Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome measures Types (...) and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

Die Medikalisierung des Sterbens hat dazu geführt, dass ein „guter Tod“ zunehmend auch von medizinischen Interventionen erwartet wird. Die Möglichkeiten einer „terminalen Sedierung“ bis zum Tode werden von vielen als Ausweg angesehen, wenn bei unerträglichem Leid und aussichtsloser Prognose der Wunsch nach aktiver Sterbehilfe angesprochen wird. Durch eine Sedierung können zwar bei schwerstkranken Patienten schwerste therapierefraktäre Leidenszustände effektiv gelindert werden. Diese Therapieoption kann aber auch in der Absicht angewendet werden, den Todeseintritt medizinisch zu beschleunigen, so dass im Zusammenhang mit der (...) Euthanasiedebatte auch das Thema der terminalen Sedierung kontrovers diskutiert wird. Richtlinien zu Indikation, Technik und Dokumentation sind notwendig, um Stellenwert und Grenzen der terminalen Sedierung im Rahmen der palliativen Betreuung am Lebensende zu verdeutlichen und durch Transparenz Fehlentwicklungen zu vermeiden. (shrink)

ZusammenfassungDie Medikalisierung des Sterbens hat dazu geführt, dass ein „guter Tod“ zunehmend auch von medizinischen Interventionen erwartet wird. Die Möglichkeiten einer „terminalen Sedierung“ bis zum Tode werden von vielen als Ausweg angesehen, wenn bei unerträglichem Leid und aussichtsloser Prognose der Wunsch nach aktiver Sterbehilfe angesprochen wird. Durch eine Sedierung können zwar bei schwerstkranken Patienten schwerste therapierefraktäre Leidenszustände effektiv gelindert werden. Diese Therapieoption kann aber auch in der Absicht angewendet werden, den Todeseintritt medizinisch zu beschleunigen, so dass im Zusammenhang mit der (...) Euthanasiedebatte auch das Thema der terminalen Sedierung kontrovers diskutiert wird. Richtlinien zu Indikation, Technik und Dokumentation sind notwendig, um Stellenwert und Grenzen der terminalen Sedierung im Rahmen der palliativen Betreuung am Lebensende zu verdeutlichen und durch Transparenz Fehlentwicklungen zu vermeiden. (shrink)

We examine the moderating role of the situational and organizational contexts in determining unethical managerial behavior, applying the case-survey methodology. On the basis of a holistic, multiple-antecedent perspective, we hypothesize that two key constructs, moral intensity and situational strength, help explain contextual moderating effects on relationships between managers’ individual characteristics and unethical behavior. Based on a quantitative analysis of 52 case studies describing occurrences of real-life unethical conduct, we find empirical support for the hypothesized contextual moderating effects of moral intensity (...) and situational strength. By examining these complex contextual moderators, we aim to contribute to organizational ethics research as we shed light on the critical role that context may play in influencing unethical managerial behavior. (shrink)

Focusing on the problem of the Prime Matter in the Philoponus' Contra Proclum (Book XI), this study offers the first translation, in French, extensively annoted and commented in the context of the 'quaestio disputata' of the Neoplatonic ...

I discuss the knowledge account of legal proof in Moss (2023) and develop an alternative. The unifying thread throughout this article are reflections on the beyond reasonable doubt (BRD) standard of proof. In Section 1, I will introduce the details of Moss’s account and how she motivates it via the BRD standard. In Section 2, I will argue that there are important disanalogies between BRD and knowledge that undermine Moss’s argument. There is however another motivation for the knowledge account: combined (...) with auxiliary claims, that is probabilistic knowledge and moral encroachment, it can provide a general solution to the puzzle of statistical evidence. Section 3 spells out the details. In Section 4, I suggest to combine the knowledge account with pragmatic encroachment, instead of moral encroachment, in order to stay clear of the thorny issues whether corporations have moral rights. In Section 5, I argue that the verdicts of Moss’s account in cases of false justified beliefs and non-luminous knowledge conflict with the BRD standard and thus call for abandoning the account. Based on the social function of the BRD standard, I suggest a replacement for the knowledge account that is also just as potent as a general solution for the puzzle of statistical evidence. While I will grant that knowledge is neither always necessary nor always sufficient for convictions, I will argue that the concept of knowledge nonetheless plays a significant and ineliminable role in legal decision-making. (shrink)

Essays discuss reason and understanding, interpretation, language, meaning, the human sciences, social sciences, and general hermeneutic theory.

