The contribution describes a case report addressed in 2011 by the clinical ethics consultation service team of the Institute of Bioethics and Medical Humanities at the “Agostino Gemelli” School of Medicine of the Università Cattolica del Sacro Cuore, Rome. The clinical case regards ethical dilemmas about the patient’s prospects for receiving an orthotopic liver transplant, because she was a non-resident and lacked a caregiver to assist her during the follow-up period, as well as a place to stay after liver transplant (...) surgery. DOI: 10.5294/pebi.2016.20.1.7. (shrink)

“HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value” (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration (...) of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA. (shrink)

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake reference to the following (...) fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice. (shrink)

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

El artículo analiza cómo la revista Medicina e Morale ha afrontado en su historia el tema de la ética en la experimentación clínica, que representa una parte muy amplia y compleja de la bioética y también de la deontología médica. Los aspectos que esta temática comprende son ya numerosos y la literatura producida ingentísima. La ética de la experimentación ha recibido particular impulso y atención a continuación de diversas experimentaciones no éticas que han turbado profundamente la opinión pública y hecho (...) necesario una fuerte reconsideración en el ámbito de la investigación clínica. En general, de los años 60's a los años 80's del siglo XX, ha prevalecido en la literatura un intenso empeño e interés en la elaboración de los principios de referencia y en la reflexión teórica relativa a varias cuestiones . De los años 90 en adelante se ha en cambio intensificado -probablemente por las exigencias nacidas en seno de los Comités de ética que precisamente en aquel período han iniciado a difundirse masivamentela elaboración de códigos, reglamentos, líneas-guía que han orientado el desarrollo de la disciplina más en sentido de procedimiento y con un acercamiento ético-deontológico. En particular, Medicina e Morale, ha estado siempre en estas temáticas, desde los inicios de su historia, constituyendo una voz original en el debate, además que un instrumento de difusión de documentos nacionales y sobre todo internacionales. La Revista ha representado, sobre todo en los últimos treinta años, un verdadero punto de referencia a nivel nacional y en algunos casos también internacional, proponiendo a veces orientaciones originales, que han sido luego acogidas en el ámbito de líneas-guía y de normativas.The article deals with how the journal Medicina e Morale has faced ethics in clinical trials, which represents a very large and complex bioethical issue, but also deontological one. This area comprises many questions and the literature is huge. It has risen after unethical clinical trials that have shocked the public and have produced a big rethinking about it. In general, from the '60s to the '80s of the XXth century, an intense commitment and interest have prevailed on the elaboration of the reference principies and on theoretical reflection on various issues, such as informed consent, the ethical significance of clinical research, the protection of vulnerable people, the risk acceptability). Since the '90s onwards the development of codes, regulations, guidelines -that have guided the development of the discipline in a procedural and also deontological sense- has increased, probably due to the large diffusion of ethics committees. Particularly, the journal "Medicina e Morale" has always been present on these issues, since the beginning of its history, creating an original voice in the debate, as well as a dissemination tool of national and especially international documentabon. The journal has been, especially in the last thirty years, a real national, and sometimes international, be nchmark, offering original suggestions which are then accepted in guidelines and regulations. (shrink)

