In this chapter, we explore the question of on what grounds reports of clinical ethics support in general, including especially clinical ethics consultation, can or should be evaluated when using a peer review system. It is our contention that to evaluate clinical ethics consultation within a peer review system aiming at transparency and fairness, a defined and shared criteria of evaluation, i.e. an evaluation standard is required. When evaluating a performed ethics consultation, we can roughly distinguish between an internal standard, (...) which refers to the conceptualization of clinical ethics consultation held by the respective consultant or by the assessed clinical ethics support service themselves, and external standards. Most important is the way how an external standard is being defined: Is it just the standard of another service or colleague? Or is it the result of a larger consensus-building process of a relevant body representing a larger group of colleagues, such as the ASBH? Or does it even rely on the “evidence” of related research? An external standard, however, may rest on criteria that are not – or not fully – accepted by the evaluated CESS or individual ethics consultant. Identifying the internal standard of an observed ethics consultant’s work may also be challenging. From the evaluator’s perspective the responsibility for making an internal standard known and unequivocal lies with the “author” of the material. The potential gap between internal and external standards marks a methodological difficulty that as such has to be addressed within peer review evaluation. (shrink)

Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in Basel, Switzerland. A (...) Likert scale questionnaire was completed by the interviewees and analysed using descriptive and inferential statistics. Results Healthcare professionals are frequently exposed to a variety of moral problems, such as end-of-life decisions, resource allocation and assessing the patient's will or decisional capacity. Thirty-four different risk factors for moral problems are identified, e.g. patient vulnerability, divergent values or world views, inadequate resources or poor ethical climate. Twenty-one early indicators are recognised such as disagreement between healthcare professionals, patients and relatives, emotional disturbances, gut feeling or conflict of conscience. A variety of preventive measures are suggested and presented in a preventive clinical ethics support process model. The most helpful measures are early ethical conversations with colleagues, early team-internal ethical case discussions and an ethics-trained contact person on the ward. Ethics training, kerbside consultations, proactive ethics consultations, ethics screening and rounds are also considered helpful. Conclusions Clinical ethics support services should not only offer reactive and complex, but also proactive and low-threshold support for healthcare professionals, patients and relatives. (shrink)

Reiner Schürmann a été appelé « l’un des philosophes majeurs du xx e siècle » et « le continuateur peut-être le plus important d’une pensée de la mystique dans la lignée d’Eckhart et de Heidegger ». Nombre des chercheurs qui connurent Schürmann ou s’intéressent aujourd’hui à son œuvre souscriraient volontiers à de tels jugements, dans la mesure où cette œuvre déploie, comme nulle autre, les conséquences philosophiques et politiques de ce que Maître Eckhart et Heidegger appellent le délaissement ou le (...) laisser être ( Gelassenheit ). Pourtant, presque rien n’a été dévoilé des deux bornes entre lesquelles s’inscrit le cheminement personnel de Schürmann quant au délaissement : sa découverte de ce concept – ou, plus exactement, de ce mode de vie – lors de ses études auprès des dominicains du Saulchoir, et la manière dont le délaissement a pu façonner sa mort trois décennies plus tard. Ces parties précoce et tardive de son œuvre, consacrées au délaissement et à sa mise en acte, sont toutefois cruciales pour comprendre le parcours de Schürmann et donc pour apprécier ce qu’il peut aujourd’hui offrir à la pensée et à l’existence. Si, dans ses œuvres publiées, Schürmann minimise l’importance de l’expérience chrétienne du délaissement, voire critique en elle une figure dérivée et même trompeuse de la Gelassenheit, c’est bien elle qui lui a permis de s’engager sur son chemin de pensée. C’est elle aussi qui, à plus d’un titre, l’attendait au terme de son parcours, lequel apparaît alors comme un cercle faisant retour en soi. (shrink)