This book represents a considerable revision and expansion of Public Choice II. Six new chapters have been added, and several chapters from the previous edition have been extensively revised. The discussion of empirical work in public choice has been greatly expanded. As in the previous editions, all of the major topics of public choice are covered. These include: why the state exists, voting rules, federalism, the theory of clubs, two-party and multiparty electoral systems, rent seeking, bureaucracy, interest groups, dictatorship, the (...) size of government, voter participation, and political business cycles. Normative issues in public choice are also examined including a normative analysis of the simple majority rule, Bergson–Samuelson social welfare functions, the Arrow and Sen impossibility theorems, Rawls's social contract theory and the constitutional political economy of Buchanan and Tullock. (shrink)

In "The Quest for Consciousness," Caltech neuroscientist Christof Koch explores the biological basis of consciousness.

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to the 411 (...) DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

Nach einer neueren, angloamerikanischen Forschungsthese ist Phantasie bei Aristoteles keine bloß repräsentierende Einbildungskraft, sondern das Vermögen, die blinden Daten der Wahrnehmung zu interpretieren und ihnen allererst gegenständlich informative Bestimmtheit zu verleihen. Folgende Abhandlung zeigt, daß diese Deutung auf einem Mißverständnis der dunklen zentralen Textstelle De anima III 3 beruht. Während Aristoteles den strengen Begriff der Phantasie von ihrem metaphorischen Begriff unterscheidet, führt die Verwechslung beider Aspekte zu einer Subjektivierung der Wahrnehmung und zu einer Kognitivierung der Phantasie, die bei Aristoteles ein (...) rein sinnliches Vermögen ist. Dadurch wird die deutliche Zäsur in der Begriffsgeschichte von phantasia, imaginatio und Einbildungskraft eingetrübt, die Aristoteles und die Antike von Avicena und Kant trennt. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Studies in Plato's Two-Level ModelIan MuellerHolger Thesleff. Studies in Plato's Two-Level Model. Helsinki: Societas Scientarum Fennica, 1999. Pp. vi + 143. N. P.After some 30 years of incisive intervention in Platonic scholarship, Holger Thesleff here offers us "an attempt to elaborate and ground more firmly some basic theses which I have propounded in various contexts before," (1) a rather modest description of what he also describes as an (...) attempt to contribute toward "a more general agreement on how to read and interpret Plato" (5). The richness of this book makes it impossible to describe in any detail, and I shall content myself with indicating some of what I take to be its principal points of view.Thesleff"s concern for agreement arises from his perception of the vastly discrepant schools of Plato interpretation, of which the most important for him might be labeled esotericist, analytic, and "literary." The last, which can hardly be called a school at all, includes a variety of scholars who downplay "literal" interpretation and emphasize such things as "dramatic artistry, the structure of the dialogues, the characterization of settings and persons, shifts of style, allusions, play, and irony" (3). Thesleff's sympathies clearly lie with these people, perhaps to an extent which, as I shall suggest, will limit the effectiveness of his attempt to move toward a consensus.As the title indicates Thesleff builds his reading around what he calls Plato's two-level model. This two-level model is not, as one might suppose, what has been called Plato's two worlds view, the belief in a world of pure being beyond the perceived world we inhabit. Indeed, it is not a doctrine or set of doctrines at all. Rather "it is an intuitive 'vision' which offers only crude basic patterns and frames for the structures of Plato's thinking, feelings, intuitions, and intentions, from his youth to his old age, and for our understanding of them" (123). Clearly one cannot expect a full and precise articulation of this vision. Thesleff proceeds by discussing in terms of their role in the earlier dialogues ten hierarchic pairs which form part of Plato's vision: divine/human, soul/body, leading/being led (particularly important in the conduct of a Socratic discussion), truth/appearance, knowledge/opinion, intellect/senses, defined/undefined, stability/change, one/many, same/different. These hierarchic or asymmetric pairs are contrasted by Thesleff with what he calls polar opposites like large/small and light/dark. He also stresses that the hierarchic pairs of Plato's two-level model involve no separation (chorismos), but rather a communion (koinônia).As the words "from his youth to his old age" in the quotation of the previous paragraph indicate, Thesleff is a "unitarian" in his approach to Plato. His Plato is not a philosopher whose positions changed through time as a result of reasoned argument. What many scholars take to be doctrines later given up, e.g., the view that learning is being reminded (anamnêsis), are "thought experiments," which are not followed up, thought experiments made within the context of the unchanging two-level vision.Although Thesleff is a unitarian in the sense I have indicated, he does believe that a kind of order of composition can be constructed for the dialogues. I say "kind of" because Thesleff's chronology involves assumptions of revisions over time, multiple authorship, and even dialogues "written down" by people other than Plato. The resulting chronology is complex, and I here only indicate it in rough form in a way which [End Page 272] brings out what I take to be its major points. Leaving out of account those Socratic" dialogues which Thesleff takes to be latish and the posthumously completed Laws, we can say that a series of late dialogues starts with the Parmenides and includes the Timaeus, Critias, Sophist, Politicus, and Philebus. All other dialogues, including the Theaetetus, were written prior to the Parmenides with the exception of the Republic, which Thesleff proposes is in its ultimate shape a late work, representing "only and purely Plato's 'own' and personal philosophy" (115). As for the other late dialogues, which have played an important... (shrink)

