Some of the foundations of Heyes’ radical reasoning seem to be based on a fractional selection of available evidence. Using an ethological perspective, we argue against Heyes’ rapid dismissal of innate cognitive instincts. Heyes’ use of fMRI studies of literacy to claim that culture assembles pieces of mental technology seems an example of incorrect reverse inferences and overlap theories pervasive in cognitive neuroscience.

Shadmehr and Ahmed cogently argue that vigor of appetitive movements is positively correlated with their value, and that value can therefore be inferred by measuring vigor. Here, we highlight three points to consider when interpreting this account: (1) The correlation between vigor and value is not obligatory, (2) the vigor effect also arises in frameworks other than optimal foraging, and (3) the term vigor can be misinterpreted, thereby affecting rigor.

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of (...) patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

ZusammenfassungEin Großteil der medizinisch und ethisch schwierigen Therapieentscheidungen betrifft kritisch kranke, einwilligungsunfähige Patienten und wird auf Basis des mutmaßlichen Patientenwillens getroffen. Das Gesetz kann hierzu nur allgemeine Vorgaben geben. Es ist für die behandelnden Ärzte essentiell, sich ein konkretes Vorgehen zu erarbeiten. Wie in der Praxis vorgegangen wird, ist bisher kaum untersucht. Ziel dieser Studie ist es, die Vielfalt der Herangehensweisen und Erfahrungen von Klinikern zum mutmaßlichen Patientenwillen zu erforschen. Wir führten semistrukturierte Interviews mit 18 Ärzten und elf Pflegekräften von (...) intensiv- und palliativmedizinischen Abteilungen eines Universitätsklinikums durch. Die Abschriften der Tonaufnahmen wurden mithilfe der Qualitativen Datenanalyse ausgewertet. Auf einer numerischen Ratingskala wurde erhoben, wie hilfreich die Kliniker das Konzept des mutmaßlichen Willens fanden. Die meisten Studienteilnehmer hielten das Konzept des mutmaßlichen Willens für sehr hilfreich. Zu ihrem Vorgehen berichteten sie, dass sie zumeist die nächsten Angehörigen befragen, zuweilen auch Professionelle und falls möglich die Patienten selbst. Gefragt werde nach früheren Äußerungen der Patienten, nach ihrer Lebenspraxis und -einstellung sowie ihrem aktuellen Verhalten. Benannt wurden auch zahlreiche Unsicherheiten und Schwierigkeiten psychologischer, sozialer, praktischer und konzeptioneller Natur. Der mutmaßliche Patientenwille wird, so unser Ergebnis, in der von uns untersuchten klinischen Praxis entsprechend den gesetzlichen Vorgaben ermittelt. Da jedoch zahlreiche Probleme berichtet werden, stellen wir konkrete Empfehlungen zur Ermittlung des mutmaßlichen Willens vor. (shrink)

Objectives Medical futility at the end of life is a growing challenge to medicine. The goals of the authors were to elucidate how clinicians define futility, when they perceive life-sustaining treatment (LST) to be futile, how they communicate this situation and why LST is sometimes continued despite being recognised as futile. Methods The authors reviewed ethics case consultation protocols and conducted semi-structured interviews with 18 physicians and 11 nurses from adult intensive and palliative care units at a tertiary hospital in (...) Germany. The transcripts were subjected to qualitative content analysis. Results Futility was identified in the majority of case consultations. Interviewees associated futility with the failure to achieve goals of care that offer a benefit to the patient's quality of life and are proportionate to the risks, harms and costs. Prototypic examples mentioned are situations of irreversible dependence on LST, advanced metastatic malignancies and extensive brain injury. Participants agreed that futility should be assessed by physicians after consultation with the care team. Intensivists favoured an indirect and stepwise disclosure of the prognosis. Palliative care clinicians focused on a candid and empathetic information strategy. The reasons for continuing futile LST are primarily emotional, such as guilt, grief, fear of legal consequences and concerns about the family's reaction. Other obstacles are organisational routines, insufficient legal and palliative knowledge and treatment requests by patients or families. Conclusion Managing futility could be improved by communication training, knowledge transfer, organisational improvements and emotional and ethical support systems. The authors propose an algorithm for end-of-life decision making focusing on goals of treatment. (shrink)

