A brain-computer interface is a rapidly evolving neurotechnology connecting the human brain with a computer. In its classic form, brain activity is recorded and used to control external devices like protheses or wheelchairs. Thus, BCI users act with the power of their thoughts. While the initial development has focused on medical uses of BCIs, non-medical applications have recently been gaining more attention, for example in automobiles, airplanes, and the entertainment context. However, the attitudes of the general public towards BCIs have (...) hardly been explored. Among the general population in Germany aged 18–65 years, a representative online survey with 20 items was conducted in summer 2018 and analysed by descriptive statistics. The survey assessed: affinity for technology; previous knowledge and experience concerning BCIs; the attitude towards ethical, social and legal implications of BCI use and demographic information. Our results indicate that BCIs are a unique and puzzling way of human–machine interaction. The findings reveal a positive view and high level of trust in BCIs on the one hand but on the other hand a wide range of ethical and anthropological concerns. Agency and responsibility were clearly attributed to the BCI user. The participants’ opinions were divided regarding the impact BCIs have on humankind. In summary, a high level of ambivalence regarding BCIs was found. We suggest better information of the public and the promotion of public deliberation about BCIs in order to ensure responsible development and application of this potentially disruptive technology. (shrink)

Background: There are numerous benefits to ethics consultation services, but little is known about the reasons different professionals may or may not request an ethics consultation. Inter-professional differences in the perceived utility of ethics consultation have not previously been studied.Methods: To understand profession-specific perceived benefits of ethics consultation, we surveyed all employees at an urban tertiary children’s hospital about their use of ethics committee services (n = 842).Results: Our findings suggest that nurses and physicians find ethics consultations useful for different (...) reasons; physicians were more likely to report normative benefits, while nurses were more likely to report communicative and relational benefits.Conclusions: These findings support an open model of ethics consultation and may also help ethics committees to better understand consultation requests and remain attuned to the needs of various professional groups. (shrink)

Urban agriculture in Cuba has played an important role for citizens’ food supply since the collapse of the Eastern Block. Through the land reform of 2008 and the Lineamientos of 2011, the Cuban government has aimed to support agriculture in order to increase national food production and reduce imports. However, the implementation of the designed measures faced obstacles. Therefore, the research objective was to display how the government’s measures aiming to support domestic food production influenced urban agriculture. The qualitative research (...) comprised semi-structured interviews with 15 urban farmers in Havana and revealed the respondents’ experiences with the land reform and the Lineamientos and the potential of the reforms to implement food sovereignty. Findings show that the land reform has facilitated access to land for newcomer and existing farmers. However, availability of agricultural inputs has been limited and they were often expensive. Thus, urban farmers frequently produced farm inputs at their plots and applied sustainable farming practices to minimize their dependence on external inputs. The reforms have generated private marketing opportunities and have stimulated urban farmers to increase production. At the same time, subsidies have been reduced and consumers have faced increasing food prices. In conclusion, the land reform and the Lineamientos have created framework conditions for food sovereignty. However, the challenge is to increase the coherence of the theoretic aim and the practical implementation of the reforms. (shrink)

Traduçáo do texto de texto Über die verschiedenen Methoden des Übersetzens , redigido no período em que Schleiermacher lecionava em Berlim. Originalmente escrito como base para uma conferência proferida em 24 de junho de 1813, na Academia Real de Ciências. A presente traduçáo baseia-se na publicaçáo inclusa na Friedrich Schleiermacher’s sämmtliche Werke , Dritte Abteilung: Zur Philosophie, Zweiter Bd., Berlin, Reimer, 1838, S. 207-245.

The rapid expansion of research on Brain-Computer Interfaces is not only due to the promising solutions offered for persons with physical impairments. There is also a heightened need for understanding BCIs due to the challenges regarding ethics presented by new technology, especially in its impact on the relationship between man and machine. Here we endeavor to present a scoping review of current studies in the field to gain insight into the complexity of BCI use. By examining studies related to BCIs (...) that employ social research methods, we seek to demonstrate the multitude of approaches and concerns from various angles in considering the social and human impact of BCI technology. For this scoping review of research on BCIs’ social and ethical implications, we systematically analyzed six databases, encompassing the fields of medicine, psychology, and the social sciences, in order to identify empirical studies on BCIs. The search yielded 73 publications that employ quantitative, qualitative, or mixed methods. Of the 73 publications, 71 studies address the user perspective. Some studies extend to consideration of other BCI stakeholders such as medical technology experts, caregivers, or health care professionals. The majority of the studies employ quantitative methods. Recurring themes across the studies examined were general user opinion towards BCI, central technical or social issues reported, requests/demands made by users of the technology, the potential/future of BCIs, and ethical aspects of BCIs. Our findings indicate that while technical aspects of BCIs such as usability or feasibility are being studied extensively, comparatively little in-depth research has been done on the self-image and self-experience of the BCI user. In general there is also a lack of focus or examination of the caregiver’s perspective. (shrink)

