Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Autobiographical memory is a specific kind of memory concerning events and issues related to yourself. Your conception of your own life involves narratives in which all of yours experiences are interrelated. Autobiographical memory connects your present self with your past experiences (that’s why it’s important for theories about continuity of self). In this article I will analyse autobiographical texts of French philosopher Jean-Jacques Rousseau in the context of autobiographical memory theories.

This collection of essays on themes in the work of John Locke , George Berkeley , and David Hume , provides a deepened understanding of major issues raised in the Empiricist tradition. In exploring their shared belief in the experiential nature of mental constructs, The Empiricists illuminates the different methodologies of these great Enlightenment philosophers and introduces students to important metaphysical and epistemological issues including the theory of ideas, personal identity, and skepticism. It will be especially useful in courses devoted (...) to the history of modern philosophy. (shrink)

Sur une suggestion de David Halperin, John Winkler, professeur à Yale puis à Stanford, rassembla, l’année de sa mort (1990), des études datées de 1981/1989, pour la plupart inédites. Leur convergence autorisait un livre sur l’éthique sexuelle grecque dans une approche sémiotique et anthropologique des pratiques sociales, se démarquant de l’histoire intellectuelle, comme de celles des idées et des mentalités, et du New Historicism des années 1980. À partir d’« observations informelles du compo...

Boris Hessen’s ‘The Social and Economic Roots of Newton’s Principia’ (see https://doi.org./10.1163/1569206X-00002041) is considered a pioneering work in the historiography of the natural sciences. For some, it marks the founding moment of the ‘externalist’ approach to this field of study. Previously, Hessen published another paper on Newton entitled ‘Preface to Articles by A. Einstein and J.J. Thomson’, which, some maintain, bears a stronger resemblance to works in the ‘internalist’ camp of the historiography of the natural sciences. For decades, scholars have (...) puzzled over why Hessen chose to argue for, seemingly, diametrically opposed positions. In this paper, however, I argue that Hessen does not advance two different historiographical methods, but a single, dialectical-materialist approach that accounts for the ‘unity in opposition’ of the external and internal dimensions of natural-scientific theory. I draw from Hessen’s two papers on Newton, his previously untranslated writings, as well as selections from the secondary literature. (shrink)

The aim of the article is to use J.-P. Sartre’s reflections to show the influence of memory and imagination on the formation of an individual’s life history. The first part of the work consist of philosophical analyses. The imaginations are analyzed here compared to the perceptions and memories. The second part is devoted to autobiography, inseparably connected with the first-person perspective. The philosopher's different creative and intellectual activities and the wide range of material his works contain allow us to expose (...) the discussed issues in a diverse and complementary way. (shrink)

When John Winkler died in 1990, he was working on a book that aimed at a wide-ranging reinterpretation of Greek tragedy as a pedagogical exercise aimed primarily at the city’s young men (“ephebes,”...

Near the end of his Euboean Discourse, Dio attacks prostitution because it encourages men to seek sexual pleasure from other sources as well, including youths from noble households. While some scholars find no evidence in this diatribe for Dio's revulsion against male-male sexual relations per se, others conclude that it does indeed reflect Dio's contempt for all sexual relations between men. This study considers afresh Dio's treatments of sexual relations between men in his Discourses, and concludes that Dio may endorse (...) both male-male and male-female sexual relations when the agent initiating sexual contact pursues philia and eunoia. On the other hand, Dio expresses his disgust when the agent uses sexual relations self-indulgently for pleasure. The content and form of his arguments illustrate his familiarity with both Stoic doctrine and the forms of popular moralizing discourse. The paper first examines Dio's remarks in the third Discourse on Kingship, where he praises sexual relations in a measured way, indicating his familiarity with Stoic teachings on eros. Second, it considers Dio's remarks in the Euboean Discourse and supports John Winkler's argument that Dio objects to prostitution because it is rooted in self-indulgent pleasure-seeking. Dio's rhetorical approach reflects his awareness of popular teachings against self-indulgence typical of Cynic-Stoic diatribe. Third, the essay argues that Dio's remarks in the First Tarsian oration condemn adult male sexual passivity, not all aspects of sexual relations between males. Fourth, brief remarks in his Borystheniticus are not to be taken as evidence for Dio's hostility to sexual relations between men, though they possibly indicate his discomfort with how he imagines non-Greeks engage in sex. (shrink)

