The term “normal” is culturally ubiquitous and conceptually vague. Interestingly, it appears to be a descriptive-normative-hybrid which, unnoticedly, bridges the gap between the descriptive and the normative. People’s beliefs about normality are descriptive and prescriptive and depend on both an average and an ideal. Besides, the term has generally garnered popularity in medicine. However, if medicine heavily relies on the normal, then it should point out how it relates to the concept of health or to statistics, and what, after all, (...) normal means. Most importantly, the normativity of the normal needs to be addressed. Since the apparently neutral label “normal” can exclude, stigmatize, and marginalize people who are defined in contrast to it as abnormal, health professionals should think twice before using the term with patients. The present critical perspective advocates against using the term “normal,” as long as no understanding of a person’s individual normality has been attained. It advocates for the right to autonomously determine one’s own normality. For health professionals I do not see worthwhile benefits of subscribing to the concept of “normality” and imposing it on their patients. But I do see many risks. (shrink)

Parents frequently attempt to shield their children from distressing prognostic information. Pediatric oncology providers sometimes follow parental request for non-disclosure of prognostic information to children, invoking what we call the stability of the family argument. They believe that if they inform the child about terminal prognosis despite parental wishes, cohesion and family structure will be severely hampered. In this paper, we argue against parental request for non-disclosure. Firstly, we present the stability of the family argument in more detail. We, then, (...) set out the (conceptual, legal, systemic) entitativity of the family and the kind of value the stability of the family argument assumes, before we set on to critically evaluate the argument. Our analysis shows that disclosure of prognostic information to children does not necessarily destabilize the family to a greater extent than non-disclosure. In fact, a systemic perspective suggests that mediated disclosure is more likely to result in a (long-term) stability of the family than non-disclosure. It is in the interest of the family to resist the initial aversive reaction to delivering bad news. In the final part, we draw a set of recommendations on how to facilitate decision-making in face of parental request for non-disclosure. (shrink)

This paper addresses psychological factors that might interfere with informed consent on the part of stable patients as potential early-phase clinical trial participants. Thirty-six semistructured interviews with patients who had either diabetes or gout were conducted. We investigated stable patients’ attitudes towards participating in a fictitious first-in-human trial of a novel intervention. We focused on an in-depth analysis of those statements and explanations that indicated the existence of psychological factors impairing decision-making capacity. Three main themes emerged: insufficient comprehension of the (...) inherent logic of clinical trials, the recourse to trust over comprehension, and visceral factors that override deliberative process. Overall, our results indicate a limited psychological capacity on the part of stable patients to meet the requirements of informed consent as set by Declaration of Helsinki. A redesigned informed consent procedure should take account of these psychological realities. (shrink)

The goal is to present how shared decision-making in paediatric oncology occurs from the viewpoints of parents and physicians. Eight Swiss Pediatric Oncology Group centres participated in this prospective study. The sample comprised a parent and physician of the minor patient. Surveys were statistically analysed by comparing physicians’ and parents’ perspectives and by evaluating factors associated with children’s actual involvement. Perspectives of ninety-one parents and twenty physicians were obtained for 151 children. Results indicate that for six aspects of information provision (...) examined, parents’ and physicians’ perceptions differed. Moreover, parents felt that the children were more competent to understand diagnosis and prognosis, assessed the disease of the children as worse, and reported higher satisfaction with decision-making on the part of the children. A patient’s age and gender predicted involvement. Older children and girls were more likely to be involved. In the decision-making process, parents held a less active role than they actually wanted. Physicians should take measures to ensure that provided information is understood correctly. Furthermore, they should work towards creating awareness for systematic differences between parents and physicians with respect to the perception of the child, the disease, and shared decision-making. (shrink)

