In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become (...) of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

F.-W. von Herrmann was a close associate of Heidegger during the final four years of the philosopher’s life. During that time, he not only had many conversations with him, but was also granted access to many writings just now appearing in the Gesamtausgabe. As a result of his proximity to Heidegger, as well as to his writings, von Herrmann seems in a unique position to provide an authoritative account of Heidegger’s work.

Freges Unterscheidung zwischen Sinn und Bedeutung von Ausdrücken ist oft als ein Modell für die Semantik natürlicher Sprachen betrachtet worden. Dagegen zeigt die vorliegende Untersuchung (z.T. durch Einordnung Freges in den historischen Kontext), dass Sinn und Bedeutung bei Frege termini technici darstellen, die der Konstruktion seiner formalen Sprache, der Begriffsschrift, dienen. Diese soll den logischen Defekten der natürlichen Sprache abhelfen, indem sie deren Vagheit und Mehrdeutigkeit eliminiert. Freges Sinn und Bedeutung sind daher von der sprachlichen Bedeutung natursprachlicher Ausdrücke scharf zu (...) unterscheiden. (shrink)

Auf Kants berühmte Frage "Wie ist Metaphysik möglich?" wird eine bejahende Antwort gegeben - eine, die Metaphysik als eine selbständige und unentbehrliche Disziplin darstellt, deren Aufgabe es ist, das Reich der wirklichen Möglichkeiten zu erforschen. Die Begriffe der "wirklichen" oder "metaphysischen" Möglichkeit und Notwendigkeit werden verteidigt und von den Begriffen verschiedener anderer Arten von Modalität unterschieden, z.B. physischer, logischer und begrifflicher Möglichkeit oder Notwendigkeit. Es wird dargelegt, daß die Gegner der Metaphysik, von den Relativisten bis zu denen, welche die Metaphysik (...) den empirischen Wissenschaften, der Erkenntnislehre oder der Sprachphilosophie unterordnen möchten, inkohärente Auffassungen annehmen. (shrink)

Thema der Arbeit ist der ontologische Status von Werken sowie die Beziehung zwischen Werken einerseits und Aufführungen, Manuskripten, Partituren, Schallplatten, Gemälden, Gebäuden, Drucken etc. andererseits. Es wird angeknüpft an den phänomenologischen Ansatz von Roman Ingarden (aber auch an den von Alexius Meinung). Diese Ansätze werden unter Verwendung moderner logischer Hilfsmittel weiterentwickelt und, wo notwendig, revidiert. Im ersten Kapitel wird ausführlich begründet, warum Werke (und zwar Werke aller Gattungen) abstrakte, typenartige Gegenstände sein müssen, die in konkreten Einzeldingen (z. B. Aufführungen) realisiert (...) sein können, jedoch von diesen Realisierungen in ihrer Existenz nicht abhängig sind. Diese These ist im weiteren Verlauf der Arbeit eine nicht mehr hinterfragte Grundvoraussetzung. Im zweiten Kapitel werden die formalen Grundlagen einer Typenontologie des Werks entwickelt. Zwei Hauptfragen stehen dabei im Vordergrund: (a) Wie kann ein Werk (also ein abstrakter Gegenstand) sinnliche Eigenschaften (z. B. Klangeigenschaften, Farbeigenschaften) haben? (b) Was macht einen Gegenstand zu einer Realisierung eines Werks? Welche Bedingungen müssen erfüllt sein, damit etwas eine Realisierung eines gegebenen Werks ist? Neben dem Begriff des Werks beruht die in dieser Arbeit entwickelte Theorie auf drei weiteren Grundbegriffen: Realisierungen, Konkretisierungen und Aktualisierungen. Realisierungen sind jene Gegenstände, in denen Werke realisiert sind. Konkretisierungen sind abstrakte Gegenstände, die durch "Vervollständigung" aus Werken hervorgehen. Sie sind immer noch unvollständig bestimmt, aber vollständiger bestimmt als die Werke, deren Konkretisierungen sie sind. Beispiele für Konkretisierungen sind Inszenierungen im Theater oder musikalische Interpretationen. Aktualisierungen sind die intentionalen Korrelate von Rezeptionsvorgängen. Sie entstehen im Verlauf der Rezeption eines Werks und werden von den Rezipienten erzeugt. Ein und dasselbe Werk kann auf verschiedene Weisen aktualisiert werden (z. B.: ein Musikstück kann auf verschiedene Weisen "gehört" werden). In eigenen Kapiteln werden Probleme der Mereologie, der Identität, des Darstellens und der Beziehung zwischen dem darstellenden Werk und dem Dargestellten erörtert. (shrink)

