In Alzheimer's disease (AD), pathological processes start in the brain long before clinical dementia. Biomarkers reflecting brain alterations may therefore indicate disease at an early stage, enabling early diagnosis. This raises several ethical questions and the potential benefits of early diagnosis must be weighted against possible disadvantages. Currently, there are few strong arguments favouring early diagnosis, due to the lack of disease modifying therapy. Also, available diagnostic methods risk erroneous classifications, with potentially grave consequences. However, a possible benefit of early (...) diagnosis even without disease modifying therapy is that it may enable early decision making when patients still have full decision competence, avoiding problems of hypothetical consents. It may also help identifying patients with cognitive dysfunction secondary to other diseases that may be responsive to treatment already today. (shrink)

Niklas Luhmann is widely recognized as one of the most original thinkers in the social sciences today. This major new work further develops the theories of the author by offering a challenging analysis of the relationship between society and the environment. Luhmann extends the concept of "ecology" to refer to any analysis that looks at connections between social systems and the surrounding environment. He traces the development of the notion of "environment" from the medieval idea--which encompasses both human and (...) natural systems--to our modern definition, which separates social systems from the external environment. In Luhmann's thought, human beings form part of the environment, while social systems consist only of communications. Utilizing this distinctive theoretical perspective, Luhmann presents a comprehensive catalog of society's reactions to environmental problems. He investigates the spheres of the economy, law, science, politics, religion, and education to show how these areas relate to environmental issues. Ecological Communication is an important work that critically examines claims central to our society--claims to modernity and rationality. It will be of great importance to scholars and students in sociology, political science, philosophy, anthropology, and law. (shrink)

Translator's Introduction Political Theory in the Welfare State [Politische Theorie im Wohl- fahrtsstaat] was originally published (Olzog, Munich) in. ...

In this paper I argue that it’s impossible for there to be a single universal theory of meaning for a language. First, I will consider some minimal expressiveness requirements a language must meet to be able to express semantic claims. Then I will argue that in order to have a single unified theory of meaning, these expressiveness requirements must be satisfied by a language which the semantic theory itself applies to. That is, we would need a language which can express (...) its own meaning. It has been well-known since Tarski that theories of meaning whose central notion is truth can’t be expressed in a language which they apply to. Here, I develop Quine’s formulation of the Liar Paradox in grammatical terms and use this to extend Tarski’s result to all theories of meaning. This general version of the paradox can be formalised as a special case of the Lawvere Fixed-Point Theorem applied to a categorial grammar. Taken together with the initial arguments, I infer that a universal theory of meaning is impossible and conclude the paper with a brief discussion on what alternatives are available. (shrink)

Language Lost and Found takes as its starting-point Iris Murdoch's claim that "we have suffered a general loss of concepts." By means of a thorough reading of Iris Murdoch's philosophy in the light of this difficulty, it offers a detailed examination of the problem of linguistic community and the roots of the thought that some philosophical problems arise due to our having lost the sense of our own language. But it is also a call for a radical reconsideration of how (...) philosophy and literature relate to each other on a general level and in Murdoch's authorship in particular. (shrink)

Germany's leading contemporary social theorist provides a definitive analysis of art as a social and perceptual system which not only represents an important intellectual step in discussions of art but also an important advance in systems theory. Luhmann insists on the radical incommensurability between psychic systems (perception) and social systems (communication). Art is a special kind of communication that operates at the boundary between the social system and consciousness in ways that profoundly irritate communication while remaining strictly internal to the (...) social. Each chapter elaborates a particular aspect of the general problem of art's status as a social system. The book draws on a vast body of research in the social sciences, phenomenology, evolutionary biology, cybernetics, and information theory, combined with an intimate knowledge of art history, literature, aesthetics, and contemporary literary theory. The book also engages virtually every major theorist of art and aesthetics from Baumgarten to Derrida. (shrink)

This chapter brings together Murdoch’s thoughts about language with other central aspects of her thought such as love, attention, perfectionism and morality. By making clear how Murdoch’s variety of linguistic philosophy differs from contemporary philosophy of language, this paper also shows that Murdoch’s philosophy contains the seeds for a fruitful form of philosophizing which brings the moral and aesthetic dimensions of language into view. “Taking the linguistic method seriously” means making clear the ways in which all concepts belong to a (...) fabric that is changing on a personal level as well as an historical one. One of the things that Murdoch can help us see is that one problem with contemporary philosophy of language, is that it does not take the linguistic method seriously enough. (shrink)

