There has been a move in medicine towards patient-centred care, leading to more demands from patients for particular therapies and treatments, and for wish-fulfilling medicine: the use of medical services according to the patient's wishes to enhance their subjective functioning, appearance or health. In contrast to conventional medicine, this use of medical services is not needed from a medical point of view. Boundaries in wish-fulfilling medicine are partly set by a physician's decision to fulfil or decline a patient's wish in (...) practice. In order to develop a better understanding of how wish-fulfilling medicine occurs in practice in The Netherlands, a qualitative study (15 semistructured interviews and 1 focus group) was undertaken. The aim was to investigate the range and kind of arguments used by general practitioners and plastic surgeons in wish-fulfilling medicine. These groups represent the public funded realm of medicine as well as privately paid for services. Moreover, GPs and plastic surgeons can both be approached directly by patients in The Netherlands. The physicians studied raised many arguments that were expected: they used patient autonomy, risks and benefits, normality and justice to limit wish-fulfilling medicine. In addition, arguments new to this debate were uncovered, which were frequently used to justify compliance with a patient's request. Such arguments seem familiar from conventional medicine, including empathy, the patient–doctor relationship and reassurance. Moreover, certain arguments that play a significant role in the literature on wish-fulfilling medicine and enhancement were not mentioned, such as concepts of disease and the enhancement–treatment dichotomy and ‘suspect norms’. (shrink)

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Background Massively parallel sequencing techniques, such as whole exome sequencing (WES) and whole genome sequencing (WGS), may reveal unsolicited findings (UFs) unrelated to the diagnostic aim. Such techniques are frequently used for diagnostic purposes in pediatric cases of developmental delay (DD). Yet policy guidelines for informed consent and return of UFs are not well equipped to address specific moral challenges that may arise in these children’s situations. Discussion In previous empirical studies conducted by our research group, we found that it (...) is sometimes uncertain how children with a DD will develop and whether they could come to possess capacities for autonomous decision-making in the future. Parents sometimes felt this brought them into a Catch-22 like situation when confronted with choices about UFs before undergoing WES in trio-analysis (both the parents’ and child’s DNA are sequenced). An important reason for choosing to consent to WES was to gain more insight into how their child might develop. However, to make responsible choices about receiving or declining knowledge of UFs, some idea of their child’s future development of autonomous capacities is needed. This undesirable Catch-22 situation was created by the specific policy configuration in which parents were required to make choices about UFs before being sequencing (trio-analysis). We argue that this finding is relevant for reconfiguring current policies for return of UFs for WES/WGS and propose guidelines that encompass two features. First, the informed consent process ought to be staged. Second, differing guidelines are required for withholding/disclosing a UF in cases of DD appropriate to the level of confidence there is about the child’s future developmental of autonomous capacities. Conclusion When combined with a dynamic consent procedure, these two features of our guidelines could help overcome significant moral challenges that present themselves in the situations of children undergoing genomic sequencing for clarifying a DD. (shrink)

In the context of astrophysical modeling at the solar system scale, we investigate the modalities implied by taking into account different levels of detail at which phenomena can be considered. In particular, by framing the analysis in terms of the how-possibly/how-actually distinction, we address the debated question as to whether the degree of plausibility is tightly linked to the degree of detail. On the grounds of concrete examples, we argue that, also in the astrophysical context examined, this is not necessarily (...) the case. (shrink)

The article discusses the original critical dialectical approach of the Soviet philosopher Valentin F. Asmus. His publications on the heritage of Western philosophical thought in the journal Pod znamenem marksizma are examples of this approach. In the 1920s and 1930s, Asmus published a number of articles analyzing a variety of the ideas developed by Western European philosophers: “An Advocate for Philosophical Intuition (Bergson and His Critique of the Intellect)” (1926); “The Alogism of William James” (1927); “The Dialectics of Necessity and (...) Freedom in Spinoza’s Ethics” (1927); “Kant’s General and Transcendental Logic” (1928); “Cosmogony and Cosmology of Descartes” (1937); “Fichte and the Vocation of Scholar” (1937); “Nicholas of Cusa. Selected Philosophical Works” (1938); and “Tommaso Campanella” (1939). These articles differed from the journal’s usual rhetoric, which was shaped in accordance with the official Soviet state ideology. Asmus, through the thinkers he examined, showed the fundamental importance of philosophy for the human personality. This article argues that Asmus, despite his closeness to dialectical materialism, adapted the official terminology and issues in his historical and philosophical articles in a way that he advanced the human right to spirituality, creative activity, and individual freedom. (shrink)