In den letzten Jahren berichteten mehr und mehr Frauen von Gewalt und Respektlosigkeit in der Geburtshilfe. Inzwischen hat sich auch die Forschung verstärkt dieses Themas angenommen. Prävalenzschätzungen sind jedoch aufgrund erheblicher methodischer Schwächen noch nicht hinreichend genau zu beziffern. Die Vielzahl und Vielfalt der bestehenden Forschungsergebnisse lassen dennoch den Schluss zu, dass es in der Geburtshilfe in fast allen Regionen der Erde regelmäßig zu Gewalt und Respektlosigkeit und damit zu Menschenrechtsverletzungen kommt. Die Folgen reichen bis hin zu Posttraumatischen Belastungsstörungen, was (...) nahelegt, dass dieser Missstand sowohl aus Menschenrechts-Gründen als auch aus Gründen der öffentlichen Gesundheit nicht übergangen werden darf. Daher ist es außerordentlich besorgniserregend, wenn geburtshilfliche Fachpersonen im Angesicht solcher Berichte und Forschung in einen Modus der Selbstverteidigung verfallen und die Erfahrungen der Frauen in Frage sowie Abrede stellen, anstatt zuvorderst mit Empathie zu reagieren. Der vorliegende Text wendet sich einigen dieser Reaktionsmuster seitens geburtshilflicher Fachpersonen zu: einem falsch verstandenen Objektivitätsanspruch und der mithin abwegigen Forderung, die subjektiven Erfahrungen der Frauen zu objektivieren, einer leugnenden und herablassenden Wortwahl sowie einer mangelnden Anerkennung des von den Frauen Geschilderten und einer aus berufsethischer Perspektive unzureichend fürsorglichen Haltung. Solcherlei Reaktionen sind nicht nur unzulässig, sondern lassen ebenjenen Respekt vermissen, den die betroffenen Frauen sich während der Geburt wünschten und dessen Abwesenheit sie verletzte oder gar traumatisierte. Schließlich sollten Gewalt und Respektlosigkeit in der Geburtshilfe sowie die beschriebenen Reaktionen darauf vor dem Hintergrund geschlechtsspezifischer Machtverhältnisse und Gewalt an Frauen generell diskutiert werden. (shrink)

Background While the theoretical benefits and harms of Artificial Intelligence (AI) have been widely discussed in academic literature, empirical evidence remains elusive regarding the practical ethical challenges of developing AI for healthcare. Bridging the gap between theory and practice is an essential step in understanding how to ethically align AI for healthcare. Therefore, this research examines the concerns and challenges perceived by experts in developing ethical AI that addresses the healthcare context and needs. Methods We conducted semi-structured interviews with 41 (...) AI experts and analyzed the data using reflective thematic analysis. Results We developed three themes that expressed the considerations perceived by experts as essential for ensuring AI aligns with ethical practices within healthcare. The first theme explores the ethical significance of introducing AI with a clear and purposeful objective. The second theme focuses on how experts are concerned about the tension that exists between economic incentives and the importance of prioritizing the interests of doctors and patients. The third theme illustrates the need to develop context-sensitive AI for healthcare that is informed by its underlying theoretical foundations. Conclusions The three themes collectively emphasized that beyond being innovative, AI must genuinely benefit healthcare and its stakeholders, meaning AI also aligns with intricate and context-specific healthcare practices. Our findings signal that instead of narrow product-specific AI guidance, ethical AI development may need a systemic, proactive perspective that includes the ethical considerations (objectives, actors, and context) and focuses on healthcare applications. Ethically developing AI involves a complex interplay between AI, ethics, healthcare, and multiple stakeholders. (shrink)

The aim of the study is to encourage a critical debate on the use of normality in the medical literature on DSD or intersex. For this purpose, a scoping review was conducted to identify and map the various ways in which “normal” is used in the medical literature on DSD between 2016 and 2020. We identified 75 studies, many of which were case studies highlighting rare cases of DSD, others, mainly retrospective observational studies, focused on improving diagnosis or treatment. The (...) most common use of the adjective normal was in association with phenotypic sex. Overall, appearance was the most commonly cited criteria to evaluate the normality of sex organs. More than 1/3 of the studies included also medical photographs of sex organs. This persistent use of normality in reference to phenotypic sex is worrisome given the long-term medicalization of intersex bodies in the name of a “normal” appearance or leading a “normal” life. Healthcare professionals should be more careful about the ethical implications of using photographs in publications given that many intersex persons describe their experience with medical photography as dehumanizing. (shrink)