ZusammenfassungWährend die juristische und medizinethische Rechtfertigung des Verzichts auf Wiederbelebung in Deutschland akademisch hinreichend geklärt ist, zeigen sich doch erhebliche Unterschiede und zahlreiche Probleme bei der praktischen Umsetzung in der Klinik. Innerhalb des interdisziplinären Behandlungsteams gehören Kommunikationsdefizite und die Intransparenz der ethischen Entscheidungsprozesse zu den häufigsten Schwierigkeiten, die in der Medizinischen Klinik für Nephrologie und Hypertensiologie am Klinikum Nürnberg mit der Implementierung einer hausinternen Leitlinie, der Anordnung zum Verzicht auf Wiederbelebung, behoben werden sollten.Die Evaluationsstudie, die 118 VaW-Anordnungen bei 4718 Behandlungsfällen (...) im Zeitraum von November 2004 bis Juli 2005 einschloss, verfolgte einen dualen Forschungsansatz. Eine quantitative Dokumentationsanalyse aller VaW-Protokolle wurde mit der leitfadengestützten Befragung von 16 Ärzten und Pflegekräften kombiniert.Teambesprechungen waren in 62,4 %, Entscheidungsgründe in 74,6 % aller VaW-Protokolle dokumentiert. Die Interviews ergaben eine positive, aber berufsgruppendifferente Bewertung der Kommunikation, wobei die Pflegenden kritischer eingestellt waren als ihre medizinischen Kollegen. Die VaW-Dokumentation bewirkte nach Auffassung aller Befragten eine hohe Nachvollziehbarkeit und Transparenz. Die VaW-Anordnung wurde darüber hinaus als gut anwendbar und praxistauglich betrachtet. Nahezu alle Befragten sprachen sich für eine Beibehaltung des VaWVerfahrens in der Klinik aus.Die Implementierung der VaW-Anordnung als hausinterne Leitlinie und Dokumentationsstandard hat zu einer Förderung des interdisziplinären Dialogs und zu einer erheblichen Verbesserung der Transparenz der ethischen Entscheidungsprozesse im Rahmen des Verzichts auf Wiederbelebung geführt. Hilfreich und praxistauglich erfreut sich die VaW-Anordnung einer hohen Akzeptanz bei Pflegenden und Medizinern und wird seit drei Jahren in der Nephrologie am Klinikum Nürnberg konsequent angewendet. (shrink)

