The notion of c̱onsistent e̱xpectations e̱quilibria (CEE) as propagated by Hommes/sorger (1998) is reviewed. Focusing on their example of a chaotic CEE constructed in the context of a cobweb model, it is argued that such an equilibrium is a temporary one. Assuming that an agent-modeled as an individual, versatile in applying the basic tools of linear time-series econometrics-has learned the CEE, I analyze the duration of the time period over which the agent maintains her/his beliefs concerning the perceived law of (...) motion (AR(1)). The analysis based on numerical simulations indicates that the use of techniques rooted in the linear paradigm is sufficient to generate convincing evidence against the underlying perceived law of motion. (shrink)

Although the computational properties of the Region Connection Calculus RCC-8 are well studied, reasoning with RCC-8 entails several representational problems. This includes the problem of representing arbitrary spatial regions in a computational framework, leading to the problem of generating a realization of a consistent set of RCC-8 constraints. A further problem is that RCC-8 performs reasoning about topological space, which does not have a particular dimension. Most applications of spatial reasoning, however, deal with two- or three-dimensional space. Therefore, a consistent (...) set of RCC-8 constraints might not be realizable within the desired dimension. In this paper we address these problems and develop a canonical model of RCC-8 which allows a simple representation of regions with respect to a set of RCC-8 constraints, and, further, enables us to generate realizations in any dimension d = 1. For three-and higher-dimensional space this can also be done for internally connected regions. (shrink)

In the early 1980s the “welfare state crisis” was a point of reference common to many European countries with advanced public social policy arrangements. In most of them the scope of expansion of social expenditure had already been reigned in after the first oil price shock in the mid-1970s. But it was the impact of the second oil price crisis, with low or negative economic growth rates and another steep rise in unemployment in the early 1980s which provided considerable ammunition (...) for critics of the welfare state in many European countries and which triggered off the crisis debate. The latter was particularly pronounced in countries with centre-right and neo-liberal governments at the time and probably most outspoken in the UK. From the start of her first period in office Margaret Thatcher was explicit about her ambition to “roll back the frontiers of the state” and to give much more room for individual and private forms of social protection. In her first election manifesto in 1979 the welfare state was singled out as part of the problem rather than part of the solution to economic and social difficulties which Britain faced at the time. In short, it seems entirely appropriate to take the early 1980s as a starting point and to focus on the UK as the country in which there was arguably more pressure on traditional social policy structures than anywhere else in Europe. (shrink)

Socially assistive devices such as care robots or companions have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. An important part of the ethical evaluation is to understand how users interact with these devices and how interaction influences users’ perceptions and their ability to express themselves. In this review, we report and critically appraise findings of non-comparative empirical studies with regard to these effects from an ethical perspective.Electronic databases and other (...) sources were queried using a comprehensive search strategy generating 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 22 reports on 21 datasets using a non-comparative design a narrative synthesis was performed.Data shows positive findings in regard to attitudes and emotional reactions of users. Varying perception of a social relation and social presence are the most commonly observed traits of interaction. Users struggle with understanding technical complexities while functionality of the devices is limited. This leads to a behavioral alignment of users towards the requirements of the devices to be able to make use of them.This evidence adds to three important ethical debates on the use of socially assistive devices in healthcare in regard to (1) reliability of existing empirical evidence to inform normative judgements, (2) ethical significance of the social presence of devices and (3) user autonomy in regard to behavioral alignment. (shrink)

This paper aims to delineate the class of aesthetic judgments linguistically. The main idea is that aesthetic judgments can be specified by a certain set of assertibility conditions, i.e., by norms that govern appropriate speech-acts. This idea is spelled out in detail and defended against various objections. The suggestion leads to an interesting account of aesthetic judgments that is theoretically fruitful: It provides the basis for a non-circular and satisfying characterization of the whole domain of aesthetic research and it marks (...) an important linguistic difference between aesthetic judgments and judgments of personal taste. (shrink)