In this paper I construct a system of semantics for classical and intuitionistic propositional logic based on epistemic norms governing belief expansion. Working in the AGM-framework of belief change, I give a generalisation of Gärdenfors’ notion of belief systems which can be defined without reference to a logical consequence operator by using a version of the Ramsey Test. These belief expansion systems can then be used to define epistemic models which are sound and complete for either classical or intuitionistic propositional (...) logic depending on which of the two notions of epistemic validity, identified by Levi and Arló-Costa, is used. Finally, I offer a discussion on how these results can be understood as providing a model theory within the framework of logical expressivism. (shrink)

X‐linked agammaglobulinemia is a heritable immunodeficiency disease caused by a differentiation abnormality, resulting in the virtual absence of B Iymphocytes and plasma cells. The affected gene encodes a cytoplasmic protein tyrosine kinase, Bruton's agammaglobulinemia tyrosine kinase, designated Btk. Btk and the other family members, Tec, Itk and Bmx, contain five regions, four of which are common structural and functional modules that are found in other signaling proteins. Mutations affect all domains of the gene, but amino acid substitutions seem to be (...) confined to certain regions. More than 150 unique mutations have been identified and are collected in a mutation database, BTKbase. Here we discuss the three‐dimensional structural implications of such mutations and their putative functional role. Of special interest are mutations affecting the pleckstrin homology domain, as Btk is the only disease‐associated protein so far reported to carry mutations in this particular module. (shrink)

Legislation for dementia care needs to be continually rethought, if the rights of older persons and other persons with dementia are to be addressed properly. We propose a theoretical framework for understanding vulnerability and dependency, which enables us to problematize the currently prevailing legal conception of adults as always able — irrespective of health or age — to act autonomously in their everyday lives. Such an approach gives rise to difficult dilemmas when persons with dementia are forced to make decisions (...) on their own about basic living conditions, such as housing and care, without decision-making support. In Sweden, for example, such matters are frequently left to the person him- or herself to decide, often without any assistance from social workers, and with family members serving as caregivers of last resort.Using vulnerability theory as the framework for our discussion, we argue that policymakers should not apply a group-oriented approach (based on factors like age, legal status, or mental capacity) to persons suffering from dementia. The needs of such individuals are as complex and varied as they themselves are. We discuss our findings from an interdisciplinary (law/social work) research project in which we examine the dilemma that social workers face when they are required, under the terms of the Swedish Social Services Act, to determine whether persons with dementia are to be granted support.We argue further that a cross-disciplinary approach — in which vulnerability theory furnishes the framework — opens up for new ways of understanding and developing social welfare law and practice. This, we believe, can help us better address the rights, interests, and needs of people with dementia, of their families, and of professionals in the social welfare system. Finally, many of the problems faced by ageing societies in general can be understood on the basis of such an approach. (shrink)

The growth of Sweden’s urban population necessitates new approaches for increasing the sustainability and energy efficiency of multifamily buildings. The development of such approaches will require a holistic and integrated understanding of the factors driving the decision making of both professionals who design buildings and end-users who live in them. This paper, therefore, uses the goal framing theory to determine which aspects of multifamily buildings are considered important by these two groups of actors. An empirical study based on semi-structured interviews (...) with professionals involved in building design and development was conducted to identify goals affecting the choices made during building design and development. In parallel, a questionnaire survey of building end-users was conducted to determine which factors guided their choice of dwelling. It was found that professionals’ design choices were primarily governed by normative goals relating to environmental benefits but were also influenced by the other goals. These included gain goals relating to budgetary constraints and keeping the building’s operational and maintenance costs low. Hedonic goals were also important; some design choices were made with the aim of providing pleasant, comfortable, and convenient living environments, or of giving the buildings a distinct aesthetic or some other special features. By comparing the professionals’ responses to the end-user surveys, it was found that the two groups had similar views concerning gain goals; both considered it important for apartments to be affordable and easy to maintain. However, their views on hedonic and normative goals differed markedly. The professionals sought to strike an optimal balance between different related aspects, whereas end-users placed greater importance on aspects relating to hedonic and gain goals when choosing dwellings. The findings provide a basis for constructive discussions on building design and development, and the scope for creating buildings that encourage end-users to adopt sustainable living practices while also satisfying their needs and preferences. (shrink)

