This article examines the relation between the critical theory of Moishe Postone and the philosophy of Theodor Adorno. While the former is clearly influenced by the latter, these influences mostly stay implicit. When explicit, he does not so easily put his own thought in line with Adorno’s and is highly critical of him. I will investigate the ways in which ideas from Adorno made their way into Postone’s work, but also where the latter diverts from them. As will be shown, (...) Postone’s critical theory runs into a problem when one examines the immanent ground of his critical norm, freedom. Adorno, on the contrary, does succeed in employing the same norm in his own immanent critique. I will conclude that the problem Postone encounters can be avoided by being more of an ‘Adornian’, and that his theory allows this. (shrink)

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Based on anthropological fieldwork among protesters against the Covid policy in Germany, this paper elaborates the symmetry of accusations made against each other by proponents and opponents of the state-imposed protection measures against the backdrop of an asymmetrical distribution of power. The social dynamics that emerged during the pandemic are often understood as the result of a knowledge controversy that most participants thus categorize as a media problem. A key finding of my research on protests against the German Covid policy (...) is that, as in my research on the controversy over mediumism, the controversy is about the agency of human and nonhuman actors and carried out to a great extent based on the same values on both sides, which at the same time accuse each other of not conforming to these values. The protesters are part of a heterogeneous minority that in large parts embodies the values of the majority and, in a way, exceeds them, i.e., a minority that is hypercritical and has extreme expectations about the values of the majority society – in this case: of solidarity, science, transparency, rationality, and coherence. From its marginal position, the minority develops a canny eye for the unfulfilled promises of the majority: its contradictions and conscious or unconscious double standards are perceived as bigotry against the backdrop of the aspiration to absence of contradiction. Therefore, this minority suspects that the motivations and goals behind the measures taken are other than just the protection of health, while the majority in turn see the minority’s commitment to society and democracy as (self-)deception and also suspect hidden motives and actors behind it. This mutual suspicion leads to a hysterical state of doubt and distrust, which is rooted in the nature of mediality. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the consequences (...) of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

This article supports calls for an increased integration of patients into taxonomic decision making in psychiatry by arguing that their exclusion constitutes a special kind of epistemic injustice: preemptive testimonial injustice, which precludes the opportunity for testimony due to a wrongly presumed irrelevance or lack of expertise. Here, this presumption is misguided for two reasons: the role of values in psychiatric classification and the potential function of first-person knowledge as a corrective means against implicitly value-laden, inaccurate, or incomplete diagnostic criteria (...) sets. This kind of epistemic injustice leads to preventable epistemic losses in psychiatric classification, diagnosis, and treatment. (shrink)

Gilbert et al. argue that the concerns about the influence of Deep Brain Stimulation on – as they lump together – personality, identity, agency, autonomy, authenticity and the self are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence (...) for that. Rather they show the challenges of doing research in a field that is stretched out over multiple disciplines. In that sense their paper is an important starting point for a discussion on methodology and offers valuable lessons for a future research agenda. (shrink)

Die Arbeit entwickelt erstmals eine von hermeneutischen Grundannahmen geleitete systematische Theorie des Films und reflektiert deren methodische Konsequenzen für die Analyse und Interpretation von Filmen. Auf der Grundlage einer zeichen- und sprechakttheoretischen Bestimmung filmischer Kommunikation werden die wichtigsten Strukturen filmischen Erzählens (Kameraführung, Montage, Erzählsituationen, verbale und nonverbale Figurenrede, Perspektivenstrukturen, uneigentliche Bilderrede) einer theoretischen und methodenpraktischen Reflexion unterzogen.

Diagnostic terms in psychiatry like ‘schizophrenia’ and ‘bipolar disorder’ are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of ‘schizophrenia.’ Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their actual usage (...) and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders. (shrink)

This paper gives insight into the Islamic bioethical discussion on harvesting and using human embryonic and adult stem cells. It describes some of the Islamic legal mechanisms involved in the bioethical discourse among Muslims. As the contemporary Islamic bioethical discourse is very diverse, the paper focuses on the critical discussion of related resolutions of the Saudi-based Islamic Fiqh Academy due to the esteem in which the IFA is held in the Islamic world and the pertinence of their rulings on this (...) issue. This study discusses the different sources of human adult and embryonic stem cells and their use from an Islamic perspective, while questioning some directions the Islamic bioethical discourse has taken. The paper invites interested parties to deliberate the use of some of the legal means resorted to in the ongoing Islamic bioethical discourse. (shrink)

