Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short- and long-term harms, and uncertainty turns provision of life support int...

In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined (...) or if they conflict at fundamental or pragmatic levels. This paper reviews existing literature in both medicine and related philosophy to analyze closer the meaning of the two notions, and to explore the extent to which they overlap or oppose each other, in theory or in practice, in particular regarding ethical assumptions and their respective practical implications. (shrink)

This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view (...) of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective. (shrink)

As vaccines against COVID-19 are scarce, many countries have developed vaccination prioritisation strategies focusing on ethical and epidemiological considerations. However, public acceptance of such strategies should be monitored to ensure successful implementation. In an experiment withN=1379 German participants, we investigated whether the public’s vaccination allocation preferences matched the prioritisation strategy approved by the German government. Results revealed different allocations. While the government had top-prioritised vulnerable people (being of high age or accommodated in nursing homes for the elderly), participants preferred exclusive (...) allocation of the first available vaccines to medical staff and personnel caring for the elderly. Interestingly, allocation preferences did not change when participants were told how many individuals were included in each group. As differences between allocation policies and public preferences can affect trust in the government and threaten the social contract between generations, we discuss possible strategies to align vaccination prioritisations. (shrink)

It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of (...) futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field. (shrink)

It is generally assumed that a corporate purpose aiming to benefit all stakeholders has a positive effect on employee motivation and engagement, but no empirical studies into these specific effects were found. To examine this assumption, a corporate mission and vision matching the definition of a higher purpose were tested in two subsequent studies. The first study (N = 270) was a cross-sectional self-report study. The second study included a longitudinal design (N = 56) modeling purpose, motivation, and engagement in (...) a cross-lagged panel design over three time-points. The results associated purpose with motivation and engagement. The subsequent longitudinal analysis confirmed the presumed directionality from purpose to engagement, but not to motivation. Hence, while a corporate purpose can be added to the list of antecedents to work engagement, the relationship with motivation, despite the significant association with purpose in the cross-sectional study, remains more complicated. The present study adds to the knowledge of the beneficial effects of a broader purpose and responds to the current surge of interest in purpose as an instrument for sustainable business. (shrink)

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why it was justifiable (...) to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

By comparing alternative evolutionary models, the International Sexuality Description Project marks the transition of evolutionary psychology to the next level of scientific maturation. The lack of final conclusions might partly be a result of the composition of the Sociosexual Orientation Inventory and the sampled populations. Our own data suggest that correcting for both gives further support to the strategic pluralism model.

We present a complete elementary axiomatization of local maps of toposes.

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction and negative interpretation bias in a student sample screened for high and low social anxiety. Results support the hypothesis that group differences in negative interpretations (...) of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing. (shrink)

During a pandemic, demand for intensive care often exceeds availability. Experts agree that allocation should maximize benefits and must not be based on whether patients could have taken preventive measures. However, intensive care units are often overburdened by individuals with severe COVID-19 who have chosen not to be vaccinated to prevent the disease. This article reports an experiment that investigated the German public's prioritization preferences during the fourth wave of the coronavirus pandemic. In a series of scenarios, participants were asked (...) to decide on ICU admission for patients who differed in terms of health condition, expected treatment benefits, and vaccination status. The results reveal an in-group bias, as vaccinated individuals preferred to allocate more resources to the vaccinated than to the unvaccinated. Participants also favored admitting a heart attack patient rather than a COVID-19 patient with the same likelihood of benefiting from ICU admission, indicating a preference for maintaining regular ICU services rather than treating those with severe COVID-19. Finally, participants were more likely to admit a patient to intensive care when this meant withholding rather than withdrawing care from another patient. The results indicate that lay prioritizations violate established allocation principles, presaging potential conflicts between those in need of intensive care and those who provide and allocate it. It is therefore recommended that allocation principles should be explained to enhance public understanding. Additionally, vaccination rates should be increased to relieve ICUs and reduce the need for such triage decisions. (shrink)

