ZusammenfassungAngesichts begrenzter anderweitiger Behandlungsmöglichkeiten wird der Gabe von Antidementiva in der gegenwärtigen medizinischen Demenz-Behandlung eine besondere Bedeutung zugeordnet. Eine evidenzbasierte ethische Analyse unter den Kriterien des Wohlergehens, des Nicht-Schadens, der Autonomie und der Gerechtigkeit zeigt jedoch, dass die Bedeutung von Antidementiva oftmals überschätzt wird und die Erwartungen zu hoch sind: Die Wirksamkeit von Antidementiva ist rein symptomatisch, sie fällt bei einer großen Anzahl an Patienten nur gering aus und bleibt für manche Patienten ohne Nutzen. Zudem sind Antidementiva mit Schadensrisiken behaftet (...) und verbrauchen finanzielle Ressourcen, deren Verteilung auf verschiedenen Ebenen zur Diskussion steht. Angesichts dieser Schwierigkeiten tritt eine bislang nur unzureichend beantwortete Grundfrage des Umgangs mit Demenz-Patienten in den Vordergrund: An welchen Zielen soll sich die Behandlung orientieren? Der folgende Artikel analysiert diese Frage vor dem Hintergrund der Grundstrukturen der derzeitigen Demenz-Behandlung und fordert hier zu einem grundlegenden Umdenken auf. (shrink)

Angesichts begrenzter anderweitiger Behandlungsmöglichkeiten wird der Gabe von Antidementiva in der gegenwärtigen medizinischen Demenz-Behandlung eine besondere Bedeutung zugeordnet. Eine evidenzbasierte ethische Analyse unter den Kriterien des Wohlergehens, des Nicht-Schadens, der Autonomie und der Gerechtigkeit zeigt jedoch, dass die Bedeutung von Antidementiva oftmals überschätzt wird und die Erwartungen zu hoch sind: Die Wirksamkeit von Antidementiva ist rein symptomatisch, sie fällt bei einer großen Anzahl an Patienten nur gering aus und bleibt für manche Patienten ohne Nutzen. Zudem sind Antidementiva mit Schadensrisiken behaftet (...) und verbrauchen finanzielle Ressourcen, deren Verteilung auf verschiedenen Ebenen zur Diskussion steht. Angesichts dieser Schwierigkeiten tritt eine bislang nur unzureichend beantwortete Grundfrage des Umgangs mit Demenz-Patienten in den Vordergrund: An welchen Zielen soll sich die Behandlung orientieren? Der folgende Artikel analysiert diese Frage vor dem Hintergrund der Grundstrukturen der derzeitigen Demenz-Behandlung und fordert hier zu einem grundlegenden Umdenken auf. (shrink)

ZusammenfassungAngesichts begrenzter anderweitiger Behandlungsmöglichkeiten wird der Gabe von Antidementiva in der gegenwärtigen medizinischen Demenz-Behandlung eine besondere Bedeutung zugeordnet. Eine evidenzbasierte ethische Analyse unter den Kriterien des Wohlergehens, des Nicht-Schadens, der Autonomie und der Gerechtigkeit zeigt jedoch, dass die Bedeutung von Antidementiva oftmals überschätzt wird und die Erwartungen zu hoch sind: Die Wirksamkeit von Antidementiva ist rein symptomatisch, sie fällt bei einer großen Anzahl an Patienten nur gering aus und bleibt für manche Patienten ohne Nutzen. Zudem sind Antidementiva mit Schadensrisiken behaftet (...) und verbrauchen finanzielle Ressourcen, deren Verteilung auf verschiedenen Ebenen zur Diskussion steht. Angesichts dieser Schwierigkeiten tritt eine bislang nur unzureichend beantwortete Grundfrage des Umgangs mit Demenz-Patienten in den Vordergrund: An welchen Zielen soll sich die Behandlung orientieren? Der folgende Artikel analysiert diese Frage vor dem Hintergrund der Grundstrukturen der derzeitigen Demenz-Behandlung und fordert hier zu einem grundlegenden Umdenken auf. (shrink)