ZusammenfassungWährend die juristische und medizinethische Rechtfertigung des Verzichts auf Wiederbelebung in Deutschland akademisch hinreichend geklärt ist, zeigen sich doch erhebliche Unterschiede und zahlreiche Probleme bei der praktischen Umsetzung in der Klinik. Innerhalb des interdisziplinären Behandlungsteams gehören Kommunikationsdefizite und die Intransparenz der ethischen Entscheidungsprozesse zu den häufigsten Schwierigkeiten, die in der Medizinischen Klinik für Nephrologie und Hypertensiologie am Klinikum Nürnberg mit der Implementierung einer hausinternen Leitlinie, der Anordnung zum Verzicht auf Wiederbelebung, behoben werden sollten.Die Evaluationsstudie, die 118 VaW-Anordnungen bei 4718 Behandlungsfällen (...) im Zeitraum von November 2004 bis Juli 2005 einschloss, verfolgte einen dualen Forschungsansatz. Eine quantitative Dokumentationsanalyse aller VaW-Protokolle wurde mit der leitfadengestützten Befragung von 16 Ärzten und Pflegekräften kombiniert.Teambesprechungen waren in 62,4 %, Entscheidungsgründe in 74,6 % aller VaW-Protokolle dokumentiert. Die Interviews ergaben eine positive, aber berufsgruppendifferente Bewertung der Kommunikation, wobei die Pflegenden kritischer eingestellt waren als ihre medizinischen Kollegen. Die VaW-Dokumentation bewirkte nach Auffassung aller Befragten eine hohe Nachvollziehbarkeit und Transparenz. Die VaW-Anordnung wurde darüber hinaus als gut anwendbar und praxistauglich betrachtet. Nahezu alle Befragten sprachen sich für eine Beibehaltung des VaWVerfahrens in der Klinik aus.Die Implementierung der VaW-Anordnung als hausinterne Leitlinie und Dokumentationsstandard hat zu einer Förderung des interdisziplinären Dialogs und zu einer erheblichen Verbesserung der Transparenz der ethischen Entscheidungsprozesse im Rahmen des Verzichts auf Wiederbelebung geführt. Hilfreich und praxistauglich erfreut sich die VaW-Anordnung einer hohen Akzeptanz bei Pflegenden und Medizinern und wird seit drei Jahren in der Nephrologie am Klinikum Nürnberg konsequent angewendet. (shrink)

Recently, the increasing interest in responsible leadership (RL) has produced a research field rich in theoretical and conceptual potential, with diverse research foci, theoretical foundations, and methodological approaches. While these developments have demarcated the field from other leadership-oriented disciplines, they have equally courted fragmentation and ambiguity in terms of the field’s positioning within the greater body of leadership studies. To map the theoretical, methodological, and empirical state of the art of the RL field, we outline recent developments and delineate important (...) research gaps and directions for future theory development and empirical research. We emphasize the transition of RL research from micro-level perspectives with normative roots to research spanning multiple levels of analysis, vis-à-vis both antecedents and outcomes. We discuss the implications of our mapping, highlighting the necessity of not only conceptualizing RL across multiple levels of analysis, but also to actively focus on interactions among RL antecedents and outcomes across these levels. Through these, we aim to contribute to the field by strengthening its conceptual foundations and anchoring it more clearly within leadership studies overall. (shrink)

Is the concept of open society still relevant in the 21st century? Do the current social, moral, and political realities call for a drastic revision of this concept? Here fifteen essays address real-world contemporary challenges to open society from a variety of perspectives. What unites the individual authors and chapters is an interest in open society's continuing usefulness and relevance to address current problems. And what distinguishes them is a rich variety of geographical and cultural backgrounds, and a wide range (...) of academic disciplines and traditions.While focusing on probing the contemporary relevance of the concept, several chapters approach it historically. The book features a comprehensive introduction to the history and current 'uses' of the theory of open society. The authors link the concept to contemporary themes including education, Artificial Intelligence, cognitive science, African cosmology, colonialism, and feminism. The diversity of viewpoints in the analysis reflects a commitment to plurality that is at the heart of this book and of the idea of open society itself. (shrink)