ZusammenfassungDie demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

ZusammenfassungDie demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

„Medizinische Notwendigkeit“ (MedN) ist der zentrale Steuerungsbegriff für die Finanzierung medizinischer Versorgung in der deutschen Gesetzlichen Krankenversicherung. Trotz seiner scheinbaren Objektivität und Bestimmtheit durch ärztliche Expertise ist der Begriff alles andere als eindeutig definiert. In diesem ersten von fünf geplanten Aufsätzen zur Begriffsklärung von MedN aus medizintheoretischer, -ethischer, rechtlicher und (sozial)medizinischer Perspektive geht es um eine Systematisierung der aktuellen Kontroversen. Damit soll eine Fundierung für Detaildebatten gelegt werden, die bisher fehlt. Geklärt werden sollen die begriffliche Struktur, Funktion, Kontextualität und Missverständlichkeit (...) von MedN sowie die grundsätzlichen Grenzen einer Begriffsanalyse für die anstehenden normativen Fragen medizinischer Leistungssteuerung. (shrink)

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

v. 1. The birth of tragedy; or, Hellenism and pessimism.--v. 2. Early Greek philosophy & other essays.--v. 3. On the future of our educational institutions. Homer and classical philology.--v. 4-5. Thoughts out of season.--v. 6-7. Human, all-too-human.--v. 8. The case of Wagner. Nietzsche contra Wagner. Selected aphorisms.--v. 9. The dawn of day.--v. 10. The joyful wisdom.--v. 11. Thus spake Zarathustra.--v. 12. Beyond good and evil.--v. 13. The genealogy of morals. Peoples and countries.--v. 14.-15. The will to power.--v. 16.--The twilight of (...) the idols; or, How to philosophise with the hammer. The antichrist.--v. 17. Ecce homo, Nietzsche's autobiography.--v. 18. Guppy, R. Index to Nietzsche. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Objectives To characterize the prevalence and content of pediatric triage policies.Methods We surveyed and solicited policies from U.S. hospitals with pediatric intensive care units. Policies were analyzed using qualitative methods and coded by 2 investigators.Results Thirty-four of 120 institutions (28%) responded. Twenty-five (74%) were freestanding children’s hospitals and 9 (26%) were hospitals within a hospital. Nine (26%) had approved policies, 9 (26%) had draft policies, 5 (14%) were developing policies, and 7 (20%) did not have policies. Nineteen (68%) institutions shared (...) their approved or draft policy. Eight (42%) of those policies included neonates. The polices identified 0 to 5 (median 2) factors to prioritize patients. The most common factors were short- (17, 90%) and long- (14, 74%) term predicted mortality. Pediatric scoring systems included Pediatric Logistic Organ Dysfunction-2 (12, 63%) and Score for Neonatal Acute Physiology and Perinatal Extensions-II (4, 21%). Thirteen (68%) policies described a formal algorithm. The most common tiebreakers were random/lottery (10, 71%) and life cycles (9, 64%). The majority (15, 79%) of policies specified the roles of triage team members and 13 (68%) precluded those participating in patient care from making triage decisions.Conclusions While many institutions still do not have pediatric triage policies, there appears to be a trend among those with policies to utilize a formal algorithm that focuses on short- and long-term predicted mortality and that incorporates age-appropriate scoring systems. Additional work is needed to expand access to pediatric-specific policies, to validate scoring systems, and to address health disparities. (shrink)

The four short works in Untimely Meditations were published by Nietzsche between 1873 and 1876.They deal with such broad topics as the relationship between popular and genuine culture, strategies for cultural reform, the task of philosophy, the nature of education, and the relationship between art, science and life. They also include Nietzsche's earliest statement of his own understanding of human selfhood as a process of endlessly 'becoming who one is'. As Daniel Breazeale shows in his introduction to this new edition (...) of R. J. Hollingdale's translation of the essays, these four early texts are key documents for understanding the development of Nietzsche's thought and clearly anticipate many of the themes of his later writings. Nietzsche himself always cherished his Untimely Meditations and believed that they provide valuable evidence of his 'becoming and self-overcoming' and constitute a 'public pledge' concerning his own distinctive task as a philosopher. (shrink)

