Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...) of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

Clinical fields of the “sciences of the mind” (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding “systems” for “processes” of the brain. These terms have a supradisciplinary” meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. It (...) provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like “structure”, “process” and “dynamics” as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like “life space” or “object representations” can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. ystem for mental dynamics. In this context, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. (shrink)

The Covid-19 pandemic has challenged both medicine and governments as they have strived to confront the pandemic and its consequences. One major challenge is that evidence-based medicine has struggled to provide timely and necessary evidence to guide medical practice and public policy formulation. We propose an extension of evidence-based corona medicine to an organismic systems corona medicine as a multilevel conceptual framework to develop a robust concept-oriented medical system. The proposed organismic systems corona medicine could help to prevent or mitigate (...) future pandemics by transitioning to a bifocal medicine that extends an empirical evidence-based medicine to a theory-oriented organismic systems medicine. (shrink)

Neuroscience is a multidisciplinary effort to understand the structures and functions of the brain and brain-mind relations. This effort results in an increasing amount of data, generated by sophisticated technologies. However, these data enhance our descriptive knowledge, rather than improve our understanding of brain functions. This is caused by methodological gaps both within and between subdisciplines constituting neuroscience, and the atomistic approach that limits the study of macro- and mesoscopic issues. Whole-brain measurement technologies do not resolve these issues, but rather (...) aggravate them by the complexity problem. The present article is devoted to methodological and epistemic problems that obstruct the development of human neuroscience. We neither discuss ontological questions nor review data, except when it is necessary to demonstrate a methodological issue. As regards intradisciplinary methodological problems, we concentrate on those within neurobiology and psychology. As regards interdisciplinary problems, we suggest that core disciplines of neuroscience can be integrated using systemic concepts that also entail human-environment relations. We emphasize the necessity of a meta-discussion that should entail a closer cooperation with philosophy as a discipline of systematic reflection. The atomistic reduction should be complemented by the explicit consideration of the embodiedness of the brain and the embeddedness of humans. The discussion is aimed at the development of an explicit methodology of integrative human neuroscience, which will not only link different fields and levels, but also help in understanding clinical phenomena. (shrink)

New data-driven technologies yield benefits and potentials, but also confront different agents and stakeholders with challenges in retaining control over their data. Our goal in this study is to arrive at a clear picture of what is meant by data sovereignty in such problem settings. To this end, we review 341 publications and analyze the frequency of different notions such as data sovereignty, digital sovereignty, and cyber sovereignty. We go on to map agents they concern, in which context they appear, (...) and which values they allude to. While our sample reveals a considerable degree of divergence and an occasional lack of clarity about intended meanings of data sovereignty, we propose a conceptual grid to systematize different dimensions and connotations. Each of them relates in some way to meaningful control, ownership, and other claims to data articulated by a variety of agents ranging from individuals to countries. Data sovereignty alludes to a nuanced mixture of normative concepts such as inclusive deliberation and recognition of the fundamental rights of data subjects. (shrink)

In their contribution ‘Ethics of the algorithmic prediction of goal of care preferences’1 Ferrario et al elaborate a from theory to practice contribution concerning the realisation of artificial intelligence (AI)-based patient preference prediction (PPP) systems. Such systems are intended to help find the treatment that the patient would have chosen in clinical situations—especially in the intensive care or emergency units—where the patient is no longer capable of making that decision herself. The authors identify several challenges that complicate their effective development, (...) application and evaluation—and offer solutions to them. One of these issues is the question of who should ultimately use said systems. While it is undisputed that clinicians should use these AI systems for their decision-making process, there is an ongoing debate about whether next of kin should use them as well. The authors advocate that ‘’access should be provided to both clinicians and loved ones with due explanations and as desired’. We will disagree with this assessment and explain in our commentary why it is important that surrogates provide their own assessments with as little external (AI) influence as possible. Why do next of kin actually participate in the process of preference finding and treatment decision-making? A key reason is that clinicians usually …. (shrink)

