Bjørn Hofmann
Biographic Data
| ID | 4620395 |
|---|---|
| NAME | Bjørn Hofmann |
| GIVEN NAMES | Bjørn |
| FAMILY NAME | Hofmann |
| SIGNATURE | HOFMANN B |
| AFFILIATIONS | University of Oslo |
| ORCID | 0000-0001-6709-4265 |
| VERIFIED | Yes |
| TOTAL WORKS | 33 |
| TOTAL CITATIONS | 13 |
| AUTHOR COUNT | 33 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Responsive Equanimity to Uncertainty
The objective of this study is to elaborate an overall concept of addressing uncertainty in clinical practice that covers a series of specific characteristics. To do so, a conceptual engineering approach has been applied, starting with describing the concepts that exist and are in use. Based on this description the functional quality of these concepts (representational devices) is evaluated and a series of criteria for an improved concept is deve…
Improving bioethics by clarifying and elaborating its methodology
In a recent article Gomez-Virseda and coauthors criticize my previous work on methodology in bioethics and argue that bioethics is a discipline. While I think that Gomez-Virseda and co-authors misconstrue my argument, state the obvious, and fail to address pressing questions to their argument, I am most thankful for the inspiration and opportunity to elaborate on why methodology matters for consolidating bioethics' professional standing, to impro…
Uncertainty tolerance in healthcare
This paper critically analyzes the meaning of uncertainty tolerance (UT), a phenomenon of growing interest in healthcare. Medical practitioners, educators, and researchers have increasingly acknowledged the importance of UT for both clinicians and patients, and called for greater attention to improving it. However, we argue that the prevailing conception of UT is an inadequate normative ideal, due to its narrow understanding of uncertainty as exc…
Problems with adversarial cooperation
Bioethics
This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as “a field of study following specific and well-established methodological rules” bioethics is not a specific discipline as there are no explicit “well-established methodological rules.” The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological …
Addressing the overuse-underuse paradox in healthcare
There is a basic contradiction in modern healthcare: while there is an urgent need for more resources to provide documented effective care in many health systems, the same systems provide extensive services that are reported to have little or no effect on people's health. This induces long wait times, delayed diagnoses and treatments, poorer prognosis, and worse outcomes. That is, a wide range of studies have demonstrated health care systems to p…
Kairos in diagnostics
Kairos has been a key concept in medicine for millennia and is frequently understood as “the right time” in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease)…
Undermining autonomy and consent
Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of tr…
Moral obligations towards human persons’ wellbeing versus their suffering
What do we owe other persons? Are we as much obliged to promote their wellbeing as we are to reduce their suffering? This question is crucial for a range of social institutions and welfare services, and especially for the health services. To address this question the article investigates prominent positions and arguments in moral philosophy. It finds that while classical utilitarianism claims that there is symmetry in the moral obligation with re…
Aesthetic Injustice
In business as elsewhere, “ugly people” are treated worse than ”pretty people.” Why is this so? This article investigates the ethics of aesthetic injustice by addressing four questions: 1. What is aesthetic injustice? 2. How does aesthetic injustice play out? 3. What are the characteristics that make people being treated unjustly? 4. Why is unattractiveness (considered to be) bad? Aesthetic injustice is defined as unfair treatment of persons due …
Temporal uncertainty in disease diagnosis
There is a profound paradox in modern medical knowledge production: The more we know, the more we know that we (still) do not know. Nowhere is this more visible than in diagnostics and early detection of disease. As we identify ever more markers, predictors, precursors, and risk factors of disease ever earlier, we realize that we need knowledge about whether they develop into something experienced by the person and threatening to the person’s hea…
On the Ethics of Withholding and Withdrawing Unwarranted Diagnoses
The number of diagnoses and the number of persons having diagnoses have increased substantially, and studies indicate that diagnoses are given or upheld even if they are unwarranted, that is, that they do not satisfy professionally accepted diagnostic criteria. In this article, the authors investigate the ethics of withholding and withdrawing unwarranted diagnoses. First, they investigate ethical aspects that make it difficult to withhold and to …
Research Integrity Attitudes and Behaviors are Difficult to alter
Background: Research integrity has obtained much attention in research communities, but also in the general public. To improve research integrity is difficult as it involves complex systems of knowledge, attitudes, and practices. The objective of this study is to investigate the knowledge, attitudes, and practices of cohorts of PhD candidates at one faculty (of medicine) over time and compare this to finished PhDs of the same cohorts. Material an…
Vagueness in Medicine