Long since, people tried to solve the mystery of the way that led to the appearance and propagation of living entities. However, no harmonious understanding of this mystery existed, because neither the scientifically grounded source minerals nor the ambient conditions were proposed and because it was groundlessly taken that the process of living matter origination is endothermal. The Life Origination Hydrate Theory (LOH-Theory) first suggests the chemical way capable of leading from the specified abundant natural minerals to origination of multitudes (...) of multitudes of simplest living entities and gives an original explanation for the phenomena of chirality and racemization delay. The LOH-Theory covers the period up to origination of the genetic code. The LOH-Theory is grounded on the following three discoveries based on the available information and on the results of our experimental works performed using original instrumentation and computer simulations. (1) There is the only one triad of natural minerals applicable for exothermal thermodynamically possible chemical syntheses of simplest living-matter components. (2) N-base, ribose, and phosphdiester radicals and nucleic acids as whole are size-compatible with structural gas-hydrate cavities. (3) The gas-hydrate structure arises around amido-groups in cooled undisturbed systems consisting of water and highly-concentrated functional polymers with amido-groups.The natural conditions and historic periods favorable for simplest living matter origination are revealed. The LOH-Theory is supported by results of observations, biophysical and biochemical experiments, and wide application of original three-dimensional and two-dimensional computer simulations of biochemical structures within gas-hydrate matrix. The instrumentation and procedures for experimental verification of the LOH-Theory are suggested. If future experiments are successful, they, possibly, could be the first step on the way to industrial synthesis of food from minerals, i.e., to execution of the work that is performed by plants. (shrink)

The subject of the study is the cultural code "Rimon", covering phytomorphic symbolic images in the Jewish pictorial semiosis. The object of the study is the traditional symbolism in the pictorial practice of the Jews of the Crimea. The article uses the methods of semantic and semiotic analysis in deciphering the meanings of plant symbols of the pictorial semiosis of the Jews of the Crimea, the method of analysis of previous studies, the method of synthesis in structuring groups of signs. (...) The authors consider the following aspects of the topic: the codes of the pictorial semiosis of the Jews of the Crimea are designated, their morphology, semantics, key meanings and the main code are substantiated. The phytomorphic Rimon code and its features are considered in detail. The main conclusions of the study are: 1. As a result of studying the traditional culture of the Jews of the Crimea, five main codes of the Jewish pictorial semiosis were identified, covering the following groups of symbols: skewomorphic (subject), phytomorphic (plant), zoomorphic (animal), numeric. The source of all codes and the generalizing code is the Sefer code (Book). The interrelationships between the codes, four key meanings – Creation, Paradise, Torah persons and Messianic aspirations are revealed. The semantic center of the code system is defined – the Torah and Aron Hakodesh, as a repository of the Torah. 2. The considered phytomorphic code Rimon is a symbolism of traditional images of plants, the mention of which is found in the Torah, as well as in the Talmud and Midrash. The images of plants in the Jewish reading convey the meanings of human virtues and negative qualities, and also indicate the Messianic hopes laid down in the Torah and especially in the Midrash of the Talmud.The scientific novelty of the study consists in the fact that for the first time a semantic-semantic analysis was carried out and the interrelationships of cultural codes in the pictorial semiosis of the Jews of the Crimea were determined, with an emphasis on the Rimon code. (shrink)

The historical factors as well as the units of the cultural knowledge which are considered to have provided Chateaubriand’s books, and “The Genius of Christianity” in particular, with the success and the content are the subject of the present article. The following historical reasons which attracted the readers’ attention to the book have been defined: the disappointment of the society with the atheistic ideals of the revolution, the need for religious cult restoring, the authorities’ desire to stop strife in the (...) country and build relationships with Catholic Europe. The semantic content of the work also contributed to its popularity because it responded to the request of finding logic in the religion, had an emotional impact and dealt with the relevant issues of the morality by means of the cultural category of sinfulness. Scientific novelty of the research implies the following: the cultural category of sinfulness objectified in F.R. Chateaubriand’s book “The Genius of Christianity” having been analyzed for the first time as well as the author’s approach to the understanding and cultural information streamlining having been identified. More over cultural-historical factors promoting the book’s prominence among Chateaubriand’s contemporaries have been studied. The author’s using rational way while explaining the basis of the sin, resorting to the strict argumentation and the evidence-based methods, denying religious irrationality have been set. The conducted research has shown the key factors leading to the book’s relevance: the society’s necessity of the religion revival, the authorities’ support of this tendency specified by the political environment. (shrink)

