Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

The aim of the present paper is to examine the contribution of evaluative conditioning (EC) to attitude formation theory in social psychology. This aim is pursued on two fronts. First, evaluative conditioning is analysed for its relevance to social psychological research. We show that conditioned attitudes can be acquired through simple co‐occurrences of a neutral and a valenced stimulus. Moreover, we argue that conditioned attitudes are not confined to direct contact with a valenced stimulus, but can be formed and dynamically (...) reformed indirectly, through association chains. Second, social research is examined in an effort to identify evaluative learning mechanisms. We suggest that several important phenomena in social psychology (e.g., ingroup favouritism, prejudice, name letter effect) are at least partly due to simple mechanisms of evaluative learning. The implications for attitude formation theory and for applied settings are discussed. (shrink)

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

The paper argues that colouring is a conventional ingredient of literal meaning characterized by a considerable degree of semantic under-determination and a high degree of context-sensitivity. The positive, though tentative, suggestion made in the paper is that whereas in the case of words such as "but" and "damn" we are dealing with words lacking in specificity, in the case of pejoratives in general, and racist jargon in particular, we are dealing with words that express concepts that purport to describe the (...) world as being in a certain way. The circumstance that in certain contexts of utterance colouring can be cancelled out, does not show that it forms a detachable part of a word's literal meaning. It only shows that to account for the interplay between context, literal meaning and assertoric content is much trickier than meets the eye. (shrink)

In a previous article, we unpacked the so-called “ethics first premise”—the idea that ethics is “prior” to politics when theorizing political legitimacy— that is denied by political realists. We defended a “justificatory” reading of this premise, according to which political justification is irreducibly moral in the sense that moral values are among the values that ground political legitimacy. We called this the “necessity thesis.” In this paper we respond to two challenges that Robert Jubb and Enzo Rossi raise against our (...) proposal. Their first claim is that our argument for the necessity thesis is question begging, since we assume rather than show that freedom and equality are moral values. The second claim is that Bernard Williams’s Basic Legitimacy Demand demonstrates the possibility of giving political legitimacy a non-moral foundation, since it allows for a distinction to be made between politics and sheer domination. We refute both claims. (shrink)

The practice-dependent approach to justice has received a lot of attention in post-millennium political philosophy. It has been developed in different directions and its normative implications have been criticized, but little attention has been directed to the very distinction between practice-dependence and practice-independence and the question of what theoretically differentiates a practice-dependent account from mainstream practice-independent accounts. The core premises of the practice-dependent approach, proponents argue, are meta-normative and methodological. A key feature is the presumption that a concept of justice (...) is dependent on the function or aim of the social practices to which it is supposed to be applied. Closely related to this meta-normative thesis is an interpretive methodology for deriving principles of justice from facts about existing practices, in particular regarding their point and purpose. These two premises, practice-dependent theorists claim, differentiate their account since they are not accepted by practice-independent accounts and they justify different principles of justice than practice-independent accounts. Our aim in this article is to refute both and, demonstrating that practice-independent accounts may indeed accept the meta-normative and methodological premises of the practice-dependent accounts, and that we are given no theoretical reason to think that practice-dependent accounts justify other principles of justice for a practice than do practice-independent accounts. In other words, practice-dependent theorists have not substantiated their claim that practice-dependence is theoretically differentiated from mainstream accounts. When practice-dependent proponents argue for other principles of justice than mainstream theorists, it will be for the usual reason in normative theory: their first-order normative arguments differ. (shrink)

Anomie, a societal and anomia an individual characteristic is employed to understand the behaviour of people and more recently it has been used to explore and understand the moral behaviour of people at work. This article reports on research undertaken to explore the relationship between organisational interest, ethical ideologies, employment, religion and ethnic origin on work and nonwork anomia. An objective of this research was to ascertain whether participants that were not employed had lower levels of work-related anomia than those (...) that were employed. The sample consisted of students (N = 209) enroled in management degrees in a UK university. Results indicate that overall work anomia was statistically significant higher than nonwork anomia. Employment status had a significant effect on levels of nonwork anomia. Religion and ethnic origin were also found to have a significant effect on anomia levels. The findings indicate that the work context may be perceived as inherently anomie and this perception is then adjusted according to the actual experience at work. This may influence ethical behaviour and explain the ethical regression that is identified in the work context. (shrink)

