Umberto Eco's Baudolino (2000) never achieved the success of his first novel, The Name of the Rose (1980), although both are historical fictions that provide literary clothing for philosophical ideas. In Baudolino, Eco again dramatizes the disagreement between rationalists and empiricists regarding the sources of our concepts and knowledge, ideas that came to the fore during the medieval period and which continue to be pertinent questions in epistemology. Propositions of either sense experience or logic and reasoning being the basis for (...) knowledge, offer Eco an opportunity for playing what he calls "a game of ambiguity about truth and lies."1 Historical uncertainties, the holes in the fabric of our knowledge about .. (shrink)

Even though co‐parenthood is one of the most significant close personal relationships that people can have, there is relatively little philosophical work on the moral duties that co‐parents owe each other. This may be due to the increasingly questionable assumption, still common in our societies, that co‐parenthood arises naturally from marriage or romantic coupledom and thus that commitment to a co‐parent evolves from a commitment to a marital or romantic partner. In this article, we argue that co‐parenthood should be seen (...) as a relationship in its own right, which generates specific moral duties. Co‐parents should come to explicit agreements with each other regarding the most important areas of potential conflict between them. Such agreements may have to be renegotiated over time. We explore some possible non‐negotiable co‐parental duties such as the duties not to alienate the child from the other parent(s) and not to trap a co‐parent in a particularly vulnerable situation. We consider some legal and societal implications of our argument and, finally, suggest some pragmatic benefits of our proposal. (shrink)

Something in the world tears away, jumps out, approaches... A world that approaches is a world that is alive and vivid. This applies not only to the existing natural world, but also to what humans create, which, in form the form of artifacts - from the hand-held ax to linguistic theory - also approaches design in terms of both object and challenge.

The study of Islamic philosophy has entered a new and exciting phase in the last few years. Both the received canon of Islamic philosophers and the narrative of the course of Islamic philosophy are in the process of being radically questioned and revised. Most twentieth-century Western scholarship on Arabic or Islamic philosophy has focused on the period from the ninth century to the twelfth. It is a measure of the transformation that is currently underway in the field that, unlike other (...) reference works, the Oxford Handbook has striven to give roughly equal weight to every century, from the ninth to the twentieth. The Handbook is also unique in that its 30 chapters are work-centered rather than person- or theme-centered, in particular taking advantage of recent new editions and translations that have renewed interest and debate around the Islamic philosophical canon. The Oxford Handbook of Islamic Philosophy gives both the advanced student and active scholar in Islamic philosophy, theology, and intellectual history, a strong sense of what a work in Islamic philosophy looks like and a deep view of the issues, concepts, and arguments that are at stake. Most importantly, it provides an up-to-date portrait of contemporary scholarship on Islamic philosophy. (shrink)

BackgroundThe bioethical debates concerning living donation and surrogacy revolve around similar ethical questions and moral concepts. Nevertheless, the ethical discourses in both fields grew largely isolated from each other.MethodsBased on a review of ethical, sociological and anthropological research this paper aims to link the ethical discourses on living kidney donation and surrogacy by providing a comparative analysis of the two practices’ relational dimension with regard to three aspects, i.e. the normative role of relational dynamics, social norms and gender roles, and (...) reciprocity. Based on this analysis, we derive conclusions for the framing of living organ donation and surrogacy in ethical theory and practice.ResultsFirst, our analysis emphasizes the relevance of acknowledging the complex relational implications of living kidney donation and surrogacy. Underestimating this relational dimension may not only lead to individual crises but endanger existing as well as newly emerging familial relationships. Second, we point out differences in the normative assessment of social norms and gender roles in the ethical debates about living kidney donation and surrogacy. In particular, we show how different evaluations of altruism affect the understanding of autonomy in both contexts. In addition, we sensitize for biased perceptions of gender roles. Finally, we argue that challenges resulting from unresolved reciprocity are an issue in living kidney donation and surrogacy independent of whether the exchange of body parts or bodily services is framed as a gift or commercial exchange. By pointing out the limits of financial compensation, we stress the relevance of non-material, relational rewards as potential remedy. (shrink)

The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among (...) trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates. (shrink)

The morphological marking that distinguishes conditionals that are called “counterfactual” from those that are not, can also be found in other modal constructions, such as in the expression of wishes and oughts. We propose to call it “X-marking”. In this article, we lay out desiderata for a successful theory of X-marking and make some initial informal observations. Much remains to be done.

