Nanomaterials have attracted much interest in the medical field and related applications as their distinct properties in the nanorange enable new and improved diagnosis and therapies. Owing to these properties and their potential interactions with the human body and the environment, the impact of nanomaterials on humans and their potential toxicity have been regarded a very significant issue. Consequently, nanomaterials are the subject of a wide range of cutting-edge research efforts in the medical and related fields to thoroughly probe their (...) potential beneficial utilizations and their more negative effects. We posit that the lack of standardization in the field is a serious shortcoming as it has led to the establishment of methods and results that do not ensure sufficient consistency and thus in our view can possibly result in research outputs that are not as robust as they should be. The main aim of this article is to present how NanoDiaRA, a large FP7 European multidisciplinary project that seeks to investigate and develop nanotechnology-based diagnostic systems, has developed and implemented robust, standardized methods to support research practices involving the engineering and manipulation of nanomaterials. First, to contextualize this research, an overview of the measures defined by different regulatory bodies concerning nanosafety is presented. Although these authorities have been very active in the past several years, many questions remain unanswered in our view. Second, a number of national and international projects that attempted to ensure more reliable exchanges of methods and results are discussed. However, the frequent lack of publication of procedures and protocols in research can often be a hindrance for sharing those good practices. Subsequently, the efforts made through NanoDiaRA to introduce standardized methods and techniques to support the development and utilization of nanomaterials are discussed in depth. A series of semi-structured interviews were conducted with the partners of this project, and the interviews were analyzed thematically to highlight the determined efforts of the researchers to standardize their methods. Finally, some recommendations are made toward the setting up of well-defined methods to support the high-quality work of collaborative nanoparticle-based research and development projects and to enhance standardization processes. (shrink)

"Hannah Arendt war der schwierigste Film, den ich je gemacht habe", sagt Margarethe von Trotta. Die grosse Denkerin Hannah Arendt fühlte sich.

Between 1819 and 1832 Friedrich Schleiermacher was giving lectures on the life of Jesus at the University of Berlin. The following article includes two partial editions, which document the introductory parts of the lectures from 1819/20 and 1829/30. Both are based on manuscripts written by Schleiermacher’s listeners. Especially to explore the development of Schleiermacher’s conceptual considerations this two partial editions should be a useful addition to the new critical edition of Schleiermacher’s Vorlesungen über das Leben Jesu published in 2018 by (...) Walter Jaeschke (KGA II/15). (shrink)

When analysing and evaluating discourse, the discourse itself, the speech event and the activity type it represents, forces the analyst to search for a theoretical and methodological framework which is suitable for analysing the activity exposed in the data. Interactive political argumentation demands both a theory of argumentation and a theory of spoken language to fully grasp what is going on in the discourse. The pragma-dialectical argumentation theory offers both analytical and evaluative tools, but rests upon a reconstruction of the (...) argumentative discourse which is hierarchical and static. If applied to interactive argumentation this kind of reconstruction will not reveal interactive aspects of the parties' argumentation. On the other hand, conversation analysis, which concentrates on interactive aspects of the discourse, does not offer a tool for the evaluation of the quality of each party's argumentation. (shrink)

This paper defends the view that in a certain sense evidence is normative. Neither a bit of evidence nor the fact that it is evidence for a certain proposition is a normative fact, but it is still the case that evidence provides normative reason for belief. An argument for the main thesis will be presented. It will rely on evidentialist norms of belief and a Broomean conception of normative reasons. Two important objections will be discussed, one from A. Steglich-Petersen on (...) whether having evidence is sufficient for having a normative reason for belief and another one from S. Street. (shrink)

How can we draw the line between health and disease? This crucial question of demarcation has immense practical implications and has troubled scholars for ages. The question will be addressed in three steps. First, I will present an important contribution by Rogers and Walker who argue forcefully that no line can be drawn between health and disease. However, a closer analysis of their argument reveals that a line-drawing problem for disease-related features does not necessarily imply a line-drawing problem for disease (...) as such. The second step analyzes some alternative approaches to drawing the line between health and disease. While these approaches do not provide full answers to the question, they indicate that the line-drawing question should not be dismissed too hastily. The third step investigates whether the line-drawing problem can find its solution in the concept of suffering. In particular, I investigate whether returning to the origin of medicine, with the primary and ultimate goal of reducing suffering, may provide sources of demarcation between health and disease. In fact, the reason why we pay attention to particular phenomena as characteristics of disease, consider certain processes to be relevant, and specific functions are classified as dys-functions, is that they are related to suffering. Accordingly, using suffering as a criterion of demarcation between health and disease may hinder a wide range of challenges with modern medicine, such as unwarranted expansion of disease, overdiagnosis, overtreatment, and medicalization. (shrink)