Der Kinder- und Jugendgesundheitssurvey soll repräsentative, gültige Daten und Erkenntnisse zur gesundheitlichen Situation von Kindern und Jugendlichen in Deutschland als entscheidende Voraussetzung für die Bewertung und die Verbesserung von deren gesundheitlicher Lage schaffen. Forschung und insbesondere Blutentnahmen an nichteinwilligungsfähigen Personen erfordern eine profunde ethische und rechtliche Überprüfung. Der Beitrag befasst sich damit, welche medizinethischen Empfehlungen und welche rechtlichen Grundsätze in Deutschland für die Bewertung relevant sind. Nach geltendem deutschen Recht können Eltern zu Blutentnahmen bei ihren Kindern nur zustimmen, wenn diese (...) in deren individuellem gesundheitlichen Interesse liegen. Ein „gruppenspezifischer Nutzen“, wie er von Medizinethikern national und international als Voraussetzung für ethische Akzeptabilität (bei minimalem Risiko der Untersuchungen) ebenfalls für sinnvoll und wichtig angesehen wird, und der in dem geplanten Survey in jedem Falle gegeben wäre, genügt deutschen Rechtsansprüchen nicht. Im Pretest hat sich der potenzielle individuelle Nutzen der Blutentnahmen bestätigt: Viele Kinder hatten biochemisch nachweisbare Gesundheitsrisiken (z. B. verborgener Nährstoffmangel, allergische Sensibilisierung, Hinweise auf Impflücken oder langfristige Gesundheitsrisiken), die ohne Blutuntersuchung nicht feststellbar gewesen wären. Bei über 90% der Kinder waren nach schriftlicher Einwilligung der Eltern und Jugendlichen sowie informeller Zustimmung der Kinder, die in jedem einzelnen Falle berücksichtigt wurde, Blutentnahmen möglich. Nach der Befragung einer Unterstichprobe ist die Akzeptanz insgesamt gut. (shrink)

SummaryP. Vardy asserts the thesis that the vicious circle principle has the same structure as Russell's paradox. But structure is not the thing itself. It is the thing objectivated from the wiewpoint of a mathematician. So this structure can be expressed in a mathematical formalism, e. g. the Λ‐calculus. Russell's paradox is understood as a result of the error of taking purely logical concepts, like negation, as lkiewise formalisable without change of meaning. The illusion of meaning in the liar's proposition: (...) Yl'am telling a lie can also be explained be the formalisable self‐referential structure of this proposition. Yet it remains an illusion because the logical intention cannot follow the structure.ResumeLe « Principe du cercle vicieux » a la même structure que le paradoxe de Russel: c'est une thèse de P. Várdy. Mais la structure n'est pas la chose même. Elle est la chose objectivée du point de vue du mathématicien et peut done être exprimée dans un formalisme mathématique, p. ex. le Λ‐calcul. L'erreur qui conduit au paradoxe de Russel, c'est de juger des concepts purement logique, p. ex. la négation, comme étant également exprimable dans un formalisme sans que leur sens ne change.L'illusion de sens que donne l'énoncé«je mens» dans le paradoxe du menteur peut aussi être expliquée par la structure formalisable d'autoréférence de cette proposition. Mais l'illusion persiste, parce que l'intention logique ne peut pas suivre la structure.ZusammenfassungRussells «Vicious circle principle» hat dieselbe Struktur wie die Russellsche Antinamie. So lautet die These P. Várdys. Aber die Struktur ist nicht die Sache selbst, sondern nur die vom mathematischen Standpunkte aus objektivierte Sache, die in einem Formalis‐onus ausgedrückt werden kann. Die Antinomie Russells wird Als Folge der irrigen Auffassung verstanden, rein logische Begriffe, wie z. B. die Negation, konnten formalisiert werden, ohne dass dabei ihr Sinn verwandelt würde. Die Sinnillusion des Satzes «Ich lüge» kann dann auch aus der selbstbezüglichen formalen Struktur des Satzes erklärt werden. Doch bleibt dies blosse Illusion, weil die logische Intention der Struktur nicht gerecht werden kann. (shrink)

