To fulfill their crucial duty of relieving suffering in their patients, physicians may have to administer palliative sedation when they implement treatment-limitation decisions such as the withdrawal of life-supporting interventions in patients with poor prognosis chronic severe brain injury. The issue of palliative sedation deserves particular attention in adults with serious brain injuries and in neonates with severe and irreversible brain lesions, who are unable to express pain or to state their wishes. In France, treatment limitation decisions for these patients (...) are left to the physicians. Treatment-limitation decisions are made collegially, based on the presence of irreversible brain lesions responsible for chronic severe disorders of consciousness. Before these decisions are implemented, they are communicated to the relatives. Because the presence and severity of pain cannot be assessed in these patients, palliative analgesia and/or sedation should be administered. However, palliative sedation is a complex strategy that requires safeguards to prevent a drift toward hastening death or performing covert euthanasia. In addition to the law on patients' rights at the end of life passed in France on April 22, 2005, a recent revision of Article 37 of the French code of medical ethics both acknowledges that treatment-limitation decisions and palliative sedation may be required in patients with severe brain injuries and provides legal and ethical safeguards against a shift towards euthanasia. This legislation may hold value as a model for other countries where euthanasia is illegal and for countries such as Belgium and Netherlands where euthanasia is legal but not allowed in patients incapable of asking for euthanasia but in whom a treatment limitation decision has been made. (shrink)

Background:Even in countries with an opt-out or presumed consent system, relatives have a considerable influence on the post-mortem organ harvesting decision. However, their reflection capacity may be compromised by grief, and they are, therefore, often prone to choose refusal as default option. Quite often, it results in late remorse and dissatisfaction. So, a high-quality reflection support seems critical to enable them to gain a stable position and a long-term peace of mind, and also avoid undue loss of potential grafts. In (...) practice, recent studies have shown that the ethical aspects of reflection are rarely and often poorly discussed with relatives and that no or incomplete guidance is offered. No review of the literature is available to date, although it could be of value to improve the quality of the daily practice.Objectives:The objective was to review and synthesize the main concepts and approaches, theories and practices of ethical reflection support of the relatives or surrogates of potential post-mortem organ donors.Research design:A narrative review was performed in the medical, psychological and ethical fields using PubMed, PsycArticles and Web of Science databases (1980–2020).Results:Out of 150 papers, 25 were finally retained. Four themes were drawn: the moral status of the potential post-mortem organ donor, the principlistic approach with its limits and critics, the narrative approach and the transcendental approach.Discussion:This review suggests an extension of psychological support towards ethical reflection support. The process of helping relatives in their ethical exploration of post-mortem organ donation is psychologically and morally characterized. The need for specialized professionals educated and experienced both in clinical psychology and in health ethics to carry out this task is discussed.Practical impact:This review could contribute to optimize the quality of the ethical reflection support by initiating an evolution from an empirical, partial and individual-dependent support to a more systematized, professionalized and exhaustive support. (shrink)

Most recent accounts of personal autonomy acknowledge that the social environment a person lives in, and the personal relationships she entertains, have some impact on her autonomy. Two kinds of conceptualizing social conditions are traditionally distinguished in this regard: Causally relational accounts hold that certain relationships and social environments play a causal role for the development and on-going exercise of autonomy. Constitutively relational accounts, by contrast, claim that autonomy is at least partly constituted by a person’s social environment or standing. (...) The central aim of this paper is to raise the question how causally and constitutively relational approaches relate to the fact that we exercise our autonomy over time. I argue that once the temporal scope of autonomy is opened up, we need not only to think differently about the social dimension of autonomy. We also need to reconsider the very distinction between causally and constitutively relational accounts, because it is itself a synchronic (and not a diachronic) distinction. (shrink)

