In order to build on the information that was obtained in the course of the first study, a follow-up survey was conducted first by phone and subsequently in a written form between August and October 2014. We contacted 1.858 hospitals in all of Germany for the follow-up survey by phone. In cases where a hospital had not participated in the first study, the willingness to participate in the follow-up survey was established in advance. The survey’s dispatch was ensured in the (...) case of acceptance. The same structured survey was used as a research tool. The data of the first study and the follow-up survey were merged and evaluated. 654 surveys could be evaluated altogether. Our survey by phone revealed that 912 hospitals in all of Germany have at least one form of clinical ethics consultation available. The health care ethics committee is the most frequently implemented structure of clinical ethics consultation. The implementation of clinical ethics consultation is dependent on sponsorship and hospital size. Recommendations to deliver structures of clinical ethics consultations have a smaller influence on the implementation compared to the certification by KTQ respectively proCum Cert. The rate of implementation in regard to the structures of clinical ethics consultation has steadily increased for years. The establishment of clinical ethics consultation in German hospitals should be further promoted. It would be desirable further to develop suitable juridical regulations in order to implement clinical ethics consultation as well as structural parameters. (shrink)

The executive board of the Academy for Ethics in Medicine and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between (...) September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly. (shrink)

Surveys of the German public have revealed a high acceptance of social freezing, i.e. oocyte conservation without medical indication. Up to now, there are no investigations available on the experiences and attitudes of health professionals towards social freezing. Between August 2015 and January 2016, we surveyed gynecologists Germany-wide on the topic social freezing. Five gynecologists specialized in reproductive medicine and five office-based gynecologists in standard care were chosen for the survey. The survey was conducted with an explorative, qualitative research design. (...) The demand for social freezing in Germany is low. With regard to their fertility age, most women attend consultations too late, they have only little previous knowledge and false expectations. The gynecologists consider it the duty of society and politics to provide for the compatibility of family and work. They relate late parenthood to disadvantages primarily for the children. A majority of the gynecologists interviewed tend to advise natural reproduction. Social freezing is often mistaken as a kind of fertility insurance. Thus, it is necessary that physicians inform women early about the possibilities and limitations of social freezing. In the first place, social freezing is not a medical or medical-ethical topic. Women consider the method as a possibility to ensure the compatibility of family and work. This compatibility should be mostly perceived as a political topic. It cannot be a medical task to solve this issue. In fact, a debate in society as a whole is necessary that includes all relevant actors. (shrink)

Anhand historischer Quellen, die sich dem hermaphroditischen Körper zuwandten, darunter zahlreichen Abbildungen, diskutiert diese Studie die Entstehung von Geschlechtlichkeit, die Praktiken der Geschlechtseinschreibung in die Körper und die hiermit korrespondierenden Effekte. Dabei werden naturgeschichtliche, medizinische und juridische Diskurse des 15. bis 19. Jh.s analysiert. Die Hermaphroditen-Beschreibungen des 15. Jh.s, beispielsweise von Paracelsus, erschüttern durch das Fehlen der Definition von Intersexualität über die doppelte Anzahl der Geschlechtsteile, das Fehlen der modernen, wohlbekannten Verbindung von Hermaphrodit und Geschlecht die Vertrautheit unseres Wissens über (...) Hermaphroditen. Solch eine Verbindung taucht erstmals in den Hermaphroditen-Diskursen des beginnenden 17. Jh.s auf. Sie wird in jenen medizinischen Traktaten produziert, die nach der "Wahrheit des Geschlechts" hermaphroditischer Körper fragen. Und genau diese Frage ist es, die den Moment markiert, da im abendländischen Denken das Geschlecht erfunden wurde. (shrink)

In the GDR, women from the age of 12 onwards have been committed to closed venerology wards. The involuntarily committed had not been informed about the medical treatment on the wards; it was performed without their consent – impinging on their physical integrity. The closed venerology wards have been controlled by the Ministry of State Security. Unofficial employee reported to the Ministry on the medical personnel and on the patients on the wards. Due to this information the Ministry of State (...) Security knew at all times, what was taking place within the closed venerology ward in Halle and who was being compulsory admitted to this ward. The Ministry of State Security diversely used this information. Physicians were simultaneously involved as unofficial employees in operational processes against individual patients. (shrink)

