Recent studies reveal some of the neurophysiological mechanisms involved in drug addiction. This prompts some theorists to claim that drug addiction diminishes responsibility. Stephen Morse however rejects this claim. Morse argues that these studies show that drug addiction involves neither compulsion, coercion, nor irrationality. He also adds that addicted people are responsible for becoming addicted and for failing to take measures to manage their addiction. After summarizing relevant neuroscience of addiction literature, this chapter engages critically with Morse to argue that (...) a subgroup of addicted people does meet plausible criteria for compulsion, coercion, or irrationality; that few addicted people are fully responsible for becoming addicted; and that some addicted people can be at least partly excused for failing to manage their addiction. Pickard and Lacey’s “responsibility without blame” approach is also suggested as a fruitful basis for future work in this field. (shrink)

„Medizinische Notwendigkeit“ (MedN) ist der zentrale Steuerungsbegriff für die Finanzierung medizinischer Versorgung in der deutschen Gesetzlichen Krankenversicherung. Trotz seiner scheinbaren Objektivität und Bestimmtheit durch ärztliche Expertise ist der Begriff alles andere als eindeutig definiert. In diesem ersten von fünf geplanten Aufsätzen zur Begriffsklärung von MedN aus medizintheoretischer, -ethischer, rechtlicher und (sozial)medizinischer Perspektive geht es um eine Systematisierung der aktuellen Kontroversen. Damit soll eine Fundierung für Detaildebatten gelegt werden, die bisher fehlt. Geklärt werden sollen die begriffliche Struktur, Funktion, Kontextualität und Missverständlichkeit (...) von MedN sowie die grundsätzlichen Grenzen einer Begriffsanalyse für die anstehenden normativen Fragen medizinischer Leistungssteuerung. (shrink)

What is the role and value of pleasure in addiction? Foddy and Savulescu have claimed that substance use is just pleasure-oriented behavior. They describe addiction as "strong appetites toward pleasure" and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. (...) Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction. Well don't get me wrong, I love using mate. If I could use successfully I would. I'd still be using. I love using. I just don't like the shit that comes with it. (shrink)

As the implementation of new approaches and procedures of medical ethics is as complex and resource-consuming as in other fields, strategies and activities must be carefully planned to use the available means and funds responsibly. Which facilitators and barriers influence the implementation of a medical ethics decision-making model in daily routine? Up to now, there has been little examination of these factors in this field. A medical ethics decision-making model called METAP was introduced on three intensive care units and two (...) geriatric wards. An evaluation study was performed from 7 months after deployment of the project until two and a half years. Quantitative and qualitative methods including a questionnaire, semi-structured face-to-face and group-interviews were used. Sixty-three participants from different professional groups took part in 33 face-to-face and 9 group interviews, and 122 questionnaires could be analysed. The facilitating factors most frequently mentioned were: acceptance and presence of the model, support given by the medical and nursing management, an existing or developing ethics culture, perception of a need for a medical ethics decision-making model, and engaged staff members. Lack of presence and acceptance, insufficient time resources and staff, poor inter-professional collaboration, absence of ethical competence, and not recognizing ethical problems were identified as inhibiting the implementation of the METAP model. However, the results of the questionnaire as well as of explicit inquiry showed that the respondents stated to have had enough time and staff available to use METAP if necessary. Facilitators and barriers of the implementation of a medical ethics decision-making model are quite similar to that of medical guidelines. The planning for implementing an ethics model or guideline can, therefore, benefit from the extensive literature and experience concerning the implementation of medical guidelines. Lack of time and staff can be overcome when people are convinced that the benefits justify the effort. (shrink)

In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less blameworthy but also as less (...) fit for ordinary interpersonal relationships. We examine how these responses, in turn, shape the addicted person’s view of themselves, their character and their capacities, and provide a negative narrative trajectory that impedes recovery. We close with a consideration of how these effects might be mitigated by adopting less demanding variations of the participant stance. (shrink)