Es ist keine bloße Metapher, wenn wir sagen, etwas stelle sich jemandem dar. Vielmehr kommt darin zum Ausdruck, dass sprachliche oder bildliche Darstellungen bestimmte Auffassungsweisen ihrer jeweiligen Gegenstände buchstäblich vor-stellen. Auf diese Weise vermitteln Darstellungen zwischen Geist und Welt bzw. zwischen Selbst und Anderen. Gleichgültig, ob wir selbst etwas erzählen oder etwas in der Zeitung lesen, ob wir ein Bild ins Netz stellen oder einen Film schauen, stets haben wir es mit Darstellungen zu tun, die Vorstellungen artikulieren und erzeugen. Der (...) Doppelsinn von Repräsentation als mentale Vorstellung und mediale Darstellung hat darin seinen guten Grund. Das Buch entfaltet eine Darstellungstheorie in therapeutisch-kritischer Absicht. Es zielt darauf, Darstellungspraxen als spezifisch menschlich, weil geistig und freiheitlich zu qualifizieren, um im Streit der Interpretationen bessere von schlechteren unterscheiden zu können. How it is that the mind is directed at the world? Far differently, the world exists in the minds of anyone, because it is mediated through perspectives and perceived only in aspects. No matter whether we tell a story, read something in the newspaper, or watch a movie, we always deal with representations that articulate and generate imaginations. This is the origin of the double meaning of representation as mental imagination and medial presentation. The book develops a theory of representation with a critical and therapeutic intention. It aims at qualifying representational practices as specifically human due to their mental and liberal character in order to be able to distinguish better from worse interpretations. (shrink)

Responding adequately to the behaviour of human and non-human animals in our environment has been crucial for our survival. This is also reflected in our exceptional capacity to detect and interpret biological motion signals. However, even though our emotions have specifically emerged as automatic adaptive responses to such vital stimuli, few studies investigated the influence of biological motion on emotional evaluations. Here, we test how the motion of animals affects emotional judgements by contrasting static animal images and videos. We investigated (...) this question (1) in non-fearful observers across many different animals, and (2) in observers afraid of particular animals across four types of animals, including the feared ones. In line with previous studies, we find an idiosyncratic pattern of evoked emotions across different types of animals. These emotions can be explained to different extents by regression models based on relevant predictor variables (e.g. familiarity, dangerousness). Additionally, our findings show a boosting effect of motion on emotional evaluations across all animals, with an additional increase in (negative) emotions for moving feared animals (except snakes). We discuss implications of our results for experimental and clinical research and applications, highlighting the importance of experiments with dynamic and ecologically valid stimuli. (shrink)

Originally published in French in 1982, Schürmann's book is an elegant and provocative answer to the question: "in light of Heidegger's deconstruction of the metaphysical bases for moral and political action, what is to be done?" According to Schürmann, in the era for which metaphysical first principles no longer provide the basis for acting, humanity will be called upon simply to respond appropriately to the ever-shifting play of presencing. Anarchy, then, means absence of rule, not of rules. Those who have (...) asked why Heidegger never came up with an "ethics" fail to understand that ethics, as traditionally understood, is grounded in the metaphysical first principles that Heidegger sought to de-construct. Schürmann argues that "the backbone of metaphysics" involves establishing rules for thinking and doing, founding principles for making the world "intelligible and masterable." "'Anarchy,' on the other hand, designates the withering away of such a rule, the relaxing of its hold". At the end of the book, Schürmann poses and answers a series of objections about the potential dangers of the anarchistic implications of Heidegger's thought, especially in view of the latter's affiliation with National Socialism from 1933 to the mid-1930s. (shrink)

This is not a work of mine. For some reason, I am unable to remove it from my page. It is a list of Dr. Reiner Schürmann's lecture notes for courses that he taught at the New School for Social Research (aka The New School).

On Heidegger's Being and Time is an outstanding exploration of Heidegger's most important work by two major philosophers. Simon Critchley argues that we must see Being and Time as a radicalization of Husserl's phenomenology, particularly his theories of intentionality, categorial intuition, and the phenomenological concept of the a priori. This leads to a reappraisal and defense of Heidegger's conception of phenomenology. In contrast, Reiner Schürmann urges us to read Heidegger 'backward', arguing that his later work is the key to unravelling (...) Being and Time . Through a close reading of Being and Time Schürmann demonstrates that this work is ultimately aporetic because the notion of Being elaborated in his later work is already at play within it. This is the first time that Schürmann's renowned lectures on Heidegger have been published. The book concludes with Critchley's reinterpretation of the importance of authenticity in Being and Time . Arguing for what he calls an 'originary inauthenticity', Critchley proposes a relational understanding of the key concepts of the second part of Being and Time : death, conscience and temporality. (shrink)

This is a welcome reprint of a book that continues to grow in importance.

