Book reviewed in this article: The Needs of Strangers. By Michael Ignatieff. The Health Economy. By Victor Fuchs. Just Health Care. By Norman Daniels.

Problems and choices -- Who shall live? -- The physician : the captain of the team -- The hospital : the house of hope -- Drugs : the key to modern medicine -- Paying for medical care.

Academic freedom and tenure, both cherished institutions of higher education, are currently under attack by many both outside and within the academy. Richard DeGeorge argues that they can be defended on ethical grounds only if they are joined with appropriate accountability, publicly articulated and defended standards, and conscientious enforcement of these standards by academic institutions and the members of the academic community.

The European project European and Latin American Systems of Ethics Regulation of Biomedical Research Project (EULABOR) has carried out the first comparative analysis of ethics regulation systems for biomedical research in seven countries in Europe and Latin America, evaluating their roles in the protection of human subjects. We developed a conceptual and methodological framework defining ‘ethics regulation system for biomedical research’ as a set of actors, institutions, codes and laws involved in overseeing the ethics of biomedical research on humans. This (...) framework allowed us to develop comprehensive national reports by conducting semi-structured interviews to key informants. These reports were summarised and analysed in a comparative analysis. The study showed that the regulatory framework for clinical research in these countries differ in scope. It showed that despite the different political contexts, actors involved and motivations for creating the regulation, in most of the studied countries it was the government who took the lead in setting up the system. The study also showed that Europe and Latin America are similar regarding national bodies and research ethics committees, but the Brazilian system has strong and noteworthy specificities. (shrink)

Public officials rely on performance data that are self-reported by organizations to evaluate progress on a wide range of prosocial outcomes. Policies that require public disclosure of performance in health care are thought to enable patients to select high-quality providers, which in turn may spur quality improvements as providers seek to protect their reputation or increase economic returns. Drawing on institutional theory that examines how conflicting institutional pressures influence organizational decisions, we theorize how profit orientation may mediate the response of (...) health care providers to disclosure mandates in a public health crisis. We focus on measures of data quality—completeness and accuracy—in self-reported data on COVID-19 status and outcomes generated by thousands of long-term care facilities. Using pooled regressions and a difference-in-differences style design, we find that overall, for-profit and not-for-profit facilities report similarly complete data but that for-profit facilities report less accurate data than their not-for-profit counterparts. Our results suggest that it may be important to incentivize each dimension of data quality separately to address differential institutional pressures that affect reporting practices. (shrink)

Das Wiskott-Aldrich-Syndrom (WAS), ein genetisch bedingter Immundefekt mit klinischer Manifestation im Kleinkindalter, wird voraussichtlich in näherer Zukunft erstmals versuchsweise durch eine somatische Gentherapie behandelt werden. Im vor- liegenden Beitrag werden die wichtigsten medizinisch-naturwissenschaftlichen Fakten dieses Krankheitsbildes sowie die bisherigen Erfahrungen mit somatischen Gentherapien bei anderen Immunmangelsyndromen ausführlich dargestellt. Sodann erfolgt eine ethische Analyse eines möglichen gentherapeutischen Eingriffs bei WAS-Patienten, bei der die spezifischen Aspekte des Wiskott-Aldrich-Syndroms – insbesondere die fast ausschließliche Betroffenheit von Kindern sowie die unterschiedlich aussichtsreiche Alter- nativoption einer (...) allogenen Knochenmarktransplantation–wesentliche Aspekte der Beurteilung sind. Im Ergebnis zeigt sich, dass ein gentherapeutischer Eingriff im vorliegenden Fall nicht im Rahmen einer Forschungsstudie, d.h. als Humanexperiment, gerechtfertigt werden kann, sondern allein als individueller Heilversuch. Gleichwohl las- sen die besonderen Risiken und die Innovativität eines solchen Eingriffs es notwendig erscheinen, diesen Heilversuch – anders als andere Heilbehandlungen mit bislang unerprobten Mitteln – in streng kontrollierter Form durchzuführen. Der neuartige Gedanke eines kontrollierten individuellen Heilversuchs zeichnet sich daher für den vorliegenden Fall, und womöglich auch für vergleichbare risikoreiche Behandlungsansätze namentlich im Bereich der Gentherapie, als geeignetes Instrument der Konzeption und Beurteilung ab. (shrink)

This article is concerned with extensions of a continuous ordering R on a set X to a subset P of the power set of X. The underlying topology will be the Hausdorff metric topology. We will see that continuous extensions of R do not require that P contain every nonempty finite subset of X. Therefore, the analysis can be applied to consumer theory and inverse choice functions. In analogy to these functions budget correspondences are established which relate alternatives x with (...) certain subsets of X, according to the extended ordering. (shrink)