This article investigates five kinds of vagueness in medicine: disciplinary, ontological, conceptual, epistemic, and vagueness with respect to descriptive-prescriptive connections. First, medicine is a discipline with unclear borders, as it builds on a wide range of other disciplines and subjects. Second, medicine deals with many indistinct phenomena resulting in borderline cases. Third, medicine uses a variety of vague concepts, making it unclea…
Avoiding hypersensitive reluctance to address parental responsibility in childhood obesity
Childhood obesity is an increasing health problem. Prior empirical research suggests that, although discussing lifestyle behaviours with parents could help prevent childhood obesity and its health-related consequences, physicians are reluctant to address parental responsibility in the clinical setting. Therefore, this paper questions whether parents might be (or might be held) responsible for their children’s obesity, and if so, whether parental …
Prioritization of Covid-19 vaccination. The added value of the “Validate” approach
Misuse of co-authorship in Medical PhD Theses in Scandinavia
Background Several studies suggest that deviations from proper authorship practices are commonplace in medicine. The aim of this study was to explore experiences of and attitudes towards the handling of authorship in PhD theses at medical faculties in Denmark, Norway, and Sweden. Methods Those who defended their PhD thesis at a medical faculty in Scandinavia during the second half of 2020 were offered, by e-mail, to participate in an online surve…
Back to WHAT? The role of research ethics in pandemic times
The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to…
Survey on the Research Misconduct and Questionable Research Practices of Medical Students, PhD Students, and Supervisors at the Zagreb School of Medicine in Croatia
This cross-sectional study evaluates the knowledge, attitudes, experiences, and behavior of final year medical students, PhD students, and supervisors at the School of Medicine of the University of Zagreb in relation to research misconduct, questionable research practices, and the research environment. The overall response rate was 36.4% (68%-100% for the paper survey and 8%-15% for the online surveys). The analysis reveals statistically signific…
Devaluation of persons by biotechnology-facilitated practices at the beginning and at the end of life
Although Phil Reed certainly advances the expressivist debate, it is not clear that the objections to the expressivist argument are so different at the end compared with the beginning of life or that this adds to and substantiates the arguments against physician assisted suicide and euthanasia. Moreover, it is not obvious that the traditional objections to the expressivist argument, for example, that there is no message, no sender, and no receive…
The death of dignity is greatly exaggerated
Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that “[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content.” While some of the commentari…
Rethinking patient involvement in healthcare priority setting
With healthcare systems under pressure from scarcity of resources and ever‐increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient…
Biases distorting priority setting
Modern health care faces an ever widening gap between technological possibilities and available resources. To handle this challenge we have constructed elaborate systems for health policy making and priority setting. Despite such systems many health care systems provide a wide range of documented low-value care while being unable to afford emerging high-value care. Accordingly, this article sets out asking why priority setting in health care has …
What Makes Some Diseases More Typical than Others? A Survey on the Impact of Disease Characteristics and Professional Background on Disease Typicality
Health professionals tend to perceive some diseases as more typical than others. If disease typicalities have implications for health professionals or health policy makers' handling of different diseases, then it is of great social, epistemic, and ethical interest. Accordingly, it is important to find out what makes health professionals rank diseases as more or less typical. This study investigates the impact of various factors on how typical var…
Research Integrity Among PhD Students at the Faculty of Medicine
This study investigates research integrity among PhD students in health sciences at three universities in Scandinavia (Stockholm, Oslo, Odense). A questionnaire with questions on knowledge, attitudes, experiences, and behavior was distributed to PhD students and obtained a response rate of 77.7%. About 10% of the respondents agreed that research misconduct strictly defined (such as fabrication, falsification, and plagiarism, FFP) is common in the…
How medical technologies shape the experience of illness
In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing dise…
The technological invention of disease
Technology has come to play a profound role in medicine since the middle of the 19th century, and many scholars have analysed the role of technology in medicine. Parallel to this development there has been a comprehensive debate on the concept of disease. This article combines these fields and investigates the influence of technology on the concept of disease. With reference to the literature it tries to elaborate an explicit account of the const…
Investigating the Reliability and Factor Structure of Kalichman’s “Survey 2