Daybreak marks the arrival of Nietzsche's 'mature' philosophy and is indispensable for an understanding of his critique of morality and 'revaluation of all values'. This volume presents the distinguished translation by R. J. Hollingdale, with a new introduction that argues for a dramatic change in Nietzsche's views from Human, All Too Human to Daybreak, and shows how this change, in turn, presages the main themes of Nietzsche's later and better-known works such as On the Genealogy of Morality. The main themes (...) of Daybreak are located in their intellectual and philosophical contexts: in Nietzsche's training as a classical philologist and his fascination with the Sophists and Thucydides; in the moral philosophies of Kant and Schopenhauer, which are the central foci of Nietzsche's critique of morality; and in the German Materialist movement of the 1850s and after, which shaped Nietzsche's conception of persons. The edition is completed by a chronology, notes and a guide to further reading. (shrink)

This remarkable collection of almost 1,400 aphorisms was originally published in three instalments. The first (now Volume I) appeared in 1878, just before Nietzsche abandoned academic life, with a first supplement entitled The Assorted Opinions and Maxims following in 1879, and a second entitled The Wanderer and his Shadow a year later. In 1886 Nietzsche republished them together in a two-volume edition, with new prefaces to each volume. Both volumes are presented here in R. J. Hollingdale's distinguished translation (originally published (...) in the series Cambridge Texts in German Philosophy) with a new introduction by Richard Schacht. In this wide-ranging work Nietzsche first employed his celebrated aphoristic style, so perfectly suited to his iconoclastic, penetrating and multi-faceted thought. Many themes of his later work make their initial appearance here, expressed with unforgettable liveliness and subtlety. Human, All Too Human well deserves its subtitle 'A Book for Free Spirits', and its original dedication to Voltaire, whose project of radical enlightenment here found a new champion. (shrink)

As is shown in the introduction of the book, the notion "illocutionary act" is used with quite a number of essentially different meanings; consequently, it is quite unclear what an "illocutionary act" is actually supposed to be. This problem is the starting point of the thesis. An argument is stated, to the effect that the introduction and use of scholarly terms like, for instance, "illocutionary act", or "performative sentence", is not entirely arbitrary. It is argued that technical terms should not (...) be re-defined without a reason, but in the absence of reasons to the contrary should be used in the way in which they have originally been introduced. This argument is applied to the notion "illocutionary act". John L. Austin is the one who introduced this notion. Consequently, his conception of these acts should be adopted unless there are good reasons to the contrary. Therefore the book provides a detailed analysis of Austin's account, and his original conception of these acts is reconstructed. The most popular alternative account of "illocutionary acts" is John R. Searle's. Therefore, secondly, the book provides an analysis of Searle's famous account of "illocutionary acts" - the first really detailed one available, including Searle's own work. It is shown that what Searle presents is in fact extremely sketchy, and can certainly not be viewed, as it often is, as an elaborated theory. It is further argued that the fundamental assumptions about language which Searle intends to illustrate with his account of "illocutionary acts" are mistaken, so that in general a theory following the lines Searle suggests is doomed to failure. Finally it is shown that Searle's account of "illocutionary acts", as far as it goes, is not an adequate adoption of the conception Austin introduced. Hence Searle's account is no reasonable alternative to Austin's account. (shrink)

Im Auftrag des Friedrich-Meinecke-Instituts der Freien Universitäauml;t Berlin herausgegeben von Hans Herzfeld und Walther Hofer (Band 1-9). Füuuml;r Band 10 herausgegeben von Gisela Bock, Jürgen Kocka und Gerhard A. Ritter.

This collection of essays assumes the main thesis of Constructive Realism: reality is created. In this volume, it is constructed by authors from various scientific disciplines and very different cultures. The Festschrift is dedicated to the founder of this philosophical approach, Professor Dr. Friedrich Wallner (University of Vienna), in celebration of his 70th birthday. Dieser Sammelband geht von der Hauptthese des Konstruktiven Realismus aus - wir konstruieren Realität. Hier wird sie von Autoren aus verschiedenen wissenschaftlichen Disziplinen und sehr unterschiedlichen (...) Kulturen aufgebaut. Dem Gründer des philosophischen Ansatzes Professor Dr. Friedrich Wallner (Universität Wien) ist diese Festschrift anlässlich seines 70. Geburtstags gewidmet. (shrink)