This article focuses on the early years of children from immigrant families in Germany. Research has documented disparities in young children’s development correlating with their family background, making clear the importance of early intervention. Institutional childcare—as an early intervention for children at risk—plays an important role in Germany, as 34.3% of children below the age of three and 93% of children above that age are in external childcare. This paper focuses on the extent to which children from families with a (...) background of migration differ in their social development when considering their age of entry into early external childcare. Data from the infant cohort study of the German National Educational Panel Study is used to analyze the impact of early institutional childcare before the age of 3 years on children’s social competence at the age of 5 years, controlling for gender, siblings, temperament, home learning activities, and socioeconomic status. Results show the effects of duration of early external childcare on peer problems for children from families with a background of migration, in such a way that children who attend early external childcare for more than 1 year before the age of three show less problem behavior with peers than those who attend for less than a year. These findings have equity implications for children with a migration background living in Germany, especially as the proportion of these children is trending upwards. (shrink)

Executive compensation has long been a prominent topic in the management literature. A main question that is also given substantial attention in the business ethics literature—even more so in the wake of the recent financial crisis—is whether increasing levels of executive compensation can be justified from an ethical point of view. Also, the relationship of executive compensation to instances of unethical behavior or outcomes has received considerable attention. The purpose of this paper is to explore the social, ecological, and existential (...) costs of economic incentives, by discussing how relying on increasing levels of executive compensation may have an adverse effect on managerial performance in a broad sense. Specifically, we argue that one-dimensional economic incentives may destroy existential, social, and systemic values that influence the manager’s commitment to ensure responsible business conduct, and have negative spillover effects that may reduce the manager’s performance. There are well-documented findings that demonstrate that reliance on sources of extrinsic motivation (such as economic incentives) may displace intrinsic motivation. Our perspective is a holistic one, in the sense that we will explore the influence of sources of extrinsic motivation on the manager’s intrinsic commitment to different types of values. We will in particular investigate how it may influence the manager’s ethical reflection and behavior or lack thereof. (shrink)

Studying teaching behavior in controlled conditions is difficult. It seems intuitive that a human learner might have trouble reliably recreating response patterns over and over in interaction. A robot would be the perfect tool to study teaching behavior because its actions can be well controlled and described. However, due to the interactive nature of teaching, developing such a robot is not an easy task. As we will show in this review, respective studies require certain robot appearances and behaviors. These mainly (...) should induce teaching behavior in humans, be interactive, match the study design, and be realizable in terms of effort. We discuss how remote controlling of the robot or simulating robot capabilities is used as an option. With this review, we introduce the field of research on studying human teaching behavior with robots as a tool in the experimental design. We will provide a structured overview of existing work, and identify main challenges of employing robots in such studies. (shrink)

A collection of essays in various fields of philosophy written in celebration of Paul Needham's fiftieth birthday.

We are living in a world which is severely crisis-ridden and faces some major challenges. The fact that we are currently facing a genuine global pandemic brings about even more uncertainty. The social and political institutions, which emerged and consolidated during the 20th century, and which created stability, have become fragile. The young generation born in the 1990s and onwards have experienced 9/11 and the ‘war against terrorism’, the financial crisis of 2008, changes to climate, environmental degradation, and most recently (...) the COVID-19 pandemic. The generation born between 1960 and 1990 have had the same experiences along with severe economic crises in the 1970s and 1980s and the Cold War. Some of these challenges are in different ways intertwined with capitalism and its crises, while others are linked to the rapid development of new technologies, in particular innovations within communication and information technologies. This introduction lists the most important grand challenges facing the world as they have emerged more recently. The five articles following this introduction address some of these challenges, with particular attention to the problems of capitalism and democracy and the relation between these two areas. Most authors agree that climate change and the destruction of the environment are the biggest and most pertinent problems to address, but it is their stance that we can only meet these challenges if democracy is functioning well. (shrink)