This article investigates five kinds of vagueness in medicine: disciplinary, ontological, conceptual, epistemic, and vagueness with respect to descriptive-prescriptive connections. First, medicine is a discipline with unclear borders, as it builds on a wide range of other disciplines and subjects. Second, medicine deals with many indistinct phenomena resulting in borderline cases. Third, medicine uses a variety of vague concepts, making it unclear which situations, conditions, and processes that fall under them. Fourth, medicine is based on and produces uncertain knowledge and (...) evidence. Fifth, vagueness emerges in medicine as a result of a wide range of fact-value-interactions. The various kinds of vagueness in medicine can explain many of the basic challenges of modern medicine, such as overdiagnosis, underdiagnosis, and medicalization. Even more, it illustrates how complex and challenging the field of medicine is, but also how important contributions from the philosophy can be for the practice of medicine. By clarifying and, where possible, reducing or limiting vagueness, philosophy can help improving care. Reducing the various types of vagueness can improve clinical decision-making, informing individuals, and health policy making. (shrink)

This paper will critically engage with Daniel Buckley's argument against “evidential minimalism” (EM), i.e., the claim that necessarily, bits of evidence (are or) provide epistemic reasons for belief. Buckley argues that in some cases, a subject has strong evidence that p (and fulfills further minimal conditions), does not believe p, but nevertheless is not epistemically criticizable and has no epistemic reason to believe p. I will defend EM by pointing out that Buckley's argument trades on an ambiguity between a strong (...) and a weak notion of criticizability. (shrink)

It is a commonly held belief among many psychological scientists that the more plausible a hypothesis, the better it is scientifically. It is also often believed that if there are two alternative theories which are equally strong in terms of explanatory power, one should choose the plausible theory over the implausible one. The goal of this article is to challenge these assumptions. Based on Popper's philosophical views, it will be argued that psychological scientists should be encouraged to formulate implausible hypotheses (...) and theories. Examples from other scientific disciplines will be presented to illustrate this argument. 2012 APA, all rights reserved). (shrink)

The objective of this article is to analyse the value-ladenness of technology in the context of medicine. To address this issue several characteristics of technology are investigated: i) its interventive capacity, ii) its expansiveness and iii) its influence on the concept of disease, iv) its generalising character, v) its independence of the subjective experience of the patient. By this analysis I hope to unveil the double face of technology: Technology has a Janus-face in modern medicine, and the opposite of its (...) factual face is evaluative. (shrink)

This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as “a field of study following specific and well-established methodological rules” bioethics is not a specific discipline as there are no explicit “well-established methodological rules.” The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological rules within subdisciplines or for specific tasks. As this does not appear to be the case, the article examines whether (...) bioethics’ adherence to specific quality criteria (instead of methodological rules) or pursuing of a common goal can make it qualify as a discipline. Unfortunately, the result is negative. Then, the article scrutinizes whether referring to bioethics institutions and professional qualifications can ascertain bioethics as a discipline. However, this makes the definition of bioethics circular. The article ends by admitting that bioethics can qualify as a discipline according to broader definitions of discipline, for example, as an “area of knowledge, research and education.” However, this would reduce bioethics’ potential for demarcation and identity-building. Thus, to consolidate the discipline of bioethics and increase its impact, we should explicate and elaborate on its methodology. (shrink)

Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the very (...) uncomfortable conclusion that disease involves transformative experiences in ways that can reduce people’s rational decision-making ability and undermine the basic principle of respect for autonomy and the moral rule of informed consent. While such cases are limited, they are crucial for medical ethics and health policy and deserve more attention and further scrutiny. (shrink)

Between 1819 and 1832 Friedrich Schleiermacher was giving lectures on the life of Jesus at the University of Berlin. The following article includes two partial editions, which document the introductory parts of the lectures from 1819/20 and 1829/30. Both are based on manuscripts written by Schleiermacher’s listeners. Especially to explore the development of Schleiermacher’s conceptual considerations this two partial editions should be a useful addition to the new critical edition of Schleiermacher’s Vorlesungen über das Leben Jesu published in 2018 by (...) Walter Jaeschke (KGA II/15). (shrink)

