The care of elderly people with dementia poses ethical problems in several respects. This paper considers the problems in relation to treatment, withdrawal of treatment (including nutrition and hydration) in terminal care, and consent to involvement in research. It is ultimately the responsibility of the physician to take the decision about whether or not to proceed with treatment, according to the best interests of the patient, but nurses, families and significant others can be involved in making the decision. When withdrawal (...) of treatment or withdrawal of nutrition and hydration in the terminal stages of dementia are being considered it is necessary to take into account the nature of the treatment, whether or not it is extraordinary, and the goals of continued nutrition. In some circumstances it may be possible for them to be withdrawn. Only research which is aimed at evaluating treatment for dementia may involve subjects who are suffering from dementia. Soigner des personnes âgés souffrant de la démence pose plusieurs problèmes éthiques. Cet article considère les problèmes concernant le traitement, cessation de traitement (y inclus nutrition et hydration) dans la phase terminale, et consentement de participation dans les recherches. C'est ultimement la décision du docteur si oui ou non de continuer avec le traitement selon les meilleurs intérêts du malade, mais les infirmiers/ères, les familles et les personnes importantes autour du malade peuvent jouer un rôle dans les décisions. Si la cessation de traitement ou cessation de nutrition et hydration dans la phase terminale de démence est envisagée il est nécessaire de tenir compte de la nature du traitement, s'il est 'extraordinaire' ou non, et le but de nutrition si on continuait. Dans quelques circonstances il est possible de les discontinuer. Seuls les recherches qui ont pour but d'évaluer les traitements pour la démence peuvent utiliser des personnes souffrant de démence. Die Pflege von älteren Personen mit Demenz stellt einige ethische Probleme. Dieser Artikel betrachtet die Probleme in Beziehung auf die Pflege, Zurückziehung von Pflege (auch von Nahrung und Getrank) der Sterbenden und der Entscheidung, in der Forschung beteiligt zu sein. Der Arzt hat die schlussendliche Verantwortung über die Entscheidung ob mit der Pflege weitergefahren werden soll oder nicht nach dem besten Interesse der Patienten. Aber das Krankenpflegepersonal, die Familie und bedeutende Andere können auch an dieser Entscheidung teilnehmen. Wenn es sich um Zurückziehung der Pflege, oder Zurückziehung von Nahrung oder Getrank in der Sterbepflege von Personen mit Demenz handelt, is es nötig, das Wesen der Pflege und die Ziele einer fortfahrenden Nahrung zu kennen. In gewissen Fällen ist es möglich, diese zurück zu ziehen. Es sollen nur Patienten mit Demenz an Forschungen teilnehmen die über die Pflege der Demenz einschätzt. (shrink)

The care of elderly people with dementia poses ethical problems in several respects. This paper considers the problems in relation to treatment, withdrawal of treatment (including nutrition and hydration) in terminal care, and consent to involvement in research. It is ultimately the responsibility of the physician to take the decision about whether or not to proceed with treatment, according to the best interests of the patient, but nurses, families and significant others can be involved in making the decision. When withdrawal (...) of treatment or withdrawal of nutrition and hydration in the terminal stages of dementia are being considered it is necessary to take into account the nature of the treatment, whether or not it is extraordinary, and the goals of continued nutrition. In some circumstances it may be possible for them to be withdrawn. Only research which is aimed at evaluating treatment for dementia may involve subjects who are suffering from dementia.Soigner des personnes âgés souffrant de la démence pose plusieurs problèmes éthiques. Cet article considère les problèmes concernant le traitement, cessation de traitement (y inclus nutrition et hydration) dans la phase terminale, et consentement de participation dans les recherches. C'est ultimement la décision du docteur si oui ou non de continuer avec le traitement selon les meilleurs intérêts du malade, mais les infirmiers/ères, les familles et les personnes importantes autour du malade peuvent jouer un rôle dans les décisions. Si la cessation de traitement ou cessation de nutrition et hydration dans la phase terminale de démence est envisagée il est nécessaire de tenir compte de la nature du traitement, s'il est 'extraordinaire' ou non, et le but de nutrition si on continuait. Dans quelques circonstances il est possible de les discontinuer. Seuls les recherches qui ont pour but d'évaluer les traitements pour la démence peuvent utiliser des personnes souffrant de démence.Die Pflege von älteren Personen mit Demenz stellt einige ethische Probleme. Dieser Artikel betrachtet die Probleme in Beziehung auf die Pflege, Zurückziehung von Pflege (auch von Nahrung und Getrank) der Sterbenden und der Entscheidung, in der Forschung beteiligt zu sein. Der Arzt hat die schlussendliche Verantwortung über die Entscheidung ob mit der Pflege weitergefahren werden soll oder nicht nach dem besten Interesse der Patienten. Aber das Krankenpflegepersonal, die Familie und bedeutende Andere können auch an dieser Entscheidung teilnehmen. Wenn es sich um Zurückziehung der Pflege, oder Zurückziehung von Nahrung oder Getrank in der Sterbepflege von Personen mit Demenz handelt, is es nötig, das Wesen der Pflege und die Ziele einer fortfahrenden Nahrung zu kennen. In gewissen Fällen ist es möglich, diese zurück zu ziehen. Es sollen nur Patienten mit Demenz an Forschungen teilnehmen die über die Pflege der Demenz einschätzt. (shrink)