Kant’s critique/doctrine distinction tracks the difference between a canon for the understanding’s proper use and an organon for its dialectical misuse. The latter reflects the dogmatic use of reason to attain a doctrine of knowledge with no antecedent critique. In the 1790s, Fichte collapses Kant’s distinction and redefines dogmatism. He argues that deriving a canon is essentially dialectical and thus yields an organon: critical idealism is properly a doctrine of science or Wissenschaftslehre. Criticism is furthermore said to refute dogmatism, by (...) which Fichte means Spinozism. Schelling repudiates Fichte’s position in his Philosophical Letters by reviving Kant’s distinction. First, ‘critique’ for Schelling names a canon that is valid for all systems—including Spinozism—and thus favours none—not even the Wissenschaftslehre. Second, Schelling coins ‘dogmaticism’ to refer to what Kant calls ‘dogmatism’: reason’s uncritical claim to doctrine. Hence, he says all systems—even Fichte’s—are susceptible to the ‘enthusiasm’ of mistaking themselves for doctrines or ‘objects of knowledge’, instead of subjectively valid ‘objects of freedom’. I reconstruct Schelling’s argument for reviving Kant’s distinction, while noting two consequences for German idealism. First, if criticism favours no system, a system’s origin cannot be an act of knowledge, e.g., intellectual intuition, but only an act of endorsement. Second, if dogmaticism entails enthusiasm, a system’s goal cannot be absolute knowledge, but only infinite striving. Hence, by retrieving Schelling’s notion of dogmaticism, we can both gain a better understanding of the Letters and register the impact of a core Kantian distinction on the German idealist project. (shrink)

This book presents G. A. Cohen's Gifford Lectures, delivered at the University of Edinburgh in 1996. Focusing on Marxism and Rawlsian liberalism, Cohen draws a connection between these thought systems and the choices that shape a person's life. In the case of Marxism, the relevant life is his own: a communist upbringing in the 1940s in Montreal, which induced a belief in a strongly socialist egalitarian doctrine. The narrative of Cohen's reckoning with that inheritance develops through a series of sophisticated (...) engagements with the central questions of social and political philosophy. In the case of Rawlsian doctrine, Cohen looks to people's lives in general. He argues that egalitarian justice is not only, as Rawlsian liberalism teaches, a matter of rules that define the structure of society, but also a matter of personal attitude and choice. Personal attitude and choice are, moreover, the stuff of which social structure itself is made. Those truths have not informed political philosophy as much as they should, and Cohen's focus on them brings political philosophy closer to moral philosophy, and to the Judeo-Christian ethical tradition, than it has recently been. (shrink)

A highly original reading of Immanuel Kant that demonstrates his interest in the social realm of human interaction.

Containing selected papers on the fundamentals and applications of Complexity Science, this multi-disciplinary book presents new approaches for resolving complex issues that cannot be resolved using conventional mathematical or software models. Complex Systems problems can occur in a variety of areas such as physical sciences and engineering, the economy, the environment, humanities and social and political sciences. Complexity Science problems, the science of open systems consisting of large numbers of diverse components engaged in rich interaction, can occur in a variety (...) of areas such as physical sciences and engineering, the economy, the environment, humanities and social and political sciences. The global behaviour of these systems emerges from the interaction of constituent components and is unpredictable but not random. The key attribute of Complex Systems is the ability to self-organise and adapt to unpredictable changes in their environment. (shrink)

A leading figure in neuroaesthetics makes the case that aesthetic experience can be meaningfully measured by the tools of neuroscience.

G.E. Moore, more than either Bertrand Russell or Ludwig Wittgenstein, was chiefly responsible for the rise of the analytic method in twentieth-century philosophy. This selection of his writings shows Moore at his very best. The classic essays are crucial to major philosophical debates that still resonate today. Amongst those included are: * A Defense of Common Sense * Certainty * Sense-Data * External and Internal Relations * Hume's Theory Explained * Is Existence a Predicate? * Proof of an External World (...) In addition, this collection also contains the key early papers in which Moore signals his break with idealism, and three important previously unpublished papers from his later work which illustrate his relationship with Wittgenstein. (shrink)

Fichte assigns ‘intellectual intuition’ a new meaning after Kant. But in 1799, his doctrine of intellectual intuition is publicly deemed indefensible by Kant and nihilistic by Jacobi. I propose to defend Fichte’s doctrine against these charges, leaving aside whether it captures what he calls the ‘spirit’ of transcendental idealism. I do so by articulating three problems that motivate Fichte’s redirection of intellectual intuition from being to acting: (1) the regress problem, which states that reflecting on empirical facts of consciousness leads (...) only to further facts and so cannot yield a first principle; (2) the rhapsody problem, which states that the categories form a haphazard set and so lack necessity unless they derive from a first principle; and (3) the nihilism problem, which states that a first principle cannot lie outside our cognition of it, lest it be the cause of our cognition and, being first, the cause of all our actions, reducing us to machines. Crucially, Fichte’s three motivating problems are in fact aspects of a single problem. Leaving any aspect unsolved spoils putative solutions to the other two. Consequently, Fichte requires a single unified solution to all three, which his doctrine of intellectual intuition provides. (shrink)

This chapter contains section titled: I II III IV V VI VII VIII IX X XI XII Coda Appendix Acknowledgements.