In this paper I offer an appraisal of James Bogen and James Woodward’s distinction between data and phenomena which pursues two objectives. First, I aim to clarify the notion of a scientific phenomenon. Such a clarification is required because despite its intuitive plausibility it is not exactly clear how Bogen and Woodward’s distinction has to be understood. I reject one common interpretation of the distinction, endorsed for example by James McAllister and Bruce Glymour, which identifies phenomena with patterns in data (...) sets. Furthermore, I point out that other interpretations of Bogen and Woodward’s distinction do not specify the relationship between phenomena and theories in a satisfying manner. In order to avoid this problem I propose a contextual understanding of scientific phenomena according to which phenomena are states of affairs which play specific roles in scientific practice and to which we adopt a special epistemic attitude. Second, I evaluate the epistemological significance of Bogen and Woodward’s distinction with respect to the debate between scientific realists and constructive empiricists. Contrary to what Bogen and Woodward claim, I argue that the distinction does not provide a convincing argument against constructive empiricism. (shrink)

In the present research, we examine the relation between leader mindfulness and employee performance through the lenses of organizational justice and leader-member relations. We hypothesize that employees of more mindful leaders view their relations as being of higher leader-member exchange quality. We further hypothesize two mediating mechanisms of this relation: increased interpersonal justice and reduced employee stress. In other words, we posit that employees of more mindful leaders feel treated with greater respect and experience less stress. Finally, we predict that (...) LMX quality serves as a mediator linking leader mindfulness to employee performance—defined in terms of both in-role and extra-role performance. Across two field studies of triadic leader-employee-peer data and dyadic leader–employee data, we find support for this sequential mediation model. We discuss implications for theorizing on leadership, organizational justice, business ethics, LMX, and mindfulness, as well as practical implications. (shrink)

Competitive athletes act within cultures of risk in sports and often decide to return to sport despite having acute health problems. The outcomes of such risky return-to-play decisions can not only negatively affect their future health, but also limit their sports performance or even upset their career paths. Following risk-management-decision theory with its focus on active risk defusing, we developed a model for understanding the process of return-to-play decision making from an athlete’s perspective. Based on the method of active information (...) search, a quasi-naturalistic return-to-play decision scenario was created in order to assess amateur team sport athletes’ decision making strategies. The main goals were to identify different information acquisition patterns and to analyze the influence of social pressure to play hurt on decision making. A total of 72 competitive team sport athletes (36 females, 36 males, m= 25.7 years of age, 3rd to 6th league level) out of three disciplines (volleyball, basketball, and handball) participated in the experimental study. Facing the same medical scenario (a partial tear of the supraspinatus tendon), athletes show different approaches to return-to-play decision making. The main focus is on potential sporting consequences of withdrawal from competition due to injury, while only few players favoring well-informed decisions based on thorough risk analysis. The athletes who chose the medically risky alternative to play hurt mostly employed strategies of active risk defusing, which got activated when severe sporting consequences were perceived. Those who chose to withdraw from competition primarily referred to maximin heuristic, particularly when social pressure to play was reduced. The findings can be used to improve rehabilitation. (shrink)

The independence of research is a key strategic issue of modern societies. Dealing with it appropriately poses legal, economic, political, social and cultural problems for society, which have been studied by the corresponding disciplines and are increasingly the subject of reflexive discourses of scientific communities. Unfortunately, problems of independence are usually framed in disciplinary contexts without due consideration of other perspectives’ relevance or possible contributions. To overcome these limitations, we review disciplinary perspectives and findings on the independence of research and (...) identify interdisciplinary prospects that could inform a research programme. (shrink)

In this paper, I argue against the view, most eloquently advocated by Dieter Schönecker, that Kant is what I call a “sensualist intuitionist.” Kant’s text does not accommodate a sensualist intuitionist reading; the fact of reason is cognized by reason, not intuition. I agree with Schönecker that the feeling of respect for the moral law makes us feel its obligatory character, but I disagree that this feeling constitutes cognition of the normative content of the moral law. We do not cognize (...) the validity of the moral law through feeling. I argue instead for what I take to be the standard view: We feel through respect for the moral law the limiting and humiliating effect that rational cognition of the moral law has on our sensibility. (shrink)

