Bjørn Morten Hofmann

• Nordenfelt, Lennart & Hofmann, Bjørn Morten (2027). Dignity. In Nesi, Hilary & Milin, Petar (Ed.), Reference Module in Social Sciences. Elsevier. ISSN 9780443157851. p. 1–7. doi: 10.1016/b978-0-443-15715-8.00018-2. Full text in Research Archive
• Hofmann, Bjørn Morten (2026). On the tetrad of human malady: disease, illness, sickness, and existential suffering. Medicine, Health care and Philosophy. ISSN 1386-7423. p. 1–12. doi: 10.1007/s11019-026-10397-5. Full text in Research Archive Show summary

  The triad of disease, illness, and sickness is well established in the philosophy, sociology, and anthropology of medicine as well as in clinical practice. Nonetheless, the triad is criticized for being too simplistic and for excluding important aspects of human suffering. One such critique is that it does not account for existential suffering, which is especially relevant in severe and life-threatening diseases. Accordingly, this study investigates whether existential suffering adds to the concepts of disease, illness, and sickness making up a tetrad of human malady. To do so, I investigate the concept of existential suffering, which is frequently described in medical terms, is diagnosed, acknowledged by health professionals, managed in treatments and care, and recognized in disease classification systems. Then I present ontological, epistemological, conceptual, normative, and pragmatic justifications for extending the triad of disease, illness, and sickness with existential suffering. Lastly, I will discuss counterarguments and objections to the various justifications. I conclude that on specific premises existential suffering can be a relevant extension of the triad to a tetrad of human malady, especially in cases of severe and life-threatening disease, but that we need to avoid medicalizing existential suffering and making health professionals masters over human meaning-making.

• Hofmann, Bjørn Morten (2026). Improving bioethics by clarifying and elaborating its methodology: a response to Gomez-Virseda and colleagues. Medicine, Health care and Philosophy. ISSN 1386-7423. doi: 10.1007/s11019-026-10368-w. Full text in Research Archive Show summary

  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 improving its quality, ascertaining its academic and educational importance, and to advancing its trustworthiness and social impact.

• Hofmann, Bjørn Morten (2026). On the Concept of Existential Disease. Health Care Analysis. ISSN 1065-3058. doi: 10.1007/s10728-026-00595-w. Full text in Research Archive Show summary

  Is “existential disease” a meaningful concept? This study scrutinizes six arguments in support of the concept. First, putative existential diseases are already discussed in the academic literature, including existential neurosis and existential OCD. Second, existential disease may be understood as occurring in the absence of “existential health,” a notion that has received increasing scholarly attention. Third, the very practices of diagnosing “existential suffering” and providing “existential therapy” appear to entail a concept of existential disease. Fourth, in the same way as physical and mental suffering corresponds to physical and mental disease, existential suffering corresponds to existential disease. Fifth, existential suffering arguably falls under several traditional definitions of disease, thereby supporting the legitimacy of the concept of existential disease. Sixth, medical interventions such as palliative sedation and assisted dying in response to existential suffering—interventions typically reserved for disease—seem to presuppose an existential form of disease. Although most of these arguments face important objections, certain conceptions of disease do warrant the category of existential disease. Nonetheless, there is a substantial risk of medicalizing existential concerns, and it is not clear that framing existential suffering as disease is the best way to respond to those who suffer existentially, especially given that health professionals may not be well equipped to address such forms of distress. Hence, more and better arguments are needed to ascertain the concept of existential disease.

• Porthun, Jan; Andenæs, Stine; Brandsæter, Ingrid Øfsti; Hofmann, Bjørn Morten & Kjelle, Elin (2026). CT sinus imaging utilization in Norway: trends over time and variation by region, age, and sex. Research in Health Services and Regions. 5. doi: 10.1007/s43999-026-00094-4. Full text in Research Archive Show summary

  Abstract Background Computed tomography (CT) of the sinuses is a standard component of radiological diagnostics. CT of the sinuses are often regarded as low-value care owing to their minimal impact on disease management. The aim of this study is to describe geographical and temporal variations in outpatient CT sinus utilisation in Norway from 2013 to 2023. Methods Administrative data on outpatient CT sinus performed in Norway between 2013 and 2023 were analysed. Descriptive statistics were performed on both unadjusted and adjusted data. Measures of geographical variation applied were: the coefficient of variation (CV), the extremal quotient (EQ), and the systematic component of variation (SCV). Sex-specific differences were formally examined by comparing female and male rates using Mantel–Haenszel standardised statistical measures. Results Between 2013 and 2023, the sex- and age-adjusted rates of CT sinus per 10,000 individuals in Norway decreased from 52 to 46. The EQ increased from 2.42 to 3.86, the CV from 26% to 31% and SCV values from 6.10 to 8.76, indicating a high level of geographical variation. The ratio of female to male for CT sinus is 1.42 (SD ± 0.11). Conclusions The decline in CT sinus is partially linked to the coronavirus pandemic and is likely attributable to the ‘Choosing Wisely’ campaign. Geographical variability, evident from 2013 to 2015 and becoming more pronounced through 2023, indicates differing CT sinus routines across hospital catchment areas in Norway. It is possible that a substantial proportion of examinations conducted on women may constitute low-value care.