Self-compassion is a mechanism of symptom improvement in post-traumatic stress disorder, however, the underlying neurobiological processes are not well understood. High levels of self-compassion are associated with reduced activation of the threat response system. Physiological threat responses to trauma reminders and increased arousal are key symptoms which are maintained by negative appraisals of the self and self-blame. Moreover, PTSD has been consistently associated with functional changes implicated in the brain’s saliency and the default mode networks. In this paper, we explore (...) how trauma exposed individuals respond to a validated self-compassion exercise. We distinguish three groups using the PTSD checklist; those with full PTSD, those without PTSD, and those with subsyndromal PTSD. Subsyndromal PTSD is a clinically relevant subgroup in which individuals meet the criteria for reexperiencing along with one of either avoidance or hyperarousal. We use electroencephalography alpha-asymmetry and EEG microstate analysis to characterize brain activity time series during the self-compassion exercise in the three groups. We contextualize our results with concurrently recorded autonomic measures of physiological arousal, parasympathetic activation and self-reported changes in state mood and self-perception. We find that in all three groups directing self-compassion toward oneself activates the negative self and elicits a threat response during the SC exercise and that individuals with subsyndromal PTSD who have high levels of hyperarousal have the highest threat response. We find impaired activation of the EEG microstate associated with the saliency, attention and self-referential processing brain networks, distinguishes the three PTSD groups. Our findings provide evidence for potential neural biomarkers for quantitatively differentiating PTSD subgroups. (shrink)

The tourism industry is a significant driver of the global economy and impacts societies all over the world that are currently experiencing radical change. Responding to these changes requires economic paradigms and educational systems based on new foundations. Humanistic tourism proposes a values-based disciplinary perspective for tourism at the intersection between humanistic and tourism management, and is rooted in human dignity and societal wellbeing. Integrating humanistic management principles into higher education tourism management programs, and changing the nature of what is (...) taught and how, would benefit students, future managers and all stakeholders. This paper aims at improving higher education tourism programs by combining humanistic management education and the Tourism Education Futures Initiative’s values-based tourism education. It draws on an integrated Humanistic Tourism Education framework to help develop future tourism managers’ skills and abilities to adopt alternative leadership models within the sector and to foster critical and responsible tourism thinking and practice. With best-practice examples from three universities in three different countries, this study illustrates new pedagogical approaches and proposes recommendations for implementing humanistic tourism management in higher education with the aim of training ethical and responsible managers equipped with an awareness of the social, cultural, and environmental challenges – and possible solutions to these – in their respective destinations. (shrink)

Cet article détaille la méthodologie mise en place dans le projet EMOLEX qui a abouti à la mise à disposition de corpus multilingues, d’interfaces d’interrogation et d’analyse de ces corpus ainsi que d’applications permettant d’exploiter les analyses linguistiques portant sur le lexique des affects dans cinq langues européennes.

Research on the influence of industry on chemical regulation has mostly been conducted within the framework of the production of ignorance. This special issue extends this research by looking at how industry asserts its interests––not just in the scientific sphere but also at other stages of policy-making and regulatory process––with a specific focus on the types of tools or instruments industry has used. Bringing together sociologists and historians specialized in Science and Technology Studies, the articles of the special issue study (...) the arenas in which instruments and practical guidelines for public policy are negotiated or used. The aim is to observe the devices in the making or in action, from the selection of actors to the production of thresholds, criteria, and other technical regulations. The introduction highlights how industry influence on expertise and regulation is undoubtedly far more pervasive and multifarious than has been conceptualized to date by social scientists. Putting this issue back at the heart of both the STS and social sciences research agendas is increasingly urgent and could lead to new inquiries able to highlight these logics even more widely, using fresh empirical examples. (shrink)

In an increasingly urbanized world, construction industry is called upon to serve the needs of human society, such as environmental protection and safety in terms of infrastructure. In this context, a sustainable and ethical development means a close connection between buildings and environment. This connection can be achieved through, for example, the concept of ecological concrete or green concrete, as it is often called. The conventional process of obtaining cement and mineral aggregates from the concrete composition generates pollution, especially through (...) greenhouse gas emissions. Also, one should not ignore the fact that extraction of the raw materials affects the habitats of the sites and of the neighboring areas. When construction materials are questioned, the ethical issues lay not in the means of expression, but mainly in the means of production. More to the point, the present contribution aimed to find solutions for enhancing the adhesion of vegetal aggregates with the cement matrix, in order to obtain a material with optimal mechanical properties, which is valued as an ethical approach of building industry. Results showed that plant aggregates can be used to obtain a building material which can be improved by using partial substitution of cement by silica fume, fly ash, or by using additives and that green concrete as an environmentally friendly material offers the alternative for lower energy use and fewer CO2 emissions. Marketers must understand not only the advantages of these green materials, but also that they have an ethical commitment to provide consumers with environmentally friendly materials. (shrink)