Die Verbindlichkeit von Patientenverfügungen (PV) wird kontrovers diskutiert. Dabei ist nicht bekannt, wie verbindlich PV von denen gewollt sind, die sie verfassen. Mit Hilfe eines anonymen Fragebogens wurden Verfasser von PV in bayerischen Palliativeinrichtungen und Beratungsstellen hierzu befragt. Von den 402 Befragten gaben 69,1% an, dass ihre PV auch für Bevollmächtigte und Betreuer strikt verbindlich sein soll. Demgegenüber räumten 23,9% ihrem Stellvertreter ein, von der PV abzuweichen. Die lebensbedrohlich Erkrankten unter den Befragten legten nicht weniger, sondern signifikant mehr Wert auf (...) hohe Verbindlichkeit. Für den Fall, dass die PV nicht anwendbar sein sollte, wünschen deren Verfasser eine Entscheidung durch ihren Vertreter. Abgelehnt wird die richterliche Entscheidung bei Dissens. (shrink)

Despite the burgeoning literature on the governance and impact of cross-sector partnerships in the past two decades, the debate on how and when these collaborative arrangements address globally relevant problems and contribute to systemic change remains open. Building upon the notion of wicked problems and the literature on governing such wicked problems, this paper defines harnessing problems in multi-stakeholder partnerships as the approach of taking into account the nature of the problem and of organizing governance processes accordingly. The paper develops (...) an innovative analytical framework that conceptualizes MSPs in terms of three governance processes harnessing three key dimensions of wicked problems. The Roundtable on Sustainable Palm Oil provides an illustrative case study on how this analytical framework describes and explains organizational change in partnerships from a problem-based perspective. The framework can be used to better understand and predict the complex relationships between MSP governance processes, systemic change and societal problems, but also as a guiding tool in organizing governance processes to continuously re-assess the problems over time and address them accordingly. (shrink)

We characterize the collapse of Buss' bounded arithmetic in terms of the provable collapse of the polynomial time hierarchy. We include also some general model-theoretical investigations on fragments of bounded arithmetic.

Describing and defining what 'Japan style' is, this book explores specific achievements in Japanese art and architecture, offering an analysis of the Japanese culture, its vision of the world and of humankind.

This paper explores the relationship between business experience in cross-sector partnerships and the co-creation of what we refer to as ‘dynamic capabilities for stakeholder orientation,’ consisting of the four dimensions of sensing, interacting with, learning from and changing based on stakeholders. We argue that the co-creation of dynamic capabilities for stakeholder orientation is crucial for CSPs to create societal impact, as stakeholder-oriented organizations are more suited to deal with “wicked problems,” i.e., problems that are large, messy, and complex. By means (...) of a grounded theory approach of inductive research, we collected and interpreted data on four global agri-food companies which have heterogeneous experience in participating in CSPs. The results of this paper highlight that only companies’ capability of interacting with stakeholders continually increases, while their capabilities of sensing, learning from, and changing based on stakeholders first increase and then decrease as companies gain more experience in CSP participation. To a large extent, this can be attributed to the development of corporate strategies on sustainability after a few years of CSP participation, which entails a shift from a reactive to a proactive attitude towards sustainability issues and which may decrease the need or motivation for stakeholder orientation. These findings open up important issues for discussion and for future research on the impact of CSPs in a context of wicked problems. (shrink)

Legends and stories about fabulous races that dwelt in India or in Africa circulated in Iran probably since the Achaemenid times. Unfortunately, scholarship on this topic has neglected some late Iranian and, especially, Zoroastrian sources, such as Draxt ī āsūrīg, the Bundahišn, the Ayādgār ī Jāmāspīg, and the New Persian epic Šāhnāme. This article examines the aforementioned sources and discusses their accounts of five fabulous races from an Iranian, and especially Zoroastrian, perspective and through a comparative approach to some similar (...) neighboring traditions. (shrink)

The relations between the Iranian, in particular Zoroastrian, and Jewish apocalyptic literature as well as their mutual influences have, since the beginning of the twentieth century, constituted a rich and exciting battlefield for the scholars of these respective traditions. This article aims to present some topics concerning the definition of Iranian apocalyptics and its relation with its Jewish counterpart, as well as to establish an updated starting point for a new scholarly debate.

We show that every model of IΔ0 has an end extension to a model of a theory where log-space computable function are formalizable. We also show the existence of an isomorphism between models of IΔ0 and models of linear arithmetic LA.