Medicalization is frequently defined as a process by which some non-medical aspects of human life become to be considered as medical problems. Overdiagnosis, on the other hand, is most often defined as diagnosing a biomedical condition that in the absence of testing would not cause symptoms or death in the person’s lifetime. Medicalization and overdiagnosis are related concepts as both expand the extension of the concept of disease. They are both often used normatively to critique unwarranted or contested expansion of (...) medicine and to address health services that are considered to be unnecessary, futile, or even harmful. However, there are important differences between the concepts, as not all cases of overdiagnosis are medicalizations and not all cases of medicalizations are overdiagnosis. The objective of this article is to clarify the differences between medicalization and overdiagnosis. It will demonstrate how the subject matter of medicalization traditionally has been non-medical (social or cultural everyday life) phenomena, while the subject matter of overdiagnosis has been biological or biomolecular conditions or processes acknowledged being potentially harmful. They also refer to different types of uncertainty: medicalization is concerned with indeterminacy, while overdiagnosis is concerned with lack of prognostic knowledge. Medicalization is dealing with sickness (sick role) while overdiagnosis with disease. Despite these differences, medicalization and overdiagnosis are becoming more alike. Medicalization is expanding, encompassing the more “technical” aspects of overdiagnosis, while overdiagnosis is becoming more ideologized. Moreover, with new trends in modern medicine, such as P4 (preventive, predictive, personal, and participatory) medicine, medicalization will become all-encompassing, while overdiagnosis more or less may dissolve. In the end they may converge in some total “iatrogenization.” In doing so, the concepts may lose their precision and critical sting. (shrink)

I sit on the edge of the bed of my youngest daughter and read the fairy tale of the Three Billy Goats Gruff. My little four-year-old daughter has heard this story thousands of times and simply loves it. In my eagerness to create a good story and a good setting I add some personal description to the story. Then she who is thrilled with the story makes a strange face and corrects my telling: “No, mama, it is not like that. (...) You have to tell the truth”. Indo-Pacific Journal of Phenomenology , Volume 11, Edition 1 May 2011, 59-67. (shrink)

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

This paper defends the view that in a certain sense evidence is normative. Neither a bit of evidence nor the fact that it is evidence for a certain proposition is a normative fact, but it is still the case that evidence provides normative reason for belief. An argument for the main thesis will be presented. It will rely on evidentialist norms of belief and a Broomean conception of normative reasons. Two important objections will be discussed, one from A. Steglich-Petersen on (...) whether having evidence is sufficient for having a normative reason for belief and another one from S. Street. (shrink)

In business as elsewhere, “ugly people” are treated worse than ”pretty people.” Why is this so? This article investigates the ethics of aesthetic injustice by addressing four questions: 1. What is aesthetic injustice? 2. How does aesthetic injustice play out? 3. What are the characteristics that make people being treated unjustly? 4. Why is unattractiveness (considered to be) bad? Aesthetic injustice is defined as unfair treatment of persons due to their appearance as perceived or assessed by others. It is plays (...) out in a variety of harms, ranging from killing (genocide), torture, violence, exclusion (social or physical), discrimination, stigmatization, epistemic injustice, harassment, pay inequity, bullying, alienation, misrecognition, stereotyping, and to prejudice. The characteristics that make people treated unjustly are (lack of) attractiveness, averageness, proportion, and homogeneity. Furthermore, prejudice, psychological biases, logical fallacies, and unwarranted fear of disease are some reasons why unattractiveness is (considered to be) bad. In sum, this study synthesizes insights from a wide range of research and draws attention to aesthetic injustice as a generic term for a form of injustice that deserves more systematic attention. Having a definition, description, and explanation of the concept makes it easier to target the problems with aesthetic injustice. As the business world is an arena of ubiquitous aesthetic injustice business ethics can take the lead in identifying, explaining, and addressing the problem. (shrink)

Ratio, Volume 34, Issue 4, Page 277-285, December 2021.