A frequent accusation directed at phenomenology and phenomenologically oriented sociology is that of power oblivion. Edmund Husserl’s phenomenologyis accused of not considering the social conditions of the possibility of the doxic experience of the world, and Alfred Schutz’s social phenomenology is blamed for neglecting the social structural preconditions of the experience of everyday reality. Based on this criticism, it is argued that the objectively given power structures, which influence the subjective experience, are not considered in Schutz’s social phenomenological reflections. Bourdieu (...) proclaims that the experience of the social world as being self-evident, as “taken for granted” in Schutz’s words, is taken into consideration without a reference to social conditions such as hierarchies of power. I will reject this reproach by demonstrating the specific potential of Schutz’s theory of the life-world and especially his theory of relevance to conceptualize the phenomenon of power with reference to the subjectivity of the individual actor. The theory of life-world offers a conceptual scheme with a specific capacity to capture theoretically the interrelation of subjective constitution and objective construction of power. (shrink)

Ramsey's critique of Keynes's ‘logical’ approach to probability is widely regarded as decisive, and his own ‘subjective’ approach and SEU framework are now familiar tools in economics. This paper challenges the standard view of Ramsey's critique and assesses the SEU model from a Keynesian viewpoint on probability. It consists of a summary of the two theories and an evaluation of Ramsey's criticisms and alternative. The two main conclusions are that although Keynes yields to Ramsey on the question of the existence (...) of logical probability relations, the formal structure of his theory is compatible with non-objectivist interpretations of probability; and that Ramsey makes far heavier demands on the capacities of the ‘rational agent’ than does Keynes. (shrink)

Traditional approaches to human information processing tend to deal with perception and action planning in isolation, so that an adequate account of the perception-action interface is still missing. On the perceptual side, the dominant cognitive view largely underestimates, and thus fails to account for, the impact of action-related processes on both the processing of perceptual information and on perceptual learning. On the action side, most approaches conceive of action planning as a mere continuation of stimulus processing, thus failing to account (...) for the goal-directedness of even the simplest reaction in an experimental task. We propose a new framework for a more adequate theoretical treatment of perception and action planning, in which perceptual contents and action plans are coded in a common representational medium by feature codes with distal reference. Perceived events (perceptions) and to-be-produced events (actions) are equally represented by integrated, task-tuned networks of feature codes – cognitive structures we call event codes. We give an overview of evidence from a wide variety of empirical domains, such as spatial stimulus-response compatibility, sensorimotor synchronization, and ideomotor action, showing that our main assumptions are well supported by the data. Key Words: action planning; binding; common coding; event coding; feature integration; perception; perception-action interface. (shrink)

