A Palestinian administrative detainee in Israel asked for the author to care for him as an independent physician while in hospital on two hunger strikes, lasting 66 and 55 days, respectively. Hunger striking is placed in the context of other forms of food refusal and artificial feeding. The various perspectives on the challenge of the medical care of hunger strikers are reviewed, as seen by the state, the public, the doctor and the patient. Institutional statements on the management of hunger (...) strikers are reviewed and the local political considerations are highlighted. In conclusion, a trusting doctor–patient relationship is presented as the crucial element for securing a successful outcome, preserving the prisoner's life and dignity with no significant political damage incurred by the State. (shrink)

Responsibility Without Understanding? How the Debate on the Ethics of Genetic Engineering Depends on Its Philosophy of Science. The main thesis in this paper is that bioethics has no own criteria to judge the chances and risks of genetic engineering. But if we distinguish (1) between different types of genetic, (2) between genetic engineering as a set of methods for experimentation and genetic engineering as an industrial technique and (3) reconstruct the metaphors and the terminology in general, which are used (...) by biologists describing their practice, it is possible to formulate such criteria. As the distinction between nature and culture is the result of human actions (not drawn by nature) and the communication about these actions and distinctions in a given cultural context, the criteria are the result of a discourse, in which not only biologists, but all members of a society argue about the reproduction and structuration of their society. (shrink)

In this article I argue that the four guiding principles of medical ethics—autonomy, beneficence, non-maleficence, and justice—reflect the values of western culture, but do not necessarily apply outside of it. Western medical practitioners faced with the care of nonwestern patients need to examine their own prejudices in order to accept, not merely tolerate, other values. Acceptance of the other requires that the doctor welcome the patient as one welcomes a guest, openly and equally, with a willingness to listen and to (...) be changed by the encounter. It is through the nurture of trusting relationships that ethical dilemmas in clinical medicine may be resolved, without recourse to the colonial moral hegemony of the principlist approach. (shrink)

The Biotheoretical Shortcomings of the Evolutionary Epistemology. The concept of evolutionary epistemology has been critically discussed by philosophers who have mainly pointed to unacceptable philosophical tenets (cf. Vittorio Hösle, this Journal, Vol. 19 (1988), pp. 348-377). However, as most philosophers are extremely reluctant to critically treat the biological theories on which the ideas of evolutionary epistemology are based, the invalid concepts of adaption escaped their critical scrutiny. Therefore the influence of preconceived biological theories on the biological basis of evolutionary epistemology (...) and the distorting consequences on the philosophical level could not be elaborated. The following context sketches a new view of organismic reasoning and its impact on evolutionary aspects of epistemology. The basic theorem of adaptation is shown to be unacceptable and invalid if organisms are conceived as autonomous entities which can only evolve according to their specific internal organismic properties. (shrink)

Summary The concept of evolutionary epistemology has been critically discussed by philosophers who have mainly pointed to unacceptable philosophical tenets (cf. Vittorio Hösle, this Journal, Vol. 19 (1988), pp. 348–377). However, as most philosophers are extremely reluctant to critically treat the biological theories on which the ideas of evolutionary epistemology are based, the invalid concepts of adaption escaped their critical scrutiny. Therefore the influence of preconceived biological theories on the biological basis of evolutionary epistemology and the distorting consequences on the (...) philosophical level could not be elaborated. The following context sketches a new view of organismic reasoning and its impact on evolutionary aspects of epistemology. The basic theorem of adaptation is shown to be unacceptable and invalid if organisms are conceived as autonomous entities which can only evolve according to their specific internal organismic properties. (shrink)