Allen Alvarez

Four papers are included in this November 2018 special issue Open Section. First is by Bjørn Hofmann and Siri Granum Carson titled _Filosofiens rolle i det offentlige ordskiftet: Hvordan har debatten om sorteringssamfunnet i 2017 påvirket forholdet mellom filosofi og samfunn? En innholdsanalyse_. Second, _Provokativ offentlig filosofi_ by Aksel Braanen Sterri. Third, Steinar Bøyum’s _The Democratic Duty to Educate Oneself._ And fourth, Jonas Jakobsen and Kjersti Fjørtoft’s _In defence of moderate Inclusivism: Revisiting Rawls and Habermas._

Background: Recent studies on public attitudes toward life extension technologies show a mix of ambivalence toward and support for extending the human lifespan. Attitudes toward genetic modification of organisms and technological enhancements may be used to categorize individuals according to political or ideological orientation such as technoprogressive or conservative and it could be easy to assume that these categories are related to more general categorizations related to culture, e.g. between Traditional and Secular-rational values in the World Values Survey. This paper discusses how attitudes toward aspects of radical life extension may be related to cultural values as revealed in an online deliberative survey among university students conducted between January 2012 to January 2013. Survey results suggest that attitudes toward radical life extension tend to be mixed among groups categorized as Traditional, Secular-rational, Survivalist, and Self-expressionist. The study explored the relation between responses of 326 university students to 5 key questions on radical life extension and the cultural values they tend to favor as indicated by their response to 20 statements from the World Values Survey.Design and Method: The survey consisted of 3 stages: an online pre-discussion survey, face-to-face discussion, and post-discussion survey. After completing the 5 main survey questions in stage 1, participants were presented two additional questionnaires: one on cultural attitudes using 20 statements from the 2004-2008 World Values Survey and another on health attitudes with 12 statements from Dutta-Bergman’s 2004 study. In stage 2, participants were engaged in a face-to-face discussion in class focusing on their responses to the five key questions. After the discussion, they were invited to reconsider the choices and reasons they posted in stage 1 in the light of the face-to-face class discussion in stage 2.Results: Responses to the five survey questions showed that there tended to be more individuals across groups who disagreed with adopting technologies that radically extend the human lifespan beyond the current limit of 120 years. Attitudes toward radical life extension did not correspond to cultural attitudes indicated by responses to the WVS questions. The proportion of agreement/disagreement to statements presented in each of the five questions varied across cultural groups and there tended to be more individuals who disagreed with radical life extension in all groups. Changes in responses after the discussion stage were not significant and most respondents maintained their prior views.Discussion: Cultural attitudes associated with familiar technologies may not correspond with attitudes toward newer technologies since beliefs and values may need to be adapted to new imagined situations that the new technologies elicit. Moral understandings associated with familiar technological habits and beliefs are not necessarily carried over to new technologies.

This open themed issue of Etikk i praksis compiles five diverse papers that overlap at key conceptual intersections around trust, care and responsibilities across national boundaries. Our globalized social environments have become more and more complex, and the information needed to understand society and our moral responsibilities have grown ever more challenging. The ‘fake news’ buzzword, used by various societal actors to cast doubt on political rivals, is shaking the trust needed to be confident about institutional sources of information. The caring attitude that serves to cement social groups and communities seems to be weakening in certain contexts, resulting in individual acts of unimaginable violence that shock us to the core. On the other hand, we are inspired when the same caring attitude mobilizes groups and individuals to reach across national boundaries and aid those who are suffering. In sorting through the generalizations and attempts to categorize the many highly complex social phenomena that occur in our interconnected global realities, we apply careful analysis of both facts and values that facilitate ethical reflection, helping us to make ethical decisions.

How should national societies build legitimate and inclusive collective identities amidst prolific multiculturalism and linguistic diversity? We argue that cultural ownership of particular ways of framing ethics should be part of this collective identity building process. We should avoid unfair domination of minority cultural identities, but how do we do this when ethical discourses themselves tend to be shaped by particular dominant identities? We look into the case of the challenges that a particular multicultural society, the Philippines, faces in its ongoing collective identity building project on three levels: ethnic and linguistic differences, the historical layers of foreign culture that have each influenced these distinct cultural identities in different degrees, and the apparent domination of Tagalog linguistic culture over others. Our answer to the question of legitimate and inclusive collective identity comes from an inter-linguistic dialogue that can be effected between cultures by harnessing similarities of ethical concepts, without compromising cultural differences. We present three different possible approaches under the following headings: Pilipino ethics, Filipino ethics and Philippine ethics, each representing a particular stance to the dominant Tagalog linguistic culture. We argue for the third option, which is the most inclusive because of how it equalizes the status of all participating cultures in the dialogue. We also draw from the possibilities afforded by the phenomena of Scandinavian semicommunication and what this practice offers in making collective identity building more inclusive.