Forschungs- und Therapieansätze einer „personalisierten Medizin“ erhalten gegenwärtig große Aufmerksamkeit und Förderung in Forschung, Wirtschaft und Politik und erwecken große Hoffnungen. Auf der Grundlage molekulargenetischer Biomarker soll ein zielgerichtetes, stratifiziertes Vorgehen im Bereich der Prävention, Diagnostik und Therapie erreicht werden. Häufig wird der Begriff „personalisierte Medizin“ als Synonym für medizinischen Fortschritt überhaupt benutzt und eine persönlichere, bessere und kostengünstigere Medizin versprochen. 1) Fortschritte in der genetischen Forschung können nicht mit besseren medizinischen Behandlungsmöglichkeiten für eine Vielzahl von Patienten gleichgesetzt werden. In (...) Wirklichkeit beschränken sich die aktuellen Fortschritte einer an genetischen Biomarkern ausgerichteten Diagnostik und Therapie auf Untergruppen von Patienten. Die Mehrheit der Kranken hat bisher keinen Vorteil. 2) Der Begriff „personalisierte Medizin“ ist unangemessen und irreführend. Vielmehr handelt es sich um eine auf genetischen Biomarkern basierte stratifizierende Medizin und nicht um eine patienten- oder personenzentrierte Medizin. 3) Die sog. „personalisierte Medizin“ ist ein stark forschungs- und industriegetriebener Bereich der Medizin. Globale Stakeholder bestimmen die Entwicklung, unabhängig finanzierte Forschung gibt es kaum. Daher besteht die Gefahr, dass wissenschaftlicher Erkenntnisgewinn durch wirtschaftliche Einzelinteressen behindert wird. Empirische Erfahrungen, z. B. der Preisentwicklung neuer Krebsmedikamente, zeigen, dass das Versprechen der Kostenersparnis jeder Evidenz entbehrt. 4) Die hohen Investitionen in die „personalisierte Medizin“ werfen wichtige ethische Fragen nach Opportunitätskosten und Prioritätensetzungen im öffentlichen Gesundheitswesen auf. Derzeit profitieren wenige Patientengruppen von den hohen Forschungs- und Behandlungskosten der „personalisierten Medizin.“ Gleichzeitig bleiben Forschung und Versorgung in anderen wichtigen medizinischen Bereichen unterfinanziert. Eine öffentliche Debatte über die Prioritäten in medizinischer Forschung und Versorgung sowie darüber, wie diese in demokratischen Gesellschaften und in öffentlichen Gesundheitssystemen umgesetzt werden können, ist erforderlich. Eine an genetischen Biomarkern ausgerichtete sog. „personalisierte Medizin“ führt nicht zu einer persönlicheren Behandlung des einzelnen Patienten und ist von einer personen- oder patientenzentrierten Medizin zu unterscheiden. Von den bisherigen Therapiefortschritten profitieren Untergruppen von Patienten, z. B. in der Onkologie. Für die Mehrheit der Patienten konnten keine Verbesserungen erzielt werden. Für eine Kostenersparnis im Gesundheitswesen fehlt jegliche empirische Evidenz, vielmehr muss nach bisherigen Erfahrungen mit Kostensteigerungen gerechnet werden. (shrink)

Parafoveal preview benefit is an implicit measure of lexical activation in reading. PB has been demonstrated for orthographic and phonological but not for semantically related information in English. In contrast, semantic PB is obtained in German and Chinese. We propose that these language differences reveal differential resource demands and timing of phonological and semantic decoding in different orthographic systems.

BackgroundSocially assistive devices (care robots, companions, smart screen assistants) have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. One of the most prevalent arguments in the debate is the double-benefit argument claiming that socially assistive devices may not only provide benefits for autonomy and well-being of their users but might also be more efficient than other caring practices and might help to mitigate scarce resources in healthcare. Against this background, we (...) used a subset of comparative empirical studies from a comprehensive systematic review on effects and perceptions of human-machine interaction with socially assistive devices to gather and appraise all available evidence supporting this argument from the empirical side.MethodsElectronic databases and additional sources were queried using a comprehensive search strategy which generated 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 39 reports using a comparative study design, a narrative synthesis was performed.ResultsThe data shows positive evidential support to claim that some socially assistive devices (Paro) might be able to contribute to the well-being and autonomy of their users. However, results also indicate that these positive findings may be heavily dependent on the context of use and the population. In addition, we found evidence that socially assistive devices can have negative effects on certain populations. Evidence regarding the claim of efficiency is scarce. Existing results indicate that socially assistive devices can be more effective than standard of care but are far less effective than plush toys or placebo devices.DiscussionWe suggest using the double-benefit argument with great caution as it is not supported by the currently available evidence. The occurrence of potentially negative effects of socially assistive devices requires more research and indicates a more complex ethical calculus than suggested by the double-benefit argument. (shrink)

In a compelling article, Peterson, Karlawish and Largent argue that supported decision-making is preferable to substitute decision-making for people with dynamic impairments. We fully...