The main public health advantages of examining gene by environment interactions in externalizing behavior lie in the realm of personalized interventions. Nevertheless, the incorporation of genetic data in randomized controlled trials is fraught with difficulties and raises ethical questions. This paper has been written from the perspective of developmental psychologists who, as researchers, see themselves confronted with important and in part new kinds of ethical questions arising from G × E research in social sciences. The aim is to explicate and (...) discuss ethical questions, based on the conviction that what is ethically salient in a research setting will also be relevant in that area of public healthcare incorporating research findings. The ethical questions discussed include: whether it is ethically responsible to withhold an effective treatment; to what extent genetic results should be disclosed; whether researchers should be allowed to collect genetic data of both child and parent; and what are costs and benefits of personalized interventions based on screening. We made an attempt to address these questions, but it is up to researchers to determine whether the solutions are suitable for their G × E research in social sciences. (shrink)

In this article, the authors examine the circumstances under which scholars can become effective figures of identification in medicine, after whom prizes or institutions are named – and under which circumstances scholars cannot or can no longer fulfill such a role. Trends and changes in professional cultural memory are examined, illustrated by the biographies and receptions of the human geneticist Hans Nachtsheim, the circulatory researcher Rudolf Thauer, the urologist Dora Teleky as well as the dentists Karl Häupl and Elsbeth von (...) Schnizer. This study shows that the evaluation criteria themselves are historically changeable and that gender is an important influencing factor. While formal criteria (e. g., membership in parties and organizations) have traditionally been important evaluation criteria, the authors advocate that actions in research and clinical practice be given even greater attention in the future. (shrink)

Remind little ones that God will always be there to love, support, and comfort them--no matter the situation--with this uplifting, reassuring board book. This powerful little book is filled to the brim with hope and comfort. Simple, child-friendly verse outlines relatable moments of crisis, uncertainty, and fear common to a child's life, and asks who helps us in each of those scenarios. "God, that's who" is the reliable answer, forming a pattern kids will quickly pick up on. Each answer reinforces (...) the book's deeply comforting message: God is always there for us. He loves us, He knows us, and He cares about our needs. As they listen to the book and look at the reassuring illustrations, little ones will learn that they can lean on God when they are upset or frightened, or anytime at all. (shrink)

There is an increasing amount of empirical work investigating the sense of agency, i.e. the registration that we are the initiators of our own actions. Many studies try to relate the sense of agency to an internal feed-forward mechanism, called the ‘‘comparator model’’. In this paper, we draw a sharp distinction between a non-conceptual level of feeling of agency and a conceptual level of judgement of agency. By analyzing recent empirical studies, we show that the comparator model is not able (...) to explain either. Rather, we argue for a two-step account: a multifactorial weighting process of different agency indicators accounts for the feeling of agency, which is, in a second step, further processed by conceptual modules to form an attribution judgement. This new framework is then applied to disruptions of agency in schizophrenia, for which the comparator model also fails. Two further extensions are discussed: We show that the comparator model can neither be extended to account for the sense of ownership (which also has to be differentiated into a feeling and a judgement of ownership) nor for the sense of agency for thoughts. Our framework, however, is able to provide a unified account for the sense of agency for both actions and thoughts. (shrink)

The neurocognitive structure of the acting self has recently been widely studied, yet is still perplexing and remains an often confounded issue in cognitive neuroscience, psychopathology and philosophy. We provide a new systematic account of two of its main features, the sense of agency and the sense of ownership, demonstrating that although both features appear as phenomenally uniform, they each in fact are complex crossmodal phenomena of largely heterogeneous functional and representational levels. These levels can be arranged within a gradually (...) evolving, onto- and phylogenetically plausible framework which proceeds from basic non-conceptual sensorimotor processes to more complex conceptual and meta-representational processes of agency and ownership, respectively. In particular, three fundamental levels of agency and ownership processing have to be distinguished: The level of feeling, thinking and social interaction. This naturalistic account will not only allow to “ground the self in action”, but also provide an empirically testable taxonomy for cognitive neuroscience and a new tool for disentangling agency and ownership disturbances in psychopathology. (shrink)