According to the so-called metaphysical conception of analyticity, analytic truths are true in virtue of meaning (or content) alone and independently of (extralinguistic) facts. Quine and Boghossian have tried to present a conclusive argument against the metaphysical conception of analyticity. In effect, they tried to show that the metaphysical conception inevitably leads into a highly implausible view about the truthmakers of analytic truths. We would like to show that their argument fails, since it relies on an ambiguity of the notion (...) of 'independence of (extralinguistic) facts'. If one distinguishes between variation independence and existence independence, the unwelcome view about the truthmakers of analytic truths no longer follows. Thus, there is at best a challenge, but no conclusive argument. The door to the metaphysical conception of analyticity is still open. (shrink)

How are we individually and as a society to handle new and emerging technologies? This challenging question underlies much of the bioethical debates of modern times. To address this question we need suitable conceptions of the new technology and ways of identifying its proper management and regulation. To establish conceptions and to find ways to handle emerging technologies we tend to use analogies extensively. The aim of this article is to investigate the role that analogies play or may play in (...) the processes of understanding and managing new technology. More precisely we aim to unveil the role of analogies as analytical devices in exploring the "being" of the new technology as well the normative function of analogies in conceptualizing the characteristics and applications of new technology. Umbilical cord blood biobanking will be used as a case to investigate these roles and functions. (shrink)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

The concept of disease has been the subject of a vast, vivid and versatile debate. Categories, such as "realist", "nominalist", "ontologist", "physiologist", "normativist" and "descriptivist", have been applied to classify disease concepts. These categories refer to underlying theoretical frameworks of the debate. The objective of this review is to analyze these frameworks. It is argued that the categories applied in the debate refer to profound philosophical issues, and that the complexity of the debate reflects the complexity of the concept itself: (...) disease is a complex concept, and does not easily lend itself to definition. (shrink)

Building upon Nancy Cartwright's discussion of models in How the Laws of Physics Lie, this paper addresses solid state research in transition metal oxides. Historical analysis reveals that in this domain models function both as the culmination of phenomenology and the commencement of theoretical explanation. Those solid state chemists who concentrate on the description of phenomena pertinent to specific elements or compounds assess models according to different standards than those who seek explanation grounded in approximate applications of the Schroedinger equation. (...) Accurate accounts of scientific debate in this field must include both perspectives. (shrink)

Theological attention to the Catholic doctrine of original sin has a history that extends from the letters of Saint Paul through the Council of Trent and Pius XII’s 1950 encyclical, Humani generis. The doctrine has traditionally been articulated through the Genesis narrative of Adam and Eve as the first human beings from whom all others descend, an account known as monogenism. In the course of the nineteenth century, scientific research into human origins increasingly relied upon polygenism, the descent of humanity (...) from non-human ancestors through a transitional population. Subsequent Catholic engagement with evolution included resistance to polygenism from the Vatican due to a perceived conflict with the doctrine of original sin. Humani generis included a prohibition that remains in place today in spite of widespread de facto acceptance of polygenism among theologians. Understanding the origin and persistence of this disparity stands to benefit from comparison to a corresponding ambivalence toward the sixteenth century Copernican hypothesis of a moving earth, only conclusively resolved in 1992. In Part I of this essay I introduce this historical comparison and describe the origins of monogenism and polygenism terminology in nineteenth century debate over the unity of the human race. I then describe the conceptual changes that transpired during the first half of the twentieth century and the resulting role of polygenism in the nouvelle théologie of the decade prior to Humani generis. Subsequent developments and implications follow in Part II. (shrink)

Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that “[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content.” While some of the commentaries misconstrued her claim (...) and argue against strawmen, others forcefully maintained that the concept of dignity has functions beyond “respect for persons and their autonomy.” One important point that came out of the debate is that dignity is a generic concept that covers more ground than “respect for persons or their autonomy.” In particular, dignity seems to have a wide range of protective functions as well as having reciprocal, relational, and social aspects. Dignity appears more attributional and norm‐formative than respect for persons and autonomy. While the claim that dignity is unclear, vague, and can be used sloganistically seems highly relevant, it is argued that this vagueness fulfils important functions in ethics. Moreover, dismissing dignity because of its lack of clarity has implications for “respect for persons” and “autonomy,” which are also used vaguely and sloganistically. No doubt medical ethics should use as a clear concept as the context requires. Nonetheless, dignity still seems to be a widely used generic concept in ethical debates and doing as much ethical work as “respect for persons” or “respect for autonomy.” Therefore, the death of dignity seems to be greatly exaggerated. (shrink)

The widespread application of technology in health care has imposed a broad range of challenges. The field of health technology assessment (HTA) is developed in order to face some of these challenges. However, this strategy has not been as successful as one could hope. One of the reasons for this is that social and ethical considerations have not been integrated in the HTA process. Nowadays however, such considerations have been included in many HTAs. Still, the conclusions and recommendations of the (...) HTAs are not followed. The reason for this may be that the methods for integrating ethics for HTA are not sufficiently developed, or that they are not adequate. This article presents a supplementary approach to the ethical inquiry in HTA. It is argued that a value analysis is crucial in order to address the ethical issues of health care technology in a fruitful way and to make viable decisions about such technology. (shrink)

