Die Zulässigkeit der terminalen Sedierung als ultima-ratio-Maßnahme der Palliativmedizin bei sterbenden Patienten, die unter anders nicht kontrollierbaren schwersten Schmerzen und seelischen Qualen leiden, wird neuerdings auch in Europa kontrovers diskutiert. Während ihre Befürworter betonen, dass die terminale Sedierung nur dann zum Einsatz kommt, wenn die Standardmethoden der Palliativmedizin versagt haben, äußern ihre Gegner Angst vor einer neuen, unkontrollierten Form der aktiven Sterbehilfe. Insbesondere dann, wenn zeitgleich mit der terminalen Sedierung auf künstliche Ernährung und Flüssigkeitszufuhr verzichtet wird, wirft man ihr die (...) Umgehung der verbotenen aktiven Sterbehilfe vor, und es wird die Forderung nach einem strafrechtlichen Verbot erhoben. In diesem Artikel wird die rechtliche Bedeutung der terminalen Sedierung untersucht. Im Laufe der Analyse wird gezeigt, dass sie weder mit aktiver Sterbehilfe noch mit verbotener ärztlicher Beihilfe zum Suizid gleichgesetzt werden kann und dass sie — unter bestimmten Bedingungen — nicht unter ein strafrechtliches Verbot fällt. Der Beitrag schließt mit einer Diskussion rechtlicher und ethischer Aspekte für die Entwicklung von Leitlinien. (shrink)

Excerpt from Die Welträthsel: Gemeinverständliche Studien Über Monistische Philosophie Dr. Philos.' Dr. Med., br. Jur., Dr. Noient.' $tofeflor on her 11mntfitdt Sem. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such (...) as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Het ethos waarin de mens leeft en handelt is in verandering zolang de mens leeft en handelt. In De maakbare moraal reflecteren verschillende filosofen over de antwoorden die het moderne en hedendaagse denken kunnen bieden op vragen die net door dat veranderend ethos tot stand worden gebracht. De idee dat moraal 'maakbaar' zou zijn houdt meteen ook een kritisch standpunt in: wat precies is er in onze morele omgang met elkaar dat beheersbaar, expliciteerbaar, voorstelbaar... zou kunnen zijn? De maakbare moraal (...) bundelt bijdragen van Daniel Acke, Hans Alma, Sonja Lavaert, Julia Maria Mönig, Johan Stuy en Adelheid Rigo, Marc Van den Bossche, Yoni Van Den Eede, Karl Verstrynge en Else Walravens. De reeks Humanismen wil het denken over de hedendaagse condition humaine op een prikkelende en eigenzinnige manier stimuleren. Het begrip humanisme krijgt hier een zeer ruime omschrijving: respect voor de mens in zijn diversiteit en pluraliteit en voor de manier waarop individuen zoeken naar identiteit en zingeving. De reeks komt tot stand onder begeleiding van prof. dr. Marc Van den Bossche van de vakgroep Wijsbegeerte en Moraalwetenschappen van de Vrije Universiteit Brussel. (shrink)

Name der Zeitschrift: Cognitive Linguistics Jahrgang: 26 Heft: 2 Seiten: 331-359.

Positive emotions are highly valued and frequently sought. Beyond just being pleasant, however, positive emotions may also lead to long-term benefits in important domains, including work, physical health, and interpersonal relationships. Research thus far has focused on the broader functions of positive emotions. According to the broaden-and-build theory, positive emotions expand people’s thought–action repertoires and allow them to build psychological, intellectual, and social resources. New evidence suggests that positive emotions—particularly gratitude—may also play a role in motivating individuals to engage in (...) positive behaviors leading to self-improvement. We propose and offer supportive evidence that expressing gratitude leads people to muster effort to improve themselves via increases in connectedness, elevation, humility, and specific negative states including indebtedness. (shrink)

