågeställningar:

- Hur stor andel av de tillfrågade gymnasieeleverna känner till ChatGPT och hur vanligt är det att de använder chattboten i skolarbeten?

- Hur använder eleverna ChatGPT i skolarbetet?

- Vilka är elevernas attityder till användningen av ChatGPT i skolan?

- Vilken inställning har gymnasieelever till användning av ChatGPT i uppgifter som bedöms?

Data har samlats in genom en så kallad "mixed-method-design" bestående av en online-enkät och semistrukturerade intervjuer. Som grund för analysarbetet har ett fenomenologiskt perspektiv tillämpats. Resultatet visar på stora olikheter vad beträffar elevers kunskaper om och användning av ChatGPT. Några elever var väl bekanta med teknologin och använde den ofta, medan andra elever hade ytterst liten kännedom om den. Överlag var majoriteten av eleverna positiva till användning av ChatGPT i undervisningen, så länge som det sker på ett sätt som är förenligt med lärande och rättvis bedömning. Däremot menade flera elever att ChatGPT inte bör användas för att skriva hela texter eller i ämnen som svenska där språket bedöms. Det framkom även att elever hade skilda uppfattningar om vad fusk innebär och huruvida det är acceptabelt att ägna sig åt fusk. Under samtalen framkom en distinktion mellan fusk och orättvisa och några elever menade att ChatGPT kan främja likvärdighet och motverka orättvisa.

This chapter discusses the justification of Bitcoin from the perspective of political philosophy. Bitcoin is a form of digital money that is not tied to a central bank or government and that primarily facilitates anonymous economic transactions on the internet. The chapter suggests that the Bitcoin movement to a large extent has been driven by a libertarian framework, stressing the right of individuals to choose their own means of transaction without government interference or oversight. However, it argues that the libertarian case ultimately is unconvincing. A better case for Bitcoin can be formulated by using an egalitarian framework, more specifically, concerns about unequal distribution of power and resources. In the end, however, the chapter makes the claim that the justification also must depend on the political and economic context, and that this seems to speak against the use of Bitcoin in reasonably well-ordered societies.

When considering the introduction of a new intervention in a budget constrained healthcare system, priority setting based on fair principles is fundamental. In many jurisdictions, a multi-criteria approach with several different considerations is employed, including severity and cost-effectiveness. Such multi-criteria approaches raise questions about how to balance different considerations against each other, and how to understand the logical or normative relations between them. For example, some jurisdictions make explicit reference to a large patient benefit as such a consideration. However, since patient benefit is part of a cost-effectiveness assessment it is not clear how to balance considerations of greater patient benefit against considerations of severity and cost-effectiveness. The aim of this paper is to explore the role of a large patient benefit as an independent criterion for priority setting in a healthcare system also considering severity and cost-effectiveness. By taking the opportunity cost of new interventions (i.e., the health forgone in patients already receiving treatment) into account, we argue that patient benefit has a complex relationship to priority setting. More specifically, it cannot be reasonably concluded that large patient benefits should be given priority if severity, cost-effectiveness, and opportunity costs are held constant. Since we cannot find general support for taking patient benefit into account as an independent criterion from any of the most discussed theories about distributive justice: utilitarianism, prioritarianism, telic egalitarianism and sufficientarianism, it is reasonable to avoid doing so. Hence, given the complexity of the role of patient benefit, we conclude that in priority practice, a large patient benefit should not be considered as an independent criterion, on top of considerations of severity and cost-effectiveness.

In this paper I will argue that some of the contradictions in the Problem of the Many occur since we're dealing with two different types of concepts of a cloud, one that is 'common-sense', and one that is 'scientific'. I will borrow from Noam Chomsky’s distinction between common-sense concepts, which are understood intuitively and are usually human-centric, and scientific concepts, which are carefully constructed and aspire to be objective. The common-sense concept of a cloud has certain properties (such as having a sharp boundary) which contradict some found in the scientific concept (such as having a vague boundary), and this is the source of some contradictions found within the Problem of the Many. I will propose that in the future we should approach the problem with this in mind, and not treat it as if we're dealing with only one concept of a cloud, but instead, several.

Current studies indicate that robotic-assisted surgery is not inferior to laparoscopic or open surgery regarding oncologic or functional outcomes. An exception may be uterine cervix cancer, where the survival after minimal invasive surgery might not be as good as after open surgery. There is less bleeding and need for blood transfusion after robotic-assisted surgery, and postoperative complications are similar to open or laparoscopic surgery. Robotic-assisted surgery offers ergonomic advantages compared to laparoscopic surgery. The effect of the surgical learning curve is not sufficiently studied. Presently robotic-assisted surgery is not cost-effective due to high costs of investments. The operation is more time consuming than laparoscopic or open surgery with risks of delaying and cancellation of other operations.