For decades scholars thought they knew Hume's position on the existence of causes and objects he was a sceptic. However, this received view has been thrown into question by the `new readings of Hume as a sceptical realist. For philosophers, students of philosophy and others interested in theories of causation and their history, The New Hume Debate is the first book to fully document the most influential contemporary readings of Hume's work. Throughout, the volume brings the debate beyond textual issues (...) in Hume to contemporary philosophical issues concerning causation and knowledge of the external world and issues in the history of philosophy, offering the reader a model for scholarly debate. This revised paperback edition includes three new chapters by Janet Broughton, Peter Kail and Peter Millican. Contributors: Kenneth A. Richman, Barry Stroud, Galen Strawson, Kenneth P. Winkler, John P. Wright, Simon Blackburn, Edward Craig, Martin Bell, Daniel Flage, Anne Jaap Jacobson, Rupert Read, Janet Broughton, Peter Millican, Peter Kail. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Emotional Responding Is to Blame It Might Not Be to ResponsibilityR. J. R. Blair (bio)Keywordsblame, responsibility, emotional responses, psychopathyIn this interesting paper, Levy argues that by failing the moral/conventional distinction task (Blair 1995), individuals with psychopathy show a fundamental inability to categorize moral harms and as such their moral responsibility for their actions is reduced. He argues that, although we might still wish to incarcerate such individuals to (...) prevent them inflicting further harm on others, we should be less enthusiastic to blame them for their actions.In many respects, I agree with much of Levy's treatise. I certainly do not regard ascriptions of blame as useful in my own work with this population. I believe that our goal should be to fully understand the nature of their emotional deficit to be able to treat it similarly to other researchers who work to treat other emotional disorders. To me, Levy's argument appears sound.However, I offer three considerations and raise questions within these considerations that might further the debate. First, not all rules involve care-based emotional responses to victims. As Levy notes, this is the origin of the moral/conventional distinction. The problem here is that we do consider someone responsible if they break a conventional transgression. The student talking in class is generally considered blameworthy for this action as long as they knew that the rule of not talking during the lesson applied to that classroom. Yet, there is no victim and no care-based emotional response. Here, the only thing necessary to ascribe blame and responsibility is that the individual knew that a rule exists. Given this holds for conventional transgressions, why must we necessarily make a special case, with respect to responsibility, for moral transgressions?I believe that Levy is fully aware of this concern. He specifically makes reference to moral responsibility and writes that:the kind and degree of wrongness, and therefore blame, which attaches to infringements of the rules [against double parking or line-jumping] is very different, and usually much less significant, than the kind and degree attaching to moral wrongs. For psychopaths, all offences are merely conventional, and therefore—from their point of view—none of them are all that serious.(2007, p. 132)But the danger here is that issues of blame and responsibility may become highly relativistic and hinge on the strength of the emotional reaction. This is a problem because, although we might judge someone as more blameworthy if he intentionally [End Page 149] runs over five people rather than one, do we really consider that there is a distinction in moral responsibility between these two cases? If not, might not responsibility relate to factual knowledge of the existence of the rule against the transgression rather than the emotional response to the transgression?Second, there is considerable debate regarding whether psychopathy represents a taxon or a continuum (e.g., Vasey et al. 2005; Edens et al. 2006). Assuming it does represent a continuum, then we have an additional concern. How little of an emotional response to the transgression reduces one's moral responsibility and blame? Is it only the very reduced (although usually not absent) levels of emotional response that are shown by individuals with psychopathy? Or should we consider moral responsibility and blame proportional to the level of the emotional response? If this latter option is adopted, then what should we do about individuals who show heightened emotional responses, for example, patients with specific anxiety disorders (Rauch, Shin, and Wright 2003)? There are already some data that inhibited children (a developmental precursor to some anxiety disorders; Kagan and Snidman 1999) show heightened conscience development (Asendorpf and Nunner-Winkler 1992). If such children commit moral transgressions, should we regard them as more morally responsible and more blameworthy than regular folks?Third, the issue of intention received little attention in this paper. I have been considered to show a similar lack of attention to intention in the past (Nichols 2002) and, moreover, in some respects the issue was of limited concern given Levy's main goals. However, I mention it because so much of whether we consider someone responsible for their actions and... (shrink)