Since 1989, clinical ethics consultation in form of hospital ethics committees was established in most of the transition countries of Central and Eastern Europe. Up to now, the similarities and differences between HECs in Central and Eastern Europe and their counterparts in the U.S. and Western Europe have not been determined. Through search in literature databases, we have identified studies that document the implementation of clinical ethics consultation in Central and Eastern Europe. These studies have been analyzed under the following (...) aspects: mode of establishment of HECs, character of consultation they provide, and their composition. The results show that HECs in the transition countries of Central and Eastern Europe differ from their western-European or U.S. counterparts with regard to these three aspects. HECs were established because of centrally imposed legal regulations. Little initiatives in this area were taken by medical professionals interested in resolving emerging ethical issues. HECs in the transition countries concentrate mostly on review of research protocols or resolution of administrative conflicts in healthcare institutions. Moreover, integration of non-professional third parties in the workings of HECs is often neglected. We argue that these differences can be attributed to the historical background and the role of medicine in these countries under the communist regime. Political and organizational structures of healthcare as well as education of healthcare staff during this period influenced current functioning of clinical ethics consultation in the transition countries. (shrink)

Die Konzepte „Informationsmetabolismus“ von Antoni Kępiński und „Autopoiesis“ von Niklas Luhmann rekurrieren auf die Struktur biologischer Zellen. Beide Autoren übertragen diese biologischen Strukturen auf ihre jeweiligen Anwendungsfelder. Während Kępiński die Funktionsweise der Psyche zu bestimmen sucht, integriert Luhmann den biologischen Ansatz in seine Systemtheorie der lebenden und psychischen Systeme. Bei der Lektüre von Kępińskis und Luhmanns Arbeiten wird deutlich, dass beide Autoren das Verhältnis zwischen einerseits Psyche und andererseits psychischem System mit ihrer jeweiligen Umwelt näher bestimmen. In Luhmanns Werk ist (...) das Verhältnis zwischen System und Umwelt umfangreich beschrieben und ausgearbeitet. Vor diesem Hintergrund werden seine Ausführungen im Folgenden verwendet, um Kępińskis Überlegungen zum „Informationsmetabolismus“, dem Verhältnis von Psyche und Umwelt, zu reflektieren. (shrink)

German medical schools have not yet sufficiently introduced students to the field of good scientific practice. In order to prevent scientific misconduct and to foster scientific integrity, courses on GSP must be an integral part of the curriculum of medical students. Based on a review of the literature, teaching units and materials for two courses on GSP were developed and tested in a pilot course. The pilot course was accompanied by a pre-post evaluation that assessed students’ knowledge and attitudes towards (...) scientific integrity and scientific misconduct. A syllabus was designed that comprised the following six topics: theoretical foundations of GSP; scientific publishing; empirical data; scientific supervision and teamwork; clinical research; personal interests. The comparison pre versus post-intervention yielded statistically significant changes in regard to the participants’ knowledge and attitude toward all forms of scientific misconduct treated in the course. As the majority of participants was not familiar with the fundamental regulations or guidelines of GSP, it seems crucial to train students in actively applying such norms to real-world conflicts. Students’ unfamiliarity with the fundamentals of GSP can be linked to the fact that many students have already experienced forms of scientific misconduct. Thus, GSP syllabi should be closely adjusted to a student’s realm of experience. All in all, courses on GSP can be seen as a potential means to increase the number of young scholars. (shrink)

Schon 1926 prägte der protestantische Theologe Fritz Jahr (1895-1953) aus Halle (Saale) den Begriff Bioethik. Der von Jahr vorgeschlagene bioethische Imperativ lautet dabei: «Achte jedes Lebewesen grundsätzlich als einen Selbstzweck und behandle es nach Möglichkeit als solchen!» Dieser Band untersucht die Perspektiven von Jahrs Thesen.

Telemedicine is a complex field including various applications and target groups. Especially telehealthcare is seen by many as a means to revolutionize medicine. It gives patients the opportunity to take charge of their own health by using self-tracking devices and allows health professionals to treat patients from a distance. To some, this means an empowerment of patient autonomy as well as an improvement in the quality of care. Others state the dangers of depersonalization of medicine and the pathologization of daily (...) life. This paper examines the ethical implications of telehealthcare, focusing on patient autonomy and quality of care by analyzing metareviews, randomized controlled trials and narrative ethical analyses on the topic. As a result, we conclude that the technically enhanced encounter between patients and health professionals may mean an empowerment of patient autonomy when it goes along with a personal relationship based on trust, assistance and support. When it comes to the quality of care, telehealthcare may lead to an improvement as long it is adopted to the patient’s individual needs. (shrink)

