This volume contains eleven papers – some theoretical, others empirical – given at the 1986 founding meeting of the International Joseph A. Schumpeter Society in Augsburg. By raising questions and offering additional statistical evidence, they further stimulate interest and discussion about the kinds of intuitive ideas that Schumpeter introduced in his seminal period before World War I. Whatever may be the academic mainline trend in economics, two policy-oriented 'disequilibrium' schools have flourished and still thrive: one stresses the need for social (...) redistribution as a counterweight to a negative propensity to unemployment; the other emphasizes the explicit roles of the dynamic entrepreneur, innovation and stressful competition in stimulating economic growth. And while it is possible that the heyday of the demand-side 'age of Keynes' is passing, it also may be true that the time of the supply-side 'age of Schumpeter' is now emerging. (shrink)

This paper draws attention to Foucault’s genealogy of critique. In a series of inquiries, Foucault traced the origins and trajectories of critical practices from the ancient tradition of parrhesia to the enlightenment and the (neo)liberal critique of the state. The paper will elucidate the insights of this history and argue that Foucault’s turn to the genealogy of critique also changed the valence of his theoretical assumptions. Foucault developed a more affirmative practice of genealogy that not only discredits truth claims by (...) tracing them back to their inglorious origins. Rather, he presents a politics of truth as a complex interaction of (governmental) power-knowledge and critique that questions the power effects of truth and rationality. This genealogy of critique contributes to current problematizations of critique by thinkers like Boltanski, Latour and Rancière in highlighting the role of epistemological and technical critique of social rationalization and political reason. (shrink)

Policy‐makers, bioethicists, and patient advocates have been engaged in a fierce battle about the merits and potential harms of a federal right‐to‐try law. This debate about access to investigational medical products has raised profound questions about the limits of patient autonomy, appropriate government regulation, medical paternalism, and political rhetoric. For example, do patients have a right to access investigational therapies, as the right‐to‐try movement asserts? What is government’s proper role in regulating and facilitating access to drugs that are still in (...) development? In this review, we analyze the history of the right‐to‐try movement, review the arguments put forth by supporters and opponents of the legislation, and consider the movement’s consequences. Two possible scenarios may emerge. One is that the right‐to‐try pathway may fail to meaningfully increase patient access to investigational products. Alternatively, certain companies may attempt to rely on the federal right‐to‐try legislation to sell investigational products, taking advantage of the provision that allows for direct costs, as there is currently no clear mechanism for enforcement or monitoring of cost calculations. (shrink)

This article elucidates the spatial order that underpins the politics of the Anthropocene – the ecological nomos of the earth – and criticizes its imperial origins and legacies. It provides a critical reading of Carl Schmitt’s spatial thought to not only illuminate the spatio-political ontology but also the violence and usurpations that characterize the Anthropocene condition. The article first shows how with the emergence of the ecological nomos seemingly ‘natural’ spaces like the biosphere and the atmosphere became politically charged. This (...) challenges the modernist separation between natural facts and political norms. It then underlines the imperial origins of this nomos by introducing the concept of air-appropriation understood as the colonization of atmospheric space by CO2 emissions. Instead of assuming that the ecological nomos represents a transition from a colonial to an ecological and cosmopolitan world order, focusing on air-appropriation highlights forms of ecological imperialism that go along with the new nomos. Accordingly, the article calls for a just redistribution of ecospace that takes into account the imperial legacies and ongoing effects of air-appropriation. (shrink)