Algorithmic predictions are promising for insurance companies to develop personalized risk models for determining premiums. In this context, issues of fairness, discrimination, and social injustice might arise: Algorithms for estimating the risk based on personal data may be biased towards specific social groups, leading to systematic disadvantages for those groups. Personalized premiums may thus lead to discrimination and social injustice. It is well known from many application fields that such biases occur frequently and naturally when prediction models are applied to (...) people unless special efforts are made to avoid them. Insurance is no exception. In this paper, we provide a thorough analysis of algorithmic fairness in the case of insurance premiums. We ask what “fairness” might mean in this context and how the fairness of a premium system can be measured. For this, we apply the established fairness frameworks of the fair machine learning literature to the case of insurance premiums and show which of the existing fairness criteria can be applied to assess the fairness of insurance premiums. We argue that two of the often-discussed group fairness criteria, independence (also called statistical parity or demographic parity) and separation (also known as equalized odds), are not normatively appropriate for insurance premiums. Instead, we propose the sufficiency criterion (also known as well-calibration) as a morally defensible alternative that allows us to test for systematic biases in premiums towards certain groups based on the risk they bring to the pool. In addition, we clarify the connection between group fairness and different degrees of personalization. Our findings enable insurers to assess the fairness properties of their risk models, helping them avoid reputation damage resulting from potentially unfair and discriminatory premium systems. (shrink)

Abstract One of the most popular objections against epistemic contextualism is the so-called ?warranted assertability? objection. The objection is based on the possibility of a ?warranted assertability manoeuvre?, also known as a WAM. I argue here that WAMs are of very limited scope and importance. An important class of cases cannot be dealt with by WAMs. No analogue of WAMs is available for these cases. One should thus not take WAMs too seriously in the debate about epistemic contextualism.

Ricœur lectured and wrote for over twenty years on negation (‘Do I understand something better if I know what it is not, and what is not-ness?') and never published his extensive writings on this subject. Ricœur concluded that there are multiple forms of negation; it can, for example, be the other person (Plato), the not knowable nature of our world (Kant), the included opposite (Hegel), apophatic spirituality (Plotinus on not being able to know God) and existential nothingness (Sartre). Ricœur, working (...) on Kant, Hegel and Sartre, decided that all these forms of negation are incompatible and also fatally flawed because they fail to resolve false binaries of negative: positive. Alison Scott-Baumann demonstrates how Ricœur subsequently incorporated negation into his linguistic turn, using dialectics, metaphor, narrative, parable and translation in order to show how negation is in us, not outside us: language both creates and clarifies false binaries. He bestows upon negation a strong and central role in the human condition, and its inevitability is reflected in his writings, if we look carefully. Ricœur and the Negation of Happiness draws on Ricœur's published works, previously unavailable archival material and many other sources. Alison Scott-Baumann argues that thinking positively is necessary but not sufficient for aspiring to happiness - what is also required is affirmation of negative impulses: we know we are split by contradictions and still try to overcome them. She also demonstrates the urgency of analysing current socio-cultural debates about wellbeing, education and equality, which rest insecurely upon our loose use of the negative as a category mistake. (shrink)

This paper discusses two versions of reliabilism: modal and probabilistic reliabilism. Modal reliabilism faces the problem of the missing closeness metric for possible worlds while probalistic reliabilism faces the problem of the relevant reference class. Despite the severity of these problems, reliabilism is still very plausible (also for independent reasons). I propose to stick with reliabilism, propose a contextualist (or, alternatively, harmlessly relativist) solution to the above problems and suggest that probabilistic reliabilism has the advantage over modal reliabilism.