Fred Dretske’s account of mental causation, developed in Explaining Behavior and defended in numerous articles, is generally regarded as one of the most interesting and most ambitious approaches in the field. According to Dretske, meaning facts, construed historically as facts about the indicator functions of internal states, are the structuring causes of behavior. In this article, we argue that Dretske’s view is untenable: On closer examination, the real structuring causes of behavior turn out to be markedly different from Dretske’s meaning (...) facts. Our argument proceeds in three steps. First, we set forth the problem of meaning individuation: We argue that the proposal that meaning facts are structuring causes of behavior commits Dretske to a very fine-grained individuation of meanings that is deeply counterintuitive. In a second step, we show that even these finely individuated meaning facts cannot do the job that they are supposed to do, since information facts—which are constitutive of, but distinct from Dretske’s meaning facts—are better candidates for the role of structuring causes. Finally, we argue that it is not even information facts, but facts of co-instantiation which are the real structuring causes of behavior. In concluding, we briefly consider the options that are left for Dretske if our arguments succeed. (shrink)

Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns. While these challenges have been studied from a wide range of perspectives, the problems prevail. This article adds value to previous analyses by identifying how the moral imperative of medicine has expanded (...) in three ways: (1) from targeting experienced phenomena, such as pain and suffering, to non-experienced phenomena (paraclinical signs and indicators); (2) from addressing present pain to potential future suffering; and (3) from reducing negative wellbeing (pain and suffering) to promoting positive wellbeing. These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship. In order to find ways to manage the moral expansion of medicine, four traditional ways of setting limits are analyzed and dismissed. However, basic asymmetries in ethics suggest that it is more justified to address people’s negative wellbeing (pain and suffering) than their positive wellbeing. Moreover, differences in epistemology, indicate that it is less uncertain to address present pain and suffering than future wellbeing and happiness. Based on these insights the article concludes that the moral imperative of medicine has a gradient from pain and suffering to wellbeing and happiness, and from the present to the future. Hence, in general present pain and suffering have normative priority over future positive wellbeing. (shrink)

I distinguish between three kinds of reliabilism for epistemic justification, namely, pure reliabilism, evidential reliabilism, and reasons reliabilism, and I argue for reasons reliabilism. Pure reliabilism and evidential reliabilism are plagued, most importantly, by the generality problem, and they cannot deal adequately with defeater phenomena. One can avoid these problems only by jettisoning the idea of process reliability. The truth connection ? which is essential for any kind of reliabilism ? has to be provided in an altogether different way, namely, (...) by means of facts in the world which serve as objective reasons (or evidence). So, as reasons reliabilism says, a justified belief has to be anchored in an objective reason which speaks in favor of its truth. Only in this way can intuitions about defeaters be preserved and explained. And reasons reliabilism can avoid the generality problem. (shrink)

Creationists who object to evolution in the science curriculum of public schools often cite Jonathan Well’s book Icons of Evolution in their support (Wells 2000). In the third chapter of his book Wells claims that neither paleontological nor molecular evidence supports the thesis that the history of life is an evolutionary process of descent from preexisting ancestors. We argue that Wells inappropriately relies upon ambiguities inherent in the term ‘Darwinian’ and the phrase ‘Darwin’s theory’. Furthermore, he does not accurately distinguish (...) between the overwhelming evidence that supports the thesis of common descent and controversies that pertain to causal mechanisms such as natural selection. We also argue that Wells’ attempts to undermine the evidence in support of common descent are flawed and his characterization of the relevant data is misleading. In particular, his assessment of the ‘Cambrian explosion’ does not do justice to the fossil record. Nor do his selective references to debate about molecular and paleontological phylogenies constitute a case against common descent. We conclude that the fossil and molecular evidence is more than sufficient to warrant science educators to present common descent as a well-established scientific fact. We also argue that diagrams depicting the ‘tree of life’ can be pedagogically useful as simplified representations of the history of life. (shrink)

