This article explores the reasons women of diverse class, racial ethnic, national, and religious backgrounds give for their decisions not to accept an amniocentesis or, having accepted one, not to pursue an abortion after diagnosis of serious fetal disability. The narratives of refusers reveal conflicts and tensions between the universalizing rationality of biomedical interventions into pregnancy and the wider heterogeneous social frame work to which women respond in their decision-making processes.

Although conventionally tracked in the "overdeveloped world" , assistive reproductive technologies are now available in many parts of the globe. This review essay reports on qualitative social science research on techniques such as In Vitro Fertilization, egg purchase, gestational surrogacy, and sex selection across national boundaries. It highlights the disruptions and recuperations of gender and generational relations; religious and legislative regulation; and the opportunities as well as oppressions that the commercialization of the reproductive body entail.

Over the last three decades, an escalating portion of U.S. school children has been classified for special education; those with diagnoses entitled to services now number 15 percent of all public school pupils. At the same time, American scientists have focused increasingly on juvenile brains, studying what one psychiatric epidemiologist labeled ‘‘social incapacities.’’ This article reports on the laboratory labors of two scientific groups: neuroscientists who scan children’s brains in search of resting state differences according to diagnosis and psychiatric epidemiologists (...) who look to epigenetics to distinguish differential diagnostic populations. The article focuses on the medicalization of childhood differences and the harmonies and discordances between what researchers and parents understand to be at the root of children’s learning and social capacities. (shrink)

The debate and implementation of Clinical Ethics Consultation is still in its beginnings in Europe and the issue of the patient's perspective has been neglected so far, especially at the theoretical and methodological level. At the practical level, recommendations about the involvement of the patient or his/her relatives are missing, reflecting the general lack of quality and practice standards in CEC. Balance of perspectives is a challenge in any interpersonal consultation, which has led to great efforts to develop “technical”approaches, e.g., (...) in psychological counseling or psychotherapeutic treatment. In ethics, unbalance or partiality is a matter of justice and has provoked significant theoretical work, also relevant for practical medical ethics. A lack of balance seems to be particularly serious in those situations, where ethical conflict is triggering a consultation and where the “parties” involved may try to persuade the consultant that their particular opinion is the most convincing; but to our knowledge the connection between patient/relatives involvement and balance has not yet been discussed in the context of CEC. Central questions of access and involvement of the patient and his/her relatives will be analysed and discussed regarding the challenge of balance and the adequate role or attitude of a Clinical Ethics Consultant. It is argued that the Clinical Ethics Consultant should have a methodological awareness regarding the concepts of “neutrality” versus “advocacy” in his/her role and try to achieve a balanced procedure that allows for an optimum of change of perspectives. The argumentation is developed along the narrative of a real case study. Recommendations concerning the involvement of the patient or the relatives are formulated for the practice of CEC. (shrink)

In this paper we assume that ‘theory’ is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES.A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist (...) in North-America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including ‘how-to’ questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end-of-life decisions (major ethical topics).In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi-centre context in several healthcare institutions. We conceptualize three ‘pillars’ as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP.We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. (shrink)

What is the status of empirical contributions to bioethics, especially to clinical bioethics? Where is the empirical approach discussed in bioethics related to the ongoing debate about principlism versus casuistry? Can we consider an integrative model of research in medical ethics and which empirical methodology could then be valuable, the quantitative or the qualitative? These issues will be addressed in the first, theoretical part of the paper. The concept of the “embedded researcher” presented in this article was stimulated by the (...) two questions, (1) how can we safeguard that our research will yield valid and meaningful results to practice? and (2), how can we convince clinical colleagues that medical ethics offers relevant contributions to the analysis and solution of problems? One tentative answer has been our effort to elaborate a coherent methodological research approach in the field of end-of-life issues integrating qualitative and quantitative as well as casuistic methodologies. This development is characterized in the second part describing the ECOPE Study (short title)“Ethical Conditions Of Passive Euthanasia.” The achievements and limitations of the suggested approach of the “embedded researcher” are discussed referring to 3 examples of our joint studies about ethical issues concerning(1) critical decision-making in neonatology(2) limitation of treatment in intensive care(3) problems with doctor-patient conversation at the end of life in oncologyConclusions from our studies are put to discussion in the final part of the paper about how to further develop research in the field of end-of-life care and, maybe,clinical bioethics as a whole. (shrink)

Name der Zeitschrift: Kant-Studien Jahrgang: 109 Heft: 1 Seiten: 72-100.