Augmentative and Alternative Communication Technology [AAC Tech] is a relatively young, multidisciplinary field aimed at developing technologies for people who are unable to use their natural speaking voice due to congenital or acquired disability. In this paper, we take a look at the role of AAC Tech in promoting an ‘empathic turn’ in the perception of non-speaking autistic persons. By the empathic turn we mean the turn towards a recognition of non-speaking autistic people as persons whose ways of engaging the (...) world and expressing themselves are indicative of psychologically rich and intrinsically meaningful experiential lives. We first identify two ways in which AAC Tech contributes positively to this development. We then discuss how AAC Tech can simultaneously undermine genuine empathic communication between autistic persons and typically developed communicators (or neurotypicals). To mitigate this concern, we suggest the AAC field should incorporate philosophical insights from Design for Emotions and enactive embodied cognitive science into its R&D practices. To make our proposal concrete, we home in on stimming as an autistic form of bodily expressivity that can play an important role in empathic communicative exchanges between autistic persons and neurotypicals and that could be facilitated in AAC Tech designed for autistic people. (shrink)

Political Correctness ist nicht nur Reizthema und Schlagwort medialer Debatten, sondern auch in Alltagskommunikation oft Ausloser hitziger Debatten um sprachliche Diskriminierung. Doch wie positionieren sich eigentlich Sprachprofis zu diesem Thema, was rat das Worterbuch? Der Einfluss von Diskursen auf Worterbucher ist zwar in der Forschung unstrittig; eine umfassende Untersuchung zur Wirkung eines bestimmten zeitgenossischen Phanomens auf einen abgeschlossenen Wortschatzbereich existierte jedoch bislang nicht. Dieser Lucke widmet sich die Autorin, die den uber eine Korpusanalyse gewonnenen Wortschatz der Political Correctness aus den (...) ersten zehn Jahren (1990-2000) des Diskurses in den ersten sechs Auflagen (1983-2006) des Duden - Universalworterbuchs untersucht. Erstmals wird hier die Diskurslexik der Political Correctness der 1990er Jahre greifbar gemacht. Daruber hinaus werden vorhandene lexikographische Strategien beschrieben sowie deren Defizite im Umgang mit problematischer Lexik aufgedeckt. Die Arbeit zeigt, dass das Ringen um einen angemessenen Sprachgebrauch, die Vermeidung von Pejorisierung feste Bestandteile des Sprachhandelns darstellen, dem sich Worterbucher mit deskriptivem oder normativem Anspruch zu stellen haben. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

This article concerns a new constraint on the interaction of quantifier phrases and epistemic modals. It is argued that QPs cannot bind their traces across an epistemic modal, though it is shown that scoping mechanisms of a differentnature are permitted to cross epistemic modals. The nature and source of this constraint are investigated.

« Cet article vise, par le recours à la catégorie de bruit, à ouvrir des voies capables de raccorder la philosophie et l’éducation. mon hypothèse centrale est que la catégorie de bruit instaure un connecteur critique qui active conjointement l’ontologie d’Alain Badiou et la pédagogie de Paulo Freire 1. Le bruit, postulé ici comme la temporalisation phénoménologique du vide ontologique de Badiou, devient la condition de possibilité à la fois de l’émergence d’un sujet et de sa fidélité à une procédure (...) de vérité. je pose ici un Sujet générique de l’éducation comme l’émanation temporelle du lieu ouvert par la catégorie philosophique de Vérité. je propose, en somme, qu’une telle “éducation dans le bruit” ne soit que l’aspect praxial, temporel et immanément freirien de la notion purement philosophique de Badiou d’une “éducation par les vérités. 2 ». (shrink)