„Strategia noastră a fost de a gândi un text util pentru profesori, dar de a-l scrie mai ales pentru studenți. Etica este interesantă cu precădere atunci când pune în joc intuiții morale sau valori diferite și când ne confruntăm cu dileme în care decizia nu este evidentă, iar dezacordul este rezonabil. Prin urmare, am încercat să ne ferim pe cât a fost posibil de verdicte și de simpla enumerare a unor interdicții. Veți observa că, de cele mai multe ori, exercițiile (...) și temele de discuție nu au soluții impuse. Nu pentru că autorii manualului nu ar adera la anumite soluții (poate nu la aceleași!), ci pentru că ni s-a părut mult mai importantă conturarea problemelor. Dilemele și întrebările deschise generează dezbateri și prilejuiesc reflecție. Sentințele, pe de altă parte, tind să ucidă discuția și să prilejuiască mai curând reacții de îmbrățișare sau de respingere vehementă. Dacă vom ajunge, în comunitățile noastre profesionale și în societate, să vorbim mai mult unii cu alții și mai puțin unii la alții, vom fi făcut probabil un pas major în direcția corectă pentru dezvoltarea unei atitudini morale.” (Autorii). (shrink)

It is widely accepted that overcoming the social-ecological crises we face requires major changes to the food system. However, opinions diverge on the question whether those ‘great efforts’ towards sustainability require systemic changes or merely systematic ones. Drawing upon Brand and Wissen’s concept of “imperial modes of living”, we ask whether the lively debates about sustainability and ‘ethical’ consumption among producers and consumers in Germany are far reaching enough to sufficiently reduce the imperial weight on the environment and other human (...) and nonhuman animals. By combining discourse analysis of agri-food businesses’ sustainability reports with narrative consumer interviews, we examine understandings of sustainability in discourses concerning responsible food provision and shed light on how those discourses are inscribed in consumers’ everyday food practices. We adopt Ehgartner’s discursive frames of ‘consumer sovereignty’, ‘economic rationality’, and ‘stewardship’ to illustrate our findings, and add a fourth one of ‘legitimacy’. Constituting the conditions under which food-related themes become sustainability issues, these frames help businesses to individualise the responsibility to enact changes, tie efforts towards sustainability to financial profits, subject people and nature to the combination of care and control, and convey legitimacy through scientific authority. We discuss how these frames, mirrored in some consumer narratives, work to sideline deeper engagement with ecological sustainability and social justice, and how they brush aside the desires of some ostensibly ‘sovereign’ consumers to overcome imperial modes of food provision through much more far reaching, systemic changes. Finally, we reflect on possible paths towards a de-imperialised food system. (shrink)

Causal pre-emption scenarios are problematic for the counterfactual framework of causation because people judge an action to be the actual cause of an outcome although the outcome would have...

We critically address current theories of figurative language, focusing on the role of literal or compositional meaning in the interpretation of non-literal expressions, including idioms and metaphors. Specifically, we formulate and discuss the processing hypothesis that compositional meaning may either facilitate or impede the recovery or construction of the intended figurative meaning depending on multiple factors, and in particular, on the expression’s decomposability and on the “strength” of semantic relations between the compositional and figurative meanings. As a case study, we (...) consider research on processing and acquisition of figurative expressions in highly verbal individuals with autism spectrum disorder in comparison to neuro-typical individuals, and examine the factors that may account for the observed comprehension deficits in the ASD group. Based on this evidence, we discuss some of the strategies employed by language users in processing non-compositional or non-literal expressions, and we highlight implications for research on natural language comprehension and processing systems in the domain of figurative meaning. (shrink)

Since the early days of physics, space has called for means to represent, experiment, and reason about it. Apart from physicists, the concept of space has intrigued also philosophers, mathematicians and, more recently, computer scientists. This longstanding interest has left us with a plethora of mathematical tools developed to represent and work with space. Here we take a special look at this evolution by considering the perspective of Logic. From the initial axiomatic efforts of Euclid, we revisit the major milestones (...) in the logical representation of space and investigate current trends. In doing so, we do not only consider classical logic, but we indulge ourselves with modal logics. These present themselves naturally by providing simple axiomatizations of different geometries, topologies, space-time causality, and vector spaces. (shrink)