Our aim with this descriptive phenomenological study was to identify and describe the essential meaning structure in the experience of postpartum depression . We interviewed four women diagnosed with major depression and analyzed the data with Giorgi’s descriptive phenomenological method. Our analysis revealed two essential meaning structures of PPD. The first structure describes the mother as thrown into a looming, dangerous world, coupled with a restricted, heavy body that hindered her attunement to her baby. Tormented by anxiety, guilt and shame, (...) she tried to deal with her pain by analytical reflection and social isolation. The second structure describes sudden lapses into intense feelings of alienation from the self, the baby, and from the social and material world. With a distorted primordial self-awareness, the mother no longer felt that she existed as herself in the world. We reflect on these findings using the insights of Fuchs, Van den Berg, Heidegger and Merleau-Ponty. (shrink)

The book is divided into two parts, the shorter of which documents and discusses the authoritative and Biblical sources for the Christian, and specifically Catholic, notion of natural law. The second section is taken up with conceptual analyses of such notions as the relation between nature and grace, nature and historical situation, and primary and secondary determinations of the natural law. A final chapter considers the possibility and scope of a Christian Sociology. The, in principle, complete integration of nature and (...) grace is maintained throughout in opposition to what Fuchs types as the postulated antinomy between these two orders that characterizes most Protestant theologies. The major confrontation between the Catholic and Protestant positions takes place in the footnotes, which are consequently of extensive bibliographical value.—E. A. R. (shrink)

In this volume, Fr. Fuchs has brought together 12 exceptionally important essays which consider various aspects of the relationship between Christian morality ...

Розкрито сутність поняття «рейтинг». Доведено значущість рейтингової оцінки для суб’єктів фінансового ринку, зокрема для страхових компаній, потенційних страхувальників, інвесторів та кредиторів.

Was in Theorien an Auflösungsvermögen verkraftet werden kann und muß, findet in der Welt, die durch Theorie rekonstruiert werden soll, eine Parallele: Was der Mensch sei, ist nicht einmal menschen- und lebensweltlich eine klare Kante. In den Humankatastrophen der letzten hundert Jahre wird er zu einer verfeuerungsfähigen Biomasse. Man kann kaum den Eindruck gewinnen, daß sich daran etwas wirklich geändert hat. Es wird Tag für Tag hekatombenweise gestorben, gemordet, gefoltert. Der Mensch wird definiert als das Wesen, das man töten kann (...) durch Hunger, Krankheit, Folter, Mord und Krieg, namenlos, zahllos, heute hier, morgen dort. Man könnte sich denken, daß die Lehre vom Menschen, die Anthropologie, ihren Grund verliert und eigentlich zur Thanatologie konvertieren müßte. Und dank Gentechnologie erscheint am Horizont die Vision, der Mensch sei nicht mehr jemand, der nach dem Bilde eines Gottes geformt sei, sondern nunmehr jemand, der in den Stand versetzt wurde, sich ein machbares Bild von sich selber zu schaffen, die Exemplare der humanen Population so zu formatieren, daß sie dem alten Ideal der Kalokagathia entsprechen: tugendhaft, schön, alters- und behinderungslos, krankheits-, rausch- und drogenfrei, angemessenen Verstandes eine Idee der Devianzausmerzung, könnte man sagen, die Idee einer leid- und schicksalsfreien Ruhewelt, einer Re-Animation des Paradiesgedankens ohne Adam und ohne Eva. (shrink)

Jürgen Habermas vertritt die These, dass sich das Konsensprinzip des kommunikativen Handelns in den Meinungs- und Willensbildungsprozess der Politik übertragen lasse. In der vorliegenden grundlegenden Kritik zeigt die Autorin, dass diese These nicht haltbar ist. Anders als Habermas annimmt, findet kommunikatives Handeln keinen Eingang in die Prozeduralität der Politik. Das politische Handeln wird vielmehr durch systemische Vorgaben bestimmt. Diese ergeben sich im Wesentlichen aus der Prozeduralität des ökonomischen Systems sowie aus der über Macht bestimmten Prozeduralität des politischen Systems selbst.

