In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to be insufficient. However, this solution is (...) unsatisfactory, because the proposed versions of practical wisdom are too individualistic of nature, while physicians are continuously operating in varying teams, and dealing with complicated technologies and pressing structures. A second point of critique is, that these versions are theory based, and thus insufficiently attuned to the actual context of everyday medical practices. Now, our proposal is to use an approach of practical wisdom that enables medical practices to counter the complexity issue and to re-invent the moral core of medical practicing as well. This implies a practice oriented approach, as thematized by practice theory, qualitative empirical research from the inside, and abduction from actual performed practical wisdom towards an apt understanding of phronèsis. (shrink)

This third edition offers increased coverage of sustainability and more chances for illustration and discussion of ethics in the messy day to day practicalities ...

In this revised and expanded edition of his well-known study of Denis Diderot's life and works, Crocker combines solid scholarship with a vivid portrayal of his subjects. Leaving firm ground only occasionally, Crocker masterfully reconstructs Diderot's life by weaving into his narrative the testimony of Diderot's contemporaries and the philosopher's own anecdotes of the more picturesque episodes of his life. The author never departs from firm ground, however, in his presentation of Diderot's works. With a rare blend of erudition and (...) a lively critical sense, he sets them forth in the light of eighteenth-century currents of thought, highlighting Diderot's most significant contributions to materialism, sensualism, and experimentalism, while at the same time preserving, in quite readable summaries, the integrity of individual writings. His extensive consideration of the twenty years Diderot devoted to the Encyclopedia is particularly stimulating. By contrast, his summary presentation of Diderot's novels is somewhat disappointing, especially since he gives all too brief mention to Diderot's innovations in that genre. A needed index is lacking, but in spite of this and other minor shortcomings, Crocker's efforts have resulted in what is clearly the best complete English biography of one of the eighteenth century's most colorful geniuses.—C. M. M. (shrink)

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

Although the field of surgical ethics focuses primarily on informed consent, surgical decision‐making, and research ethics, some surgeons have started to consider ethical questions regarding justice and solidarity with poor and minoritized populations. To date, those calling for social justice in surgical care have emphasized increased diversity within the ranks of the surgical profession. This article, in contrast, foregrounds the agency of those most affected by injustice by bringing to bear an ethic of accompaniment. The ethic of accompaniment is born (...) from a theological tradition that has motivated work to improve health outcomes in those at the margins through its emphasis on listening, solidarity against systemic drivers of disease, and proximity to individuals and communities. Through a review of surgical ethics and exploration of a central patient case, we argue for applying an ethic of accompaniment to the care of surgical patients and their communities. (shrink)

Theories of truth and vagueness are closely connected; in this article, I draw another connection between these areas of research. Gupta and Belnap’s Revision Theory of Truth is converted into an approach to vagueness. I show how revision sequences from a general theory of definitions can be used to understand the nature of vague predicates. The revision sequences show how the meaning of vague predicates are interconnected with each other. The approach is contrasted with the similar supervaluationist approach.

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

We present an experimental test of the validity of the Pauli Exclusion Principle for electrons based on the concept put forward a few years ago by Ramberg and Snow. In this experiment we perform a very accurate search of X-rays from the Pauli-forbidden atomic transitions of electrons in the already filled 1S shells of copper atoms. Although the experiment has a simple structure, it poses deep conceptual and interpretational problems. Here we describe the experimental method and recent experimental results, which (...) we interpret as an upper limit for the probability to violate the Pauli Exclusion Principle. We present also future plans to upgrade the experimental apparatus using Silicon Drift Detectors. (shrink)

In this paper I present a range of substructural logics for a conditional connective ↦. This connective was original introduced semantically via restriction on the ternary accessibility relation R for a relevant conditional. I give sound and complete proof systems for a number of variations of this semantic definition. The completeness result in this paper proceeds by step-by-step improvements of models, rather than by the one-step canonical model method. This gradual technique allows for the additional control, lacking in the canonical (...) model method, that is required. (shrink)