Anthony Brueckner argues for a strong connection between the closure and the underdetermination argument for scepticism. Moreover, he claims that both arguments rest on infallibilism: In order to motivate the premises of the arguments, the sceptic has to refer to an infallibility principle. If this were true, fallibilists would be right in not taking the problems posed by these sceptical arguments seriously. As many epistemologists are sympathetic to fallibilism, this would be a very interesting result. However, in this paper I (...) will argue that Brueckner’s claims are wrong: The closure and the underdetermination argument are not as closely related as he assumes and neither rests on infallibilism. Thus even a fallibilist should take these arguments to raise serious problems that must be dealt with somehow. (shrink)

Sentences containing predicates of personal taste (for example, ‘tasty’, ‘funny’) and aesthetic predicates (for example, ‘beautiful’) give rise to an acquaintance inference: They convey the information that speakers have first-hand experience with the object of predication and they can only be uttered appropriately if that is the case. This is surprisingly hard to explain. I will concentrate on aesthetic predicates, and firstly criticize previous attempts to explain the acquaintance phenomena. Second, I will suggest an explanation that rests on a speech (...) act theoretical version of hybrid expressivism, according to which, in uttering ‘X is beautiful’ speakers perform two illocutionary acts simultaneously: an expressive and an assertive one. I will spell out this suggestion in detail and defend it against objections. Considering puzzles related to the acquaintance inference will lead to a new argument for a promising version of hybrid expressivism in meta-aesthetics. (shrink)

Florijn’s analysis of the Dutch Supreme Court ruling on the Albert Heringa case demonstrates that the Dutch approach to justifying physician-assisted death is based primarily on the physician...

The present study examined what participants perceive of their hand movements when using a tool. In the experiments different gains for either the x-axis or the y-axis perturbed the relation between hand movements on a digitizer tablet and cursor movements on a display. As a consequence of the perturbation participants drew circles on the display while their covered hand movements followed either vertical or horizontal ellipses on the digitizer tablet. When asked to evaluate their hand movements, participants were extremely uncertain (...) about their trajectories. By varying the amount of visual feedback, findings indicated that the low awareness of one’s own movements originated mainly from an insufficient quality of the humans’ tactile and proprioceptive system or from an insufficient spatial reconstruction of this information in memory. (shrink)

Zusammenfassung. In der Medizin kommt der Differenzierung in „therapeutische” versus „nicht-therapeutische” Forschung große klinische, ethische und rechtliche Bedeutung zu. Diese Unterscheidung spielt nicht nur in der klinischen Forschungspraxis eine große Rolle, sondern sie findet sich auch in zahlreichen Gesetzen, internationalen Richtlinien und Deklarationen. Der Artikel argumentiert, dass diese Unterscheidung sowohl auf medizinischer (deskriptiver) als auch auf ethischer (normativer) Ebene problematisch ist. Durch theoretische Analyse und anhand eines klinischen Beispieles wird gezeigt, dass Patienten durch den Begriff „therapeutische Forschung” manipuliert werden können. (...) Dadurch wird eine angemessene Nutzen-Risiko-Abwägung im Prozess des Informed Consent erschwert. (shrink)

According to a widespread view, Kant's claim that moral wrongness has its ground in a contradiction underlying every immoral action is a “bluff” rooted in “dogmatic moralism”. Ever since Benjamin Constant's exchange with Kant, counterexamples have played a crucial role in showing why Kant's “universalization procedure” fails to determine the moral validity of our judgments. Despite recent attempts to bring Kant's ethics closer to Aristotle's, these counterexamples have prevailed. Most recently, Jesse Prinz has launched another attack along the same lines. (...) Prinz insists that Kant's universalization procedure fundamentally begs the question and fails to generate plausible results. Even authors who are very sympathetic to Kant, such as Allen Wood, have tried to downplay universalization, focusing instead on other formulations of the categorical imperative. In this paper, I respond directly to four of the most prominent counterexamples. In each case, I aim to show how we can uphold Kant's fundamental claim that the universal law formulation of the categorical imperative articulates the form of our particular moral judgments. (shrink)