BackgroundNormality is both a descriptive and a normative concept. Undoubtedly, the normal often operates normatively as an exclusionary tool of cultural authority. While it has prominently found its way into the field of medicine, it remains rather unclear in what sense it is used. Thus, our study sought to elucidate people’s understanding of normality in medicine and to identify concepts that are linked to it.MethodsUsing convenient sampling, we carried out a cross-sectional survey. Since the survey was advertised through social media, (...) we employed an online survey. We performed descriptive and inferential analyses. Predictors were chosen in a theory-driven manner.ResultsIn total, 323 persons from 21 countries completed the survey. Analysis revealed that the overall acceptance of normality in medicine was associated with notions of injustice, authority, discrimination, and with having a medical profession. More precisely, for the field of mental health, injustice insensitivity, genderism and transphobia, and authority were positively associated with a person’s acceptance of normality; and, for the field of physical health, injustice insensitivity and having a medical profession were positively associated with a person’s acceptance of normality. Finally, participants’ acceptance of the use of normality in the area of mental health was lower than in the area of physical health.ConclusionsWhat is considered normal has implications for clinical practice, both at an individual and at a policy-level. Acknowledging its normalistic condition, the discipline of medicine has to confront itself with its own contribution to the augmentation of social inequalities through the excessive reliance on the concept of normality. Research that centers the lived experiences of those who are being systematically marginalized because they are deemed abnormal is needed. By empirically elucidating the conceptual relationships between normality in medicine and other variables, we provide points of leverage to deprive normality of its normative power. For medicine, this is needed to first do no harm. (shrink)

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women’s autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers’ and women’s moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a survey (...) of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women’s decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women’s autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women’s enfranchisement in their own care. (shrink)

The key objective of this study is to revisit selected education reforms and interventions by central government during the period c.1918–1950 in order to evaluate their impact on the development o...

In this article, the author lists three problems that make any serious discussion about the ethics of leadership a very difficult undertaking. He then proposes a new, postindustrial paradigm of leadership. Using that understanding of leadership, two different sets of ethical analyses of leadership are possible: (I) those concerned with the process of leadership and (2) those concerned with the content of leadership (the changes proposed by the leaders and collaborators). In the end, the author suggests that the industrial paradigm (...) of ethics (the 18th century liberal philosophy) is inadequate to deal with the ethical decision making that leaders and collaborators must do in the 21 st century. Thus, a postindustrial paradigm of ethics must be developed to enable leaders and collaborators to make the tough ethical choices that will be demanded in the new millennium. (shrink)

In this paper I outline the PAIR account of joint attention as a perceptual-practical, affectively charged intentional relation. I argue that to explain joint attention we need to leave the received understanding of propositions and propositional attitudes and the picture of content connected to it behind and embrace the notions of subject mode and position mode content. I also explore the relation between joint attention and communication.

Reporting biases refer to a truncated pool of published studies with the resulting suppression or omission of some empirical findings. Such biases can occur in positive research paradigms that try to uncover correlations and causal relationships in the social world by using the empirical methods of science. Furthermore, reporting biases can come about because of authors who do not write papers that report unfavorable results despite strong efforts made to find previously accepted evidence and because of a higher rejection rate (...) of studies documenting contradictory evidence. Reporting biases are a serious concern because the conclusions of systematic reviews and meta-analyses can be misleading. The authors show that published evidence in win-win corporate social responsibility research tends to overestimate efficiency. The research field expects to find a positive association between corporate social performance and corporate financial performance, and findings meet that expectation. The authors explain how this pattern may reflect reporting bias. The empirical results show strong tentative evidence for a positive reporting bias in the CSP–CFP literature but only weak tentative evidence for CSP efficiency. The study also examines which factors, such as time trends, publication outlet, and study characteristics, are associated with higher reporting biases within this literature. (shrink)

Morals from Motives develops a virtue ethics inspired more by Hume and Hutcheson's moral sentimentalism than by recently-influential Aristotelianism. It argues that a reconfigured and expanded "morality of caring" can offer a general account of right and wrong action as well as social justice. Expanding the frontiers of ethics, it goes on to show how a motive-based "pure" virtue theory can also help us to understand the nature of human well-being and practical reason.

This book fills a gap in studies of meaning by providing detailed case studies of attested corpus data on the meanings of words and phrases.

Few have done more than Martin Gutzwiller to clarify the connection between classical time-dependent motion and the time-independent states of quantum systems. Hence it seems appropriate to include the following discussion of the origins of the time-dependent Schrödinger equation in this volume dedicated to him.