Since the BBS article in which Premack and Woodruff (1978) asked “Does the chimpanzee have a theory of mind?,” it has been repeatedly claimed that there is observational and experimental evidence that apes have mental state concepts, such as “want” and “know.” Unlike research on the development of theory of mind in childhood, however, no substantial progress has been made through this work with nonhuman primates. A survey of empirical studies of imitation, self-recognition, social relationships, deception, role-taking, and perspective-taking suggests (...) that in every case where nonhuman primate behavior has been interpreted as a sign of theory of mind, it could instead have occurred by chance or as a product of nonmentalistic processes such as associative learning or inferences based on nonmental categories. Arguments to the effect that, in spite of this, the theory of mind hypothesis should be accepted because it is more parsimonious than alternatives or because it is supported by convergent evidence are not compelling. Such arguments are based on unsupportable assumptions about the role of parsimony in science and either ignore the requirement that convergent evidence proceed from independent assumptions, or fail to show that it supports the theory of mind hypothesis over nonmentalist alternatives. Progress in research on theory of mind requires experimental procedures that can distinguish the theory of mind hypothesis from nonmentalist alternatives. A procedure that may have this potential is proposed. It uses conditional discrimination training and transfer tests to determine whether chimpanzees have the concept “see.” Commentators are invited to identify flaws in the procedure and to suggest alternatives. Key Words: apes; associative learning; concepts; convergence; deception; evolution of intelligence; folk psychology; imitation; mental state attribution; monkeys; parsimony; perspective-taking; primates; role-taking; self-recognition; social cognition; social intelligence; theory of mind. (shrink)

Merleau-Ponty hat in keiner seiner Schriften eine systematische Hermeneutik ausgearbeitet, doch finden sich in fast allen seinen Arbeiten Bemerkungen über hermeneutisch relevante Sachverhalte. Dies gilt vornehmlich für Passagen über die Erfahrung anderer Subjektivität, über die dialogische Erfahrung und über das Produzieren und Verstehen sprachlicher Äusserungen. In diesem Beitrag wird versucht, Merleau-Ponty's Auffassungen hinsichtlich der Fragen nach Sinn, Genesis und Struktur des Verstehens vorzustellen. Hierbei wird in erste Linie das Problem berücksichtigt, was sich eigentlich vollzieht, wenn man als Leser die Bekanntschaft (...) eines klassischen, bzw. ursprünglichen Werkes macht. Das Werk spricht eine neue Sprache (parole parlante, langage conquérante), die die vorgegebene Sprache (parole parlée, langage institué) neugestaltet, so wie auch die in der neuen Sprache sich niederschlagende Erfahnings- und Gedankenwelt unsere alten Gedanken auflöst und uns eine neue Sicht auf die Wirklichkeit vermittelt. Hermeneutisch relevant ist, dass der Sinn dieser parole pensante, bzw. der pensée parlante niemals vollständig gegeben ist, noch auch durch welche Auslegung dann auch je erschöpft werden kann. Das bei der Lektüre eines solchen ursprünglichen Werkes sich bildende primäre Verständnis ist als Grundlage einer sekundären Verstehensleistung anzusehen, die das Thema der Hermeneutik, insofern sie Auslegungskunst ist, darstellt. Die Rekonstruktion des ursprünglichen Sinnes eines solchen Werkes ist in den Augen Merleau-Ponty's nicht nur in ihrer Möglichkeit beschränkt, sie ist vielmehr auch nur von untergeordneter Bedeutung. Was das erste betrifft, so sieht sich jeder solcher Rekonstruktionsversuch, (der bei der Restitution des ursprünglichen Textsinnes auch die Biographie des Autors und den historischen Kontext zu berücksichtigen hat – das Werk muss ja als Antwort auf Fragen verstanden werden, die sich im Lebenszusammenhang einer Zeit gestellt haben –) mit der Tatsache konfrontiert, dass die Gedanken und Erfahrungen, die sich in einem Werk niedergeschlagen haben, häufig so sehr miteinander verwoben sind, zum andern sich im Laufe des Lebens ihres Urhebers sich verändern, dass ihre völlige Inventarisierung zu einer unmöglichen Aufgabe wird. Zudem gehört zum Sinn eines solchen Werkes auch die Wirkung, die es in der Nachwelt hervorgerufen hat. So ist der „Wahre Descartes” keine gleichsam sich selbst erhellende Ganzheit, kein absoluter Entwurf im Sinne Sartres – sondern das Ganze von Leben, Werk und Interpretationen, das niemals definitiv entziffert werden kann. Für Merleau-Ponty ist der Sinn in fortwährendem Werden begriffen. Hierin ist jedoch auch die Bedeutung der wahren Interpretation, bzw. des wahren Denkens gelegen. Wichtiger als die in sich begrenzte Möglichkeit der Rekonstruktion ist dann auch das „penser derechef”. Merleau-Ponty beruft sich ausdrücklich auf einen Gedanken von Heidegger, demzufolge der Sinn des Denkens vor allem darin gelegen ist, das noch Ungesagte und Ungedachte in einem klassischen Werk zu entfalten. In der Tat prägt dies auch die Weise, in der Merleau-Ponty mit dem Werk Husserls oder anderer Denker umgeht. Es ist Merleau-Ponty leider nicht mehr gegeben gewesen, die rudimentären Bemerkungen über die Geschichte der Philosophie, die sich in seinem letzten Werk finden, weiter auszuarbeiten, noch auch alle Konsequenzen seiner Hermeneutik zu durchdenken, in der das Fundament der Wahrheit sowohl in der Zeit lokalisiert bleibt als auch zugleich einer die Zeit überspannenden Teleologie eingefügt ist. (shrink)