This book attempts to advance Donald Griffin's vision of the "final, crowning chapter of the Darwinian revolution" by developing a philosophy for the science of animal consciousness. It advocates a Darwinian bottom-up approach that treats consciousness as a complex, evolved, and multidimensional phenomenon in nature rather than a mysterious all-or-nothing property immune to the tools of science and restricted to a single species. -/- The so-called emergence of a science of consciousness in the 1990s has at best been a science (...) of human consciousness. This book aims to advance a true Darwinian science of consciousness in which its evolutionary origin, function, and phylogenetic diversity are moved from the field’s periphery to its very centre, thus enabling us to integrate consciousness into an evolutionary view of life. Accordingly, this book has two objectives: (i) to argue for the need and possibility of an evolutionary bottom-up approach that addresses the problem of consciousness in terms of the evolutionary origins of a new ecological lifestyle that made consciousness worth having and (ii) to articulate a thesis and beginnings of a theory of the place of consciousness as a complex evolved phenomenon in nature that can help us to answer the question of what it is like to be a bat, an octopus, or a crow. -/- A Philosophy for the Science of Animal Consciousness will appeal to researchers and advanced students interested in advancing our understanding of animal minds as well as anyone with a keen interest in how we can develop a science of animal consciousness. (shrink)

A most sensible exposition of Nietzsche's philosophy.

Animal welfare has a long history of disregard. While in recent decades the study of animal welfare has become a scientific discipline of its own, the difficulty of measuring animal welfare can still be vastly underestimated. There are three primary theories, or perspectives, on animal welfare - biological functioning, natural living and affective state. These come with their own diverse methods of measurement, each providing a limited perspective on an aspect of welfare. This paper describes a perspectival pluralist account of (...) animal welfare, in which all three theoretical perspectives and their multiple measures are necessary to understand this complex phenomenon and provide a full picture of animal welfare. This in turn will offer us a better understanding of perspectivism and pluralism itself. (shrink)

In it he came fully to terms with the inadequacy of traditional democratic theory." This volume is part of a continuing series on the major works of Walter Lippmann.

Advances in psychopharmacology raise the prospects of enhancing neurocognitive functions of humans by improving attention, memory, or mood. While general ethical reflections on psychopharmacological enhancement have been increasingly published in the last years, ethical criteria characterizing physicians’ role in neurocognitive enhancement and guiding their decision-making still remain highly unclear. Here it will be argued that also in the medical domain the use of cognition-enhancing drugs is not intrinsically unethical and that, in fact, physicians should assume an important role in gating (...) their usage. For finding normative orientation, concepts of disease, normality or medicine will not be helpful since—due to their cryptonormative nature—they rather hamper than allow targeted discussion and decision-making. As an alternative, the common and widely accepted bioethical criteria of beneficence, non-maleficence, autonomy and distributive justice allow a clinically applicable, highly differentiated context- and case-sensitive approach. By embedding decision-making in a participative physician–patient relationship extrinsic objections against neurocognitive enhancement (e.g. invalid perceptions about efficacy, benefit or risk; questionable voluntariness; restrained decision-making capacity) can be curtailed. (shrink)

Recent work has demonstrated that the sense of agency is not only determined by efference-copy-based internal predictions and internal comparator mechanisms, but by a large variety of different internal and external cues. The study by Moore and colleagues [Moore, J. W., Wegner, D. M., & Haggard, P. . Modulating the sense of agency with external cues. Conscious and Cognition] aimed to provide further evidence for this view by demonstrating that external agency cues might outweigh or even substitute efferent signals to (...) install a basic registration of self-agency. Although the study contains some critical points that, so we argue, are central to a proper interpretation of the data, it hints at a new perspective on agency: optimal cue integration seems to be the key to a robust sense of agency. We here argue that this framework could allow integrating the findings of Moore and colleagues and other recent agency studies into a comprehensive picture of the sense of agency and its pathological disruptions. (shrink)

Arguing for controversial readings of many of the canonical figures, the book also focuses on lesser-known writers such as Pierre-Sylvain Regis, Nicolas ...