The author investigates the notion of linguistic meaning in gender research. She approaches this basic problem by drawing upon two very different conceptions of language and meaning: that of the logician Gottlob Frege and that of the linguist Ferdinand de Saussure. Motivated by the controversial response the Anglo-American sex/gender debate received within the German context, the author focuses on the connection between this epistemological controversy among feminists and two discursive traditions of linguistic meaning , to show how philosophy of language (...) can contribute to current feminist debates. (shrink)

The central ideas coming out of the so-called pragmatic turn in philosophy have set in motion what may be described as a pragmatic turn in normative political theory. It has become commonplace among political theorists to draw on theories of language and meaning in theorising democracy, pluralism, justice, etc. The aim of this paper is to explore attempts by political theorists to use theories of language and meaning for such normative purposes. Focusing on Wittgenstein's account, it is argued that these (...) attempts are unsuccessful. It is shown that pragmatically influenced political theorists draw faulty epistemological, ontological and semantic conclusions from Wittgenstein's view in their normative theorising, and it is argued that pragmatically influenced theories of language and meaning, however full of insight, cannot be put to substantial normative use in political theory. The general scope of the thesis is motivated by pointing to the general form of the argument and by moving beyond Wittgenstein to other philosophers of mind and language, illustrating how similar overextensions are made with regard to Robert Brandom's theory of language and meaning. (shrink)

The paper deals with the position of a scholar in the society, as articulated in the philosophy of J. G. Fichte. It also offers a brief outline of the philosophies of education of the 18th and 19th centuries and their differences. It shows different interpretations of the concept of Bildung in German philosophy, which in that time became almost a “fashion”. The spirit of that time is reflected also in the idealist views of J. G. Fichte, especially those concerning education, (...) upbringing and personality development. (shrink)

The paper tries to explain the nature and meaning of education, as well as its role in human life. Education appears to be taken for granted. Nevertheless, we need to understand its nature and ontological background. Thus the paper aims at giving at least a partial answer to the question: What is education?

The word 'bisexuality', unknown to the ancients, is used here in two senses to indicate an individual with male and female sex organs or who copulates with people of both sexes. The phenomenon of bisexuality is then analysed with reference to the Greek myth of Hermaphrodite, a 'bisexual' being, born of a nymph's love for a young man of divine descent: in the guise of a fable, the myth recounts the birth of a 'monster', who raises a question-mark over the (...) fundamental rule of the division between the sexes. As regards behaviour, the paper then shows that in both Greece and Rome bisexual behaviour was the rule for men. The concept of 'homosexuality', in contrast to heterosexuality, was not introduced till the Christian era, and then not without difficulty. Condemnation of the practice as 'against nature' began with the emperor Justinian in the 6th century. (shrink)

The paper examines the connection between identity crisis and Charles Taylor’s concept of strong evaluation. The latter is construed as one of the fundamental characteristics of human identity. It is argued that in the absence the ability of strong evaluation a specific form of identity crisis occurs. The main objective of the paper is to show the necessity of strong evaluation for “healthy identity” and for human capability “to cure” the identity already in crisis.

The paper discusses the bearing of Frege′s and Wittgenstein′s interpretations of the Context Principle on the use of proper names. It is argued that the later Wittgenstein, unlike the author of Tractatus, has many interesting things to say concerning the meaning and use of proper names that are not at variance with Frege′s views. If we bear in mind the paramount importance of context in communication we may come to see Frege′s and Wittgenstein′s observations on the fluctuating meaning of proper (...) names from a new perspective. (shrink)

This article examines the relation between the biblical Word and visuality in one of the surviving early thirteenth century manuscripts of the Bible moraliseé, the codex Vindobonensis 2554 today housed in Vienna. The analysis focuses specifically on the relations between word and visuality. The goal is to investigate the vitality that may set the Word into motion. It is argued that the matrix of textual visuality in the Vienna codex 2554 is used as an effective tool that adds vitality to (...) the biblical passages while simultaneously creating a firm hierarchy of representation and resemblances that enforces not only certain norms but also a particular world order in 13th century French society. (shrink)