Transcranial magnetic stimulation can be used to mask visual stimuli, disrupting visual task performance or preventing visual awareness. While TMS masking studies generally fix stimulation intensity, we hypothesized that varying the intensity of TMS pulses in a masking paradigm might inform several ongoing debates concerning TMS disruption of vision as measured subjectively versus objectively, and pre-stimulus versus post-stimulus TMS masking. We here show that both pre-stimulus TMS pulses and post-stimulus TMS pulses could strongly mask visual stimuli. We found no dissociations (...) between TMS effects on the subjective and objective measures of vision for any masking window or intensity, ruling out the option that TMS intensity levels determine whether dissociations between subjective and objective vision are obtained. For the post-stimulus time window particularly, we suggest that these data provide new constraints for models of vision and visual awareness. Finally, our data are in line with the idea that pre-stimulus masking operates differently from conventional post-stimulus masking. (shrink)

Die Medikalisierung des Sterbens hat dazu geführt, dass ein „guter Tod“ zunehmend auch von medizinischen Interventionen erwartet wird. Die Möglichkeiten einer „terminalen Sedierung“ bis zum Tode werden von vielen als Ausweg angesehen, wenn bei unerträglichem Leid und aussichtsloser Prognose der Wunsch nach aktiver Sterbehilfe angesprochen wird. Durch eine Sedierung können zwar bei schwerstkranken Patienten schwerste therapierefraktäre Leidenszustände effektiv gelindert werden. Diese Therapieoption kann aber auch in der Absicht angewendet werden, den Todeseintritt medizinisch zu beschleunigen, so dass im Zusammenhang mit der (...) Euthanasiedebatte auch das Thema der terminalen Sedierung kontrovers diskutiert wird. Richtlinien zu Indikation, Technik und Dokumentation sind notwendig, um Stellenwert und Grenzen der terminalen Sedierung im Rahmen der palliativen Betreuung am Lebensende zu verdeutlichen und durch Transparenz Fehlentwicklungen zu vermeiden. (shrink)

Zusammenfassung: Fehlinterpretierte Dokumente und ignorierte physikalische Fakten: Die Geschichte von,Hitlers Atombombe‘ muss korrigiert werden. Warum haben die deutschen Physiker während des Zweiten Weltkriegs keine Atombombe entwickelt? Seit mehr als 25 Jahren sind sich die Historiker einig, dass die deutschen Physiker wussten, wie eine Atombombe gebaut werden muss, dass aber ein Programm wie das amerikanische Manhattan‐Projekt zu ihrer Realisierung in Deutschland, erst recht während des Krieges, unmöglich war. Eine genaue Analyse aller erhaltenen Original‐Dokumente über die Arbeit an der Atombombe während des,Dritten (...) Reichs‘ zeigt jedoch erhebliche Fehler der Autoren durch unvollständige Analyse der Dokumente, falsches Verständnis naturwissenschaftlicher Erläuterungen und Ignorieren physikalischer Fakten. Es wird nachgewiesen, dass die deutschen Physiker bis zum Ende des Krieges nicht bemerkt hatten, dass eine Atombombe nur mit schnellen Neutronen realisiert werden kann. Nur Heisenberg hatte das richtige Prinzip spät erkannt, es aber nicht eindeutig kommuniziert und auch in keiner Weise physikalisch vertieft. Die physikalisch korrekte Interpretation der Dokumente zeigt, dass die deutschen Physiker während des Krieges erfolglos versuchten, einen Reaktor zu entwickeln, der auch eine Voraussetzung für den Bau einer Plutonium‐Bombe gewesen wäre. Aber sie wussten nicht, wie eine Bombe realisiert werden kann, weil sie nie an einer realistischen Theorie der Atombombe gearbeitet hatten. Summary: Misinterpreted Documents and Ignored Physical Facts: The History of ‘Hitler's Atomic Bomb’ needs to be corrected. Why have the German physicists not developed an atomic bomb during World War II? For more than 25 years, the historians agree that they knew how to build the bomb, but that a bomb‐development programme of the size of the US‐Manhattan‐Project would not have been possible in wartime Germany. A detailed analysis of all preserved documents on the German atomic bomb research during the ‘Third Reich’, however, reveals considerable mistakes by the authors due to incomplete analysis of documents, misinterpretations of scientific explanations and ignoring of physical facts. It is shown that until the end of the war the German physicists did not know that an atomic bomb can only be made with fast neutrons, except Heisenberg, who, however, discovered it rather late, did not communicate it clearly and did not study any bomb physics. The physically correct interpretation of the documents reveals that the German physicists worked unsuccessfully on a reactor, which would have been a prerequisite for a plutonium bomb. But they did not know how to build a bomb because they never worked on a realistic bomb theory. (shrink)