Perhaps no philosopher is more of a conundrum than Nietzsche, the solitary rebel, poet, wayfarer, anti-revolutionary Aufklärer and theorist of aristocratic radicalism. His accusers identify in his 'superman' the origins of Nazism, and thus issue an irrevocable condemnation; his defenders pursue a hermeneutics of innocence founded ultimately in allegory. In a work that constitutes the most important contribution to Nietzschean studies in recent decades, Domenico Losurdo instead pursues a less reductive strategy. Taking literally the ruthless implications of Nietzsche's anti-democratic (...) thinking - his celebration of slavery, of war and colonial expansion, and eugenics - he nevertheless refuses to treat these from the perspective of the mid-twentieth century. In doing so, he restores Nietzsche's works to their complex nineteenth-century context, and presents a more compelling account of the importance of Nietzsche as philosopher than can be expected from his many contemporary apologists. (shrink)

We present an axiomatic approach for a class of finite, extensive form games of perfect information that makes use of notions like “rationality at a node” and “knowledge at a node.” We distinguish between the game theorist's and the players' own “theory of the game.” The latter is a theory that is sufficient for each player to infer a certain sequence of moves, whereas the former is intended as a justification of such a sequence of moves. While in general the (...) game theorist's theory of the game is not and need not be axiomatized, the players' theory must be an axiomatic one, since we model players as analogous to automatic theorem provers that play the game by inferring (or computing) a sequence of moves. We provide the players with an axiomatic theory sufficient to infer a solution for the game (in our case, the backwards induction equilibrium), and prove its consistency. We then inquire what happens when the theory of the game is augmented with information that a move outside the inferred solution has occurred. We show that a theory that is sufficient for the players to infer a solution and still remains consistent in the face of deviations must be modular. By this we mean that players have distributed knowledge of it. Finally, we show that whenever the theory of the game is group-knowledge (or common knowledge) among the players (i.e., it is the same at each node), a deviation from the solution gives rise to inconsistencies and therefore forces a revision of the theory at later nodes. On the contrary, whenever a theory of the game is modular, a deviation from equilibrium play does not induce a revision of the theory. (shrink)

Recently Shakurov pioneered the study of subalgebras of diagonalizable algebras of theories of arithmetic. We show that his results extend to weaker theories.

Tomo I. Religione ed eterodossia, Normatiavità e non conformismo: Dallo gnosticismo al Romanticismo nelle prime tre edizioni -- Tomo II. Appendice alla IV edizione -- Appendice alla V edizone -- Dopo e a lato, Rassegna bibliografica ragionata sulle origini dell'Islam e la loro importanza nel determinarne i succesivi sviluppi -- Marginalia.

In this paper we argue that data science is a coherent and novel approach to empirical problems that, in its most general form, does not build understanding about phenomena. Within the new type of mathematization at work in data science, mathematical methods are not selected because of any relevance for a problem at hand; mathematical methods are applied to a specific problem only by `forcing’, i.e. on the basis of their ability to reorganize the data for further analysis and the (...) intrinsic richness of their mathematical structure. In particular, we argue that deep learning neural networks are best understood within the context of forcing optimization methods. We finally explore the broader question of the appropriateness of data science methods in solving problems. We argue that this question should not be interpreted as a search for a correspondence between phenomena and specific solutions found by data science methods; rather, it is the internal structure of data science methods that is open to precise forms of understanding. (shrink)

In this paper we apply the idea of Revision Rules, originally developed within the framework of the theory of truth and later extended to a general mode of definition, to the analysis of the arithmetical hierarchy. This is also intended as an example of how ideas and tools from philosophical logic can provide a different perspective on mathematically more “respectable” entities. Revision Rules were first introduced by A. Gupta and N. Belnap as tools in the theory of truth, and they (...) have been further developed to provide the foundations for a general theory of (possibly circular) definitions. Revision Rules are non-monotonic inductive operators that are iterated into the transfinite beginning with some given “bootstrapper” or “initial guess.” Since their iteration need not give rise to an increasing sequence, Revision Rules require a particular kind of operation of “passage to the limit,” which is a variation on the idea of the inferior limit of a sequence. We then define a sequence of sets of strictly increasing arithmetical complexity, and provide a representation of these sets by means of an operator G(x, φ) whose “revision” is carried out over ω2 beginning with any total function satisfying certain relatively simple conditions. Even this relatively simple constraint is later lifted, in a theorem whose proof is due to Anil Gupta. (shrink)