German medical students are not sufficiently introduced to the ethical principles and pitfalls of scientific work. Therefore, a compulsory course on good scientific practice has been developed and implemented into the curriculum of medical students, with the goal to foster scientific integrity and prevent scientific misconduct. Students’ knowledge and attitudes towards GSP were evaluated by a pre-post-teaching questionnaire survey. Most participants initially had startling knowledge gaps in the field. Moreover, they were not acquainted with core institutions on GSP, the office (...) of ombudsperson and the nationally binding guidelines on GSP. The pre-post-teaching comparison showed statistically significant improvement in all areas tested; moreover, after the course participants confided more trust in GSP institutions. Applying ethical rules into practice can be challenging; therefore, students need to learn to work independently with guidelines on GSP and should be introduced to institutions providing further guidance. As our study has shown, students are very willing to pursue a scientific career based on integrity and honesty, however, they lack the knowledge how to do so. In light of our results, we therefore recommend to integrate courses on GSP already at an early time into the mandatory curriculum of medical students. (shrink)

The world is experiencing a cataclysmically increasing burden from chronic illnesses. Chronic diseases are on the advance worldwide and treatment strategies to counter this development are dominated by symptom control and polypharmacy. Thus, chronic conditions are often considered irreversible, implying a slow progression of disease that can only be hampered but not stopped. The current plant-based movement is attempting to alter this way of thinking. Applying a nutrition-first approach, the ultimate goal is either disease remission or reversal. Hereby, ethical questions (...) arise as to whether physicians’ current understanding of chronic illness is outdated and morally reprehensible. In this case, physicians may need to recommend plant-based diets to every patient suffering from chronic conditions, while determining what other socioecological factors and environmental aspects play a role in the chronic disease process. This article provides insights to aspects of diet and chronic illness and discusses how the plant-based movement could redefine current understanding of chronic disease. The ethical justifications for recommending of a plant-based diet are analyzed. The article concludes that not advocating for plant-based nutrition is unethical and harms the planet and patients alike. (shrink)

I raise an example that suggests that Andrea Kern’s Knowledge View of Perception should concede that a mere perceptual experience can be a potentiality for one to know something on its basis. I argue that the Knowledge View can accommodate this suggestion by distinguishing between two kinds of defective exercises of a capacity for perceptual knowledge, namely failed and incomplete exercises. I explain that, rather than collapsing the Knowledge View into the contrary Two-Capacity View, my suggestion further articulates the definitive (...) insight of the Knowledge View, namely that perceptual experience, on the basis of which one knows, issues from the same capacity as the knowledge enabled by it. (shrink)

Many interpretations of Kant’s first Critique fail to appreciate the revolutionary nature of his account of knowledge and its implications for skepticism, givenness and mind-independence, because they read Kant as holding a compositional account of knowledge. I contend that the reason for this is that this account is both naturally appealing in its own right, and fits an influential reading of Kant’s Transcendental Deduction. On this reading, the Deduction aims to respond to a skeptical worry which issues from the empiricist (...) version of epistemic compositionalism and which questions the intelligibility of the claim to knowledge of our judgements. Against this, I argue that what Kant’s Deduction actually aims to address is a radicalization of this epistemic worry, which instead questions the intelligibility of the objective purport of our judgements. I contend that the compositional account is unable to respond to this more radical worry, thereby putting it into question both as a reading of Kant, and as an account of knowledge generally. To corroborate this, I provide a reading of the Deduction that overcomes epistemic compositionalism by thinking through its shortcomings in order to arrive at a more adequate successor account: the hylomorphic account of knowledge, which, I contend, is able to dissolve both the more radical and the epistemic worry. I suggest that this implies generally that the epistemic worry issuing from the compositional account is not self-contained, but must give way to Kant’s more radical worry, which I argue can only be addressed within the underappreciated framework of epistemic hylomorphism. (shrink)

This paper presents an approach of unsupervised learning of clusters from a citation database, and applies it to a large corpus of articles in philosophy to give an account of the structure of the discipline. Following a list of journals from the PhilPapers-archive, 68,152 records were downloaded from the Reuters Web of Science-Database. Their citation data was processed using dimensionality reduction and clustering. The resulting clusters were identified, and the results are graphically represented. They suggest that the division of analytic (...) and Continental philosophy in the considered timespan is overstated; that analytical, in contrast to Continental philosophy does not form a coherent group in recent philosophy; and that metaphors about the disciplinary structure should focus on the coherence and interconnectedness of a multitude of smaller and larger subfields. (shrink)

