BackgroundClinical ethics case consultations (CECCs) provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital.MethodsSemi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May 31, 2020. (...) All documents were analysed by two researchers independently.ResultsTwenty-four CECCs were requested within the study period, of which most (n = 22; 92%) had been initiated by physicians of the department. The patients were an average of 79 years old (R: 43–96), and 14 (58%) patients were female. The median length of stay prior to request was 12.5 days (R: 1–65 days). The most frequent diagnoses (several diagnoses possible) were cardiology-related (n = 29), followed by sepsis (n = 11) and cancer (n = 6). Twenty patients lacked decisional capacity. The main reason for a CECC request was uncertainty about the balancing of potential benefit and harm related to the medically indicated treatment (n = 18). Further reasons included differing views regarding the best individual treatment option between health professionals and patients (n = 3) or between different team members (n = 3). Consensus between participants could be reached in 18 (75%) consultations. The implementation of a disease specific treatment intervention was recommended in five cases. Palliative care and limitation of further disease specific interventions was recommended in 12 cases.ConclusionsTo the best of our knowledge, this is the first in-depth evaluation of a CECC service set up for an academic department of cardiology and intensive medical care. Patient characteristics and the issues deliberated during CECC provide a starting point for the development and testing of more tailored clinical ethics support services and research on CECC outcomes. (shrink)

"Quod habet principium sed caret fine": this idea of the perpetual is expresssed in both the schools and courts of the twelfth-century renaissance. The philosophers conceive the perpetual as intermediate between time and eternity; according to masters of the school of Chartres, moreover, the world itself is perpetual. For the troubadour poets, the perpetual functions rhetorically. The moralist Marcabru treats the personified abstraction as perpetual, continuous in identity yet subject to change, thus achieving a satiric duality of vision. The love (...) poet Bernart de Ventadorn develops a "poetics of perpetuity", using the very tensions and instabilities of fin'amors to fashions ideal and endless courtly worlds. (shrink)

The metaverse concept constructs a virtual world parallel to the real world. The social economic dynamics model establishes a systematic model for social economic dynamics simulation that integrates macroeconomy and microeconomy based on modeling mechanism of the new theory of value by analogy with Newtonian mechanics and the modeling approach of Agent-based computational economics. This article describes the SED model’s modeling mechanisms, modeling rules, and behavior equations. At the same time, this article introduces the methods, testing standards, and some typical (...) cases about using the SED model to generate the economic digital twin systems. By doing so, we hope to demonstrate that the method of computer simulation experiment based on the SED model is a scientific empirical method, which has more advantages than the existing empirical research methods in economics. The SED model, which can be fully used to form an economic engine and construct a virtual economic system by digital twin method, can be integrated with the extant physical engine in the metaverse concept to build a virtual world consisting of physics, economy, culture, and politics that is close to and coexists with reality. (shrink)

SummaryScholars have tended to overlook the political import of the ideas of Arthur Schopenhauer. This is perhaps unsurprising, since Schopenhauer himself was not a political philosopher and wrote relatively little about political matters. But Schopenhauer's near-silence on political topics should warrant our attention: why would a systematic philosopher, who made lasting contributions in metaphysics, ethics, and aesthetics, devote so little attention to politics? Connecting his political thought with his philosophy of history, I argue that Schopenhauer can best be regarded as (...) a critic of the idea of progress, especially ‘progress’ conceived of as national development or the growth of the state. (shrink)

This work discusses the origin of the architect and the architecture presented in the treatise _De Architectura_ by Vitruvius and its association with imitation. It is discussed the Vitruvian notion of the progression of humanity and its connections with the architect and the establishment of Architecture as the science of the architect. The proposal of training for professionals from various areas is analyzed, which would guarantee, according to Vitruvius, a generalist training and at the same time specialized in their field. (...) It also discusses the attributes necessary, according to the author, for a good professional, which would allow him to achieve recognition for his authority. (shrink)