Philosophical anthropology is concerned with assumptions about human nature, differential psychology with the empirical investigation of such belief systems. A questionnaire composed of 64 questions concerning brain and consciousness, free will, evolution, meaning of life, belief in God, and theodicy problem was used to gather data from 563 students of psychology at seven universities and from 233 students enrolled in philosophy or the natural sciences. Essential concepts were monism–dualism–complementarity, atheism–agnosticism–deism–theism, attitude toward transcendence–immanence, and self-ratings of religiosity and interest in meaning (...) of life. The response profiles (Menschenbild) of women and men, and of psychology students in the first and midterm of study were very similar. The method of statistical twins indicated a number of differences between students of psychology, philosophy, and the natural sciences. The majority of respondents were convinced that philosophical preconceptions on mind–body and free will have important practical implications for the way in which psychotherapists, physicians, or and judges exercise their professions. (shrink)

A frequent accusation directed at phenomenology and phenomenologically oriented sociology is that of power oblivion. Edmund Husserl’s phenomenology is accused of not considering the social conditions of the possibility of the doxic experience of the world, and Alfred Schutz’s social phenomenology is blamed for neglecting the social structural preconditions of the experience of everyday reality. Based on this criticism, it is argued that the objectively given power structures, which influence the subjective experience, are not considered in Schutz’s social phenomenological reflections. (...) Bourdieu proclaims that the experience of the social world as being self-evident, as “taken for granted” in Schutz’s words, is taken into consideration without a reference to social conditions such as hierarchies of power. I will reject this reproach by demonstrating the specific potential of Schutz’s theory of the life-world and especially his theory of relevance to conceptualize the phenomenon of power with reference to the subjectivity of the individual actor. The theory of life-world offers a conceptual scheme with a specific capacity to capture theoretically the interrelation of subjective constitution and objective construction of power. (shrink)

This paper argues that within the class of aesthetic judgments, interesting variations occur depending on whether the judgment refers to an artwork or not. Additionally, it is suggested that in order to understand and satisfactorily explain these variations, one needs a convincing specification of the notion of “art”. Thus, the main thesis of this paper is that a general theory of aesthetic judgments needs to be supplemented by a convincing and theoretically fruitful theory of art.

The mind body problem is a continuing issue in philosophy. No surveys known to us have been conducted about the actual preferences of, for example, psychology students for particular preconceptions about the mind body relation. These preconceptions may have different practical implications for decisions concerning the object and method of research, the choice of explanatory device for psychological and other research data and for the approach of professionals in practice. A questionnaire comprising ten different preconceptions about the mind body relation (...) and other items was returned by 209 German students of various disciplines and by a second sample of 233 first year psychology students. Identity theory, interactionism and complementarity were preferred most. The students clearly believed that the preference for certain preconceptions has important practical implications. There were no differences between the students of different disciplines in the choice of preferred preconceptions about the mind body relation or in the view that these preconceptions are of practical importance. (shrink)

