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)

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)

This article presents an introductory overview of the interpretations of schizophrenia offered by three phenomenological psychiatrists: Eugene Minkowski (1885-1972), Wolfgang Blankenburg (b. 1928), and Kimura Bin (b. 1931). Minkowski views schizophrenia as characterized by a diminished sense of dynamic and vital connection to the world ("loss of vital contact"), often accompanied by a hypertrophy of intellectual and static tendencies ("morbid rationalism," "morbid geometrism"). Blankenburg emphasizes the patient's loss of the normal sense of obviousness or "natural self-evidence"—a loss of the usual (...) common-sense background that enables normal persons to cope easily with the social and practical world. Kimura focuses on certain distortions of self-experience: a distinctive splitting of the subjective self, alienated awareness of one's own ongoing consciousness, and profound uncertainty about the "I-ness" of the self. In addition to a summary, this article offers a comparison and critique of these three approaches. The three approaches are also considered in light of a more recent, phenomenological formulation of schizophrenia as a disorder of self-experience (an ipseity disturbance) involving hyperreflexivity and diminished self-affection (i.e., heightened awareness of aspects of experience that would normally remain tacit or presupposed and decline in the feeling of existing as a subject of awareness). (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 lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of delusion has (...) been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 125-132 [Access article in PDF] Incomprehensibility and Understanding:On the Interpretation of Severe Mental Illness Louis A. Sass Keywords hermeneutics, psychopathology, paradox, Wittgenstein, solipsism, delusion, principle of charity, phenomenological psychopathology. I would like to begin by thanking Rupert Read for the care he has put into reading my work, and into thinking through its implications in the context of the "new-Wittgensteinian" interpretation of the (...) thought of Ludwig Wittgenstein. This interpretation derives from an influential reading of this philosopher's early book, the Tractatus Logico-Philosophicus (1961), that is not explicitly discussed in Read's article, yet that lies behind much of his argument. Read does allude to this reading of the Tractatus when he refers to the concept of "logically alien thought" (see Conant [1992]), and by citing, in his endnotes, the Diamond, Conant, and Cerbone articles that appear in Crary and Read's edited collection, The New Wittgenstein (2000). In an earlier paper that also addresses my work, "On approaching schizophrenia through Wittgenstein," Read (2001) explicitly discusses the relevance of the new-Wittgensteinian interpretation of the Tractatus.According to this new-Wittgensteinian interpretation of the Tractatus, Wittgenstein took absolutely seriously his own realization (explicitly stated at the end of the Tractatus) that his book was internally self-contradictory, and he therefore realized that all or nearly all the sentences of the Tractatus must be totally devoid of any meaning or semantic reference. According to this austere view, the vast bulk of the Tractatus only pretends to be making meaningful statements about the nature of logic and semantics; its real purpose is to give the reader the illusion of meaning, and this it does in order to lead the reader to the eventual realization that there can in fact be no meaningful statements or thoughts at the level of self-referential abstraction at which the Tractatus pretends to be operating. Further, when Wittgenstein (1961) writes (in the famous last line of the book), "Whereof one cannot speak, thereof one must be silent" (p. 189), this statement should, supposedly, not be taken as any kind of mystical pointing toward some ineffable realm or truth, but, rather, as an austere recognition that there just are no ineffable truths—that, so to speak, there just is no mystical there there. [End Page 125]Rupert Read sees an analogy between, on the one hand, the (supposedly mistaken) readers of Wittgenstein's Tractatus who think that Wittgenstein is exploiting self-contradiction to allude to some higher, ineffable truth (i.e., something that can be pointed at even if it cannot be said), and, on the other hand, my own elucidation of Schreber's contradictions (see especially Chapter 2 of Paradoxes of Delusion [1994]) to argue that Schreber can be said to be having particular kinds of experiences, which I refer to as solipsistic or quasi-solipsistic in nature. Just as Wittgenstein's self-contradictions can (supposedly) point nowhere other than to their own failure to mean, so Schreber's self-contradictory and other nonstandard statements cannot (according to Read) be used to illuminate in any meaningful way the form of experience that supposedly lies behind them—as I, for example, have tried to do by offering a phenomenological account of Schreber and schizophrenia. Patients like Schreber and Renée cannot really be understood, just as we cannot really understand logically alien thought—which, in fact, is not really thought at all; in both cases, there is only the illusion of meaning, only the mirage of an alternative mode of thinking or of living. This, at least, is Read's new-Wittgensteinian claim.Few readers of Philosophy, Psychiatry, & Psychology will, I suspect, be familiar with these discussions centering on Wittgenstein's Tractatus, which were introduced largely by the philosophers Cora Diamond and James Conant (see Crary and Read [2000]). (I myself have found their writings fascinating and inspiring in many ways, despite my ultimate disagreement on fundamental issues.) 1 Most readers of Philosophy, Psychiatry, & Psychology will have no way of assessing the validity of this austere reading of the Tractatus... (shrink)

In the United States, at least 6% of all hospital beds are in the intensive care unit or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ (...) some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1. (shrink)

mit Beitr. v. Günter C. Behrmann. hrsg. v. Günter Saße. ; Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Z 65.262-1447.

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)

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global (...) reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. (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)

What does it mean for ethics to say, as Wittgenstein did, that philosophy “leaves everything as it is”? -/- Though clearly absorbed with ethical questions throughout his life and work, Wittgenstein's remarks about the subject do not easily lend themselves to summation or theorizing. Although many moral philosophers cite the influence or inspiration of Wittgenstein, there is little agreement about precisely what it means to do ethics in the light of Wittgenstein. -/- Ethics after Wittgenstein brings together an international cohort (...) of leading scholars in the field to address this problem. The chapters advance a conception of philosophical ethics characterized by an attention to detail, meaning and importance which itself makes ethical demands on its practitioners. Working in conversation with literature and film, engaging deeply with anthropology and critical theory, and addressing contemporary problems from racialized sexual violence against women to the Islamic State, these contributors reclaim Wittgenstein's legacy as an indispensable resource for contemporary ethics. (shrink)

This article examines the structure of self-consciousness in people with schizophrenia. The findings indicate that our self-experience is not neutral with respect to the metaphysical status of the self and that it is important to attend carefully to the experience of the subject in order to understand schizophrenia. The results also suggest that the variable disruptions in the sense of self-presence, first-person perspective, and the phenomenality of experience in schizophrenics directly affect the minimal self and it may also have implications (...) for the narrative self. (shrink)