Examining alumni perspectives from three multi-term service-learning programs, this study highlights the dimensions of the cohort experience that alumni credit as critical to their learning and dev...

The American Journal of Bioethics, Volume 12, Issue 7, Page 27-30, July 2012.

In view of the numerous accounting and corporate scandals associated with various forms of moral misconduct and the recent financial crisis, economics and business programs are often accused of actively contributing to the amoral decision making of their graduates. It is argued that theories and ideas taught at universities engender moral misbehavior among some managers, as these theories mainly focus on the primacy of profit-maximization and typically neglect the ethical and moral dimensions of decision making. To investigate this criticism, two (...) overlapping effects must be disentangled: the self-selection effect and the treatment effect. Drawing on the concept of moral judgment competence, we empirically examine this question with a sample of 1773 bachelor’s and 501 master’s students. Our results reveal that there is neither a self-selection nor a treatment effect for economics and business studies. Moreover, our results indicate that—regardless of the course of studies—university education in general does not seem to foster students’ moral development. (shrink)

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

This study examines the role of human rights violations as a harbinger of civil wars to come, as well as the links between repression, state weakness, and conflict. Human rights violations are both part of the escalating process that may end in civil war and can contribute to an escalation of conflict to civil war, particularly in weak states. The role of government repression and state weakness in leading to civil war is tested empirically. The results show that both closely (...) correlate with civil war onset, especially if they are observed in combination. A two-stage model shows that, while low-level conflict leads to human rights violations, they increase the risk of an escalation to civil war in turn. Human rights violations are identified as an important aspect of understanding civil war onset as the result of an escalation over time and a clear early warning sign of wars to come. (shrink)

The definitive work on the philosophical nature and impact of the theories of Charles Darwin, written by a well-known authority on the history and philosophy of Darwinism. Broadly explores the theories of Charles Darwin and Darwin studies Incorporates much information about modern Biology Offers a comprehensive discussion of Darwinism and Christianity – including Creationism – by one of the leading authorities in the field Written in clear, concise, user-friendly language supplemented with quality illustrations Examines the status of evolutionary theory as (...) a genuine theory and its implications for philosophy, epistemology and ethics Provides a strong understanding of the philosophical nature and impact of Darwin's thought Holds wide appeal for general audiences outside the world of academic philosophy Strongly supports Darwinism and fully explores modern naturalistic explanations of religion. (shrink)

Michael Quante focuses on what Hegel has to say about such central concepts as action, person and will, and then brings these views to bear on contemporary debates in analytic philosophy. This book enables professional analytic philosophers and their students to understand the significance of Hegel's philosophy to contemporary theory of action. As such, it will contribute to the ever-increasing erosion of the barrier between the continental and analytic approaches to philosophy.

Divided into four parts, this treatise begins with well-known criticisms of nonreligious ethics and then develops an atheistic metaethics. In Part 2, Martin criticizes the Christian foundation of ethics, specifically the ’divine command theory’ and the idea of imitating the life of Jesus as the basis of Christian morality. Part 3 demonstrates that life can be meaningful in the absence of religious belief. Part 4 criticizes the theistic point of view in general terms as well as the specific Christian doctrines (...) of the atonement, salvation, and the resurrection. (publisher, edited). (shrink)

The guiding inspiration of this book is the attraction and distance that mark the relation between anthropology and philosophy. This theme is explored through encounters between individual anthropologists and particular regions of philosophy. Several of the most basic concepts of the discipline—including notions of ethics, politics, temporality, self and other, and the nature of human life—are products of a dialogue, both implicit and explicit, between anthropology and philosophy. These philosophical undercurrents in anthropology also speak to the question of what it (...) is to experience our being in a world marked by radical difference and otherness. In The Ground Between, twelve leading anthropologists offer intimate reflections on the influence of particular philosophers on their way of seeing the world, and on what ethnography has taught them about philosophy. Ethnographies of the mundane and the everyday raise fundamental issues that the contributors grapple with in both their lives and their thinking. With directness and honesty, they relate particular philosophers to matters such as how to respond to the suffering of the other, how concepts arise in the give and take of everyday life, and how to be attuned to the world through the senses. Their essays challenge the idea that philosophy is solely the province of professional philosophers, and suggest that certain modalities of being in the world might be construed as ways of doing philosophy. Contributors. João Biehl, Steven C. Caton, Vincent Crapanzano, Veena Das, Didier Fassin, Michael M. J. Fischer, Ghassan Hage, Clara Han, Michael Jackson, Arthur Kleinman, Michael Puett, Bhrigupati Singh. (shrink)