In the age of artificial intelligence, the common interest in human autonomy is experiencing a revival. Autonomy has formerly and mostly been investigated from a theoretical scientific perspective, in which scholars from various disciplines have linked autonomy with the concepts of dignity, independence from others, morality, self-awareness, and unconventionality. In a series of three semi-qualitative, preregistered online studies, we investigated laypersons' understanding of autonomy with a bottom-up procedure to find out how far lay intuition is consistent with scientific theory. First, (...) in Study 1, participants provided us with at least three and up to 10 examples of autonomous behaviors, for a total of 807 meaningful examples. With the help of blinded research assistants, we sorted the obtained examples into categories, from which we generated 34 representative items for the following studies. Next, in Study 2, we asked a new sample of participants to rate the degree of autonomy reflected in each of these 34 items. Last, we presented the five highest-rated and the five lowest-rated items to the participants of Study 3, whom we asked to evaluate how strongly they represented the components of autonomy: dignity, independence from others, morality, self-awareness, and unconventionality. We identified that dignity, independence from others, morality, and self-awareness significantly distinguished between high- and low-autonomy items, implying that high autonomy items were rated higher on dignity, independence from others, morality, and self-awareness than low autonomy items, but unconventionality did not. Our findings contribute to both our understanding of autonomous behaviors and connecting lay intuition with scientific theory. (shrink)

In their discussion paper of November 2020, Cooket alpresent a draft protocol for navigating circumstances in which emergency services are overwhelmed. Their paper suggests that COVID-related triage decisions should be based on clinical assessment, patient and family consultation, and a range of ethical considerations. In this response, we note that the protocol exhibits an ambiguity that is likely to result in irresolvable dilemmas when put into practice. This ambiguity is exemplified in the paper’s prime ethical imperative (to ‘save more lives (...) and more years of life’), which takes the form of an undefined conjunction whose practical implications are left unspecified. We see this ambiguity in the prime imperative as one manifestation of a broader set of tensions in the protocol. We show that the discipline of human rights provides an essential supplement to the ethical framework on which Cook and colleagues rely, providing a framework for understanding and working through triage dilemmas involving age, discrimination and equality. (shrink)

Deep brain stimulation as investigational intervention for symptomatic relief from Alzheimer disease has generated big expectations. Our aim is to discuss the ethical justification of this research agenda by examining the underlying research rationale as well as potential methodological pitfalls. The shortcomings we address are of high ethical importance because only scientifically valid research has the potential to be ethical. We performed a systematic search on MEDLINE and EMBASE. We included 166 publications about DBS for AD into the analysis of (...) research rationale, risks and ethical aspects. Fifty-eight patients were reported in peer-reviewed journals with very mixed results. A grey literature search revealed hints for 75 yet to be published, potentially enrolled patients. The results of our systematic review indicate methodological shortcomings in the literature that are both scientific and ethical in nature. According to our analysis, research with human subjects was performed before decisive preclinical research was published examining the specific research question at stake. We also raise the concern that conclusions on the potential safety and efficacy have been reported in the literature that seem premature given the design of the feasibility studies from which they were drawn. In addition, some publications report that DBS for AD was performed without written informed consent from some patients, but from surrogates only. Furthermore, registered ongoing trials plan to enroll severely demented patients. We provide reasons that this would violate Art. 28 of the Declaration of Helsinki, because DBS for AD involves more than minimal risks and burdens, and because its efficacy and safety are not yet empirically established to be likely. Based on our empirical analysis, we argue that clinical research on interventions of risk class III should not be exploratory but grounded on sound, preclinically tested, and disease-specific a posteriori hypotheses. This also applies to DBS for dementia as long as therapeutic benefits are uncertain, and especially when research subjects with cognitive deficits are involved, who may foreseeably progress to full incapacity to provide informed consent during the required follow-up period. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Direct-to-consumer genetic testing has been available for several years now, with varying degrees of regulation across different countries. Despite a restrictive legal framework it is possible for consumers to order genetic tests from companies located in other countries. However, German laypeople’s awareness and perceptions of DTC GT services is still unexplored. We conducted seven focus groups with German laypeople to explore their perceptions of and attitudes towards commercial genetic testing and its ethical implications. Participants were critical towards DTC GT. Criticism (...) was directed at health-related, predictive testing, while lifestyle tests were accepted and even welcomed to some extent. Participants expressed strong reservations regarding commercial provision of genetic diagnostics and expressed a lack of trust in respective companies. They preferred non-commercial distribution within the public healthcare system. Participants also expressed high expectations of physicians’ abilities to interpret information obtained via DTC GT companies and provide counseling. Legal restrictions on commercial distribution of genetic tests were opposed, with participants arguing that it should be available to consumers. DTC GT companies are not perceived as trustworthy when compared to the public healthcare system and its professional ethical standards and practices. Laypeople rated general consumer autonomy higher than their own concerns, thus recommending against strong legal regulation. We conclude that medicine’s trustworthiness may be negatively affected if commercial provision is not visibly opposed by the medical professions, while DTC GT companies may gain in trustworthiness if they adapt to standards and practices upheld in medicine. (shrink)

On peut considérer que ce qui se produit dans le travail familial thérapeutique avec une famille dans une institution donnée est révélateur du fonctionnement de la famille tel que cette dernière le projette sur l’institution. Mais ce qui se passe dans cette thérapie peut aussi refléter le fonctionnement de l’institution à ce moment précis : ce qui se vit dans l’institution a souvent des répercussions sur les prises en charge thérapeutiques.