The Analytic of the Beautiful in Kant's Critique of Aesthetic Judgment is a text of unparalleled importance in the history of philosophical aesthetics. Its main claims are adopted by some and rejected by others. A significant number of responses, of both kinds, take the Analytic to apply to all experiences of beauty—most notably, to the beauty of both nature and fine art. Our principal claim is that this assumption is mistaken. The analysis in the misleadingly titled Analytic of the Beautiful (...) applies paradigmatically to judgments of natural beauty. The experience of the beauty of most artworks is different and requires a separate analysis. We detail the modifications required in all four moments of the Analytic and thereby explicate the experience of artistic beauty. This reveals that Kant holds an interesting and historically consequential account of the experience of artistic beauty, which is significantly different from the experience of natural beauty. The analysis further reveals that despite these significant differences, the experiences are both species of a single genus. (shrink)

The contributors to _Constructing the Pluriverse_ critique the hegemony of the postcolonial Western tradition and its claims to universality by offering a set of “pluriversal” approaches to understanding the coexisting epistemologies and practices of the different worlds and problems we inhabit and encounter. Moving beyond critiques of colonialism, the contributors rethink the relationship between knowledge and power, offering new perspectives on development, democracy, and ideology while providing diverse methodologies for non-Western thought and practice that range from feminist approaches to scientific (...) research to ways of knowing expressed through West African oral traditions. In combination, these wide-ranging approaches and understandings form a new analytical toolbox for those seeking creative solutions for dismantling Westernization throughout the world. Contributors Zaid Ahmad, Manuela Boatcă, Hans-Jürgen Burchardt, Arturo Escobar, Sandra Harding, Ehsan Kashfi, Venu Mehta, Walter D. Mignolo, Ulrich Oslender, Isiaka Ouattara, Manu Samnotra, Aram Ziai. (shrink)

In this paper we assume that ‘theory’ is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES.A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist (...) in North‐America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including ‘how‐to’ questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end‐of‐life decisions (major ethical topics).In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi‐centre context in several healthcare institutions. We conceptualize three ‘pillars’ as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP.We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. (shrink)

§49 of the Critique of the Power of Judgment concludes with a striking claim regarding the freedom required for artistic expression. Kant classifies Mannerism as aping, but considers manner the only valid means of artistic expression. These opposed uses of maniera echo a historical controversy, which finds reconciliation in Kant in what I call artistic autonomy. For Kant, artistic expression of genuine originality requires autonomous action, the individual manner in which an artist selects, transforms and applies given academic rules, in (...) a way that renders an aesthetic vision meaningful. His grave concern is that artists, in their aspiration to innovate, might make the freedom to modify and transform rules into the very aim of their artistic endeavor. In order to grasp the full significance of Kant’s view, I examine the contradictory attitudes towards maniera articulated by Vasari and Bellori. Kant’s account of artistic autonomy offers an understanding of artistic succession, different from that of his predecessors. (shrink)

"Religiös Wissen, so die Grundannahme des DFG-Graduirtenkollegs "Religiöses Wissen im vormodernen Europa (800-1800)", entsteht in der Auseinandersetzung mit dem in der Bibel offenbarten, aber nicht greifbaren Wissen. Im alltäglichen Umgang der religiösen Experten und Laien wird es jedoch immer wieder transformiert und an die zeitspezifischen Gegebenheiten angepasst. Die dabei entstehenden diskursiven Konkurrenzen zwischen religiösen Wissen und anderen Wissensfeldern stehen im Fokus des interdisziplinär angelegten Sammelbandes. Die Beiträge thematisieren die unterschiedlichen Verfahrensweeisen, durch die religiöses Wissen in den Bereichen der Naturforschung, Kunst (...) oder Literatur adaptiert und modelliert wird, sowie die dabei zu Tage tretenden Spannungen, Konkurrenzen oder Synergien." --. (shrink)