Although at first sight the Speculum contains ‘too little Augustine’ for theologians who are attempting to discover the originality of this thought, it is in fact a revealing anthology. An examination of the criteria used for the selection of Scriptural quotations brings to light an important facet of his mystagogy. Both the exclusion and inclusion criteria demonstrate that Augustine’s intention is to confront his reader with his own imperfections, and this to a much greater degree than is suggested by the (...) understatement of Speculum 108 that the moral guidelines proffered should have an immediate impact. Augustine’s aim in writing the Speculum is to effect a confrontation of the reader with himself, in a first, but permanent step on the way of mystagogy. Scripture serves as a mirror to reflect as detailed and unpolished an image as possible of the person who looks into it; the confrontation must be as violent as possible. (shrink)

This article examines Augustine’s anti-Donatist claim that it is not the punishment but the cause that makes a martyr. Augustine’s non poena sed causa argument arises as part of the larger rhetoric of martyrdom that recent scholarship has highlighted in late antiquity. I argue here that a more specific look at classical rhetorical techniques can provide a better understanding of what Augustine is up to in his particular rhetoric of martyrdom. To that end, after providing an overview of North African (...) martyr discourse, I turn to forensic rhetoric and issue theory as described in Cicero and Quintilian. I show that two types of forensic arguments—one on the issue of definition and other on the contested interpretation of a legal text—shaped Augustine’s non poena sed causa approach to the Donatists’ claims to be the church of the martyrs. (shrink)

Local supplier corporate social responsibility in developing countries represents a powerful tool to improve labour conditions. This paper pursues an inter-organizational network approach to the global value chain literature to understand the influence of suppliers’ collective behaviour on their CSR engagement. This exploratory study of 30 export-oriented and first-tier apparel suppliers in Bangladesh, a developing country, makes three relevant contributions to GVC scholarship. First, we show that suppliers are interlinked in a horizontal network that restricts unilateral CSR engagement. This is (...) justified in that unilateral CSR engagement is a source of heterogeneity in labour practices; consequently, it triggers worker unrest. Second, we present and discuss an exploratory framework based on four scenarios of how suppliers currently engage in CSR given their network’s pressure toward collective behaviour: unofficial CSR engagement, geographic isolation, size and competitive differentiation, and external pressure. Finally, we show the need to spread CSR homogeneously among suppliers and to reconceptualize the meaning of CSR in developing countries, encouraging more scrutiny toward horizontal dynamics. (shrink)

The place of emotions in aesthetic response has long been a topic in contemporary philosophical theorizing. One aspect of the debate in particular seems to have become a recalcitrant problem: when experiencing fiction, we experience emotional reactions towards what we know not to exist. Is this rational? In fact, is it even possible? This article deals with the so‐called “paradox of fiction” from the viewpoint of ancient poetics. In the first section, I survey some of the main arguments proposed to (...) (dis)solve the paradox in analytic philosophy. In the second and the third sections, I address what I consider two problematic assumptions of existing analytic approaches: their prescriptive, “essentialist” attitude and their exclusive focus on matters of content. By offering a brief sketch of the ancient principles of “likelihood” and “vividness”, I argue that they provide a direct and cognitively realistic answer to the paradox insofar as they account for the neutralization of doxastic features in imaginative acts and ground affective responses to fiction in the phenomenon of “aesthetic immersion”, explained in experiential, rather than representational, terms. (shrink)

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten (...) death. In this paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

I am grateful to my friend, Professor Heinrich Schepers, editor of volume VI.4 of Leibniz’s Sämtliche Schriften und Briefe, for the time and critical attention he devotes to my lengthy review of this volume, in a detailed reply included in the present issue of this journal. Since I believe that criticism and discussion are the master key to intellectual progress, I consider myself to be extremely lucky that my painstaking work has been the object of criticism by the scholar who (...) is most familiar with the texts published in VI.4. I am also grateful to Professor Glenn Hartz, editor of The Leibniz Review, for granting me the opportunity to publish a rejoinder, generously stretching the deadline for its submission, so that it could appear along with Professor Schepers’ reply. I hope this critical exchange will foster further discussion of the issues it touches upon, particularly the reassessment of the nature of Leibniz’s rationalism, and that Leibniz scholarship will be thereby rewarded. (shrink)