D'où vient cette réalité historique particulière qu'est la morale protestante? C'est pour répondre à cette question que les deux premières parties de ce livre sont consacrées à une présentation des sources de l'éthique protestante, celles de la Réforme du 16e siècle (Luther et Calvin), et celles du puritanisme anglais. On découvrira à ce propos le lien étroit du protestantisme et de la modernité, pour le meilleur (démocratie) et pour le pire (utilistarisme). Dès lors, la question de l'avenir d'un tel lien (...) se pose et deux enjeux prioritaires sont ici mis en évidence : comment, dans une société sécularisée, faire valoir l'importance et la valeur d'une morale de conviction théologique? Comment, face à des phénomènes de retour régressif d'une religiosité irrationnelle, maintenir l'exigence d'une relation positive entre foi et raison, sagesse éthique et intelligences? Comment rester à la fois solidaire et critique de notre culture? Enfin l'auteur propose trois engagements spécifiques par quoi le protestantisme pourra prendre utilement sa part au débat contemporain sur la morale nécessaire à notre société actuelle. (shrink)

"Williams's masterful translation satisfies (at last!) a long-standing need. There are lots of good translations of Augustine's great work, but until now we have been forced to choose between those that strive to replicate in English something of the majesty and beauty of Augustine's Latin style and those that opt instead to convey the careful precision of his philosophical terminology and argumentation. Finally, Williams has succeeded in capturing both sides of Augustine's mind in a richly evocative, impeccably reliable, elegantly readable (...) presentation of one of the most impressive achievements in Western thought--Augustine's Confessions." --Scott MacDonald, Professor of Philosophy and Norma K. Regan Professor in Christian Studies, Cornell University. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.3 (2005) 195-198 [Access article in PDF] Implicit and Explicit Temporality Thomas Fuchs Keywords implicit/explicit temporality, embodiment, intersubjectivity, desynchronization, melancholia, schizophrenia Since Minkowski (1970), Strauss (1966), v. Gebsattel (1954), and Tellenbach (1980), temporality has been a main subject of phenomenological psychiatry. Drawing on philosophical concepts of Bergson, Husserl, and Heidegger, these authors have analyzed psychopathologic deviations of time experience, mainly from an individual point (...) of view, for example, as a slowing down or inhibition of lived time in depression or obsessive–compulsive disorder. Their analyses are still most valuable today, but may be carried further by introducing concepts such as embodied and intersubjective temporality into psychopathology. Martin Wyllie (2005), by opening up a wide scope of temporal phenomena and related concepts, makes a laudable effort to contribute to such a progress.In my commentary, I would like to propose a distinction that is suggested by much of Wyllie's analysis and may shed further light on psychopathology, namely between implicit and explicit temporality. If we look at a child while obliviously playing with his toys, lost to the world, we may assume that there is no sense of the time passing. Lived time runs with the movement of life, implicit in the child's experience of being engaged in his play and directed toward his goals. It "unfolds through the processes of bodily activity" (Wyllie 2005). Future and past do not stand out against the pure presence of "becoming." This implicit mode of temporality is retrieved every time that we are absorbed in what we are doing, and may even reach the climax of "flow experiences" (Csikszentmihalyi 1988) where the sense of time is lost in unimpeded, fluent performance.However, this changes when a gap arises between need and satisfaction, desire and fulfillment, or plan and execution. Now the future appears as a "not yet" or "yet to come," experienced as the temporality of awaiting, striving, or longing for. Time is felt as passing by and refusing the desired fulfillment; it becomes conscious or explicit. A similar gap arises between the present and something irretrievably lost, bringing the past to consciousness as a "no more." Again time is experienced explicitly, but now as moving on relentlessly and separating us from the lost object. The gap to the past may not be bridged any more: this is the temporality of missing or mourning. In both cases, explicit time arises as a negation of implicit or lived time (here my use of the term is a bit divergent from Wyllie's); it is experienced as a "not yet" or "no more," often with a component of displeasure or suffering (Fuchs 2001a, 2003)."Implicit" versus "explicit time" thus come near to another distinction well known in phenomenology, namely between the "lived" and [End Page 195] the "corporal body" (Leib versus Koerper). The first term refers to the body functioning in the tacit mode, as the medium of everyday performance. The second term points to the body as turning into the object of attention, for example, when it puts up resistance to our purposes, or is used as an instrument deliberately (Fuchs 2001b). In fact, implicit temporality and tacit performance of the body are nearly synonymous: Lived time may be regarded as a function of the lived body, opened up by its potentiality and capability. The more we are engaged in our tasks, the more we forget time as well as the body; we are, as it were, "inside time." On the other hand, in explicit temporality the body often appears in the corporal or explicit mode as well. For example, when falling ill, we experience our body no more as a tacit medium but rather as an object or obstacle, while we notice the slowing down of time and may even feel excluded from the movement of life. Thus, embodiment and temporality have a parallel background–foreground structure.I now try to carry these considerations further by including the intersubjective dimension of time. In an earlier paper, I describe the attunement of the living being to its environment as a continuous synchronization on the biological as... (shrink)

v. 1. Úvod do filosofie. 1. Filosofická logika.