Although research on the benefits of problem construction within the creative process is expanding, research on team problem construction is limited. This study investigates the cognitive process of problem construction and identification at the team level through an experimental design. Furthermore, this study explores team social processes in relation to problem construction instructions. Using student teams solving a real-world problem, the results of this study revealed that teams that engaged in problem construction and identification generated more original ideas. Moreover, higher (...) satisfaction and lower conflict was observed among groups that engaged in problem construction. These findings highlight the utility of problem construction for teams engaging in creative problem-solving. (shrink)

Clinical ethics consultation not only interprets moral issues at the bedside and is not restricted to giving support for the “technical” handling of these moral issues, but it has to substantively address moral values, norms, and conflicts in the process of discussing cases and problems. We call this the normative dimension and use normative in the sense of embracing moral values and convictions of persons and groups, norms, and relevant professional and ethical guidelines as well as legal frameworks. The roles (...) and activities of the consultant as a person and the quality of CEC as a process are discussed in the American Society of Bioethics and Humanities’ Core Competences for Healthcare Ethics Consultation. (shrink)

Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another “committee”. One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The (...) most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study. (shrink)

This paper analyses video recorded interactions between police officers and drivers in traffic stops in Russia. The interactions were recorded via cameras installed on the drivers’ car dashboards, and subsequently uploaded to YouTube; a practice to which over one million Russian motorists have resorted to counterbalance perceived high levels of bribery and corruption. The analysis focuses on responses to opening requests for identification in five different encounters. These show that the drivers repeatedly engage in potentially interpersonally sensitive activities in which (...) the vulnerability of face, especially that of the police officer, is interactionally manifested by launching counter requests in return. The organisation of the request–counter request sequences highlights how face and identity related concerns are interwoven in the participants’ attempts to contest each other’s authority. (shrink)

The paper describes how ethics consultation can be valuable to health professionals, patients and their families in understanding and evaluating ethical values and their consequences in a particular situation. Ethics consultation as it is practised at the university hospital of Freiburg is a special professional service offered by members of an academic institution.The practical approach and the goals are illustrated by a case study showing the difficulties of deciding about the limitation of intensive care medicine after heart surgery in the (...) setting of maximum treatment. Here, the ethics consultation was initiated by the relatives of the patient who wanted a decision to withhold further life-sustaining treatment.Following the experiences in Freiburg, it is concluded that clinical ethicists have to cover a variety of relevant fields of knowledge, need special analytical skills, and should have professional competence in counselling, including conflict mediation or crisis intervention. (shrink)

This paper explores how understandings of sociality influence the way members of two different social groups discursively animate moral conflicts. It examines how moral conflicts are constructed in life-story interviews by Chinese and Latin American migrants as they reflect on patterns of sociation with co-ethnics in London. These interviews typify the kind of conflicts that emerged across a 102 interview database where a discrepancy between expectations of how contextually-situated interpersonal relations are established and how they should unfold are. The transnational (...) setting that we focus on inevitably draws our attention to the importance of the larger relational context where interpersonal relations among migrant co-ethnics are entrenched. In this context, rights and obligations towards one another are often reconfigured to adapt to the circumstances of the new environment. This paper turns the pragmatic lens on transcultural relations. (shrink)

Initiating clinical ethics support in psychiatry and maintaining its continuity appear to be easy. This is contradicted by the observed delay or lack of CESiP, e.g. ethics consultation. On the basis of a published literature search and the discussion of practical experiences over 2.5 years 10 tasks and relating challenges of initiating and maintaining CESiP are formulated and illustrated by examples. Referral to experiences is grounded on the systematic documentation of ca. 100 CESiP activities. The tasks and challenges illustrate how (...) CESiP was initiated and maintained in child and adolescent, adult and forensic psychiatry. Each example is followed by a “rule of thumb” that was found useful in our centre. Discussion: Suggestions I–III are of organisational nature, IV–X have explicit ethical content concerning the ethos or professionalism of the ethics consultant and CES practice. Their realisation requires a minimum of stability of CESiP and considerable consultancy experience. (shrink)