Children in the pediatric intensive care unit are indisputably in a vulnerable position, dependent on nurses to acknowledge their needs. It is assumed that children should be approached from a holistic perspective in the caring situation to meet their caring needs. The aim of the study was to unfold the meaning of nursing care through nurses’ concerns when caring for children in the pediatric intensive care unit. To investigate the qualitative aspects of practice embedded in the caring situation, the interpretive (...) phenomenological approach was adopted for the study. The findings revealed three patterns: medically oriented nursing—here, the nurses attend to just the medical needs, and nursing care is at its minimum, leaving the children’s needs unmet; parent-oriented nursing care—here, the nursing care emphasizes the parents’ needs in the situation, and the children are viewed as a part of the parent and not as an individual child with specific caring needs; and smooth operating nursing care orientation—here, the nursing care is focused on the child as a whole human being, adding value to the nursing care. The conclusion drawn suggests that nursing care does not always respond to the needs of the child, jeopardizing the well-being of the child and leaving them at risk for experiencing pain and suffering. The concerns present in nursing care has been shown to be the divider of the meaning of nursing care and need to become elucidated in order to improve the cultural influence of what can be seen as good nursing care within the pediatric intensive care unit. (shrink)

Mentalization-based family therapy and family rehabilitation represent a rich variety of approaches for assisting families with difficult interaction patterns. On the other hand, adventure therapy methods have been successfully used with families to offer them empowering experiences of succeeding together against difficult odds and to improve communication between family members. Further, the health promoting qualities of spending time outdoors are now well established and recognized. The Nordic approach to mentalization-based family rehabilitation combines adventure, outdoor, and systemic therapy. We provide three (...) examples of nature-based family rehabilitation practices that are delivered as brief, multi-family psychological interventions taking place in nearby nature and aiming to support sustainable, systemic change. The current contribution is a description of clinical practice, not a systematic review or a formal evaluation. We propose that recontextualizing mentalization-based family rehabilitation to the outdoors can not only provide added health benefits, but also strengthen intra-familial attuned interaction and emotional connectedness. The outdoor adventure provides the families with embodied, multisensory experiences of verbal and, especially, non-verbal interaction that can be usefully examined through the lens of theory of mentalization. The concreteness of adventure experiences is particularly beneficial for families that have difficulties in verbal communication and/or utilizing executive functions, perhaps due to neuropsychiatric traits, intellectual disabilities, or learning difficulties. Furthermore, outdoor adventure can support the participants’ connectedness to nature. (shrink)

The requirement that theoretical and empirical research is to sustainably benefit not only the nominal researcher, but also the other research participants, is deeply embedded in the conceptual-analytical framework of Psychology from the Standpoint of the Subject and its co-researcher principle. PSS research is thus to be of emancipatory relevance to those others the researcher comes to collaborate with. Meanwhile, the question of how this requirement can be prospectively integrated into the design of a research project remains subject to debate. (...) This question emerges as particularly difficult to tackle in research projects that engage in co-research with young children: How can a researcher ensure that the young children s-he works togethe with benefit from the research project? Based on the critical analysis of an earlier research project implemented by the author, the contribution at hand suggests that PSS’ foundational notion of emancipatory relevance needs to be revisited. It argues that if a research project is to sustainably benefit young co-researchers, the technical relevance of the expected mutual emancipation should as well be explicitly considered in the project design. A discussion of recent methodological developments in child-targeted Participatory Design and Human-Computer Interaction serve as inspiration for this conceptual specification. The contribution thereby invites co-research to further investigate how emancipatory relevance cannot only to be methodologically attained via dissemination of research results and conceptual developments, but also via the actual research process it attempts to engage the co-researchers in irrespective of their age. (shrink)