Der Band untersucht das durch die Begriffe Musik, Kultur und Gedächtnis abgesteckte Feld in einer zweifachen Bewegung: Zum einen wird Musik als eine wichtige soziokulturelle Ausdrucksform quer durch alle Kulturen gefasst, ihre Bestimmung und Funktion ändern sich mit den jeweiligen soziokulturellen Kontexten und Praxen. Jedes Musikstück steht in spezifischen kulturell entwickelten Traditionen und Formen, die von ihm aktualisiert werden. Musik wirkt als "gemeinschaftsbildende Macht" (Adorno), als Ausdrucksmittel individueller oder kollektiver Identität. Zum anderen ist den vielfältigen Formen von Musik die mehrfache (...) Verbindung von Musik und Zeit gemeinsam: Die jeweilige musikalische Darbietung oder Reproduktion ist ein zeitlicher Ablauf und als solcher gedächtnishaft organisiert. Die ästhetische Erfahrung von Musik ist konstitutiv auf Gedächtnisleistungen angewiesen und Musik selbst eine temporale Kunstform. Neben dieser elementaren Zeitlichkeit zeigen sich in der Musik aber viele weitere Aspekte subjektiver und sozialer Zeit: die Geschichtlichkeit der einzelnen Stücke bzw. Werke selbst, die soziokulturelle zeitliche Lagerung von Ordnungsprinzipien wie Gattungen, Kunstformen, Stilen etc., der Wandel von basalen Formen des Musikmachens (etwa unter dem Einfluss von Medientechnologien). Der Band enthält auch die deutsche Erstveröffentlichung eines Artikels von Maurice Halbwachs zu diesem Themenfeld. Der Inhalt: Theoretische Überlegungen, "Analytische Betrachtungen. Die Herausgeber: PD Dr. Christofer Jost lehrt und arbeitet am Zentrum für Populäre Kultur und Musik der Universität Freiburg. PD Dr. Gerd Sebald ist am Institut für Soziologie der Universität Erlangen-Nürnberg tätig. (shrink)

What drives Chinese MNEs’ global CSR integration and local CSR responsiveness? Drawing on institutional theory, we argue that both antecedents reflecting globally isomorphic patterns of adaptation and antecedents mirroring the distinct characteristics of China’s institutional context are relevant. We support our argument using fuzzy-set qualitative comparative analysis on a sample of 29 of China’s globally most influential companies. We find that state influence and global CSR associations affect global CSR integration, whereas presence in the West and internationalization through mergers and (...) acquisitions predict local CSR responsiveness. Our study thus suggests that home-country characteristics are an important co-determinant of the CSR approaches of emerging-market MNEs. We further find that multicultural experience in top management teams is associated with both global CSR integration and local CSR responsiveness, supporting notions of transnational CSR. (shrink)

The aim of the present study is (1) to show, on the basis of a number of unpublished documents, how Heinrich Scholz supported his Warsaw colleague Jan Łukasiewicz, the Polish logician, during World War II, and (2) to discuss the efforts he made in order to enable Jan Łukasiewicz and his wife Regina to move from Warsaw to Münster under life-threatening circumstances. In the first section, we explain how Scholz provided financial help to Łukasiewicz, and we also adduce evidence of (...) the risks incurred by German scholars who offered assistance to their Polish colleagues. In the second section, we discuss the dramatic circumstances surrounding the Łukasiewiczes' move to Münster in the summer of 1944. (shrink)

The aim of the present study is (1) to show, on the basis of a number of unpublished documents, how Heinrich Scholz supported his Warsaw colleague Jan ?ukasiewicz, the Polish logician, during World War II, and (2) to discuss the efforts he made in order to enable Jan ?ukasiewicz and his wife Regina to move from Warsaw to Münster under life-threatening circumstances. In the first section, we explain how Scholz provided financial help to ?ukasiewicz, and we also adduce evidence of (...) the risks incurred by German scholars who offered assistance to their Polish colleagues. In the second section, we discuss the dramatic circumstances surrounding the ?ukasiewiczes' move to Münster in the summer of 1944. (shrink)

Despite increasing pressure to deal with climate change, firms have been slow to respond with effective action. This article presents a multi-level framework for a better understanding of why many firms are failing to reduce their absolute greenhouse gas emissions, which contribute to climate change. The concepts of short-termism and uncertainty avoidance from research in psychology, sociology, and organization theory can explain the phenomenon of organizational inaction on climate change. Antecedents related to short-termism and uncertainty avoidance reinforce one another at (...) three levels—individual, organizational, and institutional—and result in organizational inaction on climate change. The article also discusses the implications of this multi-level framework for research on corporate sustainability. (shrink)