The transcendental argument for God’s existence (“TAG”) claims that the existence of the Triune God is a metaphysically necessary precondition for the most basic features of human life and experience. Philosopher Sean Choi has recently argued that TAG is best understood as having the following argument pattern: (1) p, (2) Necessarily, if p, then G (God exists), and therefore (3) G. In this note, I pose a dilemma argument for the proponent of the transcendental argument (understood this way). My hope (...) is that the dilemma argument will spur further development and clarification of exactly what the transcendental argument is. (shrink)

Covid‐19 has infected thousands and killed hundreds in prisons, jails, and immigration detention facilities across the United States. Responding to this crisis, leading medical researchers have called for expanding opportunities for people in prison to participate in vaccine trials. These calls, like current regulations, focus on individualized risk assessments around consent, coercion, and harm, while ignoring the unnaturalness of deprivation conditions in U.S. prisons. We need new frameworks of analysis that refocus on structural, rather than individual, risk assessments. Integrating structural (...) perspectives—including skepticism of claims of scarcity, avoidance of representational distortions, and attention to institutional agency—into our existing, overly individualistic frameworks might permit the design of more ethical research projects involving people who are incarcerated. Still, the unnatural deprivations of incarceration might be so great that research subjects might need to be removed from prison entirely in order to ethically participate in research. (shrink)

My original dilemma claimed that the transcendental argument for God’s existence is either superfluous (if the goal is to establish the actual existence of God) or inadequate (if the goal is to establish the necessary existence of God). In this rejoinder to James Anderson, I begin by noting some important points of agreement. I then clarify the differences between pattern-I, pattern-II, and pattern-III theistic arguments. I comment on each of Anderson’s three proposed lines of response and defend by original dilemma, (...) on the assumption that TAG is formulated as a pattern-II argument. (shrink)

For Kant the definitive end of art is the expression of aesthetic ideas that are sensible counterparts of rational ideas. But there is another type of aesthetic idea: ‘Beauty can in general be called the _expression_ of aesthetic ideas: only in beautiful nature the mere reflection on a given intuition, without a concept of what the object ought to be, is sufficient for arousing and communicating the idea of which that object is considered as the _expression_.’ What are these aesthetic (...) ideas? I argue that Kant is drawing on the idealist conception of art, associated with Vasari, Bellori and Winckelmann, as presenting idealized spatial forms characteristic of natural kinds. He incorporates this conception into his analysis of the beauty of nature and adds that we have non-conceptual access to it. These idealized forms he names aesthetic normal ideas of natural species. §51 of Kant’s Critique of the Aesthetic Power of Judgment opens with an unexpected claim, described by readers as ‘puzzling’, ‘perplexing’ and even as a ‘notorious mystery’.1 1 Beauty can in general be called the _expression_ of aesthetic ideas: only in beautiful art this idea must be occasioned by a concept of the object, but in beautiful nature the mere reflection on a given intuition, without a concept of what the object ought to be, is sufficient for arousing and communicating the idea of which that object is considered as the _expression_. 2 2 I will argue that, in this passage, Kant states that there are two types of aesthetic ideas—namely, aesthetic ideas expressed in beautiful art and aesthetic ideas expressed by beautiful nature. This distinction is surprising for, before this juncture, there is no explicit claim that there are different types of aesthetic ideas. In fact, although Kant offers several seemingly general characterizations of aesthetic ideas, in none of them does he indicate that there is a subdivision of the genus. Noteworthy, too, is the claim that the distinct pleasure we take in beautiful nature is independent of concepts; for strikingly, it can be considered as the expression of what the passage above expressly calls ideas. In his analysis of fine art, Kant draws the distinction between natural and artistic beauty—a distinction that is succinctly repeated in the passage above.3 3 But when he goes on to explicate the notion of an aesthetic idea, he refers only to aesthetic ideas expressed in art. This fact is taken to support the assumption that aesthetic ideas are connected solely to art. This is the heart of the mystery of the passage, for in it, Kant explicitly talks about aesthetic ideas expressed by beautiful nature. This raises a crucial question: Does the explication of aesthetic ideas in the sections on art apply to aesthetic ideas of beautiful nature?I maintain that the answer is negative. Although, in the passage above, Kant uses the same term in relation to both kinds of beauty, he has a clear distinction in mind: Beauty in art is an aesthetically or sensuously unified expression of the conceptual richness of an idea of reason; beauty in nature is an expression of a purely aesthetically or sensuously unified richness. Obviously, this distinction is connected to other significant differences between the two kinds of beauty. But it is important to point out at the outset that the two types of aesthetic ideas have in common only the quality of being a sensuously unified richness. It is in this sense that they are both species of a single genus. But what more precisely does Kant mean by aesthetic ideas expressed by beautiful nature, and what unified richness do they express and how precisely do they express it? It is to the historical genealogy of this notion of aesthetic ideas of beautiful nature and its implications for Kant’s theory of beauty that this paper is devoted. This historical genealogy will reveal a sense of the notion of aesthetic ideas that we easily overlook but would have been familiar to Kant and his contemporaries. (shrink)