The aim of this paper is to argue that lying differs from mere misleading in a way that can be morally relevant: liars commit themselves to something they believe to be false, while misleaders avoid such commitment, and this difference can make a moral difference. Even holding all else fixed, a lie can therefore be morally worse than a corresponding misleading utterance. But, we argue, there are also cases in which the difference in commitment makes lying morally better than misleading, (...) as well as cases in which the difference is not morally relevant. This view conflicts with the two main positions philosophers have defended in the ethics of lying and misleading, which entail either that lying is in virtue of its nature worse than misleading or that there is no morally relevant difference between lying and misleading. (shrink)

In his contribution, ‘Represent me: please! Towards an ethics of digital twins in medicine’1, Braun shows that there is a fundamental ambivalence inherent in digital twins: they can either open up new freedoms for the simulated persons, or, conversely, endanger and restrict their freedom. To prevent digital twins from restricting people’s freedom, Braun suggests a strong focus on control. Braun’s focus on control is insufficient, I will argue, because his idea of control works only retroactively: it can only react to (...) restrictions of freedom that have already occurred, but it cannot prevent them, nor can it restore any lost freedom. Control is therefore insufficient to defend people’s freedom. To prove my claim, I will first use an everyday example to illustrate the fundamental ambivalence inherent in digital twins. Second, I will show that digital twins endanger people’s freedom in a hermeneutic way. Finally, I will demonstrate why controllability cannot prevent this hermeneutic endangerment. I understand digital twins, like Braun, as simulation of a person, as their dynamic and precise effigy. Simulated twins use machine-learning and artificial intelligence capabilities to make predictive analyses about the simulated person and the future development of her health. Imagine: You are eating dinner. Meanwhile, your partner lectures you about the calorie density and nutrient composition of your food, warns you that your portion size exceeds your daily calorie requirement by x calories. It calculates how your dinner will negatively impact your body mass index and physical fitness, and predicts what the consequences will be for your overall health. Based on these data and predictions, it creates an individualised diet plan for you—and at the same time shows you by how much you could improve your vital values by sticking to that plan. This example helps to illustrate the fundamental …. (shrink)

Computational models have shown how polarisation can rise among deliberating agents as they approximate epistemic rationality. This paper provides further support for the thesis that polarisation can rise under condition of epistemic rationality, but it does not depend on limitations that extant models rely on, such as memory restrictions or biased evaluation of other agents’ testimony. Instead, deliberation is modelled through agents’ purposeful introduction of arguments and their rational reactions to introductions of others. This process induces polarisation dynamics on its (...) own. A second result is that the effect size of polarisation dynamics correlates with particular types of argumentative behaviour. Polarisation effects can be soothed when agents take into account the opinions of others as premises, and they are amplified as agents fortify their own beliefs. These results underpin the relevance of argumentation as a factor in social-epistemic processes and indicate that rising issue polarisation is not a reliable indicator of epistemic shortcomings. (shrink)

This book provides a comprehensive investigation into Hans Morgenthau's life and work. Identifying power, knowledge, and dissent as the fundamental principles that have informed his worldview, this book argues that Morgenthau's lasting contribution to the discipline of International Relations is the human condition of politics.

ABSTRACT The sense of kairos is of time as having an event-like character. Fundamental here is a split between quantitative time and a qualitatively distinct moment. The decisive moment connects the kairological to crisis. By exploring the accounts of kairos in three contemporaries responding to the sense of crisis in 1920s Germany—Benjamin, Heidegger, and Tillich—this article shows the manner in action in the kairos can be understood as both responsive and non-opportunist. Themes such as the “tiger leap” (Benjamin), the “moment (...) of vision” (Heidegger), and the “shuddering” of time (Tillich) are analyzed to demonstrate how these accounts taken in dialogue with one another give an understanding of kairos, as a displacement and disruption of time as chronos and not simply as an interruption in chronological time. Such a disruption of chronological time is a necessary condition for responsible action, giving a measure also for the present. (shrink)