To develop a method for exposing and elucidating ethical issues with human cognitive enhancement. The intended use of the method is to support and facilitate open and transparent deliberation and decision making with respect to this emerging technology with great potential formative implications for individuals and society. Literature search to identify relevant approaches. Conventional content analysis of the identified papers and methods in order to assess their suitability for assessing HCE according to four selection criteria. Method development. Amendment after pilot (...) testing on smart-glasses. Based on three existing approaches in health technology assessment a method for exposing and elucidating ethical issues in the assessment of HCE technologies was developed. Based on a pilot test for smart-glasses, the method was amended. The method consists of six steps and a guiding list of 43 questions. A method for exposing and elucidating ethical issues in the assessment of HCE was developed. The method provides the ground work for context specific ethical assessment and analysis. Widespread use, amendments, and further developments of the method are encouraged. (shrink)

Kairos has been a key concept in medicine for millennia and is frequently understood as “the right time” in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease) has resulted in too early diagnoses, i.e., overdiagnoses. Nonetheless, despite vast advances in science and (...) technology, diagnoses also come too late. Accordingly, timing diagnostics right is crucial. In this article we start with giving a brief overview of the etymology and general use of the concepts of kairos and diagnosis. Then we delimit kairos in diagnostics by analysing “too early” and “too late” diagnosis and by scrutinizing various phases of diagnostics. This leads us to define kairos of diagnostics as the time when there is potential for sufficient information for making a diagnosis that is most helpful for the person. It allows us to conclude that kairos is as important in diagnostics as in therapeutics. (shrink)

H. HOFMANN, La promessa della dignità umana. La dignità dell’uomo nella cultura giuridica tedesca.

In this paper I present an account of the rational abilities that make our decisions free. Following the lead of new dispositionalists, a leeway account of free decisions is developed, and the rational abilities that ground our abilities to decide otherwise are described in detail. A main result will be that the best account of the relevant rational abilities makes them two-way abilities: abilities to decide to do or not to do x in accordance with one’s apparent reasons. Dispositionalism about (...) rational abilities will be vindicated, since it helps to see why and how these two-way abilities entail an ability to decide otherwise and, thus, free will. (shrink)

The idea of truthmakers is important for doing serious metaphysics, since a truthmaker principle can give us important guidance in finding out what we would like to include into our ontology. Recently, David Lewis has argued against Armstrong’s argument that a plausible truthmaker principle requires us to accept facts. I would like to take a close look at the argument. I will argue in detail that the Humean principle of recombination on which Lewis relies is not plausible (independently of the (...) issue of facts). Then I will show that the right truthmaker principle that vindicates facts is superior to the modified truthmaker principle that Lewis has proposed. This will lead into the topic of being and existence. It turns out that truthmaking and facts are plausible, well suited for one another, and very coherent with a plausible conception of being. (shrink)

There is a profound paradox in modern medical knowledge production: The more we know, the more we know that we (still) do not know. Nowhere is this more visible than in diagnostics and early detection of disease. As we identify ever more markers, predictors, precursors, and risk factors of disease ever earlier, we realize that we need knowledge about whether they develop into something experienced by the person and threatening to the person’s health. This study investigates how advancements in science (...) and technology alter one type of uncertainty, i.e., temporal uncertainty of disease diagnosis. As diagnosis is related to anamnesis and prognosis it identifies how uncertainties in all these fields are interconnected. In particular, the study finds that uncertainty in disease diagnosis has become more subject to prognostic uncertainty because diagnosis is more connected to technologically detected indicators and less closely connected to manifest and experienced disease. These temporal uncertainties pose basic epistemological and ethical challenges as they can result in overdiagnosis, overtreatment, unnecessary anxiety and fear, useless and even harmful diagnostic odysseys, as well as vast opportunity costs. The point is not to stop our quest for knowledge about disease but to encourage real diagnostic improvements that help more people in ever better manner as early as possible. To do so, we need to pay careful attention to specific types of temporal uncertainty in modern diagnostics. (shrink)

Is technology value-free or is it value-laden? How does technology affect human autonomy? These questions, viewed within the context of medicine, are the focus of attention in this article. The central argument is that we need neither to subscribe to the value-neutrality dictum nor to the all-encompassing value-ladenness thesis to explain the pertinent position of technology in medicine. Technology is constitutive of and strongly implicated in difficult questions of value. This, however, does not mean that technology is identical to (or (...) neutral to) these value-laden questions. Technology poses issues of value, but only some of these relate to technology qua technology. Hence, it makes a difference whether we discuss general questions of value posed by technology or whether we discuss the value-ladenness of technology. Admitting technological value-ladenness does not imply that we are subject to a technological imperative that reduces our autonomy, on the contrary, it explains how technology increases our responsibility. This is particularly prominent in medicine. (shrink)