The first edition of The Scientific Background to Modern Philosophy took the dialogue of science and philosophy from Aristotle through to Newton. This second edition adds eight chapters, taking the dialogue through the Enlightenment and up to Darwin. This anthology is an attempt to help bridge the gap between the history of science and the history of philosophy.

The threshold law for N-body fragmentation under dipole forces is formulated. It emerges from the energy dependence of the normalization of the correlated continuum wave function for N fragments. It is shown that the dipole threshold law plays a key role in understanding all threshold fragmentation phenomena since it links the classical threshold law for long-range Coulomb interactions to the statistical law for short-range interactions. Furthermore, a tunnelling mechanism is identified as the common feature which occurs for all three classes (...) of interactions, short-range, dipole and Coulomb. (shrink)

The Oxford Handbook of Metaphysics offers the most authoritative and compelling guide to this diverse and fertile field of philosophy. Twenty-four of the world's most distinguished specialists provide brand-new essays about 'what there is': what kinds of things there are, and what relations hold among entities falling under various categories. They give the latest word on such topics as identity, modality, time, causation, persons and minds, freedom, and vagueness. The Handbook's unrivaled breadth and depth make it the definitive reference work (...) for students and academics across the philosophical spectrum. (shrink)

This thought provoking book uncovers a crisis in the political imagination, a wide-spread failure to provide the passionate sense of community "in which our need for belonging can be met." Seeking the answers to fundamental questions, Michael Ignatieff writes vividly both about ideas and about the people who tried to live by them—from Augustine to Bosch, from Rosseau to Simone Weil. Incisive and moving, The Needs of Strangers returns philosophy to its proper place, as a guide to the art (...) of being human. (shrink)

We ordinarily suppose that there is a difference between having and failing to exercise a rational capacity on the one hand, and lacking a rational capacity altogether on the other. This is crucial for our allocations of responsibility. Someone who has but fails to exercise a capacity is responsible for their failure to exercise their capacity, whereas someone who lacks a capacity altogether is not. However, as Gary Watson pointed out in his seminal essay ’Skepticism about Weakness of Will’, the (...) idea of an unexercised capacity is much more difficult to make sense of than it initially appears. The aim of ’Rational Capacities’ is to provide the needed explication of this idea. (shrink)

Eldred offers a remedy to the consequences of ancient Greek misconceptions of time that are also entrenched in today’s mathematized physics. Here time is spatialized as the one-dimensionally linear ‘arrow of time’ for the sake of predicting and controlling movement. But such spatialized time distorts the phenomenon of time itself. An alternative, hermeneutic-phenomenological path begins with a pre-spatial concept of time that is genuinely three-dimensional. This paves the way for recasting who we are as humans in belonging, first of all, (...) to the free openness of 3D-temporality. This belonging enables temporally 3D-vision of the psyche that empowers us to see movement at all and reconcile its inherent contradictoriness. We are then also able to conceive ourselves no longer merely as internally cogitating, self-conscious subjects, but as engaged existentially in temporally 3D-interplay, mutually estimating and esteeming who we are. This unpredictable interplay is constrained, however, by being played out in the sociating medium of thingified value, the accumulative movement of thingified value having gained the upper hand in dictating our life-movements as well as our interplay with the earth. (shrink)

Der private, sehr gefahrdete Bucherbestand Friedrich Nietzsches gilt als ein besonders interessantes Beispiel einer Schriftstellerbibliothek des 19. Jahrhunderts.

This wide-ranging book reconstructs this debate and places within their contemporary contexts the rival claims concerning the nature of the cosmos and the ...

This will be the best way of explaining ‘Paris is the lover of Helen’, that is, ‘Paris loves, and by that very fact [et eo ipso] Helen is loved’. Here, therefore, two propositions have been brought together and abbreviated as one. Or, ‘Paris is a lover, and by that very fact Helen is a loved one’.