Advance directives (ADs) have for some time been championed by ethicists and patient associations alike as a tool that people newly diagnosed with dementia, or prior to onset, may use to ensure that their future care and treatment are organized in accordance with their interests. The idea is that autonomous people, not yet neurologically affected by dementia, can design directives for their future care that caregivers are morally obligated to respect because they have been designed by autonomous individuals. In this (...) paper, we first criticize the idea that ADs can retain moral authority in severe dementia by arguing that it is paradoxical. Second, we consider two arguments that initially seem to refute this critique of ADs, but we eventually dismiss them. The first argument states that ADs retain moral authority in severe dementia because autonomously formed interests, for example, ADs, can only be appropriately discarded by autonomous persons. This we term the historical autonomy argument. We dismiss it by demonstrating how we, in analog cases, are not obligated to continue to respect autonomously formed interests even though they have been discarded under nonappropriate conditions. The second argument is that ADs can be justified by what we term external interests. While we agree that people with severe dementia plausible can be said to have external interests, we show that ADs cannot express such interests and hence cannot be justified by them. We conclude that none of the discussed arguments support the use of ADs and because of this, the idea of ADs should be reassigned. (shrink)

Narratives surrounding ionizing radiation have often minimized radioactivity’s impact on the health of human and non-human animals and the natural environment. Many Cold War research policies, practices, and interpretations drove nuclear technology forward by institutionally obscuring empirical evidence of radiation’s disproportionate and low-dose harm—a legacy we still confront. Women, children, and pregnancy development are particularly sensitive to exposure from radioactivity, suffering more damage per dose than adult males, even down to small doses, making low doses a cornerstone of concern. Evidence (...) of compounding generational damage could indicate increased sensitivity through heritable impact. This essay examines the existing empirical evidence demonstrating these sensitivities, and how research institutions and regulatory authorities have devalued them, willingly sacrificing health in the service of maintaining and expanding nuclear technology. Radiation’s disproportionate impacts should now be the research and policy focus, as society is poised to make crucial and long-lasting decisions regarding climate change mitigation and future energy sources. (shrink)

Research and policymaking on positive mental health and well-being have increased within the last decade, partly fueled by decreasing levels of well-being in the general population and among at-risk groups. However, measurement of well-being often takes place in the absence of reflection on the underlying theoretical conceptualization of well-being. This disguises the fact that different rating scales of well-being often measure very different phenomena because rating scales are based on different philosophical assumptions, which represent radically different foundational views about the (...) nature of well-being. The aim of this paper is to examine the philosophical foundation of the Satisfaction with Life Scale in order to clarify the underlying normative commitments and the psychometric compromises involved in the translation of theory into practice. SWLS is widely used by psychologists, public health professionals, economists, and is popular in national and international surveys of well-being. This paper introduces the philosophical theory of life satisfaction and explores how three central discussions within life satisfaction theory are reflected in the construction of the SWLS; Whether we should be equally satisfied with our past, present and future, Whether we should be satisfied with all the various domains of our lives, and How to avoid the trap of “false consciousness”, i.e. that people fail to recognize the injustice or misfortune of their lives. In the end, life satisfaction theory is contrasted with affective foundational theories of well-being, to explore the magnitude and limits of SWLS as a rating scale based on life satisfaction theory. (shrink)

ABSTRACT In this survey we have investigated the experiences and attitudes of Danish physicians regarding end‐of life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non‐resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made (...) and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self‐determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

Cell morphogenesis encompasses all processes required to establish a three-dimensional cell shape. Cells acquire the architecture specific to their developmental context by using the spatial information provided by internal or external cues. As a response to these signals, cells become reorganized and establish functionally distinct subcellular domains that ultimately lead to morphological changes. In its simplest form, cell morphogenesis results in the establishment of asymmetry along one axis, a cell polarity. Although cell polarity has been studied intensively in budding yeast (...) and epithelial cells, little is known about more complex modes of cell morphogenesis involving multiple axes. In this review we compare the regulation of cell morphogenesis of different genetically well-characterized cell types in Arabidopsis thaliana. BioEssays 20:20–29, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