Can sensibility, as our capacity to be sensibly presented with objects, be understood independently of the understanding, as the capacity to form judgments about those objects? It is a truism that for judgments to be empirical knowledge they must agree with what sensibility presents. Moreover, it is a familiar thought that objectivity involves absolute independence from intellectual acts. The author argues that together these thoughts motivate a common reading of Kant on which operations of sensibility are conceived as intelligible independently (...) of acts of the understanding, so that their supposed objectivity can validate judgments as empirical knowledge. He contends that there are two reasons why this epistemic compositionalism is implausible both as a reading of Kant and in itself. First, read compositionally, Kant’s Transcendental Deduction is unable to fulfill its stated aim of showing that the categories are objectively valid, that is, exemplified by the objects that sensibility presents. Second, Kant sees that sensibility by itself cannot be understood to even purport to present objects, thus undermining the very intelligibility of compositionalism. The author argues that, given these challenges, Kant’s Deduction develops an alternative account, on which operations of sensibility and acts of the understanding can be understood only together. He contends that this epistemic hylomorphism transforms the familiar thought underlying compositionalism: objectivity simultaneously involves formal agreement with intellectual acts in general and material independence from any specific such act. He thus shows how Kant reconceives our conception of objectivity by overcoming compositionalism in favor of hylomorphism. (shrink)

Foundational investigations in quantum mechanics, both experimental and theoretical, gave birth to the field of quantum information science. Nevertheless, the foundations of quantum mechanics themselves remain hotly debated in the scientific community, and no consensus on essential questions has been reached. Here, we present the results of a poll carried out among 33 participants of a conference on the foundations of quantum mechanics. The participants completed a questionnaire containing 16 multiple-choice questions probing opinions on quantum-foundational issues. Participants included physicists, philosophers, (...) and mathematicians. We describe our findings, identify commonly held views, and determine strong, medium, and weak correlations between the answers. Our study provides a unique snapshot of current views in the field of quantum foundations, as well as an analysis of the relationships between these views. (shrink)

According to the traditional view in the philosophy of logic facts of logic bear normative authority regarding how one ought to reason. Usually this is to mean that the relation of logical consequence between statements has some special relevance for how one’s beliefs should cohere. However, as I will argue in this article, this is just one way in which logic is normative for reasoning. For one thing, belief is not the only kind of mental state involved in reasoning. Besides (...) adopting and revising beliefs, rational agents pose and resolve questions. For another thing, the consequence relation of classical logic can be conservatively extended such that it includes logical relations between questions as well. Therefore, there is an argument to be made that not only the inference of new beliefs from extant beliefs but also the process of raising additional questions falls under the normative authority of logic. Accordingly, a nuanced account of the normativity of logic presents itself, which convincingly deals with problems such as clutter-avoidance and the paradox of the preface. (shrink)

Artificial intelligence increasingly executes tasks that previously only humans could do, such as drive a car, fight in war, or perform a medical operation. However, as the very best AI systems tend to be the least controllable and the least transparent, some scholars argued that humans can no longer be morally responsible for some of the AI-caused outcomes, which would then result in a responsibility gap. In this paper, I assume, for the sake of argument, that at least some of (...) the most sophisticated AI systems do indeed create responsibility gaps, and I ask whether we can bridge these gaps at will, viz. whether certain people could take responsibility for AI-caused harm simply by performing a certain speech act, just as people can give permission for something simply by performing the act of consent. So understood, taking responsibility would be a genuine normative power. I first discuss and reject the view of Champagne and Tonkens, who advocate a view of taking liability. According to this view, a military commander can and must, ahead of time, accept liability to blame and punishment for any harm caused by autonomous weapon systems under her command. I then defend my own proposal of taking answerability, viz. the view that people can makes themselves morally answerable for the harm caused by AI systems, not only ahead of time but also when harm has already been caused. (shrink)