A model for the ideal state includes discussions of the nature and application of justice, the role of the philosopher in society, the goals of education, and the effects of art upon character.

This essay challenges the widely accepted principle that a person is morally responsible for what he has done only if he could have done otherwise. The author considers situations in which there are sufficient conditions for a certain choice or action to be performed by someone, So that it is impossible for the person to choose or to do otherwise, But in which these conditions do not in any way bring it about that the person chooses or acts as he (...) does. In such situations the person may well be morally responsible for what he chooses or does despite his inability to choose or to do otherwise. Finally the author considers certain suggestions for revising the principle he rejects or for replacing it with a principle of an altogether different kind. (shrink)

There is growing interest in the use of neurointerventions to reduce the risk that criminal offenders will reoffend. Commentators have raised several ethical concerns regarding this practice. One prominent concern is that, when imposed without the offender’s valid consent, neurointerventions might infringe offenders’ right to bodily integrity. While it is commonly held that we possess a moral right to bodily integrity, the extent to which this right would protect against such neurointerventions is as-yet unclear. In this paper, we will assess (...) whether, why, and how severely three forms of neurointervention might infringe the right to bodily integrity. We show that the severity of the infringement of the right to bodily integrity differs across different forms of neurointervention. Moreover, we argue that mental and behavioral effects of neurointerventions could in some cases be relevant to determining the severity of infringements of the right to bodily integrity. (shrink)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

In the Vocation of Man, Fichte makes the striking claim that life is eternal, rational, our true being, and the final cause of nature in general and of death in particular. How can we make sense of this claim? I argue that the public lectures that compose the Vocation are a popular expression of Fichte’s pre-existing commitment to what I call immortalism, the view that life is the unconditioned condition of intelligibility. Casting the I as an absolutely self-active or living (...) power enables his philosophical account of both the intelligibility of objects and of what it means to die. This explains his characterization of the Wissenschaftslehre as a system in which ‘all is act, movement, and life’. In Sect. 1, I explain the context of Jacobi’s use of ‘caput mortuum’ as a term for the thing in itself. In Sects. 2 and 3, I reconstruct two immortalist arguments from Fichte’s Jena period. The first is that the I’s self-activity rules out the existence of the thing in itself and thereby vanquishes ‘death’s head’. The second is that, insofar as the I charges us with the moral perfection of nature, it is the final cause of our entire life, including its end. This is to say that the I puts our every moment into question, even our last. In Sect. 4, I use these immortalist arguments to interpret the striking claim from the Vocation. (shrink)

In the field of health technology assessment, there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the strength and weaknesses of these approaches when they are applied in practice. In this paper, we analyse the applicability of some selected approaches for addressing ethical issues in HTA in the field of complex health interventions. Complex health interventions have been the focus of methodological attention in HTA. However, the (...) potential methodological challenges for ethical analysis are as yet unknown.Six of the most frequently described and applied ethical approaches in HTA were critically assessed against a set of five characteristics of complex health interventions: multiple and changing perspectives, indeterminate phenomena, uncertain causality, unpredictable outcomes, and ethical complexity. The assessments are based on literature and the authors’ experiences of developing, applying and assessing the approaches.The Interactive, participatory HTA approach is by its nature and flexibility, applicable across most complexity characteristics. Wide Reflective Equilibrium is also flexible and its openness to different perspectives makes it better suited for complex health interventions than more rigid conventional approaches, such as Principlism and Casuistry. Approaches developed for HTA purposes are fairly applicable for complex health interventions, which one could expect because they include various ethical perspectives, such as the HTA Core Model® and the Socratic approach.This study shows how the applicability for addressing ethical issues in HTA of complex health interventions differs between the selected ethical approaches. Knowledge about these differences may be helpful when choosing and applying an approach for ethical analyses in HTA. We believe that the study contributes to increasing awareness and interest of the ethical aspects of complex health interventions in general. (shrink)

Philosophy of Tsong-kha-pa Blo-bzang-grags-pa's Lam rim chen mo.