Gene editing in agriculture and food (GEAF) is a nascent development with few products and is unfamiliar among the wider US public. GEAF has garnered significant praise for its potential to solve for a variety of agronomic problems but has also evoked controversy regarding safety and ethical standards of development and application. Given the wake of other agribiotechnology debates including GMOs (genetically modified organisms), this study made use of 36 in-depth key interviews to build the first U.S. based typology of (...) proponent and critic priorities for shaping public trust in GEAF actors and objects. Key organizational actors provide early and foundational messaging, which is likely to contribute heavily to public salience, comprehension, and decision-making as potential consumers reflect upon their experiences, envision future outcomes, and consider the reputation of those trying to influence them. As is documented in our results, the trust-building priorities of these groups often stand in opposition to one another and are influenced by distinct motivations for how the public will come to trust or distrust GEAF actors and objects as more products are developed and enter the market. (shrink)

Dieses Open-Access-Buch gibt aktuelle interdisziplinäre Forschungseinblicke rund um das Fab City-Konzept. Ein Ansatz, der beschreibt, wie Produktions- und Konsumptionsweisen gestaltet werden können, sodass einerseits globale Kollaboration in und durch Communities von der Ideengenerierung bis zur Produktentwicklung physischer Güter mittels quelloffener Technologien (Open Source Software und Hardware) ermöglicht wird und andererseits die Produktion dieser Güter lokal und somit möglichst nahe am Ort des Bedarfs sowie dezentral im Sinne einer verteilten Produktion erfolgen kann, beispielsweise in Fab(rication) Labs. Ziel ist die Schaffung einer (...) möglichst nachhaltigen Produktion bzw. Wertschöpfung. Ökologisch nachhaltig, indem lange Transportwege vermieden und auf Grundlage von Kreislaufprinzipien lokale Stoffkreisläufe geschlossen werden. Ökonomisch nachhaltig, indem durch quelloffene Technologien Wettbewerbsbeschränkungen und durch föderierte Ansätze Abhängigkeiten vermieden werden. Sozial nachhaltig durch ein partizipatives Wertschöpfungssystem, in dem der Zugang zu Wissen und Knowhow sowie zu Produktionsmitteln unbeschränkt ist. Über den gesamten Produktentstehungsprozess und -lebenszyklus enthält das vorliegende, bilinguale Werk in deutscher und englischer Sprache Beiträge aus den Bereichen Citizen & Collaborative Innovation and Design, Circular Design & Economy, Open-Source-Software-Tools für die Entwicklung von Open Source Hardware, Digital Product Passport, föderierte (Open-Source-) Systeme, die Verbreitung von Open Source Hardware sowie technical literacy und economic governance. Prof. Neil Gershenfeld, Director of MIT's Center for Bits and Atoms, and Chairman of the board of The Fab Foundation: "For many years the growth of cities has been an inexorable trend, with cities acting as regional magnets and engines; the resources enabling a Fab City can also help expand opportunity beyond cities. There is now an opportunity and need for labs that can develop, deploy, and measure the frontiers of Fab City technologies. This book provides a much-needed snapshot of the current state of that challenge." Tomas Diez, Executive Director of the Fab City Foundation: "This book is an invitation for large-scale collaboration to build distributed system that can support the development of alternative modes of production, in line with the social and ecological needs of our time.". (shrink)