Even if we know all relevant descriptive facts about an act, we can still be uncertain about its moral acceptability. Most literature on how to act under such normative uncertainty operates on moral realism, the metaethical view that there are objective moral facts. Lay people largely report anti-realist intuitions, which poses the question of how these intuitions affect their interpretation and handling of normative uncertainty. Results from two quasi-experimental studies (total N = 365) revealed that most people did not interpret (...) normative uncertainty as referring to objective moral facts but rather as uncertainty regarding one’s own view, uncertainty regarding the culturally accepted view or as the result of ambivalence. Especially the anti-realist majority of participants interpreted normative uncertainty different to how it is described in the literature on choice under normative uncertainty. Metaethical views were also associated with lay peoples’ choice of uncertainty reduction strategies and with assumptions about the intended aim of such strategies. The current findings suggest that empirical investigations of normative uncertainty might benefit from considering folk metaethical pluralism, as the lay public largely disagrees with the metaethical assumptions underlying the current discourse on choice under normative uncertainty. (shrink)

The proliferation of multistakeholder initiatives (MSIs) over the past years has sparked an intense debate on the political role of corporations in the governance of global business conduct. To gain a better understanding of corporate political behavior in multistakeholder governance, this article investigates how firms construct a political identity when participating in MSIs. Based on an in-depth case study of the Accord on Fire and Building Safety in Bangladesh—an MSI established after the collapse of the Rana Plaza garment factory complex (...) in 2013 to improve working conditions in the Bangladeshi garment industry—we introduce the construct of a political CSR (corporate social responsibility) identity (PCSRI) and explore how firms construct their PCSRIs in MSIs. Employing a qualitative, inductive theory-building method, we analyze interviews and archival data to develop a framework that elucidates how companies construct their PCSRIs within a continuum ranging from conservative to progressive. We show that constructing a PCSRI involves enacting specific, yet interrelated, political strategies that are themselves shaped by several forces over time. This article contributes to the literature by providing a political perspective on organizational identity construction that extends the emerging integrative perspective in political corporate social responsibility (PCSR) research. We suggest that MSIs should be conceptualized as inherently political governance mechanisms that are driven by multidirectional and dynamic political processes of identity construction. Our study shows that corporate political engagement in MSIs is a more nuanced and complex phenomenon than presently theorized. (shrink)

In the absence of effective judicial remediation mechanisms after business-related human rights violations, companies themselves are expected to establish remediation procedures for affected victims and communities. This is a challenge for both companies and victims since comprehensive company-based grievance mechanisms are currently missing. In this paper, we explore how companies can provide effective remediation after human rights violations. Accordingly, we critically assess two different approaches to conflict resolution, alternative dispute resolution and restorative justice, for their potential to provide dialogue-based, non-judicial (...) remediation. We argue that remedy through agreement-driven ADR mechanisms risks marginalizing the interests and concerns of victims and affected community members, particularly in weak institutional contexts. Hence, we develop a dialogue-driven framework for corporate remediation of human rights violations grounded on RJ principles. This restorative framework provides a comprehensive CGM that focuses on the harms and needs of victims and aims at restoring justice through restorative dialogue. Based on a prompt discovery and a thorough investigation of the grievance, companies should design and prepare the remediation process together with victims, offenders and affected community members. Through restorative dialogue with the affected parties about the circumstances and impacts of the wrongdoing, companies can repair the harm, regain legitimacy amongst stakeholders as well as transform their business practices to avoid future human rights violations. (shrink)

This paper focuses on the use of ‘black box’ AI in medicine and asks whether the physician needs to disclose to patients that even the best AI comes with the risks of cyberattacks, systematic bias, and a particular type of mismatch between AI’s implicit assumptions and an individual patient’s background situation.Pacecurrent clinical practice, I argue that, under certain circumstances, these risks do need to be disclosed. Otherwise, the physician either vitiates a patient’s informed consent or violates a more general obligation (...) to warn him about potentially harmful consequences. To support this view, I argue, first, that the already widely accepted conditions in the evaluation of risks, i.e. the ‘nature’ and ‘likelihood’ of risks, speak in favour of disclosure and, second, that principled objections against the disclosure of these risks do not withstand scrutiny. Moreover, I also explain that these risks are exacerbated by pandemics like the COVID-19 crisis, which further emphasises their significance. (shrink)

