Name der Zeitschrift: Das Mittelalter Jahrgang: 19 Heft: 2 Seiten: 302-325.

Will understanding our brains help us to know our minds? Or is there an unbridgeable distance between the work of neuroscience and the workings of human consciousness? In a remarkable exchange between neuroscientist Jean-Pierre Changeux and philosopher Paul Ricoeur, this book explores the vexed territory between these divergent approaches--and comes to a deeper, more complex perspective on human nature.Ranging across diverse traditions, from phrenology to PET scans and from Spinoza to Charles Taylor, What Makes Us Think? revolves around a central (...) issue: the relation between the facts of science and the prescriptions of ethics. Changeux and Ricoeur ask: Will neuroscientific knowledge influence our moral conduct? Is a naturally based ethics possible? Pursuing these questions, they attack key topics at the intersection of philosophy and neuroscience: What are the relations between brain states and psychological experience? Between language and truth? Memory and culture? Behavior and action? What is a mental representation? How does a sign relate to what it signifies? How might subjective experience be constructed rather than discovered? And can biological or cultural evolution be considered progressive? Throughout, Changeux and Ricoeur provide unprecedented insight into what neuroscience can--and cannot--tell us about the nature of human experience.Changeux and Ricoeur bring an unusual depth of engagement and breadth of knowledge to each other's subject. In doing so, they make two often hostile disciplines speak to one another in surprising and instructive ways--and speak with all the subtlety and passion of conversation at its very best. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

Background: Pulsed dye laser is the gold standard for treatment of port-wine stain birthmarks but multiple treatments are required and complete resolution is often not achieved. Posttreatment vessel recurrence is thought to be a factor that limits efficacy of PDL treatment of PWS. Imiquimod 5% cream is an immunomodulator with antiangiogenic effects. Objective: We sought to determine if application of imiquimod 5% cream after PDL improves treatment outcome. Methods: Healthy individuals with PWS were treated with PDL and then randomized to (...) apply posttreatment placebo or imiquimod 5% cream for 8 weeks. Chromameter measurements for 57 PWS sites were taken at baseline and compared with measurements taken 8 weeks posttreatment. The Δa and ΔE were measured to quantify treatment outcome. Results: Two patients developed minor skin irritation. Other adverse effects were not noted. Average a was 0.43 for PDL + placebo sites and 1.27 for PDL + imiquimod sites indicating a greater reduction in erythema with imiquimod. Average E was 2.59 for PDL + placebo and 4.08 for PDL + imiquimod, again indicating a greater color improvement with imiquimod. Limitations: Effects were evaluated after a single treatment and duration of effect is unknown. Conclusion: Combined selective photothermolysis and antiangiogenic therapy may enhance PWS treatment efficacy. © 2011 by the American Academy of Dermatology, Inc. (shrink)

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

This book is a collection of 18 essays portraying a "humanistic" outlook on several contemporary moral problems, and includes such essayists as Kurt Baier, Carl Rogers, B. F. Skinner, Sidney Hook, Abraham Edel, John Somerville, and Corliss Lamont. Although each was requested first to give his own definition of humanism and then to work out one application of it from his particular field or interest, these directions are not always strictly adhered to. Half of the essays had in fact, already (...) been published in some form in The Humanist. The 5 topical headings of the book show the diversity of fields and interests portrayed: Ethics, Religion and the Meaning of Life; The Good Life; The Individual: Law, Morality and Social Organization; Justice and Society; and Death. Although the essays are of unequal philosophical depth and acumen, this variety may be appealing for some uses of this as a text. However, two of the essays in particular stand out for this reviewer: "Ethics Without Religion" by Kai Nielsen, which perceptively outlines the problematic for as well as against an ethics not rooted in religion, and "The Enforcement of Morals" by Ernest Nagel which aptly analyzes the problem of the relation between the spheres of morality and law taking as a focus the noted Hart-Devlin debate of this issue. The thread which Kurtz believes unites all of these essays is their portrayal of a humanistic viewpoint, a viewpoint which he attempts to summarize in his own 14-page introduction, "What is Humanism?" But defining humanism is not an easy task. One must steer between a strictly negative view which defines it only in relation to what it opposes, and a broader but rather indefinite view of it as some form of man-centered philosophy. Although Kurtz wants to be positive in his own definition, he seems unable to move away from a negative and rhetorical presentation in which theism is simply stated to be incompatible with humanism. Moreover, his outline of a humanistic ethics is somewhat superficial. For example, he seems unaware of the problems involved in holding that ethical values are man’s own "creation" and at the same time are normative and objective. Nevertheless, the book may be of some help as a supplementary text to stimulate undergraduate students in discussion and study of the topics treated therein.—B.A.M. (shrink)

