In order to receive controlled pain medications for chronic non-oncologic pain, patients often must sign a “narcotic contract” or “opioid treatment agreement” in which they promise not to give pills to others, use illegal drugs, or seek controlled medications from health care providers. In addition, they must agree to use the medication as prescribed and to come to the clinic for drug testing and pill counts. Patients acknowledge that if they violate the opioid treatment agreement, they may no longer receive (...) controlled medications. OTAs have been widely implemented since they were recommended by multiple national bodies to decrease misuse and diversion of narcotic medications. But critics argue that OTAs are ethically suspect, if not unethical, and should be used with extreme care if at all. We agree that OTAs pose real dangers and must be implemented carefully. But we also believe that the most serious criticisms stem from a mistaken understanding of OTAs’ purpose and ethical basis. (shrink)

Von Beginn menschlicher Reflexion war die Frage, was der Mensch seinem Wesen nach sei und welche Stellung er im Kosmos einnehme, von zentraler Bedeutung, denn schliesslich wird in ihr das Selbstverstandnis des Menschen thematisiert. Dabei wird die Komplexitat der Fragestellung deutlich, da auch nur der Versuch, diese zu beantworten, zahlreiche andere Erkenntnisse und Erfahrungsgebiete voraussetzt und somit auch immer von kulturellen Komponenten abhangt.Dabei spielen zwei Aspekte in der Deutung des Menschen eine wichtige Rolle: Zum einen erarbeiteten die modernen Naturwissenschaften zahlreiche (...) Erkenntnisse, die fur das Selbstverstandnis des Menschen hochst relevant sind. Zum anderen bilden weiterfuhrende Sinndeutungen, wie sie in religiosen Systemen durchgefuhrt werden, eine anthropologische Grundoption.Im Ausgang an die radikalisierte Moderne wurde deutlich, dass sowohl die Interpretation naturwissenschaftlicher Erkenntnisse als auch die religiosen Deutungen an kontingente Voraussetzungen geknupft sind, die eine Pluralitat von anthropologischen Bestimmungen nach sich ziehen. Mochte man diese Vielfalt nicht unverbunden nebeneinander stehen lassen, konnen diese Bestimmungen im Licht der unumganglich von allen Menschen zu leistenden Welt- und Lebensorientierung nur in einer philosophischen Analyse vernunftig aufeinander bezogen werden, wodurch mogliche Horizonte und Grenzen des anthropologischen Unternehmens deutlich werden. (shrink)

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton’s translation makes the full text of this important work more accessible in English than ever (...) before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)

Research that is initiated, designed or funded by sponsor agencies based in countries with relatively high social and economic development, and conducted in countries that are relatively less developed, gives rise to many important ethical challenges. Although clinical trials of HIV vaccines began ten years ago in the US and Europe, an increasing number of trials are now being conducted or planned in other countries, including several that are considered “developing” countries. Safeguarding the rights and welfare of individuals participating as (...) research subjects in developing countries is a priority. In September, 1997, the Joint United Nations Programme on HIV/AIDS embarked on a process of international consultation; its purpose was further to define the important ethical issues and to formulate guidance that might facilitate the ethical design and conduct of HIV vaccine trials in international contexts. This paper summarises the major outcomes of the UNAIDS consultative process. (shrink)

Introduction: Platonic dramatology -- The political and philosophical problems. Using pre-Socratic philosophy to support political reform: the Athenian stranger ; Plato's Parmenides: Parmenides' critique of Socrates and Plato's critique of Parmenides ; Becoming Socrates ; Socrates interrogates his contemporaries about the noble and good -- Paradigms of philosophy. Socrates' positive teaching ; Timaeus-Critias: completing or challenging Socratic political philosophy? ; Socratic practice -- The trial and death of Socrates. The limits of human intelligence ; The Eleatic challenge ; The trial (...) and death of Socrates -- Conclusion: Why Plato made Socrates his hero. (shrink)