ABSTRACTThe question of how to engage with stakeholders in situations of value conflict to create value that includes a plurality of conflicting stakeholder value perspectives represents one of the crucial current challenges of stakeholder engagement as well as of value creation stakeholder theory. To address this challenge, we conceptualize a discursive sharing process between affected stakeholders that is oriented toward discursive justification involving multiple procedural steps. This sharing process provides procedural guidance for firms and stakeholders to create pluralistic stakeholder value (...) through the discursive accommodation of diverging stakeholder value perspectives. The outcomes of such a discursive value-sharing process range from stakeholder value dissensus to low and increasing levels of stakeholder value congruence to stakeholder value consensus. Hence, this article contributes to the emerging literature on integrative stakeholder engagement by conceptualizing a procedural framework that is neither overly oriented towards dissensus nor consensus. (shrink)

This book explores Hobbes's ideas about the internal pacification of states, the prospect of a peaceful international order, and the connections between civil and international peace. It questions the notion of a negative Hobbesian peace, which is based on the mere suppression of violence, and emphasises his positive vision of everlasting peace in a well-governed commonwealth. The book also highlights Hobbes's ideas about international coexistence and cooperation, which he considers integral to good government. In examining Hobbes's conception of peace, it (...) provides a fresh perspective on his international political thought. The findings also have wider implications for the ways in which we think about Hobbes's relationship to the realist and liberal traditions of international thought, and will appeal to students and scholars of political theory and international relations. (shrink)

This dissertation articulates our human capacity to judge as a capacity for knowledge, specifically for empirical knowledge, and for knowledge of itself as such. I interpret and draw on the account of such knowledge presented by Kant’s Critique of Pure Reason, situate this account historically, and relate it to relevant contemporary debates. The first chapter motivates my project by assessing the insights and shortcomings of Cartesian epistemology. I argue that while Descartes draws on the essential self-consciousness of judgement to show (...) that the cogito is knowledge, he fails, by his own standards, to secure this status for any judgement beyond the cogito. I conclude that self-consciousness alone is empty, but that, since we can judge beyond the cogito, judgement can be given content from elsewhere. The next chapter evaluates the empiricist doctrine that operations of the senses by themselves give content to judgement and can vindicate it as empirical knowledge. I contend that Kant deepens Hume’s finding, that empiricism fails to enable us to explain empirical knowledge, into the more radical insight that empiricism fails to enable us to understand the senses as providing any content. I conclude that the senses alone are blind and that our account of empirical knowledge must privilege neither sensory givenness nor intellectual self-consciousness. The third chapter contrasts two readings of Kant on the cooperation between sensibility and understanding in empirical knowledge. I argue, against many Kantians, that the Transcendental Deduction shows that instead of understanding this cooperation compositionally – so that operations of sensibility are intelligible independently of acts of the understanding – we must conceive of it hylomorphically – so that the operations of sensibility and understanding constitute the mutually dependent matter and form of empirical knowing respectively. The final chapter substantiates this hylomorphism by explicating the form of knowledge as synthesis. Following Kant, I argue that inference is a species of synthesis and provide a synthetic explanation of inference. The resulting account simultaneously illustrates synthesis, addresses a prominent contemporary problem regarding the nature of inference, and explains how our capacity to know provides not just isolated glimpses of empirical reality, but a unified conception of it. (shrink)

Biological modalities (e.g., biological possibility, necessity and counterfactuality) play an important explanatory role in biological practice. However, biological modalities lack truth conditions and the inferential relationship between biological and other modalities is unclear. This thesis addresses these problems, first, by improving upon Daniel Dennett's Library of Mendel. Second, a family of modal logics is introduced. In the simplest model, states are interpreted as codons, the binary relation is interpreted as single substitution mutation and the valuation induces a partition of blocks (...) of codons that code for some amino acid. In addition, the proposed framework allows for a grading of biological possibility and captures various competing notions of biological possibility. Applications include a model checker and a lawless Lewis-style semantics for biological counterfactuals. In short, this thesis lays the groundwork for a theory of biological modalities. (shrink)

Discussions on the Anthropocene as the geology of mankind imply the question whether globalized technology such as energy technologies or A.I. ought to be first and foremost conceptualized as a strategy of the human in relation to nature or as a strategy of some humans over others. I argue that both positions are mirrored in the philosophy and sociology of technology through the concepts of technology as an extension and as a fetish. The extension concept understands technology as an extension (...) of the human body and its capabilities, resulting in a local ‘inward’ perspective. The fetish concept offers a contrary ‘outward’ perspective by drawing attention to the global socio-material context of modern technology. Despite their differences, I argue that both concepts share an underlying operation principle of technology as functional simplification. Technology always involves a functional simplification of physical as well as social causality. Sociologists and philosophers of technology would do well not to give primacy to the former as it leads to the belief in technology as a universal tool that neglects how technology is not embedded in but consists of (unequal) social arrangements. (shrink)