Sleep onset is associated with marked changes in behavioral, physiological, and subjective phenomena. In daily life though subjective experience is the main criterion in terms of which we identify it. But very few studies have focused on these experiences. This study seeks to identify the subjective variables that reflect sleep onset. Twenty young subjects took an afternoon nap in the laboratory while polysomnographic recordings were made. They were awakened four times in order to assess subjective experiences that correlate with the (...) (1) appearance of slow eye movement, (2) initiation of stage 1 sleep, (3) initiation of stage 2 sleep, and (4) 5 min after the start of stage 2 sleep. A logistic regression identified control over and logic of thought as the two variables that predict the perception of having fallen asleep. For sleep perception, these two variables accurately classified 91.7% of the cases; for the waking state, 84.1%. (shrink)

We present the idea of searching for X-rays as a signature of the mechanism inducing the spontaneous collapse of the wave function. Such a signal is predicted by the continuous spontaneous localization theories, which are solving the “measurement problem” by modifying the Schrödinger equation. We will show some encouraging preliminary results and discuss future plans and strategy.

The legitimacy of the dominant intensive meat production system with respect to the issue of animal welfare is increasingly being questioned by stakeholders across the meat supply chain. The current meat supply is highly undifferentiated, catering only for the extremes of morality concerns (i.e., conventional vs. organic meat products). However, a latent need for compromise products has been identified. That is, consumer differences exist regarding the trade-offs they make between different aspects associated with meat consumption. The heterogeneity in consumer demand (...) could function as a starting point for market segmentation, targeting and positioning regarding animal welfare concepts that are differentiated in terms of animal welfare and price levels. Despite this, stakeholders in the meat supply chain seem to be trapped in the dominant business model focused on low cost prices. This paper aims to identify conflicting interests that stakeholders in the meat supply chain experience in order to increase understanding of why heterogeneous consumer preferences are not met by a more differentiated supply of meat products produced at different levels of animal welfare standards. In addition, characteristics of the supply chain that contribute to the existence of high exit barriers and difficulty to shift to more animal-friendly production systems are identified. Following the analysis of conflicting interests among stakeholders and factors that contribute to difficulty to transform the existing dominant regime, different routes are discussed that may help and motivate stakeholders to overcome these barriers and stimulate the creation of new markets. (shrink)