Dem Beitrag geht es darum, den modernen olympischen Wettkampfsport als spezifische Form von Körpertechnologisierung zu charakterisieren und zugleich die Relevanz der Thematisierung des Sports für die praktische Philosophie aufzuzeigen. Dazu wird der Sport als alltäglicher und akzeptierter Fall von Körpertechnologisierung im Kontext der allgemeinen philosophischen Diskussion um Formen von Enhancement diskutiert. Die Spezifik olympisch-sportlicher Körpertechnologisierung liegt darin, dass die dort praktizierte Leistungssteigerung eine innere Norm, ein Maß im Hegel’schen Sinne hat. Olympische Leistungssteigerung ist kein maßloses Immer-schneller, Immer-höher, Immer-stärker, sondern eine (...) Steigerung, die unter einer sportspezifischen Bedingung steht. Deshalb kann der olympische Sport kritisiert werden, indem man ihn beim Wort seiner Verfasstheit nimmt. Wenn man ihn loben oder beargwöhnen will, muss man nicht zurückgreifen auf kulturkritisch geprägte Bedenken gegen maßlose Leistungssteigerung oder zynische Gleichgültigkeit gegenüber dem, was Individuen ihren Körpern antun. (shrink)

The issue of intersubjectivity has taken on some urgency in the recent Hegel literature: M. Theunissen views inter subjectivity as the unifying factor of the system whereas J. Habermas declares it altogether absent from Hegel, tracing its origins rather to American pragmatism. Hösle's study, a bird's-eye view of the entire system with admirable scholarly and argumentative sharpness, seems at first to fall squarely within the position taken by Critical Theory.

The author presents and defends three theses: (1) "the first is that it is not profitable for us at present to do moral philosophy; that should be laid aside at any rate until we have an adequate philosophy of psychology." (2) "the second is that the concepts of obligation, And duty... And of what is morally right and wrong, And of the moral sense of 'ought', Ought to be jettisoned if this is psychologically possible...." (3) "the third thesis is that (...) the differences between the well-Known english writers on moral philosophy from sidgwick to the present day are of little importance." (staff). (shrink)

Die Phänomenologie stellt eine der Hauptströmungen der Gegenwartsphilosophie dar und findet in zahlreichen Wissenschaften sowie in Praxis und Therapeutik starke Resonanz. Nach 120 Jahren Wirkungsgeschichte füllt die Bibliothek phänomenologischer Werke zahllose Bücherregale und selbst für Expert:innen ist die Forschungsliteratur mittlerweile unüberschaubar geworden. An allgemeinen Einführungen sowie spezialisierter Fachliteratur mangelt es dabei keineswegs, wohl aber an einem Handbuch, in dem sowohl der Vielfalt der historischen Entwicklungen als auch dem berechtigten Wunsch nach innerer systematischer Kohärenz Rechnung getragen wird. Das Handbuch Phänomenologie schließt (...) diese Lücke. Ausgewiesene Autor:innen bereiten in eigens für diesen Band verfassten Artikeln komplexe sachliche Zusammenhänge übersichtlich auf. Durch seinen Aufbau eignet sich das Handbuch sowohl für Anfänger:innen als auch für Fortgeschrittene. Anhand bündig präsentierter Grundbegriffe und Verfahren konturiert das Handbuch die Spezifik der phänomenologischen Methode, spart dabei jedoch nicht die Kontroversen und methodologischen Neuausrichtungen aus, die von ihrer Lebendigkeit und Vielstimmigkeit zeugen. Ein umfangreicher Schlussteil ist der Rezeption und Anwendung in einzelnen Wirkfeldern gewidmet. Als Hilfsmittel zur eigenständigen Erschließung der phänomenologischen Denkrichtung und zu ihrer Anwendung auf aktuelle Probleme zeichnet sich das Handbuch durch seine Leser:innenfreundlichkeit und einen stark forschungspraktischen Bezug aus. Ein Kompendium, das sich bald als ABC der Phänomenologie etablieren dürfte. (shrink)

"... elegant and provocative... Exhibit[s] a subtle mastery of Heidegger's works." —Review of Metaphysics "... splendidly precise study of Heidegger... to be recommended not only to Heidegger scholars but also to those interested in the question of what philosophical thinking has as its task in the modern technological world." —Religious Studies Review "... indispensable to understanding the later Heidegger." —Choice.