The aim of this study is to illustrate the role played by Augustine’s Commentary on the Genesis in the writings of Thomas Aquinas. This work is of great importance for Aquinas, not only because it is the work where Augustine clarifies his interpretation of creation, but also because creation is, among the theological topics, perhaps the most philosophical, insofar as it gives the opportunity of elaborating on many philosophical issues. In particular, the goal of the study is to rethink the (...) positions of Aquinas and Augustine on one of these issues, that is the relationship between soul and body. I mean to call into question two historiographical theses: first, that Augustine and Aquinas formulate positions that are irreconcilable with each other, and second, that they in no way address that which we today call the Mind-Body Problem. (shrink)

The aim of this article is to present and analyze the argumentative structures which are decisive for Leibniz’s position regarding the issue of the ontological status of material things (or bodies) and matter. I reconstruct and thoroughly analyze (i) two different argumentative strategies of Leibniz’s – viz. an “epistemic” and a “realistic” one – for his general thesis that nothing material (and a fortiori no body) has rigore metaphysico the status of a substance, as well as (ii) the corresponding suggestions (...) of his as to how the material world is to be construed out of substances and their modes. Throughout, I lay special emphasis onpinpointing the real key elements of Leibniz’s arguments and on articulating them in such terms that would allow for their direct confrontation with other paradigmatic positions regarding the issue in Leibniz’s times. (shrink)

Se habla de las traducciones de Aristóteles y Pseudo-Aristóteles en tierras gallegas o realizados por gallegos en la Edad Media; así como los problemas inherentes a toda operación de traducción en cualquier época y circunstancia. Nos centramos en Pedro Gallego, representante de la 3º generación de los traductores de la corte toledana de Alfonso X el Sabio, de quien fue amigo y confesor, aunque afincado en Murcia y obispo titular de la recién recuperada sede de Cartagena. Y pormenorizamos las distintas (...) secuencias en el traslado de una de las obras capitales de Aristóteles, que tanto interesó a los árabes, del árabe al latín, el Liber de animalibus, compendio de diversos trabajos naturalistas y de biología, que traduce nuestro autor natural de Ortigueira (mariña lucense). (shrink)

El artículo investiga las distancias o cercanías entre literatura, filosofía y psicoanálisis estudiando la metáfora de la sublimación. En primer lugar, traza los vínculos de Nietzsche y Freud con la Retórica de Aristóteles, es decir, los muestra deudores de aquella tradición literaria y retórica que, según Aristóteles, se sirve de un tipo de discurso afín a las cuestiones humanas, signadas por la posibilidad y la deliberación, antes que por la necesidad y la demostración. En segundo lugar, especifica cómo para Nietzsche (...) y para Freud la literatura no puede ser entendida ya bajo el paradigma que el propio Aristóteles comparte, esto es, la idea de que la literatura enseña o place. Tanto en Nietzsche como en Freud la literatura es una forma de sublimación y no un discurso que puede ser visto a la luz de los modelos tradicionales de la enseñanza moral o de la restringida esfera del deleite estético. Ahora bien, al servirse ambos de esa metáfora para dar cuenta del proceso que la literatura pone en obra, radicalizan, de distinta manera, una experiencia moderna: la conciencia de la paulatina elaboración de las construcciones culturales. Y entienden que dichas construcciones suponen un complejo proceso de transformación de determinados elementos, más específicos y delineados en Freud, más abiertos y dúctiles en Nietzsche. En especial se destaca la concordancia con Aristóteles para tomar la literatura como un discurso afín a las acciones humanas, pero se señala el significativo giro que la experiencia moderna comporta, pues la metáfora elegida subraya comprender el ámbito de lo humano bajo el signo de la transformación. (shrink)

El artículo trata de la apropiación que hace san Agustín de la doctrina de san Cipriano, en las controversias donatista y pelagiana. Da una visión de conjunto del uso que san Agustín hace del pensamiento de san Cipriano en estas controversias y presenta a la vez los puntos en que se hace clara referencia a Cipriano.