Genetic determinism can be described as the attribution of the formation of traits to genes, where genes are ascribed more causal power than what scientific consensus suggests. Belief in genetic determinism is an educational problem because it contradicts scientific knowledge, and is a societal problem because it has the potential to foster intolerant attitudes such as racism and prejudice against sexual orientation. In this article, we begin by investigating the very nature of belief in genetic determinism. Then, we investigate whether (...) knowledge of genetics and genomics is associated with beliefs in genetic determinism. Finally, we explore the extent to which social factors such as gender, education, and religiosity are associated with genetic determinism. Methodologically, we gathered and analyzed data on beliefs in genetic determinism, knowledge of genetics and genomics, and social variables using the “Public Understanding and Attitudes towards Genetics and Genomics” instrument. Our analyses of PUGGS responses from a sample of Brazilian university freshmen undergraduates indicated that belief in genetic determinism was best characterized as a construct built up by two dimensions or belief systems: beliefs concerning social traits and beliefs concerning biological traits; levels of belief in genetic determination of social traits were low, which contradicts prior work; associations between knowledge of genetics and genomics and levels of belief in genetic determinism were low; and social factors such as age and religiosity had stronger associations with beliefs in genetic determinism than knowledge. Although our study design precludes causal inferences, our results raise questions about whether enhancing genetic literacy will decrease or prevent beliefs in genetic determinism. (shrink)

Massimiliano Tomba’s Insurgent Universality traces a global history of revolutionary institution-building as ‘theory in action’, pushing radical democracy beyond an ontology of the political. This contribution aims to clarify the place of ‘insurgent institutions’ in Tomba’s work and suggests that an unresolved tension persists between insurgent universality as popular institutions on the one hand, and as a negative dis-ordering on the other. Exploring the promise and limitations of ‘insurgent institutions’ in light of their durability, its first part reads Insurgent Universality (...) alongside Santi Romano, the legal pluralist whose concept of the institution Tomba adopts. Secondly, the article turns to Hannah Arendt’s understanding of authority and Miguel Abensour’s discussion of ‘insurgent institutions’ as two potentially helpful accounts of democratic practice within durational time. Where Tomba remains focused on constellations between moments of rupture, Arendt and Abensour offer a politically generative understanding of durability specific to radical-democratic institutions. (shrink)

This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.

This chapter discusses some concerns regarding the effects of enhancement technologies on autonomy and authenticity, insofar as authenticity relates to autonomy. As a preliminary, it describes how enhancement and autonomy should be understood in this context along with some examples of enhancement. The chapter moves on to explain why enhancement can promote autonomy. Three types of concerns regarding the effect of enhancement technologies on autonomy are raised: (i) that medical technologies should not be used to enhance autonomy, since this is (...) not the proper use of such technologies; (ii) that some enhancement technologies are inimical to our authenticity; and (iii) that the widespread use of some enhancement technologies have negative overall consequences on people's autonomy. Different kinds of enhancements typically arouse different kinds of concerns as regards autonomy. These include cognitive, mood, physical, and aesthetic enhancement. (shrink)

Das Buch untersucht die Relation der Ahnlichkeit in ihrer Bedeutung fur Asthetik und Epistemologie der Moderne. HAtte Michel Foucault in Die Ordnung der Dinge die These formuliert, dass die Ahnlichkeit ihre Rolle als strukturierende Form des Wissens im Laufe des siebzehnten Jahrhunderts verloren habe, so geht die vorliegende Untersuchung davon aus, dass das Ahnlichkeitsdenken auch in der Moderne von grundlegender Bedeutung ist. LEitend ist dabei die Annahme, dass die Ahnlichkeit ihre besondere Relevanz nun in einem Diskurs uber asthetische Erfahrung entfaltet, (...) wobei sich von dort aus wiederum fundamentale Fragestellungen der Erkenntnistheorie eroffnen. DEn Ausgangspunkt der Untersuchung bildet die Philosophie Immanuel Kants in ihrer maSSgeblichen Bedeutung fur asthetische Theorien der Moderne. ANhand detaillierter Lekturen von Texten von Walter Benjamin, Paul Valéry und Theodor W. ADorno wird die Argumentation weiter entfaltet, womit auch die in der Forschung bislang nicht berucksichtigte Konstellation Valéry - Benjamin - Adorno erstmals genauer in den Blick genommen ist. DIe Arbeit ist im Fach der Literaturwissenschaft angesiedelt, jedoch grundsatzlich interdisziplinar auf Fragen der Asthetik und Kunsttheorie ausgerichtet. (shrink)