One of the major concerns of the social philosophy is the technological revolution and its impacts on the social systems. Critical views on the systems from the social philosophers depart from the social predicaments of their time. The pivotal critic of Karl Marx in his work of Das Capital, for example, is on poverty caused by the system of capitalism. Capitalism, for him, only produces various social downturns such as slavery, oppressions, exploitations and impoverishment. Herbert Marcuse, meanwhile, pointed at the (...) same problem, but he came from a different point of view from Marx. Marcuse criticized the abundant society. In One Dimensional Man Marcuse rendered a couple of incisive critics on the industrial society. Industrial society, for him, is marked by the abundance and surplus but this society is still oppressed under a new type of slavery, called voluntary slavery. We may briefly say that both philosophers rendered critics on the same matter of the industrial society, but the two stood on the different position. Marx’s critic was on the hungry and deficient society, while Marcuse on a satiated, plenteous and surplus society. The aim of this paper is to present of how Marcuse’s One-Dimensional Man ends in the digital age. (shrink)

The precautionary principle is often invoked in relation to pregnant women and may be one of the underlying reasons for their continuous underrepresentation in clinical research. The principle is appealing, because potential fetal harm as a result of research participation is considered to be serious and irreversible. In our paper, we explore through conceptual analysis whether and if so how the precautionary principle should apply to pregnant women. We argue that the principle is a decision-making strategy underlying risk-benefit decisions in (...) clinical research, which can be applied to pregnant women. However, the current application is a strong one, leading to the promotion of absolute exclusion or, less often, absolute inclusion of pregnant women. In order to change this paralyzing situation, a shift toward weak precautionary thinking is necessary. Instead of automatic extreme precaution, a balance will be found between harms and potential benefits of including pregnant women in clinical research. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

As early as 2002, CIOMS stated that pregnant women should be presumed eligible for participation in research. Despite this position and calls of other well‐recognized organizations, the health needs of pregnant women in research remain grossly under‐researched. Although the presumption of eligibility remains unchanged, the revision of the 2002 CIOMS International ethical guidelines for biomedical research involving human subjects involved a substantive rewrite of the guidance on research with pregnant women and related guidelines, such as those on fair inclusion and (...) vulnerability. However, close reading of the guidelines reveals morally relevant different approaches to fair inclusion of pregnant women and other under‐represented groups, such as children and incompetents. Where CIOMS sets out that children and adolescents must be included unless a good scientific reason justifies their exclusion, no such claim of having to justify exclusion appears in the guideline on pregnant women. Instead, CIOMS claims that research relevant to pregnant women’s health needs must be promoted. This paper analyses how and to what extent the guideline on pregnant women differs from other guidance on fair inclusion in the document. Accordingly, the paper evaluates to what extent the current phrasing may contribute to fair inclusion of pregnant women in research. We will conclude that a system change towards a learning health system is essential to break down the status quo of knowledge generation in the field of medication use during pregnancy and argue that the CIOMS guidelines allow for this system change. (shrink)

Editor's suggested further reading in BioEssaysA new paradigm in cell therapy for diabetes: Turning pancreatic α‐cells into β‐cells Abstract.

BackgroundThere is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study.MethodsWe conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands.ResultsThree themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment.ConclusionsHealthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

SummaryP. Vardy asserts the thesis that the vicious circle principle has the same structure as Russell's paradox. But structure is not the thing itself. It is the thing objectivated from the wiewpoint of a mathematician. So this structure can be expressed in a mathematical formalism, e. g. the Λ‐calculus. Russell's paradox is understood as a result of the error of taking purely logical concepts, like negation, as lkiewise formalisable without change of meaning. The illusion of meaning in the liar's proposition: (...) Yl'am telling a lie can also be explained be the formalisable self‐referential structure of this proposition. Yet it remains an illusion because the logical intention cannot follow the structure.ResumeLe « Principe du cercle vicieux » a la même structure que le paradoxe de Russel: c'est une thèse de P. Várdy. Mais la structure n'est pas la chose même. Elle est la chose objectivée du point de vue du mathématicien et peut done être exprimée dans un formalisme mathématique, p. ex. le Λ‐calcul. L'erreur qui conduit au paradoxe de Russel, c'est de juger des concepts purement logique, p. ex. la négation, comme étant également exprimable dans un formalisme sans que leur sens ne change.L'illusion de sens que donne l'énoncé«je mens» dans le paradoxe du menteur peut aussi être expliquée par la structure formalisable d'autoréférence de cette proposition. Mais l'illusion persiste, parce que l'intention logique ne peut pas suivre la structure.ZusammenfassungRussells «Vicious circle principle» hat dieselbe Struktur wie die Russellsche Antinamie. So lautet die These P. Várdys. Aber die Struktur ist nicht die Sache selbst, sondern nur die vom mathematischen Standpunkte aus objektivierte Sache, die in einem Formalis‐onus ausgedrückt werden kann. Die Antinomie Russells wird Als Folge der irrigen Auffassung verstanden, rein logische Begriffe, wie z. B. die Negation, konnten formalisiert werden, ohne dass dabei ihr Sinn verwandelt würde. Die Sinnillusion des Satzes «Ich lüge» kann dann auch aus der selbstbezüglichen formalen Struktur des Satzes erklärt werden. Doch bleibt dies blosse Illusion, weil die logische Intention der Struktur nicht gerecht werden kann. (shrink)