The paper is a critical discussion of scholarship on the "Critique of Pure Reason" published during the past ten years. The emphasis is on Anglo-American authors. I identify and discuss three main trends in the field: a shift from the general discussion of transcendental arguments to the analysis and evaluation of particular proofs in Kant; a renewed interest in the doctrine of transcendental idealism and the distinction between things in themselves and appearances; and the emergence of an entire body of (...) literature on Kant's philosophy of mind, centered around the idea of a "transcendental psychology." The main body of the text is supplemented by extensive bibliographical information provided in the notes. (shrink)

As Husserl already noticed, artworks themselves have a phenomenological character. This means, however, that to experience artworks as phenomena no “epoché” and no “phenomenological reduction” is necessary. The leading question of my essay is whether, and possibly how, this observation can be methodologically generalized for understanding phenomena. I discuss if, and possibly how, a phenomenological reflection on art allows and even demands a general conception of phenomenology that nevertheless does not confuse artworks with phenomena in general. My intention is to (...) show that and how phenomenality can be clarified with reference to its spatial character. Accordingly, works of architecture that are artworks will play a decisive role in my argument. (shrink)

Scientific exploration and thus our knowledge about the outside world is subject to the conditions of our experience.These conditions are condensed here into an interface model which,besides being physical,has an additional interface structure not reducible to physics. We suggest that this structure can dynamically be characterized by separate modes.Their selection and operation presupposes free will and a rudimentary concept of time and space. Based on some analogies with quantum networks it is argued that the 'observed' gets 'dressed'as a consequence of (...) the observing. Interface dynamics and system dynamics supplement each other without over- determination. (shrink)

In 'Een handvol filosofen' staan de filosofen centraal die sinds de oprichting van de Vrije Universiteit in 1880 aan deze instelling verbonden zijn geweest. Het gaat hierbij niet alleen om de inhoud van hun werk, maar ook om de personen zelf. Er waren filosofiedocenten die zich met de universiteit identificeerden en zich volledig konden ontplooien. Er waren er echter ook voor wie dit niet gold, die geïsoleerd of in gewetensnood raakten. Veel filosofiestudenten waren actief betrokken bij wat er in hun (...) faculteit gebeurde. Zij namen initiatieven, protesteerden soms tegen de gang van zaken en kozen partij in conflictsituaties. Sinds het eind van de jaren zestig van de twintigste eeuw verloor de Vrije Universiteit geleidelijk haar christelijk karakter. Tegenwoordig werken alle stafleden vanuit hun eigen motivatie mee aan een hoofdzakelijk seculier geworden universiteit, die ruimte biedt voor religieuze en levensbeschouwelijke diversiteit. (shrink)

What role does the wild duck play in Ibsen's famous drama? I argue that, besides mirroring the fate of the human cast members, the duck is acting as animal subject in a quasi-experiment, conducted in a private setting. Analysed from this perspective, the play allows us to discern the epistemological and ethical dimensions of the new scientific animal practice (systematic observation of animal behaviour under artificial conditions) emerging precesely at that time. Ibsen's play stages the clash between a scientific and (...) a romantic understanding of animals that still constitutes the backdrop of most contemporary debates over animals in research. Whereas the scientific understanding reduces the animal's behaviour, as well as its environment, to discrete and modifiable elements, the romantic view regards animals as being at one with (or violently disconnected from) their natural surroundings. (shrink)

Registered nurses (RNs) employed in an urban medical center in the USA identified moral distress as a practice concern. This study describes RNs' moral distress and the frequency of morally distressing events. Data were collected using the Moral Distress Scale and an open-ended questionnaire. The instruments were distributed to direct-care-providing RNs; 100 responses were returned. Morally distressing events included: working with staffing levels perceived as `unsafe', following families' wishes for patient care even though the nurse disagreed with the plan, and (...) continuing life support for patients owing to family wishes despite patients' poor prognoses. One high frequency distressing event was carrying out orders for unnecessary tests and treatments. Qualitative data analysis revealed that the nurses sought support and information from nurse managers, chaplaincy services and colleagues. The RNs requested further information on biomedical ethics, suggested ethics rounds, and requested a non-punitive environment surrounding the initiation of ethics committee consultations. (shrink)