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Seit über zehn Jahren moderieren die Autor*innen mit hohem Zuspruch das Ethik-Café in Einrichtungen des Sozial- und Gesundheitswesens. Menschen aus unterschiedlichen Berufen, Patient*innen, An- und Zugehörige sowie ethisch Interessierte haben im Ethik-Café die Möglichkeit, aus ihrer persönlichen und beruflichen Perspektive ethische Fragestellungen zu diskutieren, die für ihren Alltag relevant sind. Ethik-Cafés sind niederschwellig, multiprofessionell, interdisziplinär. Die Teilnehmer*innen profitieren von dieser Perspektivenvielfalt. Das Buch stellt die Konzeption sowie deren Evaluation, die theoretischen und methodischen Voraussetzungen und in vielen Beispielen die praktische Umsetzung (...) von Ethik-Cafés dar. Das entwickelte Vier-Phasen-Modell des ethischen Prozesses wird exemplarisch in 25 Ethik-Cafés zu Themen aus dem Sozial- und Gesundheitswesen angewendet und umgesetzt. Das Buch richtet sich an Mitarbeiter*innen und Führungskräfte im Sozial- und Gesundheitswesen, Lehrer*innen, Lernbegleiter*innen und Auszubildende in der generalistischen Pflegeausbildung, an Fort- und Weiterbildungsreferent*innen, Studierende, Ehrenamtliche sowie alle ethisch Interessierten. (shrink)

Nietzsche once proclaimed himself the 'Buddha of Europe', and throughout his life Buddhism held enormous interest for him. While he followed Buddhist thinking in demolishing what he regarded as the two-headed delusion of Being and Self, he saw himself as advocating a response to the ensuing nihilist crisis that was diametrically opposed to that of his Indian counterpart. In this book Antoine Panaïoti explores the deep and complex relations between Nietzsche's views and Buddhist philosophy. He discusses the psychological models (...) and theories which underlie their supposedly opposing ethics of 'great health' and explodes the apparent dichotomy between Nietzsche's Dionysian life-affirmation and Buddhist life-negation, arguing for a novel, hybrid response to the challenge of formulating a tenable post-nihilist ethics. His book will interest students and scholars of Nietzsche's philosophy, Buddhist thought and the metaphysical, existential and ethical issues that emerge with the demise of theism. (shrink)

There is a very plausible principle of the transitivity of justifying reasons. It says that if "p" is better justified than "q" (all things considered) and "q" better than "r", then "p" is better justified than "r" (all things considered). There is a corresponding principle of rational theory choice. Call one theory "a better theory than" another theory if all criteria of theory choice considered (explanatory power, simplicity, empirical adequacy, etc.), the first theory meets the criteria better than the second (...) theory. The corresponding transitivity principle says that if theory A is a better theory than theory B and if theory B is a better theory than theory C, then A is a better theory than theory C. I argue against this principle. It turns out that whenever there are 2 or more relevant and independent criteria of theory evaluation, and whenever at least of one the criteria is "non-linear" in a certain sense, there may be violations of transitivity which do not violate any standards of rationality (of theory choice). This shows, again, that theory choice cannot be seen as merely the application of given rules of rational theory choice. (shrink)

Der Titel "deutscher Idealismus" wurde von Schelling mit dem Versagen Leibnizens und Kants vor dem Cartesischen Substanzen-Dualismus ("res cogitans", "res extensa") in Zusammenhang gebracht. Weder Spinozas Deus sive Natura noch der Leibnizschen Monadenlehre noch Kants transzendentalem Idealismus der Erscheinung und des Dinges an sich sei es gelungen, das ideengeschichtlich geforderte System des theogonischen Vernunft-Absoluten zu entwerfen. Die jetzt aktuelle Aufgabe lautet, den Weg von Kant bis Fichte und Hegel ideengeschichtlich aufzuzeichnen.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Challenging the assumption that that the capitalist transformation includes a radical break with the past, this edited volume traces how historically older forms of social inequality are transformed but persist in the present to shape the social structure of contemporary societies in the global South. Each society comprises an interpretation of itself - including the meaning of life, the concept of a human being and the notion of a collective. This volume studies the interpretation that various societies have of themselves. (...) This interpretation is referred to as social ontology. All chapters of the edited volume focus on the relation between social ontology and structures of inequality. They argue that each society comprises several historical layers of social ontology that correspond to layers of inequality, which are referred to as sociocultures. Thereby, the volume explains why and how structures of inequality differ between contemporary collectives in the global South, even though all of them seem to have similar structures, institutions, and economies. The volume is aimed at academics, students and the interested public looking for a novel theorization of social inequality pertaining to collectives in the global South. (shrink)