This article deals with scientific advice to the public where the relevant science is subject to public attention and uncertainty of knowledge. It focuses on a tension in the management and presentation of scientific uncertainty between the uncertain nature of science and the expectation that scientific advisers will provide clear public guidance. In the first part of the paper the tension is illustrated by the presentation of results from a recent interview study with nutrition scientists in Denmark. According to the (...) study, nutrition scientists feel their roles as ‘‘public advisers’’ and ‘‘scientists’’ differ in that the former involves an expectation that they will provide unambiguous advice of the kind that might relegate scientific uncertainty to the background. In the second, more general, part of the paper we provide a normative analysis of different strategies of dealing with the tension. The analysis is structured around the extremes of either total concealment or full openness regarding scientific uncertainty. The result of analysis is that scientific advisers should not simply ‘‘feed’’ scientific conclusions to the public. They should rather attempt to promote the ability and willingness of the public to assess and scrutinize scientific knowledge by displaying uncertainties in the scientific basis of advice. On the other hand, scientific advisers must accommodate the public’s need for guidance. Such guidance should be restricted by careful consideration of what it is relevant for the public to know in order to evaluate scientific advice in practical terms. (shrink)

Abstract.Mandatory risk assessment is intended to reassure concerned citizens and introduce reason into the heated European controversies on genetically modified crops and food. The authors, examining a case of risk assessment of genetically modified oilseed rape, claim that the new European legislation on risk assessment does nothing of the sort and is not likely to present an escape from the international deadlock on the use of genetic modification in agriculture and food production. The new legislation is likely to stimulate the (...) kind of emotive reactions it was intended to prevent. In risk assessment exercises, scientific uncertainty is turned into risk, expressed in facts and figures. Paradoxically, this conveys an impression of certainty, while value-disagreement and conflicts of interest remain hidden below the surface of factuality. Public dialogue and negotiation along these lines are rendered impossible. The only option left to critics is to resort to claims of fear and to call for new risk assessments to be performed, on and on again. Science is allowing itself to be abused by accepting the burden of proof in matters more suited to reflection and negotiation. The specific challenge to science would be to take care of itself – rethinking the role and the limitations of science in a social context, and, thereby gaining the strength to fulfill this role and to enter into dialogue with the rest of society. Scientific communities appear to be obvious candidates for prompting reflection and dialogue on this issue. (shrink)

The parents of Charlie Gard, who was born August 4, 2016, with an exceedingly rare and incurable disease called mitochondrial DNA depletion syndrome, fought a prolonged and heated legal battle to allow him access to experimental treatment that they hoped would prolong his life and to prevent his doctors from withdrawing life-sustaining care. Charlie's clinicians at the Great Ormond Street Hospital in London believed that the brain damage Charlie had suffered as a result of frequent epileptic seizures, along with many (...) other severe disabilities, would render any innovative therapy futile, and they disagreed with his parents’ wishes to use an experimental therapy. They felt it in Charlie's best interest that he be allowed to die. A battle ensued among Charlie's parents, his doctors, and a guardian who had been appointed to represent him that drew the attention of politicians and prominent persons from all over the world. The case was much in the news over the past year, but it has also been frequently misunderstood. (shrink)

In this survey we have investigated the experiences and attitudes of Danish physicians regarding end-of-life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non-resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found (...) acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self-determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

It is difficult to translate the title “Wissen und Glauben” (Knowledge and Faith, see Romans 11:33 and I Corinthians 13:13) into English, because there ist a debate between Kant, Jacobi, Fichte and Hegel behind it. Through Fichtes “Wissenschaftslehre” knowledge has been accepted as the basic element of all scholarship, whereas faith belongs to religion.

It is difficult to translate the title “Wissen und Glauben” into English, because there is a debate between Kant, Jacobi, Fichte and Hegel behind it. Through Fichtes “Wissenschaftslehre” knowledge has been accepted as the basic element of all scholarship, whereas faith belongs to religion.First of all we will show, that knowledge and faith have an independent root. Each can exist by itself whithout the other one. Secondly, we will show how they complement one another. In fact faith can be sufficient (...) for the individual without knowledge. But faith can only achieve its richness and its public effectiveness together with knowledge, the πλήρωμα of faith needs knowledge. Knowledge on the other hand can neither take its depth nor reach its totality without faith. Knowledge that wants to enlighten itself must rely on faith. Faith shows knowledge that it is neither fully founded on man nor can it be fully considered as an image of the universe. On the one hand faith is criticism of self-empowered knowledge, on the other hand it is the way to surpass knowledge and to complete it. (shrink)

Volume 19, Issue 6, June 2019, Page 22-25.