Ludwik Fleck is remembered for his monograph published in German in 1935. Reissued in 1979 as Genesis and development of a scientific fact Fleck’s monograph has been claimed to expound relativistic views of science. Fleck has also been portrayed as a prominent scientist. The description of his production of a vaccine against typhus during World War II, when imprisoned in Buchenwald, is legendary in the scholarly literature. The claims about Fleck’s scientific achievements have been justified by referring to his numerous (...) publications in international scientific journals. Though frequently mentioned, these publications have scarcely been studied. The present article discusses differences in interpretation and evaluation of science in relation to the background of the interpreters. For this purpose Fleck’s scientific publications have been scrutinized. In conjunction with further sources reflecting the desperate situation at the time in question, the results of the study account for a more restrained picture of Fleck’s scientific accomplishments. Furthermore, based on the review of the latter, certain demands characterizing good science could be articulated. The restricted possibilities of those not trained in science or not possessing field specific knowledge, evaluating science are discussed, as are also formal aspects of scientific papers and questions related to research ethics. (shrink)

If one of the most important aims of education on military ethics is to strengthen moral competence, we argue that it is important to base ethics education on virtue ethics, the Socratic attitude and the process of ?living learning?. This article illustrates this position by means of the example of a ?train the trainer? course on military ethics for Non-Commissioned Officers (NCOs), which is developed at the Netherlands Defence Academy, and uses a number of examples both from its structure and (...) from experiences from its actual use. (shrink)

A previous paper in this Journal, ‘Must Managers Leave Ethics at Home? Economics and Moral Anomie in Organisational Decisions’1 explored the scope for moral decision making in organisations and developed the concept of moral anomie, the absence of moral awareness and judgement in organisational decisions. We suggested that the industrial economy developed within a framework of neoclassical economics and scientific enquiry to the exclusion of ethics. This paper reports on a subsequent exploratory research project in three disparate Australian organisations. It (...) sought to establish whether individuals acting in and for organisations find themselves able to exercise moral autonomy in making organisational decisions or are likely to make morally heteronomous or anomous decisions. (shrink)

Considered by many Taoists and non-Taoists alike to be an essential guide to living, Lao-tzu's Treatise on the Response of the Tao was written by the twelfth-century sage Le Ying-chang. Presenting foundational teachings and practices of the Action and Karma school of Taoism, it is replete with folk stories illustrating the teachings and an introductory essay that discusses the more esoteric meaning of the passages. Told with clarity and depth, these seminal Taoist teachings offer guidance on leading a balanced healthy (...) life. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

As a metaphysical theory, radical ontic structural realism is characterised mainly in terms of the ontological primacy it places on relations and structures, as opposed to the individual relata and objects that inhabit these relations/structures. The most popular criticism of ROSR is that its central thesis is incoherent. Bain attempts to address this criticism by arguing that the mathematical language of category theory allows for a coherent articulation of ROSR’s key thesis. Subsequently, Wüthrich and Lam and Lal and Teh have (...) criticised Bain’s arguments and claimed that category theory fares no better than set theory in coherently articulating the main ideas of ROSR. In this paper, we defend Bain’s main arguments against these critiques, and attempt to elaborate on the sense in which category theory can be seen as providing a coherent articulation of ROSR. We also consider the relationship between ROSR and Categorical Quantum Mechanics. (shrink)

This article explores Southern Saami reindeer herders’ experiences and contestations over state consultation and corporate dialogue during a conflict over the Øyfjellet wind energy project in Norway. Informed by a committed research approach and juxtaposition with findings from Indigenous peoples' territorial struggles in Latin-America, the article provides critical perspectives on governance practices in a Nordic-Saami green colonial context. The research draws on ethnography from a consultation meeting between Jillen Njaarke, the impacted reindeer herding community, and state authorities, as well as (...) diverse written material. The study suggests that the state- and corporate-led “dialogues” displaced the root cause of the conflict, revealed epistemic miscommunication, and perpetuated relations of domination which limited emancipatory effects for Jillen Njaarke. The premises and discourses underpinning the “dialogues” further reproduced racist notions which devalue ancestral Saami reindeer herding knowledges, practices, and landscape relations. These findings challenge dialogue as prescription of good governance and conflict resolution in a context where democracy and compliance with Indigenous peoples’ rights are perceived as high. (shrink)