Forschungs- und Therapieansätze einer „personalisierten Medizin“ erhalten gegenwärtig große Aufmerksamkeit und Förderung in Forschung, Wirtschaft und Politik und erwecken große Hoffnungen. Auf der Grundlage molekulargenetischer Biomarker soll ein zielgerichtetes, stratifiziertes Vorgehen im Bereich der Prävention, Diagnostik und Therapie erreicht werden. Häufig wird der Begriff „personalisierte Medizin“ als Synonym für medizinischen Fortschritt überhaupt benutzt und eine persönlichere, bessere und kostengünstigere Medizin versprochen. 1) Fortschritte in der genetischen Forschung können nicht mit besseren medizinischen Behandlungsmöglichkeiten für eine Vielzahl von Patienten gleichgesetzt werden. In (...) Wirklichkeit beschränken sich die aktuellen Fortschritte einer an genetischen Biomarkern ausgerichteten Diagnostik und Therapie auf Untergruppen von Patienten. Die Mehrheit der Kranken hat bisher keinen Vorteil. 2) Der Begriff „personalisierte Medizin“ ist unangemessen und irreführend. Vielmehr handelt es sich um eine auf genetischen Biomarkern basierte stratifizierende Medizin und nicht um eine patienten- oder personenzentrierte Medizin. 3) Die sog. „personalisierte Medizin“ ist ein stark forschungs- und industriegetriebener Bereich der Medizin. Globale Stakeholder bestimmen die Entwicklung, unabhängig finanzierte Forschung gibt es kaum. Daher besteht die Gefahr, dass wissenschaftlicher Erkenntnisgewinn durch wirtschaftliche Einzelinteressen behindert wird. Empirische Erfahrungen, z. B. der Preisentwicklung neuer Krebsmedikamente, zeigen, dass das Versprechen der Kostenersparnis jeder Evidenz entbehrt. 4) Die hohen Investitionen in die „personalisierte Medizin“ werfen wichtige ethische Fragen nach Opportunitätskosten und Prioritätensetzungen im öffentlichen Gesundheitswesen auf. Derzeit profitieren wenige Patientengruppen von den hohen Forschungs- und Behandlungskosten der „personalisierten Medizin.“ Gleichzeitig bleiben Forschung und Versorgung in anderen wichtigen medizinischen Bereichen unterfinanziert. Eine öffentliche Debatte über die Prioritäten in medizinischer Forschung und Versorgung sowie darüber, wie diese in demokratischen Gesellschaften und in öffentlichen Gesundheitssystemen umgesetzt werden können, ist erforderlich. Eine an genetischen Biomarkern ausgerichtete sog. „personalisierte Medizin“ führt nicht zu einer persönlicheren Behandlung des einzelnen Patienten und ist von einer personen- oder patientenzentrierten Medizin zu unterscheiden. Von den bisherigen Therapiefortschritten profitieren Untergruppen von Patienten, z. B. in der Onkologie. Für die Mehrheit der Patienten konnten keine Verbesserungen erzielt werden. Für eine Kostenersparnis im Gesundheitswesen fehlt jegliche empirische Evidenz, vielmehr muss nach bisherigen Erfahrungen mit Kostensteigerungen gerechnet werden. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"But I Don’t Feel It":Values and Emotions in the Assessment of Competence in Patients With Anorexia NervosaJochen Vollmann (bio)Keywordscompetence assessment, mental capacity, informed consent, psychiatry, anorexia nervosaThe respect of the self-determination of patients obliges physicians to obtain the patient's consent before providing medical treatment. One important condition for a valid informed consent is the patient's competence to make autonomous health care decisions. Therefore, a proper assessment of competence to (...) make health care decisions is crucial particularly in patients with mental disorders (Vollmann 2000; Helmchen and Vollmann 2001). In recent years, several empirical studies on the assessment of competence in patients suffering from different mental disorders have been performed using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T; Grisso and Appelbaum1998). This assessment tool is based on legal standards of competence such as understanding, reasoning, appreciation, and expressing a choice. Since its first publication, the MacCAT-T has been widely accepted as a "gold standard" of competence assessment in the psychiatric literature. In recent years the MacCAT-T has been applied to patients suffering from depression, schizophrenia, dementia, angina pectoris, and normal controls (for overview, see Welie [2001] and Bauer and Vollmann [2002]).Tan and her colleagues (2006) use the MacCAT-T the first time to assess competence to make treatment decisions in patients with anorexia nervosa. Coming from clinical practice, the authors have noticed that the MacCAT-T might not work in this group of patients. Therefore, they use semi-structured interviews in addition to the MacCAT-T to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. They use grounded theory techniques for a qualitative analysis of the data as well as five brief, self-administered questionnaires to ascertain levels of psychopathology.The results of the study show that anorexia nervosa can have complex and variable effects on concentration, beliefs, and thought processing without affecting the ability to perform well on the MacCAT-T. At the same time, participants also report a change in their value system as well as in their personal identity. The authors argue that the results of their studies suggest that the competence to refuse treatment might be compromised in [End Page 289] people with anorexia nervosa in ways that are not captured by the MacCAT-T. This is an interesting finding in patients with anorexia nervosa, because in all other studies with patients suffering from mental disorders such as dementia, depression, and schizophrenia, the MacCAT-T identified more patients as limited in their competence to make health care decisions in comparison with other methods of competence assessment such as clinical judgment (Vollmann et al. 2003). The authors argue on the basis on their qualitative, semistructured interviews that anorexia nervosa–specific difficulties with a thought process and the change of values are missed by the MacCAT-T.Furthermore, Tan and her associated could not find a relationship between the participants' scores on the psychopathological scales, the MacCAT-T scores, and their difficulties expressed during the qualitative interviews, although the small size of the study precludes statistical analysis. In an earlier study, clinical dementia scales but not neuropsychological testing correlated with formal (MacCAT-T) and clinical assessment of competence. Therefore, psychopathological factors might play a different role in different subgroups of patients suffering from different mental problems. However, the idea of an objective neuropsychological model of competence assessment, again, finds no support in the presented empirical data.The qualitative data from patients with anorexia nervosa underline the problem of the cognitive bias of the MacCAT-T assessment and the illusion of value-free categories. It has been argued that the cognitive focus for the MacCAT-T is in itself a normative convention and that the MacCAT-T is missing the complexity of the process to make health care decisions in real life. Therefore, values and emotions should be considered in addition to cognitive functions in assessing competence to make health care decisions (Breden and Vollmann 2004; see also "Mental capacity" 2004). Although many authors agree that the cognitive approach of capacity assessment is important but not sufficient for the assessment of competence to make health care decisions, it remains an... (shrink)