Evolving practice requires peer review of clinical ethics (CE) consultation for quality assessment and improvement. Many institutions have identified the chart note as the basis for this process, but to our knowledge, electronic health record (EHR) systems are not necessarily designed to easily include CE consultation notes. This article provides a framework for the inclusion of CE consultation notes into the formal EHR, describing a developed system in the Epic EHR that allows for the elaborated electronic notation of the CE (...) chart note. The implementation of the “meaningful use” criteria for EHR, mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, requires that health professionals meet certain standards for quality, efficiency, and safety, all of which overlap with the goals of standardization, peer review, and quality improvement within CE consultation. (shrink)

In Western societies scientists are increasingly expected to seek media exposure and cooperate with industry. Little attention has been given to the way such expectations affect the role of scientific experts in society. To investigate scientists’ own perspectives on these issues eight exploratory, in-depth interviews were conducted in Denmark with reputable nutrition scientists. Additionally, eight interviews were held with ‘key informants’ from the field of nutrition policy. It was found that nutrition scientists experience two dilemmas: first, between their aspiration to (...) make a collective impact on public health and the powerful incentives of each to appear frequently in the media with new messages; second, between their need to cooperate with the food industry for financial reasons and their fear that this may compromise their independence and scientific integrity. It is argued that the dilemmas identified in this study should be dealt with openly by the relevant groups of scientists. (shrink)

As more young people feel safe to outwardly identify as transgender or gender expansive (TGE), meaning that their gender identity does not align with the sex they were assigned at birth, an increasing number of youth who identify as TGE seek gender-affirming medical care (GAMC). GAMC raises a number of ethical questions, such as the capacity of a minor to assent or consent, the role of parents or legal guardians in decisions about treatment, and implications for equitable access to care (...) when differing parental or custodial viewpoints are present. These questions are further complicated by the difficulties in explaining the limits of long-term research in GAMC, with regard to the preservation of fertility, for example. We present two de-identified composite case studies to highlight dilemmas that may arise and offer recommendations to better support patient- and family-centered decision making for GAMC. These include employing a multidisciplinUniverary shared decision-making approach, disentangling informed consent and assent from chronological age, developing a consistent approach to the assessment of decisional capacity, and developing age-appropriate informational materials. (shrink)

BackgroundDementia care is essential to promote the well-being of patients but remains a difficult task prone to ethical issues. These issues include questions like whether manipulating a person with dementia is ethically permissible if it promotes her best interest or how to engage with a person who is unwilling to recognize that she has dementia. To help people living with dementia and their carers manage ethical issues in dementia care, we developed the CARE intervention. This is an intervention focused on (...) promoting the ethical self-efficacy of people living with dementia and carers, i.e., their confidence that they can manage ethical issues when they occur. The purpose of this paper is to explain and discuss how we have developed the CARE intervention to promote the ethical self-efficacy of people living with dementia, their family, and professional carers through a specific and, we believe, new use of literary texts.MethodsThe CARE intervention has been developed in two phases: First, we conducted a needs assessment of the occurrence of ethical issues in dementia care and the need for an intervention to support people living with dementia and their carers in managing such issues. Second, in a design phase, we developed the CARE intervention to meet identified needs.ResultsTo address identified ethical issues in dementia care we designed the CARE intervention as a workshop format where people living with dementia and carers can meet, discuss literary texts, and deliberate on how to solve such issues. The workshop is structured by the following elements: An agenda of ethical issues, a collection of literary cases exemplifying ethical issues, a moderator with an understanding of dementia care, and an overview of the ethical principles relevant to the discussion of ethical issues. >This workshop concept is operationalized in three applications tailored to meet the specific ethical issues of each of the study´s three target groups: people living with dementia and family carers, professional and family carers, and professional carers.ConclusionWe conclude the paper by stating that it is possible to develop an intervention that promotes the ethical self-efficacy of people living with dementia and family and professional carers. (shrink)