This paper offers an alternative view of spacetime different from both substantivalism and relationism. Using basic ideas underlying the fiber bundle formulation of field theories, it illustrates the function of spacetime in individuating local fields. As the system of numerical identities for entities that we can individually refer to, spacetime is an intrinsic, indispensable, and inalienable structure of the physical world with distinct entities.

Background: Financial conflict of interest in clinical research is an area of active debate. While data exist on the perspectives and roles of academic institutions, investigators, industry sponsors, and scientific journals, little is known about the perspectives of potential research participants.Methods: The authors surveyed potential research participants over the internet, using the Harris Interactive Chronic Illness Database. A potential research participant was defined by: self report of diagnosis by a health care professional and willingness to participate in clinical trials. Email (...) invitations were sent to 20 205 persons with coronary artery disease, breast cancer, or depression; a total of 6363 persons were screened; of these, 86% or 5478 met inclusion criteria and completed the survey. The outcome measures were respondents’ ratings on: importance of knowing conflict of interest information, whether its disclosure ought to be required, and its effect on willingness to participate—across seven widely discussed scenarios of financial conflicts of interest .Results: Majority responded that knowing conflict of interest information was “extremely” or “very” important; a larger majority felt financial conflicts of interest should be disclosed as part of informed consent . In all seven scenarios, a majority was still willing to participate but in some scenarios a sizable minority would be wary of participation. Respondents were more wary of individual than institutional conflicts of interest. Illness group and sociodemographic factors had modest effects and did not affect the main trends.Conclusions: The prevailing practice of non-disclosure of financial conflicts of interest in clinical research appears contrary to the values of potential research participants. (shrink)

Det er eit uttalt mål å gjøre grunnskulelærarutdanninga forskingsbasert. I det dominerande tankemønsteret i grunnskulelærarutdanninga er det konstruert ei motsetning mellom vitskapleg kunnskap og erfaringskunnskap. Vitskapleg kunnskap vert skildra som noko positivt, medan erfaringskunnskap får ei negativ omtale. Dette filosofiske essayet vil framskrive ei re-oppfatning av denne dikotomien. Målet med arbeidet er å redusere dikotomien mellom desse to kunnskapsformene og vise ei forståing som er meir jambyrdig, og som samlande kan bli kalla for lærarens levande kunnskap. Teorien om levande kunnskap (...) tar utgangpunkt i mennesket si heilskapande erkjenningsevne. Mennesket sin kognitive kapasitet inneheld både rasjonelle, etiske, emosjonelle og motoriske erkjenningar. Eit avgjørande aspekt med den levande kunnskapen er lærarens etiske- emosjonelle kunnskap og sensibilitet i tillegg til den logisk rasjonelle evna. (shrink)

This article opens with general and historical remarks on philosophy of science's problems with the concept of discovery. Then, drawing upon simple examples of Watson's and Crick's non-philosophical usage, I characterize phrases of the type "x discovers y" semantically. It will subsequently be shown how widespread philosophical discussion on discovery violates the semantic constraints of phrases of the type "x discovers y." Then I provide a philosophical reconstruction of "x discovers y" that is in keeping with the "folk" notion (...) of discovery. The philosophical ingredients of this approach are taken from a certain aspect of action theory and from epistemological reliabilism. The approach draws upon the concept of superior action and connects this concept to progressive research. In contrast to normal actions, superior actions are primarily explained by competencies. This perspective includes reminders of what some nineteenth-century philosopher-scientists had advocated as a competence-oriented view on scientific research. Finally, this approach is applied to the case of Watson's and Crick's discovery. (shrink)

This essay is an attempt to participate in a discussion about metaphysics today. I claim that metaphysic now seems silenced or taken for granted. Machiavelli’s idea of fortuna or fate represents question and perception that cannot be recognized empirically. My aim is to place Machiavelli into an ongoing discussion about the distinction between nature and culture and perception of reality as organic or harmonic. As part of this, I will discuss fortuna’s place in modern research based teacher education, which places (...) our fate in the hand of science, the institutionalization of learning and the lack of virtue. In conclusion, I wish to express some critical remarks on this development, not taking into account the metaphysical speculation. (shrink)