Tomemos el camino iniciado por Ricœur, quien, de la mano de Aristóteles, reconoce en el Mythos, en la trama, la estructura lingüística más conveniente para decir aquello en lo que consiste “devenir un sí mismo”. ¿Caben relatos que digan más pertinentemente qué es un sí mismo? La aparición, cada vez más insistente, de otros modos de narrar ―extraños y peculiares por su falta de estructura y por su condición de narraciones decepcionantes― cuestionan que la trama sea el modo narrativo que (...) más le pertenece a la identidad personal. Tal sería el caso de P. Handke, J. Winkler, H. Müller, T. Bernhard, C. Lispector, E. Jelinek, D. Kis o W.G Sebald. Entonces cabría la posibilidad de relatarnos no ya para sostenernos, para apacentarnos con viento ―en palabras de Sánchez Ferlosio― sino para decir más verdaderamente lo que somos: ruido y furia. «Es significativo que la relación que aquí se aprecia entre nuestra lectora y la literatura sea tan radicalmente filosófica. La lectora ha escrito un texto en el que destellan los aspectos más nodales del pensar contemporáneo, que en su realidad no deja de ser clásico. No se trata de que haya escudriñado asuntos filosóficos en los textos literarios, es que lo que resulta filosófico es su propia lectura, su mirada, su consideración, porque trata a los textos como la literatura se trata a sí misma». (shrink)

Pars 1. Contemplativa -- Pars 2. Activa.

There is some complementarity of models for the origin of the electroencephalogram (EEG) and neural network models for information storage in brainlike systems. From the EEG models of Freeman, of Nunez, and of the authors' group we argue that the wavelike processes revealed in the EEG exhibit linear and near-equilibrium dynamics at macroscopic scale, despite extremely nonlinear – probably chaotic – dynamics at microscopic scale. Simulations of cortical neuronal interactions at global and microscopic scales are then presented. The simulations depend (...) on anatomical and physiological estimates of synaptic densities, coupling symmetries, synaptic gain, dendritic time constants, and axonal delays. It is shown that the frequency content, wave velocities, frequency/wavenumber spectra and response to cortical activation of the electrocorticogram (ECoG) can be reproduced by a “lumped” simulation treating small cortical areas as single-function units. The corresponding cellular neural network simulation has properties that include those of attractor neural networks proposed by Amit and by Parisi. Within the simulations at both scales, sharp transitions occur between low and high cell firing rates. These transitions may form a basis for neural interactions across scale. To maintain overall cortical dynamics in the normal low firing-rate range, interactions between the cortex and the subcortical systems are required to prevent runaway global excitation. Thus, the interaction of cortex and subcortex via corticostriatal and related pathways may partly regulate global dynamics by a principle analogous to adiabatic control of artificial neural networks. (shrink)

Chapter Introduction. Syntactic focus theory and the phenomenon of secondary predication The primary goal of this monograph is to examine the interaction of ...

