BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

Here the philosopher and physicist David Z Albert argues, among other things, that the difference between past and future can be understood as a mechanical phenomenon of nature and that quantum mechanics makes it impossible to present the entirety of what can be said about the world as a narrative of “befores” and “afters.”.

Longtermism is the thesis that in a large class of decision situations, the best thing we can do is what is best for the long-term future. The scope question for longtermism asks: how large is the class of decision situations for which this is true? In this paper, I suggest that the scope of longtermism may be narrower than many longtermists suppose. I identify a restricted version of longtermism: swamping axiological strong longtermism (swamping ASL). I identify three scope-limiting factors - (...) probabilistic and decision-theoretic phenomena which, when present, tend to reduce the prospects for swamping ASL. I argue that these scope-limiting factors are often present in human decision problems, then use two case studies from recent discussions of longtermism to show how the scope-limiting factors lead to a restricted, if perhaps nonempty, scope for swamping ASL. (shrink)

Once upon a time, the twentieth-century investigations of the behaviors of sub-atomic particles were thought to have established that there can be no such thing as an objective, observer-independent, scientifically realist, empirically adequate picture of the physical world.

Recent methodological debates regarding the place of feasibility considerations in normative political theory are hindered for want of a rigorous model of the feasibility frontier. To address this shortfall, I present an analysis of feasibility that generalizes the economic concept of a production possibility frontier and then develop a rigorous model of the feasibility frontier using the familiar possible worlds technology. I then show that this model has significant methodological implications for political philosophy. On the Target View, a political ideal (...) presents a long-term goal for morally progressive reform efforts and, thus, serves as an important reference point for our specification of normative political principles. I use the model to show that we can- not reasonably expect that adopting political ideals as long-term reform objectives will guide us toward the realization of morally optimal feasible states of affairs. I conclude by proposing that political philosophers turn their attention to the analysis of actual social failures rather than political ideals. (shrink)

Diese Abhandlung von 1748 fand unter den Zeitgenossen endlich die große und ungeteilte Beachtung, die Hume für seine kritischen Untersuchungen zur dogmatischen und empirischen Erkenntnis erwarten durfte. Seit Kants Bekenntnis, er sei durch diesen Text aus einem "dogmatischen Schlummer" erweckt und zu seinen eigenen kritischen Untersuchungen bewegt worden, gilt das Buch als Humes bedeutendstes Hauptwerk.

Are demands for equality motivated by envy? Nietzsche, Freud, Hayek, and Nozick all thought so. Call this the Envy Objection. For egalitarians, the Envy Objection is meant to sting. Many egalitarians have tried to evade the Envy Objection.. But should egalitarians be worried about envy? In this paper, I argue that egalitarians should stop worrying and learn to love envy. I argue that the persistent unwillingness to embrace the Envy Objection is rooted in a common misunderstanding of the nature of (...) the charge, what it reveals, and what can be said in response to it. I develop what Bernard Williams might call a vindicatory genealogy of envy, thereby allowing us to see that envy, rather than undermining egalitarian intuitions, can in fact play a distinct justificatory role (when it is fitting), which undermines the Envy Objection. (shrink)

In this paper, I motivate skepticism about the causal efficacy of moral properties in two ways. First, I highlight a tension that arises between two claims that moral realists may want to accept. The first claim is that physically indistinguishable things do not differ in any causally efficacious respect. The second claim is that physically indistinguishable things that differ in certain historical respects have different moral properties. The tension arises to the extent to which these different moral properties are supposed (...) to have different effects on people. I will introduce a class of cases in which this tension arises and suggest that the moral properties in these cases have no causal power. I will also question whether there are differences between the moral properties in these cases and moral properties in other cases that do not involve physically indistinguishable things that could make the latter moral properties causally efficacious. The second way that I motivate skepticism consists in pointing out a unique feature of cases in which moral properties are supposed both to supervene on historical properties and to be causally efficacious. These cases allow us to change moral properties with alleged effects while we hold constant the nonmoral candidates for causal contribution to those effects. This feature of these cases is unique because in most other cases the moral properties supervene on the physical properties in the nonmoral candidates, such that we cannot change the former while holding constant the latter. This way of changing moral properties provides empirical grounds for testing their causal efficacy. (shrink)

In _Speech and Phenomena,_ Jacques Derrida situates the philosophy of language in relation to logic and rhetoric, which have often been seen as irreconcilable criteria for the use and interpretations of signs. His critique of Husserl attacks the position that language is founded on logic rather than on rhetoric; instead, he claims, meaningful language is limited to expression because expression alone conveys sense. Derrida's larger project is to confront phenomenology with the tradition it has so often renounced--the tradition of Western (...) metaphysics. (shrink)

