I lagen om etikprövning framgår det att forskning om känsliga personuppgifter kräver ett godkännande av Etikprövningsmyndigheten. Exakt vilka personuppgifter som ska betraktas som känsliga är emellertid oklart, inte minst de uppgifter som rör hälsa. Syftet med artikeln är att diskutera vilken hälsoinformation som bör betraktas som känslig.

Det är endast ohälsa lagen bör syfta på, inte positiv hälsa. Ohälsa bör då uppfattas bredare än som avsaknad av sjukdom eller skada, även om dessa bör omfattas av lagen. Vi har två möjligheter här: ohälsa som nedsatt välbefinnande samt som nedsatt funktionsförmåga. Slutligen diskuterar vi huruvida lagen bör omfatta indikatorer på ohälsa eller ohälsans bestämningsfaktorer och kommer fram till att indikatorerna som regel bör inkluderas, medan information om riskfaktorer bara bör betraktas som känsliga personuppgifter i undantagsfall.

Migration is a stressful experience and research shows that newly arrived migrants in Sweden suffer from different challenges and struggle to relate to parenting in a new culture that is different from their own. The Swedish Child Health Services (CHS) focuses on promoting health among children, as well as supporting parents in parenting. Although this is a goal, migrant parents participate at lower rates in parental support groups. This paper aims to discuss how the Swedish CHS can support these families and address the need for improvement in the parental support offered to migrant parents during transition into their host country. In addition, this paper also aims to review and discuss the advantages of using a community-based participatory research approach together with the Swedish CHS to identify and apply culturally appropriate support programs to increase health literacy among migrant parents.  

The Swedish government decided to place greater emphasis and resources on supporting parents and promoting equal health among families in Sweden, with special emphasis on migrants and other vulnerable groups. This report from the Swedish government indicates the importance of creating knowledge about new ways, methods, and actions that may be needed to increase this support. One suggestion of this paper is to provide culturally appropriate healthcare work using a community-based participatory research approach, where migrant parents themselves are actively involved in the development of support programs. This approach will not only provide migrant families knowledge and support, it will also build on their needs and the challenges they can share, and receive support to overcome.

Etikprövningslagen (Lag 2003:460) är huvudsakligen lätt att tolka, men ett kriterium innefattar en oklarhet som kan skapa tolkningsproblem och leda till att forskningsprojekt granskas i onödan. Syftet med denna artikel är att diskutera detta kriterium för att se hur det kan, eller borde kunna, tolkas.Kriteriet gäller forskning som ”utförs enligt en metod som syftar till att påverka forskningspersonen fysiskt eller psykiskt” eller ”som innebär en uppenbar risk att skada forskningspersonen” och innehåller således två krav. Frågan är om inte det första kravet är alltför inklusivt, eftersom det även gäller metoder där det inte finns någon risk för skada.Artikeln presenterar några viktiga distinktioner och tolkningsalternativ, och exempel ges på forskning som verkar omfattas av lagen trots att den knappast borde kräva etikprövning. Författarna avslutar med några tentativa förslag till lösning på problemet.

The Swedish Act concerning the Ethical Review of Research Involving Humans (Lag 2003:460) is relatively easy to understand. However, one criterion is unclear, creating an interpretative problem, which might lead to unnecessary reviewing of research projects. The aim of this paper is to discuss this criterion to see how it could, or should, be interpreted.The criterion concerns research that “is conducted according to a method that aims to influence a research participant physically or mentally” or “that might entail an obvious risk of harm for the participant,” and, thus, includes two conditions. The question is whether the first condition is not too inclusive, since it also covers the use of methods where there is no risk of harm.The article presents some crucial distinctions and alternative interpretations, and gives examples showing that the law seems to cover research that is not in need of ethical reviewing. The authors conclude with some tentative suggestions for solving this problem.

Background: The voices of those who have grown up in a family with maternal intellectual or developmental disability (IDD) are valuable for gaining an understanding of their situation, which is essential in order to be able to support these families and avoid potentially detrimental situations.

Aim: The study aim was to describe the experience of having grown up in a family where the mother has an IDD, with a focus on everyday life and perceived health consequences in adult life.

Method: A qualitative method with retrospective narrative interviews and narrative content analysis was chosen. In-depth interviews were performed with four women who had experiences of a childhood with maternal IDD.

Findings: Four themes emerged: Living under adverse circumstances; Dealing with one’s everyday life situation; Receiving insufficient support and wishing for more; and The echo from childhood into adult life. The findings revealed a distressing childhood, characterized by neglect, abuse, anxiety, and overburdening responsibilities, and also endeavors to keep the family situation a secret, while at the same time wanting the adult world to react.

Discussion: The findings can hopefully stimulate occupational therapists and other professionals to more effectively identify the situation of these children and provide support to prevent adverse future health conditions and poor well-being.

