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Background: Mammography screening has generated considerable professional and public debate. In this study, we investigate whether women receive sufficient information about the benefits and disadvantages of the Norwegian Breast Cancer Screening Program to enable them to make informed, independent choices., Material and Method: Informational material from the Norwegian Breast Cancer Screening Program for 1996, 2003, 2009 and 2017 was analysed and compared with information from the independent inquiry into the mammography screening programme headed by the Research Council of Norway. The criteria that are essential in order to make informed choices are as follows: benefit (absolute and relative reduction in mortality), disadvantages (false-positive results, overdiagnosis, overtreatment and anxiety), implementation (following invitation, recall, and findings requiring treatment), and limitations (interval cancer)., Results: Information provided to women has significantly improved from 1996 to 2017. Nevertheless, the information in 2017 lacks important details regarding the disadvantages of screening, such as overdiagnosis and overtreatment., Interpretation: The Norwegian Breast Cancer Screening Program does not provide sufficient information for women to be able to make informed, independent choices. Women are nudged to participate by prescheduled appointments, and the information is insufficiently balanced and nuanced.

BACKGROUND Increasing attention is being paid to research misconduct in academic journals and in the media, but we know relatively little about its extent or attitudes to research misconduct, or how these are changing. This study therefore aims to investigate PhD candidates' knowledge, own actions and attitudes to specific forms of research misconduct.MATERIAL AND METHOD In autumn 2015, an anonymous questionnaire survey was distributed to all participants in the introductory course for PhD candidates at the Faculty of Medicine at the University of Oslo.RESULTS Altogether 77 PhD candidates (79 %) responded to the questionnaire. A total of 62 % conducted clinical research and 25 % conducted basic research. Around one in four had heard about serious forms of research misconduct in the previous year, and around 4 % were aware of various forms of serious research misconduct in their own department in the previous year. Compared to earlier studies, an increasing number (16 %) responded that they had been subjected to unethical pressure with regard to inclusion or order of authors. Approximately two-thirds were uncertain of whether their department had written policies for academic conduct. One-third of PhD candidates did not disassociate themselves from actions that are generally viewed as scientific misconduct. One-tenth thought it acceptable to falsify or fabricate data in order to expedite publication, one-fifth did not object to taking the credit for others' ideas, and almost half did not believe it was wrong to attempt a number of methods of analysis until one arrived at a significant answer.INTERPRETATION PhD candidates at the Faculty of Medicine were aware of research misconduct, both generally and from their own department. They themselves reported some type of scientific misconduct, and a large majority were uncertain of their department's guidelines. Some of the candidates also accepted several forms of research misconduct.

Background: Patient autonomy and informed consent is increasingly emphasized in clinical practice, professional ethics and health care legislation., Material and Methods: Literature on patient autonomy and informed consent was assembled, analyzed, and common norms compared with Norwegian legal regulations., Results: The procedure of obtaining informed consent may increase patient participation and prevent unwanted treatment and care. Such a practice is in line with the principle of patient autonomy. An act is normally considered autonomous when the following three criteria are fulfilled: Sufficient understanding, competence to consent and that the consent is given voluntarily. In clinical practice it is sometimes impossible to meet all these criteria. Furthermore, it is often demanding to tailor the information and the decision-making process to the individual patient's background and preferences. When the patient lacks competence to consent, the Norwegian health care legislation assigns an especially large responsibility to the health care personnel. Recently, health care personnel's authority to use force in such situations have been expanded., Interpretation: The increased emphasis on patient autonomy and informed consent places high demands on health care personnel's moral considerations, ability to communicate, and understanding of roles and responsibilities. Assessment of competence to consent will probably become an important challenge to Norwegian health care personnel in the near future.

Disease is more than dysfunctional organs, morphological abnormalities and genetic divergence. It is also about existence, self-conception and social identity. Disease changes us as persons, but how this happens is usually not discussed in medical textbooks. However, literature appears to be rich in descriptions of these perspectives. This article explores The magic mountain by Thomas Mann to elucidate the relationship between personal identity and disease. I will argue that such knowledge is important to modern clinical practice.

"The physician as a technician" is a metaphor for a significant critique of modern medicine. This article approaches some of these critiques. The notion of medicine as an art is sometimes used to remind us of and in praise of the non-technical aspects of medicine. After indicating some difficulties with modern conceptions of medicine as art, I bring in the ancient concept of art, "téchnê", arguing that it avoids some of the difficulties of the modern art concept. Téchnê actually integrates the scientific, technical and normative aspects of medicine and gives a positive interpretation of the claim that the physician has become a technician. The concept provides medicine with a fruitful framework for understanding both technology and philosophy.

In 1994, Willem Kolff published his results on haemodialysis on humans. His achievements were based on 19th century medicine. Richard Bright had contributed to the knowledge of kidney diseases and Graham and Fick had described diffusion through semipermeable membranes. Some initial tests of haemodialysis had been performed by Abel and Haas in the beginning of the 20th century. But it was Kolff's publication that initiated three innovative decades of development of artificial kidneys: the development from sausage casing to the hollow fiber kidneys.

In the public debate on Norwegian health care it is claimed that hospitals use old and hazardous medical equipment. A survey carried out on 2,031 pieces of equipment at Lillehammer hospital showed an average age of 7.35 years and a mean life span of 14.91 years. The survey showed that the failure rate was highest for newer equipment. It also showed that the operator error rate was higher for newer devices, older equipment being less complex and therefore easier to use. The results did not support the claim that hospitals use old and hazardous medical equipment.

The basis of electrocardiography was established in the innovative years between 1850 and 1930. Men like Waller, DuBois-Reymond, and Einthoven were the innovators of what we today recognize as modern electrocardiography. Others, like Lewis and Bedford, introduced analysis of cardiac arrhythmias, of the S-T segment and the QRS complex. The article gives an overview of this innovative period and its instrumentation.

Development in technology has introduced advanced technological apparatus into the health care sector. New technology has led to increased possibilities in diagnostics and treatment, but it also represents a substantial risk. A survey at the Lillehammer Hospital showed a relatively high rate of apparatus failure. However, only in a few cases was this of any consequence to the patient or the operator. The survey showed that preventive maintenance reduces the failure rate and that operator training and user checks reduce the risk related to medical apparatus.

Health and disease are cardinal concepts in all medical activity. There are two main theories of the conceptual structure of medicine. The reductionist theory defines the concept of disease as deviation of bodily or mental functions, while the holistic theory tries to establish a positive concept of health. The reductionist theory claims to be essensialistic, descriptive and objective, while the holistic theories are supposed to be nominalistic, normative and subjective. A presentation of the theories show that both positions involve conceptual difficulties.

Computer-based patient record systems have become very common in the primary health service, but their effects have seldom been documented. Three surveys were carried out in the municipality of Sør-Varanger, in 1993, 1994 and 1995, to discover how such a system has affected the running of the municipal medical centres. The most significant changes were organisational. Certain tasks changed hands, others were dispensed with, and new ones were added. Information on patients became more readily available, and services to the public were improved. Many more patients received an answer to questions concerning information in the case record, and far fewer forms had to be filled in manually. Despite this, computerisation had seemingly led to little change in effectiveness, and the total load of work remained the same. The survey also showed that simple extensions to the system could produce marked improvements.