What challenges must a principle of need for prioritisations in health care meet in order to be plausible and practically useful? Some progress in answering this question has recently been made by Hope, Østerdal and Hasman. This article continue their work by suggesting that the characteristic feature of principles of needs is that they are sufficientarian, saying that we have a right to a minimally acceptable or good life or health, but nothing more. Accordingly, principles of needs must answer two (...) distributive questions: when do we have sufficient and how should we prioritise among those who do not yet have a sufficiency? Furthermore, it is argued that Roger Crisp’s theory of need, which combines sufficientarianism with prioritarianism below the threshold of need, is better equipped than alternatives to answer these questions as well as meeting the challenges formulated by Hope, Østerdal and Hasman. However, Crisp’s theory faces two major challenges. First, it has to say something about the currency of distribution: a principle of need must be complemented either with a theory on the human good or a theory about the proper goals of health care. Second, it has to say something about where the threshold should be set. However, any attempt to set a threshold seems morally arbitrary in the light of the sufficientarian idea that those just above the threshold never should be given priority over those just below the threshold. (shrink)

The importance of GS for understanding Nietzsche’s philosophy cannot be overestimated. While it can be disputed whether or not modern Nietzsche scholarship started with the revaluation of GS—as the editors claim with Giorgio Colli—the work forms an important link between the early and late writings of Nietzsche and especially Z. Klassiker Auslegen—Interpreting Classics—is a series dedicated to interpreting important works of philosophy as a whole through chapters successively discussing the individual chapters of the work. The book at hand consists of (...) two introductions—one for the volume, another one discussing the genesis of the edition of GS—and eight chapters covering each of the preface, the “Prelude in... (shrink)

Werner Hamacher's thought, despite its relevance and scope in other languages, has had a rather tenuous reception in the Spanish-speaking world to date. It is even possible to speak of the obstruction, in some of its points, of the circulation of his thought, as a product of the complexity of its translation. These difficulties, far from being reducible to a merely technical problem, are discussed hand in hand with the comparative reading of some of his texts in Spanish. His thought (...) from and in the language, sometimes despite it, illustrates the relevance of considering translation as a key operation for the philosophical debate in general and in Spanish-speaking countries in particular. (shrink)

This article is about the justifiability of accepting worse cost effectiveness for orphan drugs, that is, treatments for rare diseases, in a publicly financed health care system. Recently, three arguments have been presented that may be used in favour of exceptionally advantageous economic terms for orphan drugs. These arguments share the common feature of all referring to considerations of justice or fairness: the argument of the irrelevance of group size, the argument from the principle of need, and the argument of (...) identifiability. It is argued that all of these arguments fail to support the conclusion that orphan drugs should be subsidized to a larger extent than treatments for common diseases. The argument of the irrelevance fails to distinguish between directly and indirectly relevant considerations of fairness or justice. The recent attempt to revive the moral relevance of identifiability has provided no novel reasons to think that identifiability is morally relevant in itself or due to considerations of fairness and justice. The argument from the principle of need does not fail due to any inherent flaw in the principle as such. Rather, this principle can be interpreted in different ways, and none of these interpretations support exceptionally advantageous terms economically for treating rare diseases specifically. It is concluded that we are awaiting justice based reasons for the preferential treatment of orphan drugs. (shrink)