There are great health disparities in the world today, both between countries and within them. This problem might be seen as related to the access to various kinds of capabilities. It is not fully clear, however, what the exact relation is between health and capabilities. Neither Amartya Sen nor Martha Nussbaum has explicitly formulated a theory of health to go with their theories of capabilities. This paper attempts to present a clarification of the conceptual relation between health and capabilities. Health, it is argued, should be seen as a holistic multi-dimensional phenomenon, made up of basic abilities and subjective well-being, and of fundamental states and processes. Using this theory, the paper shows how health is related to Nussbaum's ten capabilities. It is argued that health, in the senses described, is a necessary part of all ten capabilities. Moreover, some of the capabilities on Nussbaum's list, such as thinking and imagining, and practical reasoning, refer to health. Finally, it is shown that even though health is part of all capabilities, health cannot itself primarily be seen as a capability. An acceptable degree of health is required as a functioning for any theory of human flourishing to be reasonable.

Abstract Background: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. Aim: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. Method: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. Results: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. Conclusion: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them.

‘Recovery’ is a term used in many contexts, and especially within medicine, care, and psychiatry. People can recover from a number of bad states, e.g., heartache, hunger, poverty, and indebtedness. However, given the context of this article, social psychiatry, the term appears to be about ‘getting better’, or even ‘being healed’ from a disease, disorder, illness, or similar condition. Even so, in the medical and psychiatric literature the term is used in a number of different ways, and a variety of end goals for recovery are suggested, some of which convey very different approaches to, or methods for, treating (helping, supporting, facilitating) individuals, users, clients, or patients, in order for them to recover. That the term comes with many meanings becomes even more clear when one approaches the field of social psychiatry, where the ‘recovery movement’ in psychiatry makes both a theoretical and ethical/political point in viewing recovery as a very special, and ‘valuable’, process or phenomenon. The aim of this paper, then, is to formulate a definition of the concept that might be particularly useful in the context of social psychiatry. First, the basic concept ‘recovery’ will be defined, abstractly, and second, it will be decided what, exactly, is the quality (or qualities) that the individual should regain. Several ideas about what the valued dimension should consist of will be discussed, e.g., symptom reduction, mental functioning, health, subjective well-being, happiness, quality of life, empowerment, and a meaningful life.

One important ethical issue for health promotion and public health work is to determine what the goals for these practices should be. This paper will try to clarify what some of these goals are thought to be, and what they ought to be. It will specifically discuss two different approaches to health promotion, such as, behavior change and empowerment. The general aim of this paper is, thus, to compare the behavior-change approach and the empowerment approach, concerning their immediate (instrumental) goals or aims, and to morally evaluate the strengths and weaknesses of these two goal models, in relation to the ultimate goal of health promotion. The investigation shows that the behavior-change approach has several moral problems. First of all, it is overly paternalistic and often disregards the individual’s or group’s own perception of what is important—something that also increases the risk of failed interventions. Furthermore, it risks leading to ‘victim blaming’ and stigmatization, and to increased inequalities in health, and it puts focus on the ‘wrong’ problems, i.e., behavior instead of the ‘causes of the causes’. It is thereafter shown that the empowerment approach does not have any of these problems. Finally, some specific problems for the empowerment approach are discussed and resolved, such as, the idea that empowering some groups might lead to power over others, the objection that the focus is not primarily on health (which it should be), and the fact that empowered people might choose to live lives that risk reducing their health.

Aldrig i mänsklighetens historia har jordens befolkning haft det så bra som de har det nu. Världens rikedomar är större än de någonsin tidigare varit och i takt med det ökade välståndet blir världens invånare överlag allt friskare och allt äldre. Samtidigt har de generella välfärds- och hälsoökningarna inte kommit alla till del. En person som idag föds i USA förväntas tjäna 100 gånger mer under sin livstid än en samtida person i Zambia, samtidigt som en genomsnittlig japan förväntas leva 38 år längre än en sierra leonian. Ett stort problem är således att den globala hälsoförbättringen de senaste decennierna har varit djupt ojämlik. Syftet med denna bok är att redogöra för de globala folkhälsoproblem som idag utgör den största bördan för mänskligheten, liksom för de övergripande globala faktorer som har en påverkan på olika befolkningars hälsa. Boken syftar även till att presentera en begreppslig ram för folkhälsoområdet, och den diskuterar ett antal etiska aspekter rörande den globala hälsosituationen och dess olika orsaker. Den argumenterar slutligen för att det globala samfundet bör ta ett större ansvar för att åtgärda nuvarande problem och skapa en hållbar förändring.

BackgroundThere might be a need for support for families where the mother has an intellectual disability, in order to counteract the effects of potential parental inadequacy and other detrimental aspects of the family situation. The purpose of this study was to describe how professionals characterized such support and the collaboration required. Materials and methodsFocus group interviews involving 29 professionals were conducted and analysed using content analysis ResultsFive themes were identified: The roles and activities of the professionals involved; ways in which needs of support are identified; problems in identifying mothers with an intellectual disability; how professionals coordinate their support and work together; and the dilemma concerning legislative actions ConclusionsBy identifying both fruitful and problematic aspects of professional support, the findings may be used to enhance future support. More efficient chains of information and improved inter-sector collaboration between professions may further enhance the support practices