Charles Parsons’ book “Mathematical Thought and Its Objects” of 2008 (Cambridge University Press, New York) is critically discussed by concentrating on one of Parsons’ main themes: the role of intuition in our understanding of arithmetic (“intuition” in the specific sense of Kant and Hilbert). Parsons argues for a version of structuralism which is restricted by the condition that some paradigmatic structure should be presented that makes clear the actual existence of structures of the necessary sort. Parsons’ paradigmatic structure is the (...) so-called ‘intuitive model’ of arithmetic realized by Hilbert’s strings of strokes. This paper argues that Hilbert’s strings, considered as given in intuition, cannot play the role Parsons assigns to them: the criteria of identity of these strings do not have the sharpness that Parsons wants to see in them, and Parsons inadvertently projects abstract structures into his ‘intuitive model’. This diagnosis is exemplified with respect to (a) Parsons’ distinction between addition and multiplication on the one hand and exponentiation on the other and (b) his analysis of arithmetical knowledge in simple cases like “7 + 5 = 12”. All in all, it is claimed that Parsons book contains many important insights with respect to, for example, different versions structuralism, the notion of “natural number” and its uniqueness, induction, predicativity and other things, for which he is rightly famous, but that his way of drawing on the notion of intuition leaves too many questions unanswered. (shrink)

States act wrongly. Sometimes, they are held responsible, or take responsibility of their own accord, to remediate their wrongdoing: they cease to act wron.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Background The use of Artificial Intelligence (AI) has the potential to provide relief in the challenging and often stressful clinical setting for physicians. So far, however, the actual changes in work for physicians remain a prediction for the future, including new demands on the social level of medical practice. Thus, the question of how the requirements for physicians will change due to the implementation of AI is addressed. Methods The question is approached through conceptual considerations based on the potentials that (...) AI already offer and the focus on central normative concepts of trust, explainability, and responsibility which play an important role when implementing AI in everyday clinical practice. Conclusion Interpersonal communication will not disappear upon implementation of AI. Instead, it is much more likely that the exchange between various actors in medical practice will become increasingly important. This adds another level of complexity to practical concepts such as Shared-Decision-Making, which must be addressed in empirical research, including the involvement of AI systems as actors in communication. (shrink)

Considered by many to be one of the major influences on modern Humanistic Judaism, Felix Adler (1851-1933) was a professor of political and social ethics and a social reformer who founded the Ethical Culture movement. First published in 1903 "Life and Destiny" contains quotations from Adler's lectures for the New York Society for Ethical Culture in its early years. It covers such things as the meaning of life, religion, immortality, moral ideas, the ethical outlook, and related topics.

Ist Identität eine Funktion des Gedächtnisses? Mithilfe von Walter Benjamins Erfahrungstheorie kritisiert Felix Denschlag die Theorie des »kollektiven Gedächtnisses« von Maurice Halbwachs sowie Jan und Aleida Assmann und ergänzt sie im Sinne einer Theorie der Vergangenheitsverhältnisse. Der Identitätsbegriff wird - gegenüber der Konstruktion einer bruchlosen Kontinuität - als »kontinuierliche Diskontinuität« begriffen und dem willentlich verfügbaren Gedächtnis wird ein weit darüber hinaus gehender Bereich einer »schöpferischen Unordnung« entgegensetzt. Auf diese Weise lässt sich das individuelle Erfahrungsmoment gegenüber der intersubjektiv verfügbaren und (...) beherrschbaren sozialen Identität betonen. (shrink)