Given the prevalence of misconduct in research and among students in higher education, there is a need to create solutions for how best to prevent such behaviour in academia. This paper proceeds on the assumption that one way forward is to prepare students in higher education at an early stage and to encourage a smoother transition from academic integrity to research integrity by incorporating academic integrity training as an ongoing part of the curriculum. To this end, this paper presents three (...) checklists developed as part of the Erasmus+ Strategic Partnership project _Bridging Integrity in Higher Education, Business and Society_ (BRIDGE, 2020-1-SE01-KA203-077973). The aim of the checklists is to help students and their supervisors to bridge academic integrity and research integrity in research training. The checklists target master students, doctoral students, and their supervisors. This paper presents the theoretical background of the checklists, how they were developed, their content, and how they may be used in supervising thesis/dissertation work to promote a transition from academic integrity to research integrity. (shrink)

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...) effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. (shrink)

The objective of this study is to examine the contemporary approaches to Da'wah methodology in Malaysia. This study undertook an examination of the impact of social media platforms on conversion rates within the context of the Da'wah methodology. The use of a quantitative approach is implemented through the application of a cross-sectional research design. A questionnaire survey was devised to gather data from Islamic scholars residing in Malaysia. Questionnaires were disseminated to Islamic scholars using social media platforms. A total of (...) 155 valid responses were collected to investigate the impact of social media on conversion rates. The study focused on various factors including content type, frequency of exposure, duration of exposure, and follow-up interactions. The findings obtained from the application of Structural Equation Modelling (SEM) indicate that social media platforms play a significant role in increasing the conversion rate of individuals from different religious backgrounds to Islam. The impact of social media on content type, frequency of exposure, duration of exposure, and follow-up interactions is generally perceived as positive, as it tends to enhance the likelihood of conversion rates. This research holds practical significance for Islamic scholars seeking to enhance conversion rates using diverse social media platforms. (shrink)

The placebo drug reactions from controlled trials were studied for the first time systematically for efficacy and the safety in drug data pooled from randomized, placebo-controlled, multicentre studies. Results: The efficacy of placebo on clinical symptoms and outcome varied between the therapeutic indications. However, no placebo effects on laboratory values, as e.g. blood glucose or Hb1c in diabetics, were noted. The frequency and type of placebo-induced adverse reactions also varied between indication groups. The placebo side effect profile was largely similar (...) to the side effect profile of the active treatment. The mechanisms of placebo effects are manyfold and varied (e.g. endorphin release, conditioning), much lacks explanation. Conclusion: Since the prescription of non-evidence based medicines (= pseudoplacebos) may clearly also result in serious adverse effects, such practice may not only be non-beneficial but may even be harmful. In clinical research, the judicious use of placebo remains essential to establish the efficacy and safety, safeguarding that patients receiving placebo will not be subject to harm and are fully informed. (shrink)

BackgroundImplementation of recommendations from clinical practice guidelines is essential for evidence based clinical practice. However, the most effective methods of implementation are unclear. We conducted a national, cluster-randomised, blinded implementation trial to determine if midwife or doctor local implementation leaders are more effective in implementing a guideline for use of oral dextrose gel to treat hypoglycaemic babies on postnatal wards. To prevent any conscious or unconscious performance bias both the doctor and midwife local implementation leaders were kept unaware of the (...) trial. This paper reports the ethical dilemmas and practical challenges of ensuring clinicians remained unaware of their involvement in an implementation trial.MethodsWe sought approval from the National Health and Disability Ethics committee to keep clinicians unaware of the trial by waiving the standard requirement for locality approval usually required for each district health board. The ethics committee did not approve a waiver of consent but advised that we approach the chief executive of each district health board to ask for provisional locality approval. Ultimately it was necessary to seek ethics approval for three separate study designs to keep clinicians unaware of the trial.ResultsThe median time for chief executive approval was 16 days and for locality approval was 57 days. We completed 21 different locality approval forms for 27 hospitals.ConclusionsKeeping clinicians unaware of their involvement in a national implementation cluster-randomised trial is feasible. However, despite a national ethics committee, significant logistical challenges were time consuming and delayed trial completion. Co-ordination of the locality approval process would help facilitate multi-centre trials. (shrink)