After what has been termed the affective or emotional turn in sociology and many other academic fields, there is still a dearth of methodologies for systematic empirical emotion analysis in sociology. The article addresses this gap and argues that the principles of narrative analysis can be fruitfully extended to the systematic empirical investigation of emotions. A short description of key principles and tools in narrative analysis will serve as the basis for showing how the same concepts can be used to (...) gain access to the emotional side of human experience. To this end the article engages with philosophical debates to develop a specific theoretical notion of emotions—their narrative nature—and discusses the emotional nature of narrative. Specifically, this calls into question any clear-cut distinction between meaning and emotion. Based on this, the text then employs linguistic and some psychological and literary research to demonstrate and systematize key ways in which emotions can be expressed narratively as well as on the level of sentences and words. Together this forms an encompassing methodological framework that can capture the emotionality of human experience in its manifold forms. Specifically, this also addresses the problem of non-conscious emotions. (shrink)

The particularly significant theory of the symbol of Alfred Schutz is based on a combination of the two perspectives of phenomenological individualism and pragmatic realism. This theory on the one hand explains processes of symbolic meaning constitution from a phenomenological viewpoint, specifically following Edmund Husserl. On the other hand it demonstrates the functioning of symbols through pragmatic social action, which is relevant for symbolic reality construction. The paper elaborates both perspectives within the Schutzian theory of the symbol with reference to (...) diverse interpretations of Franz Kafka’s novel The Castle. It outlines the decisive capacity of symbols to overcome and harmonize diverse and often contradictory meanings that are expressed and at the same time united by the symbol itself. (shrink)

Today, avatars often represent users in digital worlds such as in video games or workplace applications. Avatars embody the user and perform their actions in these artificial environments. As a result, users sometimes develop the feeling that their self merges with their avatar. The user realizes that they are the avatar, but the avatar is also the user—meaning that avatar’s appearance, character, and actions also affect their self. In the present paper, we first introduce the event-coding approach of the self (...) and then argue based on the reviewed literature on human-avatar interaction that a self-controlled avatar can lead to avatar-self merging: the user sets their own goals in the virtual environment, plans and executes the avatar’s actions, and compares the predicted with the actual motion outcomes of the avatar. This makes the user feel body ownership and agency over the avatar’s action. Following the event-coding account, avatar-self merging should not be seen as an all-or-nothing process, but rather as a continuous process to which various factors contribute, including successfully taking the perspective of the avatar. Against this background, we discuss affective, cognitive, and visuo-spatial perspective taking of the avatar. As evidence for avatar-self merging, we present findings showing that when users take the avatar’s perspective, they can show spontaneous behavioral tendencies that run counter to their own. (shrink)