On peut considérer que ce qui se produit dans le travail familial thérapeutique avec une famille dans une institution donnée est révélateur du fonctionnement de la famille tel que cette dernière le projette sur l’institution. Mais ce qui se passe dans cette thérapie peut aussi refléter le fonctionnement de l’institution à ce moment précis : ce qui se vit dans l’institution a souvent des répercussions sur les prises en charge thérapeutiques.

We discuss two-layered logics formalising reasoning with paraconsistent probabilities that combine the Łukasiewicz [0, 1]-valued logic with Baaz ▵\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\triangle $$\end{document} operator and the Belnap–Dunn logic. The first logic (introduced in [7]) formalises a ‘two-valued’ approach where each event ϕ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\phi $$\end{document} has independent positive and negative measures that stand for, respectively, the likelihoods of ϕ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\phi (...) $$\end{document} and ¬ϕ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\lnot \phi $$\end{document}. The second logic that we introduce here corresponds to ‘four-valued’ probabilities. There, ϕ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\phi $$\end{document} is equipped with four measures standing for pure belief, pure disbelief, conflict and uncertainty of an agent in ϕ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\phi $$\end{document}.We construct faithful embeddings of and into one another and axiomatise using a Hilbert-style calculus. We also establish the decidability of both logics and provide complexity evaluations for them using an expansion of the constraint tableaux calculus for. (shrink)

There is an ongoing expert debate with regard to financial incentives in order to increase organ supply. However, there is a lacuna of empirical studies on whether citizens would actually support financial incentives for organ donation.

Wilke et al. make significant headway in gaining a better understanding of the influence affect cues may have on action perception and judgement. In our view their account also brings up a row of important questions demanding further research. This concerns the role of conceptual and non-conceptual content and the different effects emotions of the same valence may play in the perception and judgement of action.

The excavations carried out beside the north rampart of the lower town of Amathus have revealed the existence of a large archaic deposit, most probably originating from a destruction of the palace on the acropolis. This is the first part of a series of articles devoted to the material from this deposit. It deals with the context of its discovery, and considers the circular structure, which requires careful attention, filled by this material.

Flower symmetry is considered a morphological novelty that contributed significantly to the rapid radiation of the angiosperms, which already puzzled Charles Darwin and prompted him to name this phenomenon an ‘abominable mystery’. In 2009, the bicentenary of Darwin's birth and the 150th anniversary of the publication of his seminal work, ‘On the Origin of Species’, this question can now be more satisfactorily readdressed. Understanding the molecular control of monosymmetry formation in the model species Antirrhinum opened the path for comparative studies (...) with non‐model species revealing modifications of this trait. TCP transcription factors, named after TEOSINTE BRANCHED 1 in maize, CYCLOIDEA in snapdragon and PCF in rice, control flower monosymmetry development and contributed to establishing this trait several times independently in higher angiosperms. The joint advances in evolutionary and developmental plant research, combined in the novel research field named Evo/Devo, aim at elucidating the molecular mechanisms and strategies to unravel the mystery of how this diversity has been generated. (shrink)

Language development is not completed when children enter primary school. As the comprehension of connectives (such as although, despite) is important for understanding and producing academic texts and, thus, relevant for school success, we investigated its development and influential factors across primary school age on the basis of a newly developed and validated test instrument. Drawing on a German sample of N = 627 children (57.6 % language minority learners) in Grades 2 to 4, results of growth curve models showed (...) students’ initial level of the comprehension of connectives to be negatively related to its growth rate. Additional analyses revealed this association to be due mainly to parental socioeconomic status (SES) rather than children’s language background. Particularly, parental SES and children’s receptive grammar impacted initial level as well as growth rate of connective comprehension. Our results indicate the need for early and continuous sensitization of children for the register of academic language especially in the group of children from low socioeconomic background. (shrink)