The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical (...) issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one’s own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account. (shrink)

The permissibility of nudging in public policy is often assessed in terms of the conditions of transparency, rationality, and easy resistibility. This debate has produced important resources for any ethical inquiry into nudging, but it has also failed to focus sufficiently on a different yet very important question, namely: when do nudges undermine a patient’s voluntary consent to a medical procedure? In this paper, I take on this further question and, more precisely, I ask to which extent the three conditions (...) of transparency, rationality, and easy resistibility can be applied to the assessment of voluntary consent too. After presenting two examples, designed to put pressure on these three conditions, I show that, suitably modified, the three conditions can remain significant in the assessment of voluntary consent as well. However, the needed modifications are very substantial and result in a rather complicated view. To propose a tidier solution, I argue that nudging undermines voluntary consent if and only if it cannot be ‘interpersonally justified’ to the patient. I use the three modified conditions to motivate the idea of interpersonal justification and also to further specify the principles it involves. My resulting view is especially attractive because it builds on already existing insights from the debate on nudging, updates those insights with an eye to medical consent, and finally unites them in an elegant and simple framework. (shrink)

There is a crisis of valuation practices in the current academic life sciences, triggered by unsustainable growth and “hyper-competition.” Quantitative metrics in evaluating researchers are seen as replacing deeper considerations of the quality and novelty of work, as well as substantive care for the societal implications of research. Junior researchers are frequently mentioned as those most strongly affected by these dynamics. However, their own perceptions of these issues are much less frequently considered. This paper aims at contributing to a better (...) understanding of the interplay between how research is valued and how young researchers learn to live, work and produce knowledge within academia. We thus analyze how PhD students and postdocs in the Austrian life sciences ascribe worth to people, objects and practices as they talk about their own present and future lives in research. We draw on literature from the field of valuation studies and its interest in how actors refer to different forms of valuation to account for their actions. We explore how young researchers are socialized into different valuation practices in different stages of their growing into science. Introducing the concept of “regimes of valuation” we show that PhD students relate to a wider evaluative repertoire while postdocs base their decisions on one dominant regime of valuing research. In conclusion, we discuss the implications of these findings for the epistemic and social development of the life sciences, and for other scientific fields. (shrink)

Definition of the problem Few concepts in recent ethical debates have enjoyed as much popularity as the concept of discrimination. However, a comparative discussion of the concept, including its conceptual nuances and its ethical significance for health care, has so far been lacking. The aim of this paper is to develop a nuanced understanding of discrimination based on the philosophical and sociological literature against the background of ethically relevant medical and nursing scenarios. Methods Using practical examples from health care, we (...) discuss direct, indirect, and statistical discrimination; we examine the importance of intentions and the role of collective actors. In addition, we analyze which social groups may experience discrimination and the respective importance of forms of epistemic injustice. Conclusions We argue that despite its complexity, the concept offers significant added value because it allows us to highlight forms of disadvantage that go beyond the violation of individual specific rights or interests. As a knowledge-based system of great societal influence, health care exhibits some characteristics that can foster discrimination. Acknowledging this fact is essential in order to effectively address discrimination. (shrink)

Kaum ein Begriff der ethischen Debatten der letzten Jahre hat eine solche Konjunktur erlebt wie der Begriff der Diskriminierung. Eine vergleichende Erörterung des Konzepts einschließlich seiner begrifflichen Nuancen und seiner ethischen Bedeutung für das Gesundheitswesen fehlte jedoch bislang. Ziel dieses Beitrags ist die Entwicklung eines differenzierten Verständnisses von Diskriminierung auf der Basis der philosophischen und soziologischen Literatur vor dem Hintergrund ethisch relevanter medizinischer und pflegerischer Szenarios. Anhand von praktischen Beispielen aus dem Gesundheitswesen erörtern wir die Besonderheiten direkter, indirekter und statistischer (...) Diskriminierung, wir untersuchen die Bedeutung von Absichten und die Rolle von kollektiven Akteuren. Zudem diskutieren wir, welche sozialen Gruppen diskriminiert werden können und welche Rolle Formen epistemischer Ungerechtigkeit dabei spielen. Argumentiert wird, dass das Konzept trotz seiner Komplexität einen signifikanten Mehrwert bietet, weil es erlaubt, Formen der Benachteiligung aufzuzeigen, die über die Verletzung einzelner spezifischer Rechte oder Interessen hinausgehen. Als wissensbasiertes System von großem gesellschaftlichen Einfluss weist das Gesundheitswesen einige Eigenschaften auf, die Diskriminierung begünstigen können. Dies zu erkennen ist unerlässlich, um Diskriminierung wirksam entgegentreten zu können. (shrink)