We develop a mathematical formalism that allows to study decoherence with a great level generality, so as to make it appear as a geometrical phenomenon between reservoirs of dimensions. It enables us to give quantitative estimates of the level of decoherence induced by a purely random environment on a system according to their respectives sizes, and to exhibit some links with entanglement entropy.

Les auteurs de cet essai, spécialistes reconnus de l'écologie, reviennent sur le sens de l'écologie, notion cruciale et pourtant sujette à toutes les confusions. Ils retracent avec force et simplicité son origine historique et philosophique afin d'en saisir les enjeux politiques, économiques et urbains dans le monde d'aujourd'hui. Cette mise au point est l'occasion de redéfinir le sens du progrès ou de la modernité, à l'heure où la planète souffre d'une surexploitation de ses ressources par l'Homme. Cet ouvrage critique nous (...) offre l'opportunité de redéfinir la place de l'Homme dans un monde où l'hégémonie d'un anthropocentrisme inconsidéré n'est plus viable. C'est enfin un hymne à la beauté du monde et une revendication : le droit de chacun à préserver ses racines et ses repères. L'écologisme politique doit s'opposer à l'effacement des signes naturels, culturels et historiques qui donnent aux territoires leurs personnalités et les ancrent dans une histoire. L'écologisme ne peut se résumer à une simple tendance : il s'agit d'un humanisme se souciant des générations à venir, qui s'attache à préserver et à transmettre un héritage commun à tous. (shrink)

The paper presents a research programme for the neuroscience of consciousness called 'neurophenomenology' and illustrates it with a recent pilot study . At a theoretical level, neurophenomenology pursues an embodied and large-scale dynamical approach to the neurophysiology of consciousness . At a methodological level, the neurophenomenological strategy is to make rigorous and extensive use of first-person data about subjective experience as a heuristic to describe and quantify the large-scale neurodynamics of consciousness . The paper focuses on neurophenomenology in relation to (...) three challenging methodological issues about incorporating first-person data into cognitive neuroscience: first-person reports can be biased or inaccurate; the process of generating first-person reports about an experience can modify that experience; and there is an 'explanatory gap' in our understanding of how to relate first-person, phenomenological data to third-person, biobehavioural data. (shrink)

This paper examines Claude Tresmontant's attempt to provide a philosophical argument in favour of God's existence using the results of modern science. Like many contemporary theists, Tresmontant believes that discoveries in the field of astrophysics, rightly interpreted, lead to the postulation of a deity. This paper challenges the philosophical presuppositions of Tresmontant's argument and the thesis that current cosmological theories can be used to construct a valid proof of the existence of God.

The epistemology of models has to face a conundrum: models are often described as highly idealised, and yet they are considered to be vehicles for scientific explanations. Truth-oriented—veritist—conceptions of explanation seem thereby undermined by this contradiction. In this article, I will show how this apparent paradox can be avoided by appealing to the notion of fiction. If fictionalism is often thought to lead to various flavours of instrumentalism, thereby weakening the veritist hopes, the fiction view of models offers a framework (...) much richer than it seems at first sight. To do so, I will call upon the concepts of modality, counterfactual structure and credible worlds. In the end, veritism of explanation and fiction can indeed go hand in hand, but the scope of explanations we can hope to draw from models must be more precisely delineated. (shrink)

Laboratoire de Neurosciences Cognitives et Imagerie Ce´re´brale (LENA), Hoˆpital de La Salpeˆtrie`re, Centre National de la Recherche Scientifique (CNRS).

Introduction to and overview over my book "Epistemic Contextualism. A Defense" (OUP 2016).