In this article Troels Norager discusses the subject of sacrifice in the context of Kierkegaard's Works of Love and Fear and Trembling. The first section argues that contrary to contemporary attempts to turn Kierkegaard into a phenomenologist of love, Kierkegaard should be regarded as a radical Christian thinker who (partly for biographical reasons) deliberately emphasized the necessity of being willing to sacrifice one's most precious love object. The second part deals with Abraham's dilemma in Genesis 22 and argues, critically surveying (...) the intriguing interpretation proposed by Ingolf Dalferth, that no credible solution to this deeply troubling story is to be found. In the final section the author ponders the contemporary significance of Abraham's sacrifice and briefly points to insights from eminent political philosophers like Rawls and Habermas. This leads to the conclusion that theology should finally be taking leave of Abraham by rejecting Abraham as the 'Father of faith' and as a paradigm to be emulated. Instead, theologians and philosophers of religion are called upon to embrace our post-secular modernity without surrendering to the demands of authoritarian religion. (shrink)

This article presents a response to Richard Rorty's paper "Is Philosophy Relevant to Business Ethics?" The author questions Rorty's views on the depreciation of the role of philosophy in applied ethics, and outlines four reasons why philosophy retains its relevance. The author addresses the role of moral reasoning in the development of the moral imagination. The author also concludes that humans have the means necessary to make moral progress and are capable of moral reasoning, and need only to develop a (...) strong moral imagination. (shrink)

Fichte's System of Ethics, published in 1798, is at once the most accessible presentation of its author's comprehensive philosophical project, The Science of Knowledge or Wissenschaftslehre, and the most important work in moral philosophy written between Kant and Hegel. Fichte's ethics integrates the discussion of our moral duties into the systematic framework of a transcendental theory of the human subject. Its major philosophical themes include the practical nature of self-consciousness, the relation between reason and volition, the essential role of the (...) drives in human willing, the possibility of changing the natural world, the reality of one's own body, the reality of other human beings, and the practical necessity of social relations between human beings. This volume offers a translation of the work together with an introduction that sets it in its philosophical and historical contexts. (shrink)

Israel has a long history of concern with chemical and biological threats, since several hostile states in the Middle East are likely to possess such weapons. The Twin-Tower terrorist attacks and Anthrax envelope scares of 2001 were a watershed for public perceptions of the threat of unconventional terror in general and of biological terror in particular. New advances in biotechnology will only increase the ability of terrorists to exploit the burgeoning availability of related information to develop ever-more destructive bioweapons. Many (...) areas of modern biological research are unavoidably dual-use by nature. They thus have a great potential for both help and harm; and facilitating the former while preventing the latter remains a serious challenge to researchers and governments alike. This article addresses how Israel might best (1) prevent hostile elements from obtaining, from Israel’s biological research system, materials, information and technologies that might facilitate their carrying out a biological attack, while (2) continuing to promote academic openness, excellence and other hallmarks of that system. This important and sensitive issue was assessed by a special national committee, and their recommendations are presented and discussed. One particularly innovative element is the restructuring and use of Israel’s extensive biosafety system to also address biosecurity goals, with minimal disruption or delay. (shrink)

In this paper, I will reread the history of molecular genetics from a psychoanalytical angle, analysing it as a case history. Building on the developmental theories of Freud and his followers, I will distinguish four stages, namely: (1) oedipal childhood, notably the epoch of model building (1943–1953); (2) the latency period, with a focus on the development of basic skills (1953–1989); (3) adolescence, exemplified by the Human Genome Project, with its fierce conflicts, great expectations and grandiose claims (1989–2003) and (4) (...) adulthood (2003–present) during which revolutionary research areas such as molecular biology and genomics have achieved a certain level of normalcy—have evolved into a normal science. I will indicate how a psychoanalytical assessment conducted in this manner may help us to interpret and address some of the key normative issues that have been raised with regard to molecular genetics over the years, such as ‘relevance’, ‘responsible innovation’ and ‘promise management’. (shrink)