The relations between reason, motivation and value present problems which, though ancient, remain intractable. If values are objective and rational how can they move us and if they are dependent on our contingent desires how can they be rational? E. J. Bond makes a bold attack on this dilemma. The widespread view among philosophers today is that judgements contain an irreducible element of personal commitment. To this Professor Bond proposes an account of values as objective and value judgements as true (...) or false, employing a distinction between grounding and motivating reasons to establish their connection with action. He defines and tests his position against a number of recent theories, providing in the process forceful criticism of Williams, Wiggins, Foot, Narveson and Nagel, among others. A distinctive contribution to the subject, it will stimulate interest and worthwhile debate among philosophers, while also serving as an introduction to this vital topic. (shrink)

Derek Parfit’s view of personal identity raises questions about whether advance decisions refusing life-saving treatment should be honored in cases where a patient loses psychological continuity; it implies that these advance decisions would not be self-determining at all. However, rather than accepting that an unknown metaphysical ‘further fact’ underpins agential unity, one can accept Parfit’s view but offer a different account of what it implies morally. Part II of this article argues that contractual obligations provide a moral basis for honoring (...) advance decisions refusing life-saving and/or life-sustaining medical treatment; advance decisions have similarities to contracts, such as life insurance policies and will-contracts, that come into effect when the psychological discontinuity is through death. (shrink)

« La déconstruction, c’est la pulvérisation d’un socle spéculatif où la vie trouverait son assise, sa légitimation, sa paix. » Autrefois son élève, Reiner Schürmann identifie dans l’oeuvre de Heidegger un impensé, le principe d’anarchie. Contre cette métaphysique occidentale qu'il s'applique à déconstruire, le penseur de la présence aurait fait de l'être et de l'agir une seule et même question. Et sapé ainsi toute possibilité de définir un fondement rationnel sur lequel construire une philosophie pratique. Que l'agir humain, à l'époque (...) technologique, se trouve privé d'arché : voilà ce que cette étude majeure, lisant Heidegger à rebours, a permis de dévoiler. (shrink)

Die forensische Kinder- und Jugendpsychiatrie steht in einem komplexen Spannungsfeld medizinischer, rechtlicher und sozialer Anforderungen. Die ethischen Herausforderungen, die sich daraus für den stationären Maßnahmenvollzug ergeben, sind bisher kaum untersucht, spezifische Hilfestellungen für Behandelnde fehlen. Diese Studie hat zum Ziel, ethische Themenfelder und Probleme in diesem Bereich zu identifizieren und ein Instrument zur Früherkennung und -intervention ethischer Probleme im Klinikalltag zu entwickeln. Methode: Eine systematische Literaturrecherche sowie eine Beobachtungstudie in der Jugendforensik der Universitären Psychiatrischen Kliniken Basel werden durchgeführt. Die Beobachtungsdaten (...) werden mittels qualitativer Inhaltsanalyse ausgewertet. Das Instrument wird auf der Basis der Resultate nach einer neuen Methode entwickelt. In der Literaturrecherche wurden 14 valide Publikationen identifiziert, die hauptsächlich ethische Probleme der Gerichtspsychiatrie thematisieren wie professionelle Rollenkonflikte, ethische Probleme der Diagnostik und Begutachtung oder der Umgang mit vertraulichen Informationen. Empirische oder empirisch-normative Studien fehlen. In der Beobachtungsstudie wurden 24 ethische Themen und spezifische Probleme identifiziert, besonders häufig sind ethische Fragen zu Moralkompetenzen der Jugendlichen, zur Behandlungsqualität, zum Umgang mit Regeln und Sanktionen und zur Freiheits- und Privatsphäre. Das Instrument zur Früherkennung und -intervention ethischer Probleme enthält die vier Kernelemente Risikofaktoren, Indikatoren, Interventionsplanung und Entscheidungsfindung. Der Maßnahmenvollzug der forensischen Kinder- und Jugendpsychiatrie offenbart ein breites Spektrum ethischer Themen mit spezifischen ethischen Problemen, welche in der Literatur bisher nur unzureichend untersucht sind. Das hier entwickelte Instrument FIEP unterstützt Behandelnde dabei, ethische Probleme frühzeitig zu erkennen und effizient zu bearbeiten. (shrink)