Since uncertainty is a major challenge in medicine and bears the risk of causing incorrect diagnoses and harmful treatment, there are many efforts to tackle it. For some time, AI technologies have been increasingly implemented in medicine and used to reduce medical uncertainties. What initially seems desirable, however, poses challenges. We use a multimethod approach that combines philosophical inquiry, conceptual analysis, and ethical considerations to identify key challenges that arise when AI is used for medical certainty purposes. We identify several (...) challenges. Where AI is used to reduce medical uncertainties, it is likely to result in (a) patients being stripped down to their measurable data points, and being made disambiguous. Additionally, the widespread use of AI technologies in health care bears the risk of (b) human physicians being pushed out of the medical decision-making process, and patient participation being more and more limited. Further, the successful use of AI requires extensive and invasive monitoring of patients, which raises (c) questions about surveillance as well as privacy and security issues. We outline these several challenges and show that they are immediate consequences of AI-driven security efforts. If not addressed, they could entail unfavorable consequences. We contend that diminishing medical uncertainties through AI involves a tradeoff. The advantages, including enhanced precision, personalization, and overall improvement in medicine, are accompanied by several novel challenges. This paper addresses them and gives suggestions about how to use AI for certainty purposes without causing harm to patients. (shrink)

Recently, a shadow has been cast over how geographical scale has been theorized. Neil Brenner has argued that scale risks becoming a empty concept because it has been conflated with other terms in geography such as place, region, and space; Marston, Jones, and Woodward have proposed doing away with scale altogether; while Wood has accused geographers of having a “scale fetish.” The following article defends the theory of scale against these various detractors and attempts to become a bulwark to support (...) the many contributions that geographers have made to effectively characterizing the socio-spatial world. I outline four ways of understanding geographical scale: measurement, size, hierarchy, and relation. I then argue for an understanding of scale that is relational because I believe it provides the most adequate language to characterize how geographers have come to understand the social ontology of the spatialworld. Moreover, I set out to show how the relational description of scale, complements other research on scale, which has shown the importance of scale in the production of geographical difference and uneven social relations. Hence, the understanding of scales relationally, allows for people to have relative positions in the world. Finally, I speculate on two implications that the understanding of scale relatively has for characterizing the effects of globalization: 1) the possibilities that this understanding has for confronting a dominant tenant in the ideology of neoliberalism; 2) the promise that it offers for forms of political resistance. (shrink)

In moral and political philosophy, collective obligations are promising “gap-stoppers” when we find that we need to assert some obligation, but can not plausibly ascribe this obligation to individual agents. Most notably, Bill Wringe and Jesse Tomalty discuss whether the obligations that correspond to socio-economic human rights are held by states or even by humankind at large. The present paper aims to provide a missing piece for these discussions, namely an account of the conditions under which obligations can apply to (...) loose collections of agents that do not qualify as collective agents in their own right. I first explain the notion of joint obligations of loose collections of agents as opposed to collective obligations of collections of agents that are collective agents in their own right, and argue that the conditions under which agents can jointly have obligations are the conditions under which they are jointly able to do what is required. I then build on Virginia Held’s seminal work on the moral responsibility of “random collections” to develop such conditions for joint ability. My discussion shows that collections of individuals can more easily be subject to moral obligations than previously assumed. It also shows that putative joint obligations need to be carefully time-indexed, and that it is largely an empirical question whether a given collection can be subject to a moral obligation to perform a given joint action at a particular time. (shrink)

When several agents together produce suboptimal outcomes, yet no individual could have made a difference for the better, Act Consequentialism counterintuitively judges that all involved agents act rightly. I address this problem by supplementing Act Consequentialism with a requirement of modal robustness: Agents not only ought to produce best consequences in the actual world, but they also ought to be such that they would act optimally in certain counterfactual scenarios. I interpret this Modally Robust Act Consequentialism as Act Consequentialism plus (...) a requirement of moral virtue, namely, to reliably act rightly and to act rightly for the right reasons. (shrink)

In the past few decades world architecture has seen radical changes as the result of industrialization, standardization and mass production. For Soviet architecture this half century of scientific and technical revolution along with the growth of economic potential has been the most fruitful in its history. If we return to the past and try to form a judgment on the urbanism of our day we will no doubt see that what is offered us by new cities, modern residential zones and (...) social amenities corresponds to our dreams of the cities of the future. From the point of view of the past, we have only to look at the zones of Yassenevo, Tropariovo, the Olympic village or the civic centers of Tashkent or Navoi. (shrink)