The development of theories of global cortical dynamics, using linear wave theory, owes much to the pioneering work of Nunez. His work leads to clear predictions on relations of brain size, axonal conduction velocity, and the frequencies of the cerebral rhythms. These predictions do not appear to be fulfilled, but their falsification constrains the range of parameters applicable in further formulations.

Freeman's pioneering work -- and neurodynamics in general -- has largely ignored specification of an anatomical framework within which features of coherent objects are represented, associated, deleted, and manipulated in computations. Recent theoretical work suggests such a framework can emerge during embryogenesis by selection of neuron ensembles and synaptic connections that maximize the magnitude of synchrony while approaching ultra-small-world connectivity. The emergent structures correspond to those of both columnar and non-columnar cortex. With initial connections thus organized, spatio-temporal information in sensory (...) inputs can generate systematic and specific patterns of synchronous oscillation, with consequent synaptic storage. The theoretical assemblies of connections resemble experimentally observed 'lego sets', while facilitation and interference among synchronous patterns, particularly when executed by fast synapses under metabolic entanglement, imply powerful parallel computation. (shrink)

Mit dem vorliegenden Buch wird eine erkenntnistheoretische Fundierung f r eine empirische Rechtswissenschaft und f r eine ihr ad quate Methode angeboten. Im Mittelpunkt steht eine grundlegende Untersuchung des Verh ltnisses von Sein und Sollen. Veranschaulicht durch eine kritische Auseinandersetzung mit den tragenden Gedanken der reinen Rechtslehre Hans Kelsens und mit ihrem geistesgeschichtlichen Hintergrund, dem bisher noch keine geb hrende Beachtung zuteil geworden ist, entwickelt der Verfasser theoretische Grundpositionen f r eine dem positiven Recht und seiner sozial-kulturellen Erheblichkeit angemessene Rechtserkenntnislehre (...) und Rechtstheorie. Diese gr nden sich auf die transzendentale Logik Immanuel Kants. Der Verfasser, Doyen der sterreichischen Staatsrechtslehre und Leitfigur vieler Juristengenerationen, legt mit diesem Buch das Ergebnis seiner jahrzehntelangen Befassung mit Fragen der Rechtstheorie und der Rechtserkenntnislehre vor. Er kommt zum Ergebnis, da die Rechtswissenschaft die Verkn pfung von Sein und Sollen in Rechtserzeugung, Rechtsbestand und Rechtsverwirklichung erkenntnistheoretisch, rechtstheoretisch und methodologisch beachten mu, will sie das Recht als ein komplexes Kulturph nomen gegenstandsgerecht begreifen. Eine rein normative Rechtslehre versperrt den erkenntnism igen Zugang zum Wesen des positiven Rechts, das nicht nur als ein formales Sollen, sondern auch als eine seinsgebundene wert- und zweckhafte Sinneinheit in Form und Inhalt erkannt, beschrieben, erkl rt, verstehend gedeutet und seinen Eigenarten gem dargestellt werden mu. (shrink)