Both utilitarian and deontological moral theories locate the source of our moral beliefs in the wrong sorts of considerations. One way this failure manifests itself, we argue, is in the ways these theories analyze the proper human relationship toward the non-human environment. Another, more notorious, manifestation of this failure is found in Derek Parfit's Repugnant Conclusion. Our goal is to explore the connection between these two failures, and to suggest that they are failures of act-centered moral theories in general. As (...) such, they cannot be fixed by simply developing a better version of such a theory. Virtue-based theories, we suggest, provide a more promising alternative. (shrink)

It is argued that certain recent advances in the construction of a theory of the collapses of Quantum Mechanical wave functions suggest the possibility of new and improved foundations for statistical mechanics, foundations in which epistemic considerations play no role.

This book uncovers the lost history of Christianity's encounters with Pythagorean ideas before the Renaissance. David Albertson skillfully examines ancient and medieval theologians, particularly Thierry of Chartres and Nicholas of Cusa, who successfully reconceived the Trinity and the Incarnation within the framework of Greek number theory. David Albertson challenges modern assumptions about the complex relationship between religion and science.

This paper argues that higher-order doubt generates an epistemic dilemma. One has a higher-order doubt with regards to P insofar as one justifiably withholds belief as to what attitude towards P is justified. That is, one justifiably withholds belief as to whether one is justified in believing, disbelieving, or withholding belief in P. Using the resources provided by Richard Feldman’s recent discussion of how to respect one’s evidence, I argue that if one has a higher-order doubt with regards to P, (...) then one is not justified in having any attitude towards P. Otherwise put: No attitude towards the doubted proposition respects one’s higher-order doubt. I argue that the most promising response to this problem is to hold that when one has a higher-order doubt about P, the best one can do to respect such a doubt is to simply have no attitude towards P. Higher-order doubt is thus much more rationally corrosive than non-higher-order doubt, as it undermines the possibility of justifiably having any attitude towards the doubted proposition. (shrink)

We discuss two recent attempts two solve Schrodinger's cat paradox. One is the modal interpretation developed by Kochen, Healey, Dieks, and van Fraassen. It allows for an observable which pertains to a system to possess a value even when the system is not in an eigenstate of that observable. The other is a recent theory of the collapse of the wave function due to Ghirardi, Rimini, and Weber. It posits a dynamics which has the effect of collapsing the state of (...) macroscopic systems. We argue that the modal interpretation cannot account for non-accurate measurements and that both accounts have the consequence that in ordinary measurement situations the observables that ends up well defined are not quite the ones that we want to be well defined. (shrink)