In 2017, the German ethics commission for automated and connected driving released 20 ethical guidelines for autonomous vehicles. It is now up to the research and industrial sectors to enhance the development of autonomous vehicles based on such guidelines. In the current state of the art, we find studies on how ethical theories can be integrated. To the best of the authors’ knowledge, no framework for motion planning has yet been published which allows for the true implementation of any practical (...) ethical policies. This paper makes four contributions: Firstly, we briefly present the state of the art based on recent works concerning unavoidable accidents of autonomous vehicles (AVs) and identify further need for research. While most of the research focuses on decision strategies in moral dilemmas or crash optimization, we aim to develop an ethical trajectory planning for all situations on public roads. Secondly, we discuss several ethical theories and argue for the adoption of the theory “ethics of risk.” Thirdly, we propose a new framework for trajectory planning, with uncertainties and an assessment of risks. In this framework, we transform ethical specifications into mathematical equations and thus create the basis for the programming of an ethical trajectory. We present a risk cost function for trajectory planning that considers minimization of the overall risk, priority for the worst-off and equal treatment of people. Finally, we build a connection between the widely discussed trolley problem and our proposed framework. (shrink)

People can be uncertain in their moral judgments. Philosophers have argued that such uncertainty can either refer to the underlying empirical facts (empirical uncertainty) or to the normative evaluation of these facts itself (normative uncertainty). Psychological investigations of this distinction, however, are rare. In this paper, we combined factor-analytical and experimental approaches to show that empirical and normative uncertainty describe two related but different psychological states. In Study 1, we asked N = 265 participants to describe a case of moral (...) uncertainty and to rate different aspects of their uncertainty about this case. Across this wide range of moral scenarios, our items loaded onto three reliable factors: lack of information, unclear consequences, and normative uncertainty. In Study 2, we confirmed this factor structure using predefined stimulus material. N = 402 participants each rated eight scenarios that systematically varied in their degree of uncertainty regarding the consequences of the described actions and in the value conflict that was inherent to them. The empirical uncertainty factors were mainly affected by the introduction of uncertainty regarding consequences, and the normative uncertainty factor was mainly affected by the introduction of value conflict. Our studies provide evidence that the distinction between empirical and normative uncertainty accurately describes a psychological reality. We discuss the relevance of our findings for research on moral judgments and decision-making, and folk metaethics. (shrink)

Focused correlation compares the degree of association within an evidence set to the degree of association in that evidence set given that some hypothesis is true. A difference between the confirmation lent to a hypothesis by one evidence set and the confirmation lent to that hypothesis by another evidence set is robustly tracked by a difference in focused correlations of those evidence sets on that hypothesis, provided that all the individual pieces of evidence are equally, positively relevant to that hypothesis. (...) However, that result depends on a very strong equal relevance condition on individual pieces of evidence. In this essay, we prove tracking results for focused correlation analogous to Wheeler and Scheines’s results but for cases involving unequal relevance. Our result is robust as well, and we retain conditions for bidirectional tracking between incremental confirmation measures and focused correlation. (shrink)

Bernard Williams described the case of a lorry driver who runs over a child through no fault of his own. In this article, I pursue two aims. First, I want to motivate a puzzle about Williams’s case, which I call the Lorry Driver Paradox and which consists of three individually plausible but jointly inconsistent claims. Second, I want to offer a solution to this paradox based on a novel approach to so-called strict moral answerability. I conclude by responding to the (...) objection that strict answerability is a contradiction in terms. (shrink)

In the chapter on Observing Reason in the Phenomenology, as well as in §368 of the Philosophy of Nature, Hegel deals with the life sciences of his time. There, he labels the methodology of its representatives, namely zoology and comparative anatomy, as external teleology. In this paper I want to show that by doing so he is actually discussing a general kind of functionalism. Thereby, I want to highlight a line of thought in Hegel's texts which represents a productive reading (...) of external teleology contrary to a destructive reading on which scholars have mainly focussed. (shrink)