ZusammenfassungIn massenmedialen Darstellungen wird das Hormon Oxytocin gegenwärtig als biochemische Basis von Sozialität und wirkmächtiger neuropharmakologischer Lösungsansatz für die (Wieder‑)Herstellung der gesellschaftlichen Kohäsion verhandelt. Mit Blick auf die ursprüngliche Bedeutung des Hormons als „Körperhormon“ zu Beginn des 20. Jahrhunderts soll im vorliegenden Artikel die außergewöhnliche Karriere von Oxytocin vom Regulator des Geburtsvorgangs hin zum Regulator der Gesellschaft nachgezeichnet werden. Woraus bezieht eine solch voraussetzungsvolle Behauptung ihre Intelligibilität und Akzeptabilität? Unsere Analyse des wissenschaftlichen Diskurses um Oxytocin (1906–1990), des massenmedialen Diskurses seit (...) den 1990er Jahren sowie dessen Rückwirkungen auf den wissenschaftlichen Diskurs im gleichen Zeitraum verweist auf eine Serie von Re-Konfigurationen von wissenschaftlichen Theorien und Praktiken, sowie der Konzeption der Substanz an sich. Nachdem es sich in der ersten Hälfte des 20. Jahrhunderts etabliert, wird Oxytocin bereits in den 1950er Jahren zum Neurohormon, findet in den folgenden Jahrzehnten jedoch kaum wissenschaftliche Aufmerksamkeit. Erst im Zuge des massenmedialen Interesses für die postulierten Wirkungen des Hormons in Zusammenhang mit Liebe und Bindung gerät die Substanz zunehmend in den Fokus empirischer Forschung. Die Rezeption von Oxytocin als neurohormonelle Basis der individuellen Soziabilität speist sich zum einen aus dem massenmedialen Diskurs, zum anderen aus bereits in der ersten Hälfte des 20. Jahrhunderts gemachten biopolitischen Verknüpfungen, die auf die Regulierung des Lebendigen abzielen, sowie aus einem technowissenschaftlichen Modus der Oxytocinforschung: an ihrem Schnittpunkt avanciert Oxytocin zum Sozialhormon, so unsere These. (shrink)

Die Einführung der Fallpauschalen-basierten Finanzierung der Krankenhäuser ist ein erneuter Versuch, die Kosten in diesem Bereich zu reduzieren. Folge dieses Anreizsystems ist u. a. eine deutliche Verkürzung der Verweildauer der Patienten im Krankenhaus. Das wiederum führt zu durchschnittlich kränkeren Patienten und einer deutlichen Arbeitsverdichtung für alle. Vor diesem Hintergrund wird anhand empirischer Daten die Situation der Pflege mit drastischen Einschränkungen beschrieben und es werden Hypothesen zur Begründung aufgestellt. Daran knüpft sich die Frage, welche Art der Versorgung die Patienten mit kürzer (...) werdender Verweildauer und immer häufiger auftretenden chronischen Krankheiten neben der ärztlichen Therapie benötigen. Dies baut auf der Theorie der Aufgaben zur Krankheitsbewältigung auf, die Patienten befähigen sollen, mit Krankheiten in ihrem eigenen Sinne umgehen zu können. Die Kernaufgaben der Pflege werden hier mit dem Ziel der forcierten Förderung der Entlassungsfähigkeit verbunden mit einem Empowerment der Patienten verknüpft. Organisatorisch bietet sich als Lösung der Einsatz von Primary Nurses an. Die derzeitige Situation in der Pflege widerspricht den genannten Sollvorstellungen diametral. Im Sinne einer sicheren und effektiven Versorgung von Patienten im Krankenhaus muss der Pflegedienst inhaltlich völlig anders aufgestellt und mit weiteren Kompetenzen ausgestattet werden. (shrink)