In this philosophically sophisticated and historically significant work, John H. Zammito reconstructs Kant's composition of The Critique of Judgment and reveals that it underwent three major transformations before publication. He shows that Kant not only made his "cognitive" turn, expanding the project from a "Critique of Taste" to a Critique of Judgment but he also made an "ethical" turn. This "ethical" turn was provoked by controversies in German philosophical and religious culture, in particular the writings of Johann Herder and the (...) Sturm und Drang movement in art and science, as well as the related pantheism controversy. Such topicality made the Third Critique pivotal in creating a "Kantian" movement in the 1790s, leading directly to German Idealism and Romanticism. The austerity and grandeur of Kant's philosophical writings sometimes make it hard to recognize them as the products of a historical individual situated in the particular constellation of his time and society. Here Kant emerges as a concrete historical figure struggling to preserve the achievements of cosmopolitan Aufkl-rung against challenges in natural science, religion, and politics in the late 1780s. More specifically Zammito suggests that Kant's Third Critique was animated throughout by a fierce personal rivalry with Herder and by a strong commitment to traditional Christian ideas of God and human moral freedom. "A work of extraordinary erudition. Zammito's study is both comprehensive and novel, connecting Kant's work with the aesthetic and religious controversies of the late eighteenth century. He seems to have read everything. I know of no comparable historical study of Kant's Third Critique."-Arnulf Zweig, translator and editor of Kant's ;IPhilosophical Correspondence, 1759-1799;X "An intricate, subtle, and exciting explanation of how Kant's thinking developed and adjusted to new challenges over the decade from the first edition of the Critique of Pure Reason to the appearance of the Critique of Judgment. "--John W. Burbidge, Review of Metaphysics "There has been for a long time a serious gap in English commentary on Kant's Critique of Judgment Zammito's book finally fills it. All students and scholars of Kant will want to consult it."--Frederick Beiser, Times Literary Supplement. (shrink)

This article compares Kant and Fichte from the double stand- point of identity and difference with regard to two thinkers who were at first united by a master-student relation but who later on drifted apart from each other due to mutual defamation. At the center of the present discussion stands the relationship between spirit of freedom and system’s form which binds Kant and Fichte beyond methodological divergences and doctrinal differ- ences. The critical comparison between Kant and Fichte will be developed (...) in four steps: it will start with the general positioning of Kant within German Idealism, and then move on to Kant’s double critical enterprise of grounding an aprioristic doctrine of principles of nature and freedom; it will later on address the conception championed by Fichte of having pre- sented the “first system of freedom”, and from there it will focus on the manifestations of freedom within Fichte’s philosophical system, with Kant’s position as contrast. (shrink)

El presente artículo compara a Kant y a Fichte en la perspectiva doble de identidad y diferencia referida a dos pensadores a quienes une una primera relación de maestro y alumno y a quienes separa una posterior difamación mutua. En el centro de la presentación se encuentra la relación entre espíritu de libertad y forma del sistema que une a Kant y a Fichte más allá de divergencias metódicas y de diferencias doctrinales. La comparación crítica entre Kant y Fichte se (...) desarrollará en cuatro etapas: partirá de la ubicación general de Kant dentro del idealismo alemán y se extenderá a la empresa doble de Kant, expresada de forma crítica, de una doctrina de los principios apriorística de naturaleza y libertad, para después ir a la concepción enfáticamente reclamada por Fichte de un “primer sistema de la libertad”,[1] y de ahí a las manifestaciones de la libertad en el sistema filosófico de Fichte, teniendo como punto de vista rector el contraste con Kant.[2] Palabras clave: [1] En la forma de citación de la Gesamtausgabe de Fichte se señalará el tomo y el volumen con números romanos y arábigos respectivamente, y después el número de página en cuestión. [2] El presente artículo es parte de un proyecto de carácter más amplio, cuyo tema es la dilucidación del aporte filosófico de Kant y de Fichte; de ahí que se haga continua referencia a publicaciones particulares de mi autoría. (shrink)