We defend our multifactorial weighting model of the sense of agency and our critique of the comparator model against the critiques that have been brought forward by and . Building on the specification of our model that emerges from this response, we will suggest a distinct mechanism how weighting of different agency factors might work: internal and external agency cues are constantly weighted according to their reliability in a given situation. Thus, the weighting process underlying the sense of agency might (...) follow the principles of optimal cue integration. We review recent empirical evidence for this hypothesis, demonstrating that the multifactorial weighting model is not only testable, but has in fact already received first empirical support. (shrink)

Die Fortschritte in der Psychopharmakologie führen zu einem immer breiteren Angebot an Substanzen zur Verbesserung der Stimmung, des Gedächtnisses oder der exekutiven Funktionen. Dieses Angebot trifft auf die Wünsche und Bedürfnisse vieler Menschen, ihre mentalen Leistungen und Zustände zu verbessern. Wie sollte die Medizin mit diesen Wünschen umgehen? An welchen Kriterien sollte sich insbesondere der ärztliche Entscheidungsprozess orientieren? Im Folgenden soll gezeigt werden, dass sich aus einer „Treatment-enhancement-Unterscheidung“, einem Krankheits- oder Normalitätsbegriff oder einem bestimmten Medizinkonzept keine zielführenden normativen Kriterien für (...) diesen Entscheidungsprozess ableiten lassen. Demgegenüber wird ein Entscheidungsmodell entwickelt, das auf traditionellen Kriterien ärztlichen Handelns beruht: dem Kriterium des Wohlergehens, des Nichtschadens und der Autonomie. Mit diesem Modell soll zugleich ein neues Konzept einer „wunscherfüllenden Medizin“ vorgeschlagen werden: eine subjektive Medizin mit ärztlichem Empfehlungs- und Vetovorbehalt. (shrink)

Since the 1980s scholars have been increasingly confronted with expectations to orient themselves toward societal and economic priorities. This normative demand for societal responsiveness is inscribed in discourses aimed at increasing the usefulness, competitiveness, and control of academia. New performance criteria, funding conditions, and organizational forms are central drivers of this debate – thereby, they change the conditions in which scholars conduct research and advance their careers. However, little is known so far about the impact these institutional changes have on (...) the habitus of academics. This article analyzes how stable and consistent habitus formations among academics turn out to be in the course of institutional changes. We compare the habitus formations of two generations of German scholars before and after institutional changes gained pace in Germany. Three distinct habitus formations can be identified, which we refer to as “self-fulfilling,” “self-surpassing,” and “self-asserting.” These habitus formations hold across the two generations, but the lines between them become blurry in the new generation. (shrink)

Introduction: the advance of governmentality -- Foucault, power, and governmentality: introduction; what is governmentality?; beyond the microphysics of power?; from theory of the state to genealogy of the state; history of the art of government; pastoral power; raison d'état; liberal governmentality; five propositions on foucault and governmentality -- Governmentality 3.4.7.: introduction; governmentality after Foucault; governmentality and the political sciences; some problems in governmentality -- Foucault effect redux? some notes on international governmentality studies: constellation; a few preliminary observations; problems and debates (...) in international governmentality studies -- Reconnecting governmentality and genealogy: introduction; genealogy and governmentality; pluralizing genealogy; practicing genealogy; lines of descent: the family tree of power?; counter-memory and re-serialization; the retrieval of forgotten struggles and subjugated knowledges -- Conclusion: encountering governmentality: governmentality as a new cartography of power; from mapping to encountering; governmentality and politics. (shrink)

The nature and function of thoughts have been a central topic of philosophy from its ancient beginnings, yet its critical assessment was put forward in particular by the development of the philosophy of mind in the last decades: thoughts were no longer taken to be the secure basis of which we immediately know the content and its nature , but to be mental entities that require critical investigation concerning the determination of their content and nature. Thoughts are traditionally discussed in (...) connection with reasoning, planning, and justification, but the intrinsic connection between thoughts and rationality was later challenged by psychological conceptions that dismissed rationality as a central notion for a theory of thinking. (shrink)