Background In Scandinavia 13–28% of gynecology patients have experienced abuse in health care in their life time, which contradicts the ethical obligations not to harm the patient and to protect the patient's dignity. Concerning learning to act ethically, scholars have emphasized the importance of combining theoretical and practical dimensions. This article explores Forum Play as a way of learning to act ethically in abusive situations in health care. Method Ten health-care workers participating in a Forum Play course took part in (...) this study. To explore participants' experiences of Forum Play, semi-structured interviews were conducted and processed by using the grounded theory analysis techniques of coding and constant comparison. Results The analysis resulted in the core category “developing response–ability.” It encompasses the processes bringing about the ability to respond adequately to situations where abuse occurs and the conditions for these processes, as well as the participants' achieved understanding of the third person's potential to act in a situation with a power imbalance. Forum Play allows participants to reflect on both verbal and body language, and gives them time to enact and think through issues of moral agency. Conclusion The simulated reality of Forum Play offers a platform where learning to act ethically in abusive situations in health care is facilitated by providing a safe space, suspending constricting structural conditions such as hierarchies and lack of time, fostering moral imagination, allowing creativity in developing and trying out a variety of acting alternatives, and reflecting upon the observed and experienced situation. (shrink)

People struggling with addiction are neither powerless over their addiction, nor are they fully in control. Lewis vigorously objects to the brain disease model of addiction, because it makes people lose belief in their self-efficacy, and hence hinders their recovery. Although he acknowledges that there is a compulsive state in addiction, he objects to the claim that this compulsion is carved in stone. Lewis argues that the BDMA underestimates the agency of addicted people, and hence hinder their recovery. Lewis’s work (...) offers us a very much to be welcomed neurobiology of recovery. It offers addicted people a hopeful and respectful narrative for their recovery that treats them as agents rather than as damaged brains. However, I argue that overestimating people’s agency can also result in people losing belief in their self-efficacy. Lewis’s strong focus on the agency of addicted people might not match their experiences of struggle, hence reinforcing their feelings of guilt when they fail to control their use. I propose to replace the notion of addiction as a disease with a notion of a disease-like stage in addiction. I call this stage the duress stage in addiction, in which the addictive behaviour is largely impervious to the agent’s values and to available techniques of self-control. However, the agent can overcome this stage by developing new techniques of self-control, by building on their self-concept and belief in self-efficacy, by changing their environments and habits, and by engaging in projects that are meaningful to the agent. (shrink)

Excerpt: How does subjective well-being change over the life course and what concepts do people draw upon when they answer questions about their well-being? Does well-being indeed change or are people endowed with a set level of happiness around which their well-being fluctuates? These are some of the questions this paper will address with a focus on three domains of life: family, work, and health.

Determining what constitutes an anticipatable incidental finding from clinical research and defining whether, and when, this IF should be returned to the participant have been topics of discussion in the field of human subject protections for the last 10 years. It has been debated that implementing a comprehensive IF-approach that addresses both the responsibility of researchers to return IFs and the expectation of participants to receive them can be logistically challenging. IFs have been debated at different levels, such as the (...) ethical reasoning for considering their disclosure or the need for planning for them during the development of the research study. Some authors have discussed the methods for re-contacting participants for disclosing IFs, as well as the relevance of considering the clinical importance of the IFs. Similarly, other authors have debated about when IFs should be disclosed to participants. However, no author has addressed how the “actionability” of the IFs should be considered, evaluated, or characterized at the participant's research setting level. This paper defines the concept of “Actionability at the Participant's Research Setting Level” for anticipatable IFs from clinical research, discusses some related ethical concepts to justify the APRSL concept, proposes a strategy to incorporate APRSL into the planning and management of IFs, and suggests a strategy for integrating APRSL at each local research setting. (shrink)

ABSTRACTThis is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task, an Emotional Visual Search Task, and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: (...) evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying... (shrink)

The nomadic Kazaks inhabiting Xinjiang Province, China, retain many aspects of their pre‐Islamic way of life, including the use of methods of traditional healing usually classified under the rubric of "shamanism." These practices are closely related to those in Kazakstan, Mongolia, and other parts of the former Soviet Union.The present study addresses aspects of traditional healing in use among the Xinjiang Kazaks in recent times, and presents a native taxonomy of these practices obtained during recent fieldwork in Xingjiang. Special attention (...) is paid to the use of words, sound, and movement in healing contexts by elders and specialized individuals. (shrink)