Exploring Textual Action questions how we analyse works of art after the performative turn and shows how the interplay of performativity (textual action), space and topography, and the converging of genres and art forms is essential in modern drama, theatre, prose fiction, poetry and film. The volume also fosters a keen concern for the development of congenial theory. Its 14 detailed essays analyse works of art ranging from Balzac, Melville and George Eliot, to Breton, Kafka, Benjamin, Blixen and Woolf; and (...) from W.C. Williams, Bresson and Scorsese, to Sarraute, Duras, Reygadas, Dumont and Waltz. The approach of these studies discloses the art works as creative and dynamic utterances with active and shaping forces so powerful, and consequential, that they have the potential to transform human perception and blur clear distinctions between art and "real" life. Using an alternative and dynamic method and suggesting a direction towards the detailed analysis of literature, art, media and culture, Exploring Textual Action addresses current debates within the humanities. (shrink)

Some libertarians argue that informed consent alone makes transactions in the labour market morally justified. In contrast, some of their critics claim that such an act of consent is no guarantee against coercion. To know whether agreements are voluntary, we need to assess the quality of the offers or the prevailing background conditions. ISCT theorists argue that it is imperative to take social norms into account when evaluating the labour market. We present a novel framework for moral assessment in the (...) labour market, which takes consent, background conditions and norms into account, but which mainly focuses on the offers and demands made. Consent renders a transaction legitimate in the same way we regard a fair election legitimate even if we object to its outcome. For offers to be substantially justified, exploitation must be avoided and offers must give expression to the value of community. Only then they are morally justified. (shrink)

A large body of evidence supports the idea that a common fronto-parietal network is activated across a range of diverse cognitive functions. Jung & Haier's (J&H's) review demonstrates a very similar pattern of activity, which correlates with individual differences in intelligence. We propose that these converging lines of evidence are best interpreted as a general role of the fronto-parietal network in integration and control.

Belief merging aims at combining several pieces of information coming from different sources. In this paper we review the works on belief merging of propositional bases. We discuss the relationship between merging, revision, update and confluence, and some links between belief merging and social choice theory. Finally we mention the main generalizations of these works in other logical frameworks.

The objective of the presented research was to test whether working memory, measured using the Spin the Pots task, is an important factor in passive vocabulary development in 2- and 3-year-old children. Two longitudinal studies were conducted. In the first, 135 children participated in the first study. At 18 months their responding to joint attention was measured, and then at 24 months their working memory and passive vocabulary was tested. It was demonstrated that responding to joint attention predicts the level (...) of development of working memory, which in turn influences the extent of the passive vocabulary. In the second study, 113 children participated - at 30 months their working memory was measured, and at 24 months and then 36 months their passive vocabulary was tested. It was observed that at the age of 3 working memory is still a significant predictor of passive vocabulary. The usefulness of the Spin the Pots task for measuring the working memory of young children was shown and discussed in conclusions. (shrink)

ABSTRACT We consider in this work the problem of iterated belief revision. We propose a family of belief revision operators called revision with memory operators and we give a logical (both syntactical and semantical) characterization of these operators. They obey what we call the principle of strong primacy of update: when one revises his beliefs by a new evidence, then all possible worlds that satisfy this new evidence become more reliable than those that do not. We show that those operators (...) have a satisfying behaviour concerning the iteration of the revision process. Then we provide four particular operators of this family. (shrink)

We propose in this paper a new family of belief merging operators, that is based on a game between sources : until a coherent set of sources is reached, at each round a contest is organized to find out the weakest sources, then those sources has to concede. This idea leads to numerous new interesting operators and opens new perspectives for belief merging. Some existing operators are also recovered as particular cases. Those operators can be seen as a special case (...) of Booth's Belief Negotiation Models [BOO 02], but the achieved restriction forms a consistent family of merging operators that worths to be studied on its own. (shrink)