Cet article discute, à travers le parcours critique d’un récent ouvrage d’Anselm Jappe, la thèse d’une illimitation « narcissique » constitutive de la forme subjective propre aux rapports de production capitalistes contemporains. Montrant que cette perspective est fondée sur une conception monolithique et unilatérale de l’histoire du capital et de ses sujets, ainsi que sur une réduction illégitime de toute forme d’in????inité au « mauvais in????ini » de l’illimitation, nous soutenons la nécessité de penser un infini positif irréductible tant à (...) l’illimitation abstraite de la valorisation qu’aux dispositifs capitalistes qui limitent les puissances d’autodétermination et d’autoactivation des individus.This article critically discusses the thesis, recently developed by Anselm Jappe, of a “narcissistic” illimitation constitutive of the subjective form typical of contemporary capitalist relations of production. By showing that this perspective is grounded on a monolithic and one-sided conception of the history of capital and its subjects, as well as on an illegitimate reduction of every form of infinity to the “bad infinity” of illimitation, we defend the necessity to conceive a positive form of infinity, irreducible to both the abstract illimitation of valorization and the capitalist apparatuses that limit the individual power of self-determination and self-activity. (shrink)

In this paper we elaborate Lacan's theory on courtly love to establish a link between literature, psychoanalytic practice and psychoanalytic theory. Lacan himself had already established the link between courtly love and psychoanalytic practice as a way of working through the mourning for the structural lack in the Symbolic order. As such, both can be seen as an anticipation of anticipation: not the object itself is anticipated, but rather the anticipation of this object. Through the use of Stiegler's reinterpretation of (...) the concept of the pharmakon we understand psychoanalytic theory and literature in general as attempts to work through this mourning by creating an anamnesis, a “long circuit” of knowledge in which the creators are implied with their own subjectivity. An analysis of Graham Swift's novel Ever After and of Italo Calvino's novel If on a winter's night a traveler demonstrate how this principle applies to the processes of writing and reading. (shrink)

This is the fullest existing collection of the texts, for the moment only in Italian translation, with an introduction, notes, general presentation of the texts, various indexes (part of this material is to be found in an attached CD).

Die Fortschritte in der Psychopharmakologie führen zu einem immer breiteren Angebot an Substanzen zur Verbesserung der Stimmung, des Gedächtnisses oder der exekutiven Funktionen. Dieses Angebot trifft auf die Wünsche und Bedürfnisse vieler Menschen, ihre mentalen Leistungen und Zustände zu verbessern. Wie sollte die Medizin mit diesen Wünschen umgehen? An welchen Kriterien sollte sich insbesondere der ärztliche Entscheidungsprozess orientieren? Im Folgenden soll gezeigt werden, dass sich aus einer „Treatment-enhancement-Unterscheidung“, einem Krankheits- oder Normalitätsbegriff oder einem bestimmten Medizinkonzept keine zielführenden normativen Kriterien für (...) diesen Entscheidungsprozess ableiten lassen. Demgegenüber wird ein Entscheidungsmodell entwickelt, das auf traditionellen Kriterien ärztlichen Handelns beruht: dem Kriterium des Wohlergehens, des Nichtschadens und der Autonomie. Mit diesem Modell soll zugleich ein neues Konzept einer „wunscherfüllenden Medizin“ vorgeschlagen werden: eine subjektive Medizin mit ärztlichem Empfehlungs- und Vetovorbehalt. (shrink)