A precondition for reducing scientific misconduct is evidence about scientists' attitudes. We need reliable survey instruments, and this study investigates the reliability of Kalichman's "Survey 2: research misconduct" questionnaire. The study is a post hoc analysis of data from three surveys among biomedical doctoral students in Scandinavia (2010-2015). We perform reliability analysis, and exploratory and confirmatory factor analysis using a spl…
Scientific Dishonesty
As we need knowledge about the prevalence of scientific dishonesty, this study investigates the knowledge of, experiences with, and attitudes toward various forms of scientific dishonesty among PhD students at the main medical faculties in Sweden and Norway. An anonymous questionnaire was distributed to all post-graduate research students attending basic PhD courses at the medical faculties in Stockholm and Oslo during the fall 2014. The respondi…
The technological invention of disease
Technology has come to play a profound role in medicine since the middle of the 19th century, and many scholars have analysed the role of technology in medicine. Parallel to this development there has been a comprehensive debate on the concept of disease. This article combines these fields and investigates the influence of technology on the concept of disease. With reference to the literature it tries to elaborate an explicit account of the const…
The inference from a single case
Are there similarities between scientific and moral inference? This is the key question in this article. It takes as its point of departure an instance of one person's story in the media changing both Norwegian public opinion and a brand-new Norwegian law prohibiting the use of saviour siblings. The case appears to falsify existing norms and to establish new ones. The analysis of this case reveals similarities in the modes of inference in science…
Scientific Dishonesty
As we need knowledge about the prevalence of scientific dishonesty, this study investigates the knowledge of, experiences with, and attitudes toward various forms of scientific dishonesty among PhD students at the main medical faculties in Sweden and Norway. An anonymous questionnaire was distributed to all post-graduate research students attending basic PhD courses at the medical faculties in Stockholm and Oslo during the fall 2014. The respondi…
Making sense of complexity in context and implementation
BACKGROUND: The effectiveness of complex interventions, as well as their success in reaching relevant populations, is critically influenced by their implementation in a given context. Current conceptual frameworks often fail to address context and implementation in an integrated way and, where addressed, they tend to focus on organisational context and are mostly concerned with specific health fields. Our objective was to develop a framework to f…
Response to Commentary
Responsible Research and Innovation in the context of human cognitive enhancement
Human cognitive enhancement (HCE) is an area in which non-therapeutic enhancements have been widely debated. Some applications are already on the market and available for home use (e.g. non-invasive brain stimulation devices), while other forms of enhancement such as ‘smart drugs’ or pharmacological enhancers are readily available (albeit ‘off-label’ or illegally obtained). Private and public interest in HCE may well intensify as the field engage…
Investigating the Reliability and Factor Structure of Kalichman’s “Survey 2
A precondition for reducing scientific misconduct is evidence about scientists' attitudes. We need reliable survey instruments, and this study investigates the reliability of Kalichman's "Survey 2: research misconduct" questionnaire. The study is a post hoc analysis of data from three surveys among biomedical doctoral students in Scandinavia (2010-2015). We perform reliability analysis, and exploratory and confirmatory factor analysis using a spl…
How medical technologies shape the experience of illness
In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing dise…
Devaluation of persons by biotechnology-facilitated practices at the beginning and at the end of life
Although Phil Reed certainly advances the expressivist debate, it is not clear that the objections to the expressivist argument are so different at the end compared with the beginning of life or that this adds to and substantiates the arguments against physician assisted suicide and euthanasia. Moreover, it is not obvious that the traditional objections to the expressivist argument, for example, that there is no message, no sender, and no receive…
The death of dignity is greatly exaggerated
Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that “[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content.” While some of the commentari…
Rethinking patient involvement in healthcare priority setting
With healthcare systems under pressure from scarcity of resources and ever‐increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient…
Biases distorting priority setting
Modern health care faces an ever widening gap between technological possibilities and available resources. To handle this challenge we have constructed elaborate systems for health policy making and priority setting. Despite such systems many health care systems provide a wide range of documented low-value care while being unable to afford emerging high-value care. Accordingly, this article sets out asking why priority setting in health care has …