In der gegenwärtigen Diskussion um Patientenverfügungen dominieren die Fragen nach deren Reichweite und Verbindlichkeit. Diese bilden, ebenso wie die Kontroverse um diese beiden Themen, die professionsspezifische Sichtweise von Ärzten und Juristen ab. Aus Patientenperspektive jedoch, so die Ergebnisse einer Studie mit 272 Tumorpatienten, stellt sich die Situation anders dar: Hier fungieren Patientenverfügungen vielmehr als Türöffner für eine intensivere Kommunikation mit Ärzten, aber auch mit Angehörigen und mit sich selbst. Die Frage nach der Verbindlichkeit spielt demgegenüber nur eine nachgeordnete Rolle.

Remaining important tasks in finding and developing new drugs and vaccines for HIV/AIDS, malaria, cancer and other diseases require continued industry research and development. Industry’s research and development pipeline has produced drugs that have saved AIDS victims previously facing certain death, but still no cure nor vaccine is yet available. Experience with the process of research and development indicates that it requires more than a decade of development to produce a new drug with costs in the hundreds of millions of (...) dollars. Intellectual property protection is critically important in assuring that drug development continues. Partnerships between industry and the public sector have increased access to new therapies in developing countries and promise to enhance access to both patented and generic medicines in the future. (shrink)

Neben grundsätzlichen konzeptionellen Fragen der sog. Individualisierten Medizin (IM), prägen ethische Bedenken und Fragen die aktuellen Debatten um die IM. Allerdings ist bislang noch nicht geklärt, in welchem methodischen Rahmen diese Fragen verortet werden können. Für die Entwicklung eines solchen Rahmens wird das Modell der First- und Second-Wave-Bioethics diskutiert und an zwei konkreten Herausforderungen – 1) dem Verhältnis der IM zur evidenz-basierten Medizin und 2) am Konzept der genetischen Risikoperson – aufgezeigt. Eine solche Kontextualisierung der IM-Debatte legt den Grundstein für (...) eine adäquate Erfassung und Bearbeitung sozialethischer Fragen (z. B. im Hinblick auf das Problem der Eigenverantwortung). (shrink)

O artigo apresenta uma analise a partir da renovação eclesiológica do Vaticano II, em seguida apresenta a pneumatologia como origem desta renovação. A comunhão na Igreja só será possível através do Espírito Santo.

This paper examines two models of thinking relating to the issue of the right to die in dignity: one takes into consideration the rights and interests of the individual; the other supposes that human life is inherently valuable. I contend that preference should be given to the first model, and further assert that the second model may be justified in moral terms only as long as it does not resort to paternalism. The view that holds that certain patients are not (...) able to comprehend their own interests in a fully rational manner, and therefore ‘we’ know what is good for these patients better than ‘they’ do, is morally unjustifiable. I proceed by refuting the ‘quality of life’ argument, asserting that each person is entitled to decide for herself when it is worth living and when it is not. In this connection, a caveat will be made regarding the role of the family. (shrink)

The reflections presented in this text are just indications of the "way" Jesus preached. He turns his preaches a path to hope. In Jesus' practice we find some fundamental requirements for preaching, among them: to preach the Good News, the awakening of faith, using the language of his time, being in the middle of people to beter understand their lives, respecting people's freedom, correcting any kind of religious closure, meeting people, preach the Word firstly to the poor and excluded ones. (...) Preaching is announcing Jesus Christ as pastor, priest and prophet; is announcing the kerygma, talking about the Kingdom and applying Good News in people's lives. (shrink)