Background and aim Child and adolescent forensic psychiatry is fraught with complex medical, legal, and social tensions. The ethical challenges this entails for inhospital treatment have hardly been investigated, and specific support for health care professionals is lacking. This study identifies ethical issues and problems in this area and develops a tool for early detection and intervention of ethical problems in clinical practice. Methods A systematic literature search and an observational study in adolescent forensics at the University Psychiatric Clinics Basel (...) are conducted. The observation data are evaluated using a qualitative content analysis. The instrument is developed based on the results using a new method. Results In the literature search, 14 valid publications were identified that mainly address ethical conflicts in legal psychiatry, such as professional role conflicts, ethical problems in diagnostics and assessment, or confidentiality issues. Empirical or empirical–normative studies are missing. In the observational study, 24 ethical issues and specific conflicts were identified. Ethical questions about moral competencies of the adolescents, the quality of treatment, the handling of rules and sanctions, and freedom and privacy are particularly common. The Instrument for Early Detection and Intervention of Ethical Problems (FIEP) contains the four core elements risk factors, indicators, intervention planning and decision-making. Conclusions Inhospital treatment in forensic child and adolescent psychiatry reveals a broad spectrum of ethical issues with specific ethical problems, which are hardly investigated in literature so far. The FIEP instrument developed here supports health care practitioners in recognizing ethical problems at an early stage and addressing them efficiently. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

In this paper we assume that ‘theory’ is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES.A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist (...) in North-America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including ‘how-to’ questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end-of-life decisions (major ethical topics).In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi-centre context in several healthcare institutions. We conceptualize three ‘pillars’ as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP.We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. (shrink)

In this paper we assume that ‘theory’ is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES.A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist (...) in North‐America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including ‘how‐to’ questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end‐of‐life decisions (major ethical topics).In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi‐centre context in several healthcare institutions. We conceptualize three ‘pillars’ as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP.We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. (shrink)

Arguing that psychologists and their predecessors have invariably relied on metaphors in articulation, the contributors to this volume offer a new "key" to understanding a critically important area of human knowledge by specifying the major metaphors.

" --John Sallis In Broken Hegemonies, the late distinguished philosopher Reiner Schürmann offers a radical rethinking of the history of Western philosophy from the Greeks through Heidegger.

The text presented here is an edited transcription of a thirteen-page unpublished typescript titled “Heidegger and the Mystical Tradition” by Reiner Schürmann. It dates back to the time following the completion of Schürmann’s book on Meister Eckhart and exhibits the preliminary conception of the former’s famous ‘practical a priori.’ Focusing on the relation between Heidegger’s meditative thinking and a mystical tradition inaugurated by Meister Eckhart, the text retrieves the steps of the latter’s path to Releasement as a practical transformation of (...) existence (Part I). In so doing, it provides a detailed account of Releasement as the condition for a peculiar experience of thinking “in which one fundamental attitude manifests itself throughout an itinerary of human existence and which tends to make this itinerary the very condition for the understanding of truth.” By hinging on Heidegger’s different acceptations of ‘letting-be’—as well as on his verbal understanding of Being as Anwesen (presencing) and Ereignis (appropriation-event)—the text indicates Releasement as the coincidence of Being’s and man’s ways to be and shows how it is in the very “urgency of a new existence and thought” that the proximity between Heidegger and Meister Eckahrt’s mystical tradition comes to the fore. (shrink)