Despite what you have heard over the years, the famous evil deceiver argument in Meditation One is not original to Descartes. Early modern meditators often struggle with deceptive demons. The author of the Meditations is merely giving a new spin to a common rhetorical device. Equally surprising is the fact that Descartes’ epistemological rendering of the demon trope is probably inspired by a Spanish nun, Teresa of Ávila, whose works have been ignored by historians of philosophy, although they were a (...) global phenomenon during Descartes’ formative years. In this paper, I first answer the obvious question as to why previous early modernists have missed something so important as the fact that Descartes’ most famous publication relies on a well-established genre and that his deceiver argument bears a striking similarity to ideas in Teresa’s final work, El Castillo Interior? I discuss the meditative tradition at the end of which Descartes’ Meditations stands, present evidence to support the claim that Descartes was familiar with Teresa’s proposals, contrast their meditative goals, and make a point-by-point comparison between the meditative steps in Teresa’s Interior Castle and those in Descartes’ Meditations which constitute their common deceiver strategy. My conclusion makes a case for a broader and more inclusive history of philosophy. (shrink)

Für ökonomische Evaluationen medizinischer Leistungen steht ein etabliertes Methodenspektrum zur Verfügung. Ziel der Arbeit ist, anhand ausgewählter Aspekte herauszuarbeiten, inwieweit diese Methoden für den derzeit viel diskutierten Bereich der Personalisierten Medizin anwendbar sind bzw. welche Besonderheiten dabei auftreten und wie diese adressiert werden können. Für die vorliegende Arbeit wurde eine explorative Literaturrecherche durchgeführt. In Abgrenzung zur herkömmlichen Medizin kann je nach Blickwinkel die Personalisierte Medizin entweder hinsichtlich der physiologischen Unterschiede oder hinsichtlich der individuellen Präferenzen der Beteiligten betrachtet werden. Je nach (...) Betrachtungsweise ergeben sich unterschiedliche methodische Herausforderungen an gesundheitsökonomische Evaluationen. Verbesserte Ausrichtung der Versorgung an physiologischen Unterschieden stellt die Evaluation beispielsweise vor das Problem, dass aufgrund des oftmals kleinen Stichprobenumfangs häufig Evidenz zur Parametrisierung von Entscheidungsmodellen fehlt. Informationswertanalysen können Hinweise über den potenziellen Nutzen weiterer Forschung geben. Das Konzept des „Expected Value of Individualized Care“ bietet einen den Informationswertanalysen sehr ähnlichen Ansatz, um den potenziellen Wert eines Einbezugs individueller Präferenzen in die Versorgung zu quantifizieren. Welfarismus und Extra-Welfarismus bieten unterschiedliche Lösungsansätze, wie Nutzen Biomarker-basierter Information im Sinne von „Empowerment“ in Evaluationen einbezogen werden können. Generell sind die Methoden der gesundheitsökonomischen Evaluation auch auf den Bereich der Personalisierten Medizin anwendbar. Es stellen sich jedoch eine Reihe spezifischer Herausforderungen, zu deren Lösung weiterer Forschungsbedarf besteht. (shrink)

Contemporary critical approaches to bioethics increasingly present themselves as “relational,” though the meaning of relationality and its implications for bioethics seem to be many and varying. I argue that this confusion is due to a multiplicity of relational approaches originating from distinct theoretical lineages. In this article, I identify four key differences among commonly referenced relational approaches: the scope and nature of relationships considered, the extent of the determining influence on individual selfhood, and the integrity of individual selfhood. Importantly, these (...) four differences carry consequences for the usage of relational approaches within academic and clinical bioethics. I show that these differences attach to multiple objects of critique within mainstream bioethics and imply distinct metaethical commitments. Although I issue a cautionary note about combining relational approaches from distinct lineages, I close by suggesting that many such approaches may have their use, drawing on Susan Sherwin's sense of bioethical theories as lenses. (shrink)

Descartes intended to revolutionize seventeenth-century philosophy and science. But first he had to persuade his contemporaries of the truth of his ideas. Of all his publications, Meditations on First Philosophy is methodologically the most ingenuous. Its goal is to provoke readers, even recalcitrant ones, to discover the principles of “first philosophy.” The means to its goal is a reconfiguration of traditional methodological strategies. The aim of this chapter is to display the methodological strategy of the Meditations. The text’s method is (...) more subtle and more philosophically significant than has generally been appreciated. Descartes’ most famous work is best understood as a response to four somewhat separate philosophical concerns extant in the seventeenth century. Section 1 describes these. Section 2 discusses how Descartes uses and transforms them. A clearer sense of the Meditations’ methodological strategy provides a better understanding of exactly how Descartes intended to revolutionize seventeenth-century thought. (shrink)