In this paper I will argue that liberal multiculturalism is neither a necessary nor a convincing extension of liberalism. In evaluating the two main strands of liberal multiculturalism, I will first analyse the approaches of Charles Taylor and Bhikhu Parekh as the main proponents of the version that focuses on the cultures themselves and raises the issue of the value of cultures in connection with public discourse. I will then turn to Amy Gutmann and Will Kymlicka as liberal multiculturalists who (...) use the liberal norm of individual equality as a starting point. I will show that the arguments adduced in favour of liberal multiculturalism fail, due to the following shortcomings. Taylor’s approach is underspecified with respect to the relationship between the process of evaluating cultures and its outcome. Gutmann’s theory fails to bridge the gaps between the individual, cultural belonging and positive duties of the state. Parekh’s and Kymlicka’s theories lead back to liberalism. I conclude that the idea of cultural difference has little of substance to add to the liberal view of social justice. (shrink)

This is a case study on a series of at least thirty-four sixteenth-century notebooks from the Sloane collection, which reconsiders early modern note taking techniques and the organisation of knowledge. These notebooks were written by an anonymous compiler, a physician who read widely in the alchemical and medical literature available in his lifetime, the late sixteenth century. In the alchemica, he devotes individual volumes to specific alchemical substances, which are connected with each other by means of a complex system of (...) cross-referencing; they are constantly revised and change appearance according to the physician's latest ideas about alchemical medicines. As a result, the notebooks not only preserve received information — they also represent an equivalent to the alchemical workshop, where the combination of different textual elements generates knowledge. (shrink)

TheoryDigital technologies have become an integral part of everyday life that children are exposed to. Therefore, it is important for children to acquire an understanding of these technologies early on by teaching them computational thinking as a part of STEM. However, primary school teachers are often reluctant to teach CT. Expectancy-value theory suggests that motivational components play an important role in teaching and learning. Thus, one hindrance to teachers’ willingness to teach CT might be their low expectancies of success and (...) high emotional costs, e.g., anxiety towards CT. Thus, introducing preservice teachers to CT during their university years might be a promising way to support their expectancies and values, while simultaneously alleviating their emotional costs. Prior CT competences might contribute to these outcomes.AimsWe investigated whether a specifically designed seminar on CT affected preservice teachers’ expectancies and values towards programming.Method: A total of 311 German primary school and special education preservice teachers took part in the study. The primary school preservice teachers received a seminar on CT and programming with low-threshold programming tasks, while the special education teachers served as a baseline group. The seminar was specifically designed to enhance expectancies and values and decrease emotional costs, following implications of research on expectancy-value theory.ResultsThe preservice teachers who visited the seminar gained higher expectancies and values towards CT and programming compared to the baseline group. Moreover, their emotional costs decreased. CT was positively related to change in expectancies and values and negatively related to emotional costs.DiscussionInterventions with low-threshold programming tasks can support primary school preservice teachers in finding trust in their abilities and values towards CT. Moreover, their anxiety towards CT and programming can be alleviated. Thus, first steps in preparing preservice teachers to teach CT in their future classrooms can be taken in university. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders has elicited numerous criticisms throughout its history. Its particularly controversial status has not been resolved by the recent release of the DSM-5 ; rather, the new edition has amplified debates in psychiatry as well as philosophy and the wider public. To a certain extent, such controversies are to be expected because of the influential role the DSM plays in science and health care. Researchers have often been required to use the DSM classification (...) to get funded and published, clinicians need to use it for diagnosis, and patients need a DSM code to get reimbursed for treatment.1 Classification in psychiatry shapes the course of research... (shrink)

When doing research among vulnerable populations, researchers are obliged to protect their subjects from harm. We will argue that traditional ethical guidelines are not sufficient to do this, since they mainly focus on direct harms that can occur: for example, issues around informed consent, fair recruitment and risk/harm analysis. However, research also entails indirect harms that remain largely unnoticed by research ethical committees and the research community. Indirect harms do not occur during data collection, but in the analysis of the (...) data, and how the data is presented to the scientific and wider societal community. Highly stigmatized research subjects, like substance‐dependent parents, are especially at risk of encountering indirect harm, because the prejudice against them is so persistent. In this paper we discuss two forms of indirect harm. First, researchers have to be aware how their results will be preceived by society. Even when subjects are presented in an objective way, further, out of porportion stigmatization can occur. Researchers sometimes try to counteract this by whitewashing their results, at the risk of downplaying their respondents’ problems. The second risk researchers face is that their own normative judgements influence how they question such parents, report results and interpret statements. Researchers’ own normative judgements may influence the way they present their subjects. This article reviews a broad range of research that exhibits such indirect harms, discussing how and why indirect harms occur and formulating corresponding recommendations on how to prevent them. (shrink)

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)