The U.S. federal government provides two tracks for eligible patients to obtain access outside clinical trials to investigational interventions currently under study for potential clinical benefits: the Food and Drug Administration’s expanded access pathway and the pathway created by the more recent Right to Try Act. In this issue of the Hastings Center Report, with a critical focus on patients, industry, and the research enterprise, Kelly Folkers and colleagues frame the inherent challenges that these pathways are meant to solve and (...) have also inadvertently created. But an additional key focus is how the relevant situations should be managed at the bedside and how the system risks both inefficient and inequitable access to options at the institutional level. Although either pathway could be helpful to patients, the challenges of having the pathways coexist are greater than the sum of their parts. Individual clinicians represent the front line of the regulatory and eligibility challenges of expanded access and right to try, making clinical education a critical component of a comprehensive approach to using them well. But it is medical institutions that must take the lead on supporting access to investigational options in the most equitable and effective manner possible. (shrink)

Inhalt: Vorwort von H.-M. Pawlowski / S. Smid / R. Specht - H.-M. Pawlowski: Probleme der Rechtsbegrundung im Staat der Glaubensfreiheit - V. Gerhardt: Selbstandigkeit und Selbstbestimmung. Freiheit bei Kant und Schelling - H. Folkers: Die durch Freiheit gebaute Stadt Gottes - W. E. Ehrhardt: Mythologie und Offenbarung der Freiheit - W. Bartuschat: Uber Spinozismus und menschliche Freiheit beim fruhen Schelling - C. Cesa: Schellings Kritik des Naturrechts - H. J. Sandkuhler: F. W. J. Schelling - Philosophie als Seinsgeschichte und (...) Anti-Politik - D. Losurdo: Von Louis Philippe bis Louis Bonaparte - R. Pettoello: Die Dialektik der menschlichen Freiheit als Emanzipation und als Abfall von Gott - H. Klenner: Schelling und die Rechtsphilosophie - S. Smid: Freiheit als Keim des Rechts - W. Schmied-Kowarzik: Freiheit - Recht - Geschichte - J. Simon: Die Wirklichkeit der Freiheit (Kant, Schelling, Hegel) - W. Schild: Die verstandlichen Schwierigkeiten des Rechtsdenkens mit dem Freiheitsbegriff - Personenregister. (shrink)

There is a relationship between time and technology which has been obvious since the classical philosophies of time. Even telling the time necessitates technologies relating to measuring and counting. Technological developments have changed the temporal state of our reality. Key terms such as deceleration, synchronisation, prevention and de-temporalisation point to relevant problem areas in this respect. This yearbook, whose thematic focus is 2021, endeavours to reveal new technological and philosophical perspectives on the temporal conditions in which we think, communicate, work (...) and live. With contributions by Cornelius Borck, Stefan Böschen, Christopher Coenen, Olivier Del Fabbro, Andreas Folkers, Yvonne Förster, Alexander Friedrich, Steve Fuller, Gabriele Gramelsberger, Thilo Hagendorff, Thomas Hilgers, Dirk Hommrich, Erich Hörl, Sebastian Lederle, Janne Mende, Jürgen Meutgens, Carl Mitcham, Oliver Müller, Alfred Nordmann, Tom Poljanšek, Maurice Merleau-Ponty, Ludger Schwarte, Astrid Schwarz, René von Schomberg, René Umlauf, Sarine Waltenspül, Bastian Weiß, Langdon Winner and Yongmou Liu. (shrink)