Ziel des PVS Sonderheftes ist es, die seit einiger Zeit boomende Konjunktur des Verantwortungsbegriffs zu reflektieren, die Relevanz dieses Begriffes zu analysieren und seinen Wandel angesichts gesellschaftlicher und technischer Veranderungen zu erfassen. Eines der wichtigsten Kriterien zur Beurteilung politischer Entscheidungen ist deren Verantwortlichkeit. Der Begriff der Verantwortung bezieht sich auf einen Rahmen normativer Erwartungen, die je nach Politikfeld starker rechtlich oder moralisch ausgepragt sind. Verantwortung bedeutet insbesondere, einem Akteur die Folgen seines Handels zuschreiben zu konnen. Ein Kernproblem aktueller Verantwortungskonzeptionen besteht (...) in der Diffusion von Verantwortung. Einerseits sind immer mehr Akteure an immer mehr Handlungszusammenhangen beteiligt, aber gleichzeitig sind immer weniger Akteure fur ihre Handlungsfolgen allein verantwortlich. Die Beitrage des Heftes diskutieren die Folgen dieser Dilemmata sowohl in ihren theoretischen Konsequenzen als auch empirisch anhand verschiedener Felder lokaler, nationaler und internationaler Politik. Der Band versammelt Expertinnen und Experten aus unterschiedlichen Disziplinen: von der Politikwissenschaft uber die Rechtswissenschaft bis hin zur Soziologie und Philosophie. (shrink)

Aesthetic emotions are elicited by different sensory impressions generated by music, visual arts, literature, theater, film, or nature scenes. Recently, the AESTHEMOS scale has been developed to facilitate the empirical assessment of such emotions. In this article we report a semantic profile analysis of aesthetic emotion terms that had been used for the development of this scale, using the GRID approach. This method consists of obtaining ratings of emotion terms on a set of meaning facets which represent five components of (...) the emotion process. The aims here were to determine the dimensionality of the GRID features when applied to aesthetic emotions and compare it to published results for emotion terms in general, and to examine the internal organization of the domain of aesthetic emotion terms in order to identify salient clusters of these items based on the similarity of their feature profiles on the GRID. Exploratory Principal Component Analyses suggest a four-dimensional structure of the semantic space consisting of valence, power, arousal, and novelty, converging with earlier GRID studies on large sets of standard emotion terms. Using cluster analyses, 15 clusters of aesthetic emotion terms with similar GRID feature profiles were identified, revealing the internal organization of the aesthetic emotion terms domain and meaningful subgroups of aesthetic emotions. While replication for further languages is required, these findings provide a solid basis for further research and methodological development in the realm of aesthetic emotions. (shrink)

The morbidity of tick‐borne encephalitis (TBE) varies yearly by as much as 10‐fold among the people of Western Siberia. This long‐term variation is dependent on many factors such as the density of the tick populations, the prevalence of TBE virus (TBEV) among sub‐adult ticks, the yearly virulence of the TBEV, and prophylactic measures. Here we highlight the role of small mammal hosts in the circulation of TBEV through the ecosystem. Refining classical models of non‐viremic horizontal transmission, we emphasize the recently (...) understood fact that the physiological and immunological status of the small mammal hosts affects the tick and virus‐host interactions. In addition to its theoretical interest, our approach may lead to some practical improvements in the precision of epidemiological forecasts and perhaps in forestalling the severity of outbreaks of TBE, or, at least, in forewarning medical authorities and the general public of impending TBE outbreaks. (shrink)

Das Verhältnis zwischen Kirche und säkularer Kultur steht einmal mehr in Frage. Gehören die Kunstwerke der christlichen Tradition als lebendige Quelle noch in unsere Gegenwart, oder nicht vielmehr einer Vergangenheit an, die höchstens noch von musealem Interesse ist? Ist eine intellektuelle Durchdringung des Glaubens, eine christliche, katholische/protestantische Intellektualität sinnvoll, notwendig, überhaupt möglich?

ObjectiveTo investigate the association of pre-existing migraine in patients hospitalised and who recovered from severe acute respiratory syndrome coronavirus 2 infection with the presence of post-coronavirus disease symptoms.BackgroundNo study has investigated the role of migraine as a risk factor for development of post-COVID symptoms.MethodsA case-control study including individuals hospitalised during the first wave of the pandemic was conducted. Patients with confirmed previous diagnosis of migraine were considered cases. Two age- and sex-matched individuals without a history of headache per case were (...) also recruited as controls. Hospitalisation/clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety/depressive symptoms and sleep quality. Multivariable conditional logistic regression models were constructed.ResultsOverall, 57 patients with confirmed diagnosis of migraine and 144 non-migraine controls who had recovered from COVID-19 were assessed at 7.3 months after hospital discharge. The number of post-COVID symptoms in the migraine group was significantly greater than in the non-migraine group. Fatigue was significantly more prevalent in the migraine group. However, no between-groups difference in the prevalence of headache as a post-COVID symptom was detected.ConclusionPatients with a history of migraine who recovered from COVID-19 exhibited more long-term fatigue as post-COVID sequelae than those without migraine. Some of the pathophysiological changes associated with migraine could predispose to the occurrence of post-COVID symptoms. (shrink)