• Hoff, Eivor Hovde; Hofmann, Bjørn Morten; Kraft, Kristian Bandlien; Mykletun, Arnstein & Østby, Kristian Amundsen (2026). Variations in general practitioners’ referrals to low-value MRI examinations in Norway: A nationwide register-based study. European Journal of General Practice. ISSN 1381-4788. 32(1). doi: 10.1080/13814788.2026.2706207. Full text in Research Archive Show summary

  Background Large variations in diagnostic imaging use raise concerns about low-value care, inequity, and inefficient use of resources. Magnetic resonance imaging (MRI) of the head, lumbosacral spine, and knee has been identified as potentially low-value examinations in several clinical contexts. Objectives To examine variation in general practitioners’ referrals to low-value MRI examinations in Norway and assess whether differences are associated with GP and practice characteristics. Methods Using national registry data, we linked patients’ completed MRI examinations to their regular GP and calculated GP-specific MRI rates per 1000 listed patients. We classified GPs into deciles and compared the characteristics of GPs in the highest (High-10) and lowest (Low-10) referral deciles. We examined predictors of variation using pooled OLS regression models with year fixed effects and GP-clustered standard errors. Results GPs in the top referring decile (High-10) referred patients for potentially low-value MRI examinations at three times the rate of those in the lowest referring decile (Low-10). Experienced (specialist-certified) GPs referred approximately 2.7 fewer examinations per 1000 listed patients per year than less experienced GPs (non-specialists). Shorter consultation times, higher consultation frequency and higher hourly fee income were all associated with higher MRI use – with the strongest association for private MRI. A higher patient disease burden was associated with more total examination, but fewer private examinations per 1000 listed patients per year. Conclusion Referral rates varied markedly between GPs. Specialist-certified GPs had lower rates than non-specialists, and higher activity levels and income from fees were associated with higher referral rates – particularly to private providers.

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• Hofmann, Bjørn Morten & Kjelle, Elin (2026). Medisinsk Overaktivitet – Riktig bruk av radiologiske tjenester. Full text in Research Archive
• Cairns, Patrick; Knapstad, Ida Katrine; Ishaq, Bushra; Bache-Mathiesen, Lena Kristin; Wangensteen, Urd Teresia & Pedersen, Reidar [Show all 10 contributors for this article] (2026). Norway Update – Nordic ChiCaP symposium. Full text in Research Archive Show summary

  Conference talk at symposium for members of the Nordic Childhood Cancer Predisposition collaboration group – 13th-14th April 2026.

• Cairns, Patrick; Ishaq, Bushra; Knapstad, Ida Katrine; Pedersen, Reidar; Hofmann, Bjørn Morten & Wangensteen, Urd Teresia [Show all 10 contributors for this article] (2026). Hopes and Concerns of Adolescent Patients and their Caregivers Related to Genetic Predisposition Testing in Childhood Cancer Care: A Three-Year Longitudinal Follow-Up. Full text in Research Archive
• Adams, Jonathan & Hofmann, Bjørn Morten (2026). Responsible Explainable Artificial Intelligence in Medicine: Towards a Framework for Ethical and Epistemic Assessment. Universitetet i Oslo. ISSN 9788234808975. Full text in Research Archive Show summary

  This thesis is about responsible explainable artificial intelligence (AI) in medicine, aiming to build a principle-based framework to assess the knowledge that AI offers in the medical field and the ethical implications of AI in medicine. A key challenge that motivates this work is AI explainability: do we understand why AI systems produce the results that they do, and if not, then is that a problem for medical ethics? The thesis argues that medical ethics should adopt the emerging principle of ‘explicability’ to enable us to make ethical problems visible in AI systems and therefore connect traditional ethical principles to concrete responsibilities. The thesis argues that the principle of explicability, rather than being an unnecessary addition, resembles more established principles in its key focus on connecting abstract theory to clinical practice. The thesis also proposes a structured tool for evaluating medical AI, called ‘the ethical-epistemic matrix’. While ethical principles are often applied to medical AI, this matrix includes ‘epistemic’ (i.e. knowledge-related) principles, which assess the kinds of knowledge that AI systems can provide. The epistemic principles put forward are: accuracy, consistency, relevance and instrumental efficacy. This thesis also shows how the matrix can be used to explore the implications of medical AI by applying its principles to medical AI systems in general and for the specific case of sleep apnoea detection, which is relevant to the Respire project of which this PhD work is part. Overall, this thesis advances both the conceptual and methodological foundations for evaluating responsible explainable AI in medicine and provides a practical framework within which to conduct such evaluation. These contributions can support further development of principle- and matrix-based approaches to the evaluation of medical AI, as well as interdisciplinary collaborations aiming to implement responsible explainable medical AI in practice.

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