El presente artículo tiene como objetivo reconstruir la ética de la resistencia que Nietzsche propone en _El Anticristo _partiendo de la imagen que se ofrece en el prólogo a modo de declaración de intenciones: “preferible _vivir en medio del hielo_”. Dicha ética le exige al individuo la superación de la psicología de la convicción o de la fe y recurre, como método, a la Filología entendida como “_ephexis _en la interpretación”. La apropiación nietzscheana de ese término procedente del pirronismo obliga (...) a medir la utilidad de las enseñanzas escépticas para un individuo que aspira a autorrealizarse, _a llegar a ser el que es_. Con este fin ha de poner entre paréntesis los lugares comunes y asegurarse una posición hermenéutica propia que quiere evitar la_ des-simismación_ y que renuncia, por ello, a implicarse en la rutina democrática de las sociedades modernas. En sintonía con la sensibilidad pirrónica que anima a cultivar la distancia y la indiferencia, se acabará mostrando, en primer lugar, que Nietzsche se dirige exclusivamente a una comunidad de lectores afines y que, en segundo lugar, suspende la vocación política de su propuesta. (shrink)

This paper addresses the question as to whether the methodology followed in building/assessing string theory can be considered scientific in the same sense, say, that the methodology followed in building/assessing the Standard Model of particle physics is scientific, by focussing on the "founding" period of the theory. More precisely, its aim is to argue for a positive answer to the above question – there is no real change of scientific status in the way of proceeding and reasoning in fundamental physical (...) research – in the light of a historical analysis of the early developments of the string theoretical framework. (shrink)

The relevance of symmetry to today's physics is a widely acknowledged fact. A significant part of recent physical inquiry – especially the physics concerned with investigating the fundamentalbuilding blocks of nature – is grounded on symmetry principles andtheir many and far-reaching consequences. But where these symmetries come from and what their real meaning is are open questions, at the center of a developing debate among physicists and philosophers of science. To tackle the problems arising in considering the symmetry issue is (...) the main purpose of this paper. Starting with briefly recalling the bases for the discussion – how symmetry enters and operates in physics, its special effectiveness in the quantum domain and the many relevant functions it performs (Sections 1–3), the paper then focus on the general interpretative questions that arise and the sorts of answers that have been given (Section 4). (shrink)

Da sempre svalutato e marginalizzato dalla riflessione filosofica, il tema della cura č tornato a imporsi all'attenzione, particolarmente all'interno del pensiero femminista. A partire dal testo di Carol Gilligan In a different voice, si č sviluppato un dibattito che coinvolge molti approcci disciplinari. Ciň che tuttavia resta ancora inesplorato č il problema delle motivazioni che stanno a fondamento della relazione di cura. Qui la filosofia puň offrire il suo fondamentale contributo: riabilitare la cura significa ripensare il soggetto, per opporre al (...) paradigma moderno di un soggetto sovrano quello di un soggetto in relazione. La de-rimozione e la valorizzazione della costitutiva vulnerabilitÀ del soggetto consente di fondare l'universalitÀ della cura e di uscire dalla falsa alternativa tra individualismo e altruismo: vale a dire di pensare un soggetto capace di cura in quanto si riconosce a sua volta bisognoso di cura. (shrink)

Recently it has become clear that trafficking of integrins to late endosomes is key to the regulation of integrin expression and function during cell migration. Here we discuss the molecular machinery that dictates whether integrins are sorted to recycling endosomes or are targeted to late endosomes and lysosomes. Integrins and other receptors that are sorted to late endosomes are not necessarily degraded and, under certain circumstances, can be spared destruction and returned to the cell surface to drive cell migration and (...) invasion. We will discuss how the exchange of adhesion receptors and other key regulators of cell migration between late endosomes/lysosomes and the plasma membrane can promote dynamic turnover of adhesions during cell migration. (shrink)

¿Qué significa "fracasar" para un naturalista metodológico? ¿Está éste abocado al escepticismo, y es este un fracaso? Para responder a estas preguntas, realizaré (1) un análisis de lo que se considera "naturalismo" en Hume, desde el que analizaré (2) la crisis escéptica narrada en la conclusión del Libro I del Tratado. Allí defenderé que la metafórica utilizada, engarzada con el concepto de fracaso, permite dos lecturas: una que une necesariamente naturalismo metodológico y escepticismo mitigado, y otra que no. No obstante, (...) concluiré que en ambos casos se dibuja una misma experiencia de límite que permite construir ciencia y filosofía no-excepcionalistas. (shrink)

The article substantiates the possibility of interpreting expertise as a research communicative practice, in contrast to the expert “comparison with the sample”. Inside the so-called examinations, a counter-examination is institutionally integrated. The communication of expert and counter-expert position, which is a phenomenological personality choice, can take a form of personal institutionalized communication, and can be mediated by mediators and media texts. The results of examination and counter-interaction are determined by many factors, among which the coincidence (mismatch) of the images of (...) the future. Communication between a layman and an expert about science-dimensional situations can be considered in prism of various optics – linguistic, sociological, socio-political, psychological optics, fixing a number of several paradoxes (equality, limited choice, excess / deficit). (shrink)