The main object of this article is to contribute to a clearer use of the concept reflection. The question is whether reflection has become an overexposed and diluted medicine in educational thinking. To answer this question I will examine how reflection is understood and what direction and theoretical foundation the concept is based on. The article is a Habermas inspired interpretation of basic textbooks for teacher education. In the textbooks, reflection is presented as a good medicine for the professional teacher (...) and a continuous reflection will improve the professional practice by developing consciousness in action. In the conclusion I will present some recommendations on how to improve the understanding and use of reflection. My main goal is to provide reflection with a theoretical content and a clearer direction. Reflection is a knowledge searching, which is not based on experience and facts, but which is closely tied to philosophical thinking, critical theory and the ability to develop an overview. (shrink)

The purpose of this paper is to reflect on how the Corona pandemic might influence human understanding of our position of being in the world. In the first part of the paper, we present how a pandemic can be under- stood in relation to our society and our educational system. Then, we will present problems and questions highlighted by the pandemic and the kind of transformations needed to address these problems. The core ele- ments that require transformation are the understanding (...) of the essence of man or the human condition, the understanding of what caring for nature and even a pandemic means, and how to measure human action and values. (shrink)

Background eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. Purpose to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the (...) COVID-19 pandemic. Methods A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. Ethical considerations Permission to conduct the study was obtained from the Institutional Review Board. Results Participants stated that “eHealth enabled compassionate care during the pandemic” by ensuring patient care availability and accessibility. They shared experiences of “communicating compassionate care via eHealth” with suggestions of addressing patients’ needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended “setting realistic mutual expectations” considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered “low eHealth literacy hinders compassion.” Additionally, they recommended the need for “institutional/system-level support to foster compassionate care.” Conclusion Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

I identify three functions of language: the communicative, the objectifying, and the objective. I claim that of these three functions, the objective function is the most essential, in the sense specified in the paper, and the communicative the least. I further indicate that language use without the communicative function is more prevalent than might commonly be believed.

Let n ≥ 3 be an integer. We show that it is consistent that every σ1n-set of reals is universally Baire yet there is a projective well-ordering of the reals. The proof uses “David’s trick” in the presence of inner models with strong cardinals.

Social evolution theory conventionally takes an externalist explanatory stance, treating observed cooperation as explanandum and the positive assortment of cooperative behaviour as explanans. We ask how the circumstances bringing about this positive assortment arose in the first place. Rather than merely push the explanatory problem back a step, we move from an externalist to an interactionist explanatory stance, in the spirit of Lewontin and the Niche Construction theorists. We develop a theory of ‘social niche construction’ in which we consider biological (...) entities to be both the subject and object of their own social evolution. Some important cases of the evolution of cooperation have the side-effect of causing changes in the hierarchical level at which the evolutionary process acts. This is because the traits that act to align the fitness interests of particles in a collective can also act to diminish the extent to which those particles are bearers of heritable fitness variance, while augmenting the extent to which collectives of such particles are bearers of heritable fitness variance. In this way, we can explain upward transitions in the hierarchical level at which the Darwinian machine operates in terms of particle-level selection, even though the outcome of the process is a collective-level selection regime. Our theory avoids the logical and metaphysical paradoxes faced by other attempts to explain evolutionary transitions. (shrink)

Self-enhancement is the biasing of one’s view of oneself in a positive direction. The brain correlates of self-enhancement remain unclear though it has been reported that the medial prefrontal cortex may be important for producing self-enhancing responses. Previous studies have not examined whether the neural correlates of self-enhancement depend on the particular domain in which individuals are enhancing themselves. Both moralistic and egoistic words were presented to participants while transcranial magnetic stimulation was applied to the MPFC, precuneus or in a (...) sham orientation. Participants were asked to make decisions as to the words describing themselves, some of which were positive and some of which were negative. It was found the MPFC TMS significantly disrupted egoistic self-enhancement when TMS was delivered to the MPFC. Judgments involving moralistic words were not influenced by TMS. These data provide further evidence that MPFC is involved in self-enhancement, and that the role of MPFC may be selective in this regard. (shrink)

By comparing mechanisms in nativism, empiricism, and culturalism, the target article by Steels & Belpaeme (S&B) emphasizes the influence of communicational constraint on sharing color categories. Our commentary suggests deeper considerations of some of their claims, and discusses some modifications that may help in the study of communicational constraints in both humans and robots.

While the current generative paradigm in linguistics leans heavily toward computation, investigations on conscious representations are much welcome. The SOC model examines the acquisition of complex representations in individuals. We note that heterogeneity of representation in populations is a central issue that must be addressed as well. In addition to the self-organizing processes proposed for the individual, interactions among individuals must be incorporated in any comprehensive account of language.