Conference proceedings on Mongolian contributions to Buddhist knowledge.

This paper looks at what David Kaplan's work on indexicals can teach us about logic and the philosophy of logic, and also what Kaplan's logic (i.e. the Logic of Demonstratives) can teach us about indexicals. The lessons are i) that logical consequence is not necessary truth-preservation, ii) that that the linguistic doctrine of necessary truth (also called conventionalism about modality) fails, and iii) that there is a kind of barrier to entailment between non-context-sensitive and context-sensitive claims.

Throughout his career, Schelling assigns knowledge of the absolute first principle of philosophy to intellectual intuition. Schelling's doctrine of intellectual intuition raises two important questions for interpreters. First, given that his doctrine undergoes several changes before and after his identity philosophy, to what extent can he be said to “hold onto” the same “sense” of it by the 1830s, as he claims? Second, given that his doctrine of intellectual intuition restricts absolute idealism to what he calls a “science of reason”, (...) which he says cannot prove the absolute’s existence, what other doctrine does he require in order to prove this? I will answer these questions by tracing the shifts in Schelling’s doctrine of intellectual intuition from the 1790s to the 1830s and drawing out its evolving methodological role within his science of intelligibility. (shrink)

Modern science faces a series of problems that undermine confidence in its reliability. To solve these problems, we must reflect on what makes science work and what leads it astray. This book is about Science, its strengths and weaknesses. The papers that scientists write form a vast resource of evidence and theory that is doubling about every ten years, along with the number of scientists. The size of this resource makes it hard for it to be used effectively by scientists, (...) and along with this are growing concerns about its integrity and reliability. This book looks at the scientific method, as currently applied and as understood philosophically by scientists, the social structure of science, and the structure of scientific communication through journals. It includes case studies of controversies, and looks at how fields develop over time. (shrink)

The concept of facticity denotes conditions of experience whose necessity is not logical yet whose contingency is not empirical. Although often associated with Heidegger, Fichte coins ‘facticity’ in his Berlin period to refer to the conclusion of Kant’s metaphysical deduction of the categories, which he argues leaves it a contingent matter that we have the conditions of experience that we do. Such rhapsodic or factical conditions, he argues, must follow necessarily, independent of empirical givenness, from the I through a process (...) of ‘genesis.’ I reconstruct Fichte’s argument by tracing the origin of his neologism, presenting his Jena critique of Kant’s rhapsodic appeal to the forms of judgment, and illustrating the Jena period’s continuity with the Berlin period’s genetic method, while noting a methodological shift whereby Fichte directs his critique against his own doctrine of intellectual intuition in order to eliminate its ‘factical terms.’. (shrink)

Fichte argues that the conclusion of Kant’s transcendental deduction of the categories is correct yet lacks a crucial premise, given Kant’s admission that the metaphysical deduction locates an arbitrary origin for the categories. Fichte provides the missing premise by employing a new method: a genetic deduction of the categories from a first principle. Since Fichte claims to articulate the same view as Kant in a different, it is crucial to grasp genetic deduction in relation to the sorts of deduction that (...) Kant offers. I propose to interpret genetic deduction as the simultaneous fulfillment of two tasks: answering the question quid facti by deriving the categories from the I and answering the question quid juris by establishing our entitlement to the categories as conditions of experience. While the second task represents Fichte’s agreement with Kant’s transcendental deduction, the first reflects his correction of Kant’s metaphysical deduction. (shrink)