AimsTo examine attitudes towards physician-assisted suicide (PAS) among physicians in Sweden and compare these with the results from a similar cross-sectional study performed in 2007.ParticipantsA random selection of 250 physicians from each of six specialties (general practice, geriatrics, internal medicine, oncology, surgery and psychiatry) and all 127 palliative care physicians in Sweden were invited to participate in this study.SettingA postal questionnaire commissioned by the Swedish Medical Society in collaboration with Karolinska Institute in Stockholm. ResultsThe total response rate was 59.2%. Slightly (...) fewer than half [47.1% (95% CI 43.7–50.5)] of the respondents from the six specialties accepted PAS, which is significantly more than accepted PAS in the 2007 study [34.9% (95% CI 31.5–38.3)]. Thirty-three percent of respondents were prepared to prescribe the needed drugs. When asked what would happen to the respondent’s own trust in healthcare, a majority [67.1% (95% CI 63.9–70.3)] stated that legalizing PAS would either not influence their own trust in healthcare, or that their trust would increase. This number is an increase compared to the 2007 survey, when just over half [51.9% (95% CI 48.0–55.2)] indicated that their own trust would either not be influenced, or would increase.ConclusionsThe study reveals a shift towards a more accepting attitude concerning PAS among physicians in Sweden. Only a minority of the respondents stated that they were against PAS, and a considerable proportion reported being prepared to prescribe the needed drugs for patient self-administration if PAS were legalized. (shrink)

In this article I try to show in what sense Emmanuel Levinas’ ‘ethics as first philosophy’ moves our ethical thinking away from what has been called ‘centrist ethics’. Proceeding via depictions of the structure of Levinasian ethics and including references to examples as well as to some empirical research, I try to argue that human beings always already find themselves within an ethical universe, a space of meaning. Critically engaging with the writings of David Gunkel and Lucas Introna, I try (...) to argue that these thinkers, rather than clarifying, distort our ethical understanding of how we stand in relation to artefacts. Drawing a distinction between how pervasive our ethical relationship to other human beings, and living animals, is and how the nature of artefacts is tied to us, I conclude by indicating that the aspiration to give artefacts an ethical face suggests a fantasy to avoid ethical responsibility and generates what I call a ‘compensatory logic’. (shrink)

Zusammenfassung: Der Beitrag systematisiert, kontextualisiert und evaluiert den eigentumstheoretischen Hintergrund der derzeit breit geführten Debatte um bezahlbaren Wohnraum in deutschen Großstädten. Ausgehend von der These, dass hinter der sogenannten ‚Wohnungskrise‘ eigentlich eine ‚Bodenkrise‘ steht, werden drei zentrale Konflikte um die politische Rahmung des Eigentums an Boden diskutiert: die Frage nach dem Gebrauch, der Verwertung und dem Eigentumsschutz. Dabei werden die normativen Potentiale eines immanenztheoretischen, apriorisch pflichtgebundenen Eigentumsverständnisses für eine zeitgemäße Wohnraum- und Bodenpolitik ausgelotet.

abstract Even though much research has been devoted to studies of safety, the concept of safety is in itself under‐theorised, especially concerning its relation to epistemic uncertainty. In this paper we propose a conceptual analysis of safety. The paper explores the distinc‐tion between absolute and relative safety, as well as that between objective and subjective safety. Four potential dimensions of safety are discussed, viz. harm, probability, epistemic uncertainty, and control. The first three of these are used in the proposed definition (...) of safety, whereas it is argued that control should not be included in a reasonable definition of safety. It is shown that strictly speaking, an objective safety concept is not attainable. Instead, an intersubjective concept is proposed that brings us as close as possible to an objective concept. (shrink)

The functional separation of risk assessment and risk management has long been at the heart of risk analysis structures. Equally long it has been criticized for creating technocratic risk management due to valuations being done in the risk assessment to which the stakeholders do not have access. The criticism has mostly been of an ethical nature. Arguably, in separating risk assessment and risk management, one hopes to fulfil two requirements: Social requirement: we want risk management to meet the goals and (...) needs of society. Scientific requirement: we do not want political views to influence the assessment of facts. We ask in this paper whether it is, in principle, possible to separate risk assessment from risk management. The crucial distinction between risk assessment and risk management we take to be between what kinds of values are involved in them and that separation is meant to shield risk assessment from risk management values and vice versa. Risk assessment is judged to be a scientific activity that should only involve scientific values. We go through a paradigmatic example of good science to see what those scientific values are and whether they are the only ones influencing science. We also present an example of a risk assessment in order to compare it to science. We conclude that the values involved in both science and risk assessment are of the same kind and that they both involve extra-scientific values. The paper ends with a short discussion of whether the above requirements can be met even though risk assessment and risk management are interdependent. (shrink)