Research on teams and teamwork has flourished in the last few decades. Much of what we know about teams and teamwork comes from research using short-term student teams in the lab, teams in larger organizations, and, more recently, teams in rather unique and extreme environments. The context in which teams operate influences team composition, processes, and effectiveness. Small organizations are an understudied and often overlooked context that presents a rich opportunity to augment our understanding of teams and team dynamics. In (...) this paper, we discuss how teams and multi-team systems in small organizations may differ from those found in larger organizations. Many of these differences present both methodological and practical challenges to studying team composition and processes in small complex organizational settings. We advocate for applying and accepting new and less widely used methodological approaches to advance our understanding of the science of teams and teamwork in such contexts. (shrink)

Journal of Philosophy of Education, EarlyView.

Wittgenstein’s private language argument claims that language and meaning generally are public. It also contends with our appreciation of artworks and reveals the deep connection in our minds between originality and the temptation to think of original meaning as private. This problematic connection of ideas is found in Kant’s theory of fine art. For Kant conceives of the capacity of artistic genius for imaginatively envisioning original content as prior to and independent of finding the artistic means of communicating this content (...) to others. This raises the question of whether we can conceive of art as both original and meaningful without succumbing to privacy. (shrink)

Ethische Leitlinien für die klinische Praxis erfreuen sich zunehmender Beliebtheit. Damit klinisch-ethische Leitlinien aber überhaupt erfolgreich wirksam werden können, ist noch Pionierarbeit zu leisten. Solche Leitlinien müssen wissenschaftlich stärker fundiert und ihre praktische Anwendbarkeit muss verbessert werden. In dieser Arbeit werden die ersten Schritte des Projekts METAP zur methodischen Entwicklung und praktischen Implementierung einer Leitlinie für eine patientengerechte Versorgung am Krankenbett beschrieben und zur Diskussion gestellt. Das Projekt orientiert sich methodisch an der Entwicklung medizinischer Leitlinien und generiert damit eine forschungs- (...) und konsensgestützte Leitlinie, die systematischer Evaluation und Modifikation unterliegt und Rechenschaft über ihre wissenschaftliche Fundierung gibt. Zusätzlich zur Leitlinie bietet das Projekt in der Form eines Handbuchs ein Entscheidungsfindungsverfahren an, welches unter anderem deliberative Aspekte unterstützt. Das Handbuch konzentriert sich auf ethische Fragen der Mikroallokation und liefert darüber hinaus Informationen über empirische, ethische und rechtliche Grundlagen für Therapieentscheidungen. Anhand eines Eskalationsmodells können unterschiedliche Instrumente nach Bedarf als ethische Lösungsstrategien eingesetzt werden, von der Kurzfassung im Kitteltaschenformat („Leporello“) mit den wichtigsten Fakten, weiterführenden Texten und Empfehlungen mit normativen und prozeduralen Hinweisen, über stationsinterne Lösungsversuche bis hin zum Ethikkonsil. Klinische Partner sind von Beginn an aktiv in den Entwicklungsprozess eingebunden und verbessern so die Praxistauglichkeit und Akzeptanz sowie die Ausrichtung des Instrumentariums an den tatsächlichen Bedürfnissen. Dieses partnerschaftliche, partizipative Vorgehen scheint eine wichtige Voraussetzung dafür zu sein, dass METAP in der Klinik Fuß fassen konnte. (shrink)