Contrary to what many philosophers believe, Calvinism neither makes the problem of evil worse nor is it obviously refuted by the presence of evil and suffering in our world. Or so most of the authors in this book claim. While Calvinism has enjoyed a resurgence in recent years amongst theologians and laypersons, many philosophers have yet to follow suit. The reason seems fairly clear: Calvinism, many think, cannot handle the problem of evil with the same kind of plausibility as other (...) more popular views of the nature of God and the nature of God's relationship with His creation. This book seeks to challenge that untested assumption. With clarity and rigor, this collection of essays seeks to fill a significant hole in the literature on the problem of evil. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to Susan Laird, “Musical Hunger: A Philosophical Testimonial of Miseducation”Estelle R. JorgensenSusan Laird’s lament of her “musical under-education,” her youthful lack of opportunity for the sorts of experiences for which she hungered and its life-long after-effects, and her invocation of hunger as a metaphor for music education raise compelling questions. In a feminized field such as music, particularly piano playing, her hunger is particularly poignant. Also, the (...) notion of “musical taste” takes on new meaning, and the musical, educational, and ethical questions this metaphor evokes reveal its richness as a means of thinking about music education. This metaphor joins others such as Barbara Thayer Bacon’s metaphor of the quilt, Jane Roland Martin’s metaphor of the home, Iris Yob’s metaphor of pilgrimage, Elizabeth Gould’s metaphor of the nomad, Virginia Richardson’s metaphor of the steward, and Randall Allsup’s metaphor of the garage band, each of which illumines music education differently.1 Without one, we miss important insights into the thought and practice of music education; when taken together, they offer a richer view than were we to see music education in terms of one alone. [End Page 75]Although metaphor evokes imaginative thought and practice in music education, it is also limited. As Nelson Goodman aptly puts it, metaphor is a “matter of teaching an old word new tricks” and an “expedition abroad in which associations with one realm are applied in another.”2 Its power lies in its evocative and imaginative quality as it startles and surprises, challenges familiar ways of thinking and doing, and opens new possibilities for how we might think, act, and be differently. Although Laird would not want to literalize musical hunger or equate it with physical hunger—physical and spiritual realms intersect but they are not equivalent—it is possible to freeze a metaphor or literalize the vitality out of it. Testing it systematically, we enter the ground between metaphor and model, or what Iris Yob thinks of as the metaphorical model.3 While metaphor may prompt an intellectual journey, it cannot take us the entire way. In its particularistic and imaginative appeal, it opens reflection though it cannot suffice. A metaphor may also have a dark side. For example, envisaging the teacher’s role as salvific in providing bread for the hungry or preventing gluttony or food addictions may foster a paternalistic view that substitutes the teacher’s view of a student’s long term interests for the student’s directly-known and immediately perceived needs and interests, thereby subverting Laird’s expressed interest in the student’s desires. The educational “sin” of addiction may also be “redeemed” in Schefflerian fashion by pointing to important contributions of musicians who were doubtless excessive in their musical engagements.4 These possibilities suggest that we shall need to examine critically the metaphor and what it means for music education and move beyond the metaphor to its related models of music education.One of the interesting questions that Laird’s metaphor of hunger raises is the possibility of spiritual hunger, especially in a pervasively materialistic world. Matters related to spirituality have been addressed variously by writers in music education, whether it be the “healing” and ecologically-oriented approach of June Boyce-Tillman, the evolutionary and anthropologically grounded holistic approach of Anthony Palmer, the ethically-based approach of David Carr, the introspective and politically-charged writing of Cathy Benedict and Randall Allsup, the feminist perspectives of Elizabeth Gould, Charlene Morton, Roberta Lamb, and Deanne Bogdan, or the religiously grounded work of Iris Yob.5 Notions of spiritual hunger might be seen differently within the various lenses that these writers bring to music education but they all underscore the importance of knowing that goes beyond the literal, utilitarian, generalizable, and vocational to address the life of mind and body that Susanne Langer terms “feeling” and with which the arts, myths, rituals, and religions have to do.6 As such, they rebuke general education that is limited to reading, writing, and arithmetic, and driven by tests, standards, and mandates that often give short shrift to matters of human spirituality. Still, as the recent unanimous resolution in favor of... (shrink)

I distinguish between two conceptually different kinds of physical space: a space of ordinary material bodies, which is the space of points at which I could imaginably place the tip of my finger, or the center of a billiard-ball, and a space of elementary physical determinables, which is the smallest space of points such that stipulating what is happening at each one of those points, at every time, amounts to an exhaustive physical history of the universe. In all classical physical (...) theories, these two spaces happen to coincide – and what we mean by calling a theory “classical”, and all we mean by calling a theory “classical”, is precisely that these two spaces coincide. But once the distinction between these two spaces in on the table, it becomes clear that there is no logical or conceptual reason why they must coincide – and it turns out that a very simple way of pulling them apart from one another gives us quantum mechanics. (shrink)

Este artigo tem como objetivo compreender a institucionalização e o funcionamento do Conselho de Alimentação Escolar enquanto um conselho gestor de política pública no município de Ijuí, localizado no Noroeste do Estado do Rio Grande do Sul, bem como analisar sua atuação e os desafios da gestão. O referencial teórico utilizado foi de conselhos gestores de políticas públicas na perspectiva da gestão social. Trata-se de uma pesquisa exploratória, cuja estratégia de investigação foi o estudo de caso único, com abordagem qualitativa (...) dos dados coletados por meio de pesquisa documental e entrevistas. Os resultados apontam a atuação do CAE em Ijuí/RS como efetiva, apesar dos entraves enfrentados. O principal desafio identificado foi quanto à recomposição de seus membros, processo que está ocorrendo com êxito. Conclui-se que a institucionalização de um CAE ocorre a partir da interação entre os diferentes órgãos que compõem um programa governamental, como no caso do PNAE, e que o seu funcionamento depende da atuação efetiva de todos os atores envolvidos. (shrink)

Pʻilisopʻayutʻyan sahmanumnerě -- Porpʻyuri "Neratsutʻyun" verlutsutʻyuně -- Aristoteli "Analitikayi" meknutʻyuně.