Durch den rasanten Fortschritt in den Neurowissenschaften ergibt sich ein bidirektionales Implikationsverhältnis zwischen Ethik und Neurowissenschaften: Einerseits haben neurowissenschaftliche Erkenntnisse epistemische Implikationen für anthropologisch-ethische Grundkonzepte, andererseits haben ethische Kriterien normative Implikationen für neurowissenschaftliche Interventionen. Die Neuroethik untersucht diese normativen Implikationen systematisch auf der metaethischen, der theoretischen und der praktischen Ebene. Um eine spezifische und differenzierte ethische Analyse der einzelnen neurowissenschaftlichen Interventionen zu ermöglichen, soll hier eine bereichsspezifische, neuroethische Kriteriologie vorgestellt werden. Durch exemplarische Anwendung ihrer einzelnen Kriterien auf gegenwärtige und zukünftige (...) neurowissenschaftliche Forschungs- und Interventionsmöglichkeiten soll gezeigt werden, dass sie eine systematische und zugleich praktisch anwendbare Möglichkeit bietet, einen normativen Orientierungsrahmen für Neurowissenschaften und Neurologie zu gewinnen. Insofern sie auf weitgehend konsensfähigen ethischen Prinzipien basiert, kann sie zudem als ethische Grundlage für einen breiten klinischen und wissenschaftlichen Diskurs dienen. (shrink)

Durch den rasanten Fortschritt in den Neurowissenschaften ergibt sich ein bidirektionales Implikationsverhältnis zwischen Ethik und Neurowissenschaften: Einerseits haben neurowissenschaftliche Erkenntnisse epistemische Implikationen für anthropologisch-ethische Grundkonzepte, andererseits haben ethische Kriterien normative Implikationen für neurowissenschaftliche Interventionen. Die Neuroethik untersucht diese normativen Implikationen systematisch auf der metaethischen, der theoretischen und der praktischen Ebene. Um eine spezifische und differenzierte ethische Analyse der einzelnen neurowissenschaftlichen Interventionen zu ermöglichen, soll hier eine bereichsspezifische, neuroethische Kriteriologie vorgestellt werden. Durch exemplarische Anwendung ihrer einzelnen Kriterien auf gegenwärtige und zukünftige (...) neurowissenschaftliche Forschungs- und Interventionsmöglichkeiten soll gezeigt werden, dass sie eine systematische und zugleich praktisch anwendbare Möglichkeit bietet, einen normativen Orientierungsrahmen für Neurowissenschaften und Neurologie zu gewinnen. Insofern sie auf weitgehend konsensfähigen ethischen Prinzipien basiert, kann sie zudem als ethische Grundlage für einen breiten klinischen und wissenschaftlichen Diskurs dienen. (shrink)

In his theory of time Aristotle does not often mention the present time and nowhere gives a detailed account of it. Nonetheless, present time plays an important role in his conception. I primarily argue for the following claims: (1) According to Aristotle there is a perception of motion and there is a perception of time. These combined perceptions can neither occur in the past nor in the future nor in an indivisible now. Thus, there must be a present time. (2) (...) Aristotle acknowledges the passage of time. This passage of time can only be understood as a passing present. And since an indivisible now cannot pass, the passage of time delivers a further argument for the basic assumption of a present time. – For the most part I simply follow Aristotle’s argument in Physics IV 10 and 11. In doing so, I distinguish present time and now in the introductory puzzles, investigate the passing present in the co-perception of change and time, discuss the relation between change and the passage of time as well as the relation between the passing present and the different nows. (shrink)

The last several years have seen vibrant debates among policymakers and scholars on whether to craft new human rights (or novel interpretations of existing ones) around neurotechnologies. These con...

A pioneering study that illuminates the connection of music, poetry, mystical praxis and social history underlying the ceremony of the Mevlevi Dervishes. Mevlana Jalaluddin Rumi, whose life and mystical poetry provided the inspiration for the Mevlevi Sufi order, is one of the world's best-known poets, yet the centuries-long musical tradition cultivated by the Mevleviye remains much less known. In this deeply researched book, renowned scholar Walter Feldman traces the historical development of Mevlevi music and brings to light the remarkable (...) musical and mystical aesthetics of the Mevlevi ayin - the instrumental and vocal accompaniment to the sublime ceremony of the 'Whirling' Dervishes. (shrink)