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

It has been proposed that the implicate order can be given mathematical expression in terms of an algebra and that this algebra is similar to that used in quantum theory. In this paper we bring out in a simple way those aspects of the algebraic formulation of quantum theory that are most relevant to the implicate order. By using the properties of the standard ket introduced by Dirac we describe in detail how the Heisenberg algebra can be generalized to produce (...) an algebraic structure in which it is possible to describe space translations in a way that is analogous to the description of rotations in a Clifford algebra. This approach opens up the possibility of going beyond the limits of the present quantum formalism and we discuss briefly some of the new implications. (shrink)

The author states that his purpose in this work is not primarily Peirce scholarship but epistemology. But the concentration is on Peirce’s theory of knowledge, a concentration which centers around what the author thinks is Peirce’s most valuable contribution to the subject—a solution to the problem of skepticism. In contrast to Descartes’ assertion that knowledge must be based on primitive intuitions, Peirce contends that all thought is in process, an organically intertwined system of inferences, a continuous flow of signs. Because (...) thinking is a process in time, it is always fallible. Rather than this being a hindrance to knowledge, Davis sees this as the key to Peirce’s escape from skepticism, for the knowledge so described is a continuous self-corrective process, a web which, if we but make the effort to untangle it, will continue to reward us with advance toward the truth. Of more revolutionary importance to the theory of knowledge, according to Davis, is Peirce’s theory of abduction, his answer to the problem of how synthetic knowledge is possible. Abduction is the act of making up explanatory hypotheses. It issues in insights which are the outgrowth of creativity and imagination. The test of these unifying ideas is their appropriateness or ability to satisfy our sensibilities. It is instinct, or that to which we are naturally bent, which guides the abductive process. Throughout this book great emphasis is placed on the importance of this to Peirce and to an adequate epistemology of instinct, feelings, the work of the heart, or sensibility. The scientist, as Davis sees it, is thus akin in method to the creative artist. While Davis intends also to show how this aspect of Peirce is consistent with his pragmatic maxim, their relationship is never quite clarified in this work. Nevertheless, the book is a well-written and very readable treatment of Peirce’s epistemology. It also includes a great many comparisons with similar and contrasting positions as found in a wide range of contemporary and classical philosophical treatises.—B.A.M. (shrink)

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

The editor of this book has put together here a very manageable selection from the published articles of C. S. Peirce and has prefaced it with his own very fine 42-page introduction. Being published articles, these have the advantages of being those which Peirce himself thought to be complete. Moreover, they are also thus able to be arranged chronologically and topically. This Moore does by including articles which fall into four major groups: 1) On epistemology, from The Journal of Speculative (...) Philosophy, 1868; 2) On Peirce’s early pragmatism and on the nature of scientific inquiry, from Popular Science Monthly, 1873-1878; 3) On Peirce’s basic metaphysics, from The Monist, 1891-1893; and 4) On his later pragmatism, from The Monist, 1905-1906. In his introduction, the editor summarizes and interrelates some of the key questions in Peirce’s philosophy and in these writings—questions on the nature of potentiality, the validity of the process of scientific inquiry, and the problem of the definition of concepts. Much of this treatment revolves around Peirce’s grappling with the key problem of the nature of universals. In the medieval dispute between the extreme realists and the nominalists, Peirce takes a middle moderate realist position, "that the referent of a concept is to be found in the experience of a specific object". On either of the other views, scientific knowledge would be impossible. (shrink)

From pre-Christian times until the present day, philosophers have discussed whether, given evil, belief in God can logically be maintained. Theists and non-theists remain unconvinced by one another's arguments. This study re-examines the question of God and evil from a neutral standpoint and claims that neither side has come to adequate grips either with the question itself or with the other side's case, chiefly because of failure to distinguish the kinds of problem raised by evil.