The question of how society should deal with social conflicts arising from cultural differences persists. Should we adopt an exclusivist approach by excluding reasons based on specific cultural traditions from public debates about social policy, especially because these reasons do not appeal to the public at large? Or should we resort to an inclusivist approach by including reasons based on cultural traditions in public debate to give recognition to the diverse cultural identities of those who practice these traditions? While these two approaches assign different roles to cultural traditions in public debate, both seem to welcome compromise between conflicting parties. This paper reviews contending normative approaches for dealing with conflicts in multicultural societies and explores the place of culture-based reasons in public debates designed to resolve conflicts

Rational justification of claims with empirical content calls for empirical and not only normative philosophical investigation. Empirical approaches to bioethics are epistemically valuable, i.e., such methods may be necessary in providing and verifying basic knowledge about cultural values and norms. Our assumptions in moral reasoning can be verified or corrected using these methods. Moral arguments can be initiated or adjudicated by data drawn from empirical investigation. One may argue that individualistic informed consent, for example, is not compatible with the Asian communitarian orientation. But this normative claim uses an empirical assumption that may be contrary to the fact that some Asians do value and argue for informed consent. Is it necessary and factual to neatly characterize some cultures as individualistic and some as communitarian? Empirical investigation can provide a reasonable way to inform such generalizations. In a multi‐cultural context, such as in the Philippines, there is a need to investigate the nature of the local ethos before making any appeal to authenticity. Otherwise we may succumb to the same ethical imperialism we are trying hard to resist. Normative claims that involve empirical premises cannot be reasonably verified or evaluated without utilizing empirical methods along with philosophical reflection. The integration of empirical methods to the standard normative approach to moral reasoning should be reasonably guided by the epistemic demands of claims arising from cross‐cultural discourse in bioethics.

Ethical beliefs may vary across cultures but there are things that must be valued as preconditions to any cultural practice. Physical and mental abilities vital to believing, valuing and practising a culture are such preconditions and it is always important to protect them. If one is to practise a distinct culture, she must at least have these basic abilities. Access to basic healthcare is one way to ensure that vital abilities are protected. John Rawls argued that access to all-purpose primary goods must be ensured. Amartya Sen and Martha Nussbaum claim that universal capabilities are what resources are meant to enable. Len Doyal and Ian Gough identify physical health and autonomy as basic needs of every person in every culture. When we disagree on what to prioritize, when resources to satisfy competing demands are scarce, our common needs can provide a point of normative convergence. Need-based rationing, however, has been criticized for being too indeterminate to give guidance for deciding which healthcare services to prioritize and for tending to create a bottomless-pit problem. But there is a difference between needing something (first-order need) and needing to have the ability to need (second-order need). Even if we disagree about which first-order need to prioritize, we must accept the importance of satisfying our second-order need to have the ability to value things. We all have a second-order need for basic healthcare as a means to protect our vital abilities even if we differ in what our cultures consider to be particular first-order needs.

Application of egalitarian and prioritarian accounts of health resource allocation in low‐income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that result from such allocation schemes. Insufficient health care and severe deprivation of health resources are difficult to accept even when justified by aggregative efficiency or legitimized by fair deliberative process in pursuing equality and priority oriented outcomes. I affirm the sufficientarian argument that, given extreme scarcity of public health resources in low‐income countries, neither health status equality between populations nor priority for the worse off is normatively adequate. Nevertheless, the threshold norm alone need not be the sole consideration when a country's total health budget is extremely scarce. Threshold considerations are necessary in developing a theory of fair distribution of health resources that is sensitive to the lexically prior norm of sufficiency. Based on the intuition that shares must not be taken away from those who barely achieve a minimal level of health, I argue that assessments based on standards of minimal physical/mental health must be developed to evaluate the sufficiency of the total resources of health systems in low‐income countries prior to pursuing equality, priority, and efficiency based resource allocation. I also begin to examine how threshold sensitive health resource assessment could be used in the Philippines.