Resumen Hay imágenes poderosas y hay imágenes potentes. Todavía más, hay imágenes potentes que hacen resistencia al poder, que son acto y gesto de resistencia en sí mismas. Entre marzo y agosto del año 2017 la sociedad venezolana vivió uno de los períodos más sensibles de la ya prolongada crisis institucional del país, caracterizada visiblemente por cotidianas protestas de calle duramente reprimidas por las fuerzas de seguridad del Estado, fenómeno que fue nombrado por los medios de comunicación internacionales como la (...) Primavera venezolana o la Rebelión de Abril. En un contexto hipermediatizado por las imágenes recirculadas por las redes sociales digitales y la prensa internacional, principalmente, destacan para mí los trabajos realizados por tres fotógrafos venezolanos: Gabriel Osorio, Vladimir Marcano Sifontes y Gabriel Méndez, cuyas fotografías testimonian experiencias traumáticas colectivas de resistencia al poder político en su propio «aquí y ahora» contingente, y articulan sus reflexiones desde el diálogo con ese otro sin nombre (el venezolano común, anónimo) en imágenes potentes que se tornan gestos de resistencia y migración. (shrink)

The 17th and 18th centuries were the theatre of the fight between two main theories concerning the development of organisms: preformationism (or preformism) and epigeneticism (or epigenesis). According to the first, the formation of new features during organisms’ development can be seen as the result of a mere unfolding of features that were preformed in the sperm, the egg, or the zygote. According to epigeneticism, there is no pre-existing form, and development is a process where genuinely new characters emerge from (...) formless matter. The debate involved naturalists, anatomists, physiologists, microscopists, medical doctors, and philosophers as well. Current developmental biology is, according to some, still inspired (or haunted) by the age-old controversy. The aim of this contribution is twofold. First, to discuss in which guise, if any, the old controversy is still shaping the contemporary debate in biology and philosophy of biology; and, second, to sketch Schelling’s position on that debate, suggesting that it may contain some still valuable philosophical insight. (shrink)

A brief introduction to the physics and philosophy of symmetry breaking.

In this paper I introduce the concept of biodiversity by means of its peculiar story and defend the importance of biodiversity as an autonomous object of scientific enquiry (Sections 1 and 2). I then discuss two difficulties, (i) the lack of an agreed definition and (ii) the elusiveness of the notion of biodiversity. While I argue that (i) is a problem that can be handled, I suggest that (ii) follows from the vagueness of the concept of diversity and its cognate (...) kind (Sections 3 and 4). Yet, the notion of kind, connecting biodiversity to taxonomy, indicates the path to follow in order to explore what biodiversity is, even though it is a way full of hurdles to overcome (Sections 5 and 6). (shrink)

This article introduces a different insight on the role of leadership in the process to develop sustainability and achieve lasting improvement in quality of life. Authors bring together the societal, organizational and individual levels of sustainability in one conceptual framework and discuss the interconnectedness among these three levels. The conclusion is that an effective approach to sustainability starts from the inside, i.e. from the individual level. This implies a decisive role for personal leadership in the change path towards sustainability. It (...) brings new challenges and responsibilities for higher education in the preparation of a new generation of managers and leaders who can think and act from a sustainability perspective. (shrink)

Though research on sustainable tour operating practices is increasing, its focus is mainly on large tour operators. Moreover, most research is geographically limited to Europe. Literature on inbound tour operators (ITOs) based in destination countries such as Africa is almost non-existent. In an effort to reduce the gap on literature available on sustainable tour operating in third world destinations, this research focuses on ITOs in Kenya. Its aim is to identify gaps between attitudes, intentions and behavior towards sustainable tourism of (...) ITOs in Kenya and shade some light on how these gaps can be addressed. A dedicated questionnaire survey was developed for this research and sent out to 300 ITOs in Kenya. Moreover, 10 in-depth interviews were held. This paper describes the background of the research, both from a scholarly and management perspective, and the developed research instruments. During the IABS 2011 conference full results will be presented. (shrink)

Global mental health in a changing world -- Contemporary humanitarianism -- Humanitarian ethics -- Professional and personal challenges in humanitarian work -- Managing ethical challenges in global mental health -- Aspirational guidance : principles of humanitarian assistance -- Operational guidance : IASC guidelines -- Ethical dilemmas : damned if you do and damned if you don't -- Ethically questionable practices -- Safety imperative and self-care -- Values-based ethical framework and core competencies in global mental health -- Ethical considerations for refugee (...) mental health providers in the United States -- Conclusion and future directions. (shrink)

The ‘Greek Crisis’ in Europe: Race, Class and Politics offers a critical comparative account of Greek ‘economic crisis’ narratives in Greek, German and Danish mainstream news Media. Building on a m...