Befahigung ist in den letzten Jahrzehnten zu einem zentralen Begriff sowohl in der politischen Philosophie als auch in der Sozialpolitik geworden. Was damit gemeint ist, ist freilich umstritten. Der Band versucht, die Bedeutungsgehalte des Befahigungsbegriffs und daruber seine Leistungsfahigkeit fur die sozialphilosophische und die politische Diskussion zu klaren. Dabei bleibt die Autorin nicht bei der Beschaftigung mit dem Capabilities Approach nach Martha Nussbaum und Amartya Sen stehen, sondern analysiert vor allem die Rezeptionen des Befahigungsansatzes und zwar speziell im Bereich der (...) theologischen Ethik. Als zentrales Problem sowohl des Capabilities Approach als auch der theologischen Ethik wird deren Liberalismusfahigkeit herausgearbeitet. Eine Auseinandersetzung daruber, wie und ob mit dem Befahigungskonzept sozialethisch ein "liberales Minimum", durch das die Freiheit jedes und jeder einzelnen gewahrleistet werden kann, ist das Ergebnis der Untersuchung. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:ST. THOMAS ON ANGELIC TIME AND MOTION J. J. MACINTOSH University ofCalgary Calgary, Alberta, Canada A. THOMAS'S STANDARD DOCTRINE: THE NEED FOR ASINGLE TIME. T HERE IS an under-discussed problem about time for St. Thomas. Most discussions of his views on time center around either the question of God's foreknowledge or around the notions of eternity and aeviternity. Even those discussions which deal directly with Thomas's views on time (...) ignore the issue I wish to discuss here.' The problem is this: St. Thomas held both that there is a single time, created by God, and that there are three distinct times: two for the angels, and one for the rest of creation. Moreover, he seems, fairly explicitly, to have been unwilling to adopt either of the obvious ways out of this apparent contradiction. Thomas believed, and often said, that time is unitary, and typically offered an Aristotelian reason for the claim: "the true reason why time is one, is to be found in the oneness of the first movement by which, since it is most simple, all other movements are measured. Therefore time is referred to that movement, not only as a measure is to the thing measured, but also as accident 1 See, for example, Piero Ariotti, "Celestial reductionism of time: on the scholastic conception of time from Albert the great and Thomas Aquinas to the end of the 16th century," Studia Internationale Filosofia 4 (1972): 91-120, and Antonio Moreno, "Time and Relativity: Some Philosophical Considerations," The Thomist 45 (1981): 62-79. I have referred to this problem earlier in "Time and St. Thomas" (in To Myselffrom Others, ed. David Miller [Warwick: University of Warwick, 1989)), and in "Aquinas, Ockham, and Prior (and the unexpected examination),'' Auckland Philosophy Papers, no. 1 (1990). 547 548 J. J. MACINTOSH is to subject; and thus receives unity from it."2 Moreover, such a doctrine is necessary if what he tells us about the foreknowledge of God, and God's inability to change the past,3 not to mention his views on the knowledge that angels and demons have of what is genuinely future, is to be correct. Briefly, those views commit him to a view of a single time that is linear past, and is nonbranching future as well.4 There is some exegetical question as to whether or not his views on time, contingency, and freedom led him to adopt a truth-gap account of genuinely future tense contingent propositions, but that the singleness of time is required has not been questioned.5 This is not the place to deal with the difficulties Aquinas faced concerning God's foreknowledge, but a brief introductory word is in order to show how central the singleness of time is for his thought in this area. Since all past- and present-tense truths have necessity per accidens (that is, they concern matters which are now irrevocable), the class of contingent truths is a proper subset of genuinely future-tense claims. A proper subset because 2 Summa Theologiae, I, q. 10, a. 6 c (hereafter cited as sn; English translation by the Fathers of the English Dominican Province, 5 vols., (1920; reprint, Westminster, Maryland: Christian Classics, 1981). This is the translation I have standardly used, sometimes with slight changes, but I have also made use of the translation by the Blackfriars (61 vols. [London: Blackfriars, in conjunction with Eyre and Spottiswood, 1964-81], hereafter cited as Blackfriars). 3 Thus, for example, "God can make the existence of an angel not future; but He cannot cause him not to be while he is, or not to have been, after he has been" (ST I, q. 10, a. 5, ad 3). 4 By contrast, Ockham, for example, adopted an implicit tense logic with branching future possibilities. As far as I know, no mediaeval thinker allowed branching pasts. For a discussion of that possibility, see John Mackie, Truth, Probability and Paradox: Studies in Philosophical Logic (Oxford: Clarendon Press, 1973). For a helpful general discussion of the issues involved, see R. Thomason, "Combinations of Tense and Modality," in D. Gabbay and D. Guenthner, eds., Handbook of Philosophical Logic, 3 vols. (Dordrecht: D. Reidel, 1984), 2... (shrink)