Restrictive visitation policies produce inequities in healthcare that have meaningful consequences for patients’ health and well-being. There is a surplus of existing literature exploring the consequences of reduced visitation in the setting of pediatric patients lacking decision-making capacity, but relatively little scholarship addressing visitation restriction for less vulnerable adults possessing capacity. Here, we present the case of a patient who suffered serious complications of childbirth, during the delivery of her healthy newborn, leading to prolonged hospitalization. During her treatment course, she (...) was subsequently denied visitation with her newborn, who had been discharged from the hospital, and this had detrimental effects on her recovery. Hospital policies restricting visitation during the COVID-19 pandemic were intended to reduce the risk of disease exposure for both patients and staff, despite conflicting evidence demonstrating this benefit. In contrast, they often have negative effects on patient stress, mood, and physical recovery. The sequelae of this US-based case study argue the need for more holistic hospital visitation policies, placing a specific lens on adult patients receiving a visitation from their newborn children. (shrink)

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

Der von W. SELB (S.) und H. KAUFHOLD (K.) unter dem Titel „Das Syrisch-Römische Rechtsbuch“ (SRRB) edierte Text hat seit dem Ende des 17. Jahrhunderts zunächst in Form von kleinen Fragmenten in verschiedenen orientalischen Sprachen Spuren in der europäischen rechtsgeschichtlichen Forschung hinterlassen. Erst mit der Entdeckung einer syrischen Handschrift im Britischen Museum durch J. P. N. Land 1858 ist das Werk in einem wesentlichen Textzeugen bekannt und seitdem durch weitere Funde ergänzt, ins Lateinische und moderne Sprachen übersetzt und juristisch kommentiert (...) worden. Dennoch hat es bislang keine auf allen (syrischen) Handschriften beruhende kritische Edition erfahren. Die Autoren machen dies im ersten Kapitel (Bd.1, 27–42) verständlich, indem sie die Irrungen und Wirrungen der Wissenschaftsgeschichte des Textes darlegen. In diesem ersten Kapitel werden die Grundfragen, welche sich mit dem Text und seinem Verständnis verbinden, in offener und klarer Sprache formuliert. Das SRRB ist demnach eine einheitliche Sammlung von Erklärungen zu juristischen Texten zumeist normativen Charakters (Kaiserinstitutionen, leges) oder seltener von Juristenschriften (z. B. Paulussentenzen) aus verschiedenen Zeiten, die als „interpretatio“ um das Jahr 474 n. Chr. in griechischer Sprache entstanden ist (I, 46). Diese Erkenntnis, die S. im Kern schon in seiner Habilitationsschrift thesenhaft formuliert hat, wird durch die gegenwärtige Schrift erhärtet. Sie bildet die Grundlage für jede weitere Beschäftigung mit der Quelle. Richtungsweisend sind ebenfalls die nunmehr angestellten Überlegungen zum Verfasser des SRRB. In einer Handschrift (R III) wird ein Ambrosius confessor als Autor benannt. Diese Notiz deutete die Forschung bislang als Hinweis auf den Kirchenvater Ambrosius von Mailand, der freilich als Autor eines juristischen Werkes mit prononciert östlicher Verbreitung schwerlich in Frage kommt. Dennoch haben die Autoren die handschriftliche Notiz nicht als völlig aus der Luft gegriffen betrachtet. (shrink)

The purpose of this study is to examine the importance that real patients attach to their right to withdraw from an on-going feasibility randomised trial (RCT) evaluating types and timings of breast reconstruction (two parallel trials) following mastectomy for breast cancer. Our results show that, while some respondents appreciated that exercising the right to withdraw would defeat the scientific objective of the trial, some patients with a surgical preference consented only given the knowledge they could withdraw if they were not (...) allocated to their preferred treatment. (shrink)

The rational-agent frame of reference for the analysis of corporate strategic decision-making may be expanded to a moral-agent perspective where decision content is seen as comprising both commercial and ethical factors. Relevant factors may then be classified on the basis of the ethical decision principles to which they relate: rational-egoism, self-referential altruism or deontology. This approach is then applied to the problem of decision support for strategic divestment by MNCs.