A precursor to the hard problem of consciousness confronts nihilism. Like physicalism, nihilism collides with the first-personal fact of what perception and action are like. Unless this problem is solved, nature’s inclusion of conscious experience will remain, as Chalmers warns the physicalist, an “unanswered question” and, as Jacobi chides the nihilist, “completely inexplicable". One advantage of Kant’s Copernican turn is to dismiss the question that imposes this hard problem. We need not ask how nature is accompanied by the first-person standpoint (...) because “I think” is an apperceptive form of thinking that must be able to accompany any cognition of nature. Kant’s formal conception of apperception worries Fichte in his Nova Methodo lectures. This conception arguably cannot exhaust the ground of experience, for it does not show why we posit objects “at all". For Fichte, it is our agency that first opens a world of objects, viz., as subjects, means, ends, and obstacles. In what follows, I argue that, for Fichte, the I poses no hard problem because it collides exclusively with nihilistic views like Spinozism, which are refuted by a properly transcendental idealist conception of apperception, according to which the first-person standpoint is the absolute ground of our experience of nature. If transcendental idealism refutes nihilism, nature is no more explicable than that there is something it is like for me to perceive and act. In Section 1, I show why Kantian apperception is necessary for possible experience. In Section 2, I reconstruct Fichte’s argument that a modified conception of apperception refutes guises of nihilism, thereby solving the hard problem of consciousness. In Section 3, I suggest that transcendental idealism undermines Chalmers’ proposed solution to and Dennett’s dismissal of this problem. (shrink)

In the Freedom essay, Schelling charges that (1) idealism fails to grasp human freedom’s distinctiveness and that (2) this failure undermines idealism's attempt to refute pantheism, as exemplified by Spinoza. This raises two questions, which I will answer in turn: what, for Schelling, is distinctive of human freedom; and how does the idealists’ failure to grasp it render them unable to refute pantheism? To answer these questions, I will reconstruct Schelling’s argument that freedom has the distinctness of being the unconditioned (...) condition of the world’s intelligibility. My reconstruction will illustrate how Schelling’s notion of freedom as primal will grounds the alleged primacy of practical reason as Kant and Fichte conceive it. I will then consider three objections to Schelling’s argument. Throughout, I will develop the Schellingian idea that freedom is enacted in an unprethinkable decision that cannot be anticipated by any law or principle. (shrink)

Книга адресована любителям истории, а также всем, кто считает, что истории является главным богатством как отдельным народов, так и всего человечества.

Адресовано курсантам и слушателям образовательных учреждений, учебных центров, центров дополнительной подготовки, курсов повышения квалификации системы МВД Российской Федерации.

Foucault’s remarks concerning psychoanalysis are ambivalent and even prima facie contra-dictory, at times lauding Freud and Lacan as anti-humanists, at others being severely criti-cal of their imbrication within psychiatric power. This has allowed a profusion of interpretations of his position, between so-called ‘Freudo-Foucauldians’ at one extreme and Foucauldians who condemn psychoanalysis as such at the other. In this article, I begin by surveying Foucault’s biographical and theoretical relationship to psychoanalysis and the sec-ondary scholarship on this relationship to date. I pay (...) particular attention to the discussion of the relationship in feminist scholarship and queer theory, and that by psychoanalytic thinkers, as well as attending to the particular focus in the secondary literature on Fou-cault’s late work and his relationship to the figure of Jacques Lacan. I conclude that Fou-cault’s attitude to psychoanalysis varies with context, and that some of his criticisms of psychoanalysis in part reflect an ignorance of the variety of psychoanalytic thought, partic-ularly in its Lacanian form. I thus argue that Foucault sometimes tended to overestimate the extent of the incompatibility of his approach with psychoanalytic ones and that there is ultimately no serious incompatibility there. Rather, psychoanalysis represents a substantively different mode of inquiry to Foucault’s work, which is neither straightforwardly ex-clusive nor inclusive of psychoanalytic insights. (shrink)