What Makes Some Diseases More Typical than Others? A Survey on the Impact of Disease Characteristics and Professional Background on Disease Typicality
Health professionals tend to perceive some diseases as more typical than others. If disease typicalities have implications for health professionals or health policy makers' handling of different diseases, then it is of great social, epistemic, and ethical interest. Accordingly, it is important to find out what makes health professionals rank diseases as more or less typical. This study investigates the impact of various factors on how typical var…
Research Integrity Among PhD Students at the Faculty of Medicine
This study investigates research integrity among PhD students in health sciences at three universities in Scandinavia (Stockholm, Oslo, Odense). A questionnaire with questions on knowledge, attitudes, experiences, and behavior was distributed to PhD students and obtained a response rate of 77.7%. About 10% of the respondents agreed that research misconduct strictly defined (such as fabrication, falsification, and plagiarism, FFP) is common in the…
Back to WHAT? The role of research ethics in pandemic times
The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to…
Survey on the Research Misconduct and Questionable Research Practices of Medical Students, PhD Students, and Supervisors at the Zagreb School of Medicine in Croatia
This cross-sectional study evaluates the knowledge, attitudes, experiences, and behavior of final year medical students, PhD students, and supervisors at the School of Medicine of the University of Zagreb in relation to research misconduct, questionable research practices, and the research environment. The overall response rate was 36.4% (68%-100% for the paper survey and 8%-15% for the online surveys). The analysis reveals statistically signific…
Vagueness in Medicine
This article investigates five kinds of vagueness in medicine: disciplinary, ontological, conceptual, epistemic, and vagueness with respect to descriptive-prescriptive connections. First, medicine is a discipline with unclear borders, as it builds on a wide range of other disciplines and subjects. Second, medicine deals with many indistinct phenomena resulting in borderline cases. Third, medicine uses a variety of vague concepts, making it unclea…
Avoiding hypersensitive reluctance to address parental responsibility in childhood obesity
Childhood obesity is an increasing health problem. Prior empirical research suggests that, although discussing lifestyle behaviours with parents could help prevent childhood obesity and its health-related consequences, physicians are reluctant to address parental responsibility in the clinical setting. Therefore, this paper questions whether parents might be (or might be held) responsible for their children’s obesity, and if so, whether parental …
Prioritization of Covid-19 vaccination. The added value of the “Validate” approach
Misuse of co-authorship in Medical PhD Theses in Scandinavia
Background Several studies suggest that deviations from proper authorship practices are commonplace in medicine. The aim of this study was to explore experiences of and attitudes towards the handling of authorship in PhD theses at medical faculties in Denmark, Norway, and Sweden. Methods Those who defended their PhD thesis at a medical faculty in Scandinavia during the second half of 2020 were offered, by e-mail, to participate in an online surve…
Temporal uncertainty in disease diagnosis
There is a profound paradox in modern medical knowledge production: The more we know, the more we know that we (still) do not know. Nowhere is this more visible than in diagnostics and early detection of disease. As we identify ever more markers, predictors, precursors, and risk factors of disease ever earlier, we realize that we need knowledge about whether they develop into something experienced by the person and threatening to the person’s hea…
On the Ethics of Withholding and Withdrawing Unwarranted Diagnoses
The number of diagnoses and the number of persons having diagnoses have increased substantially, and studies indicate that diagnoses are given or upheld even if they are unwarranted, that is, that they do not satisfy professionally accepted diagnostic criteria. In this article, the authors investigate the ethics of withholding and withdrawing unwarranted diagnoses. First, they investigate ethical aspects that make it difficult to withhold and to …
Research Integrity Attitudes and Behaviors are Difficult to alter
Background: Research integrity has obtained much attention in research communities, but also in the general public. To improve research integrity is difficult as it involves complex systems of knowledge, attitudes, and practices. The objective of this study is to investigate the knowledge, attitudes, and practices of cohorts of PhD candidates at one faculty (of medicine) over time and compare this to finished PhDs of the same cohorts. Material an…
Kairos in diagnostics
Kairos has been a key concept in medicine for millennia and is frequently understood as “the right time” in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease)…
Undermining autonomy and consent
Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of tr…
Medicine (22 works) · Psychology (18 works) · Political science (14 works) · Alternative medicine (10 works) · Epistemology (10 works) · Law (10 works) · Social Psychology (10 works) · Sociology (10 works) · Computer Science (9 works) · Ethics in medical practice (8 works)