BackgroundThe landscape of clinical research has evolved over the past decade. With technological advances, the practice of using electronic informed consent (eIC) has emerged. However, a number of challenges hinder the successful and widespread deployment of eIC in clinical research. Therefore, we aimed to investigate the views of various stakeholders on the potential advantages and challenges of eIC.MethodsSemi-structured interviews were conducted with 39 participants from 5 stakeholder groups from across 11 European countries. The stakeholder groups included physicians, patient organization representatives, (...) regulator representatives, ethics committee members, and pharmaceutical industry representatives, and all were involved in clinical research. Interviews were analyzed using the framework method.ResultsInterviewees identified that a powerful feature of eIC is its personalized approach as it may increase participant empowerment. However, they identified several ethical and practical challenges, such as ensuring research participants are not overloaded with information and offering the same options to research participants who would prefer a paper-based informed consent rather than eIC. According to the interviewees, eIC has the potential to establish efficient long-term interactions between the research participants and the research team in order to keep the participants informed during and after the study. Interviewees emphasized that a personal interaction with the research team is of utmost importance and this cannot be replaced by an electronic platform. In addition, interviewees across the stakeholder groups supported the idea of having a harmonized eIC approach across the European Member States.ConclusionsInterviewees reported a range of design and implementation challenges which needs to be overcome to foster innovation in informing research participants and obtaining their consent electronically. It was considered important that the implementation of eIC runs alongside the face-to-face contact between research participants and the research team. Moreover, interviewees expect that eIC could offer the opportunity to enable a personalized approach and to strengthen continuous communication over time. If successfully implemented, eIC may facilitate the engagement of research participants in clinical research. (shrink)

This book concerns the foundations of epistemic modality and hyperintensionality and their applications to the philosophy of mathematics. I examine the nature of epistemic modality, when the modal operator is interpreted as concerning both apriority and conceivability, as well as states of knowledge and belief. The book demonstrates how epistemic modality and hyperintensionality relate to the computational theory of mind; metaphysical modality and hyperintensionality; the types of mathematical modality and hyperintensionality; to the epistemic status of large cardinal axioms, undecidable propositions, (...) and abstraction principles in the philosophy of mathematics; to the modal and hyperintensional profiles of the logic of rational intuition; and to the types of intention, when the latter is interpreted as a hyperintensional mental state. Chapter \textbf{2} argues for a novel type of expressivism based on the duality between the categories of coalgebras and algebras, and argues that the duality permits of the reconciliation between modal cognitivism and modal expressivism. I also develop a novel topic-sensitive truthmaker semantics for dynamic epistemic logic, and develop a novel dynamic two-dimensional semantics. Chapter \textbf{3} provides an abstraction principle for epistemic (hyper-)intensions. Chapter \textbf{4} advances a topic-sensitive two-dimensional truthmaker semantics, and provides three novel interpretations of the framework along with the epistemic and metasemantic. Chapter \textbf{5} applies the fixed points of the modal $\mu$-calculus in order to account for the iteration of epistemic states in a single agent, by contrast to availing of modal axiom 4 (i.e. the KK principle). The fixed point operators in the modal $\mu$-calculus are rendered hyperintensional, which yields the first hyperintensional construal of the modal $\mu$-calculus in the literature and the first application of the calculus to the iteration of epistemic states in a single agent instead of the common knowledge of a group of agents. Chapter \textbf{6} advances a solution to the Julius Caesar problem based on Fine's `criterial' identity conditions which incorporate conditions on essentiality and grounding. Chapter \textbf{7} provides a ground-theoretic regimentation of the proposals in the metaphysics of consciousness and examines its bearing on the two-dimensional conceivability argument against physicalism. The topic-sensitive epistemic two-dimensional truthmaker semantics developed in chapters \textbf{2} and \textbf{4} are availed of in order for epistemic states to be a guide to metaphysical states in the hyperintensional setting. -/- Chapters \textbf{8-12} provide cases demonstrating how the two-dimensional hyperintensions of hyperintensional, i.e. topic-sensitive epistemic two-dimensional truthmaker, semantics, solve the access problem in the epistemology of mathematics. Chapter \textbf{8} examines the interaction between my hyperintensional semantics and the axioms of epistemic set theory, large cardinal axioms, the Epistemic Church-Turing Thesis, the modal axioms governing the modal profile of $\Omega$-logic, Orey sentences such as the Generalized Continuum Hypothesis, and absolute decidability. These results yield inter alia the first hyperintensional Epistemic Church-Turing Thesis and hyperintensional epistemic set theories in the literature. Chapter \textbf{9} examines the modal and hyperintensional commitments of abstractionism, in particular necessitism, and epistemic hyperintensionality, epistemic utility theory, and the epistemology of abstraction. I countenance a hyperintensional semantics for novel epistemic abstractionist modalities. I suggest, too, that observational type theory can be applied to first-order abstraction principles in order to make first-order abstraction principles recursively enumerable, i.e. Turing machine computable, and that the truth of the first-order abstraction principle for hyperintensions is grounded in its being possibly recursively enumerable and the machine being physically implementable. Chapter \textbf{10} examines the philosophical significance of hyperintensional $\Omega$-logic in set theory and discusses the hyperintensionality of metamathematics. Chapter \textbf{11} provides a modal logic for rational intuition and provides a hyperintensional semantics. Chapter \textbf{12} avails of modal coalgebras to interpret the defining properties of indefinite extensibility, and avails of hyperintensional epistemic two-dimensional semantics in order to account for the interaction between the interpretational and objective modalities and truthmakers thereof. This yields the first hyperintensional category theory in the literature. I invent a new mathematical trick in which first order structures are treated as categories, and Vopenka's principle can be satisfied because of the elementary embeddings between the categories and generate Vopenka cardinals while bypassing the category of Set in category theory. Chapter \textbf{13} examines modal responses to the alethic paradoxes. Chapter \textbf{14} examines, finally, the modal and hyperintensional semantics for the different types of intention and the relation of the latter to evidential decision theory. (shrink)

1 Einleitung: Die konstruktivistische Herausforderung strukturgenetischer Subjekttheorien........................................................ 11 1. 1 Sozialisationstheorie - jenseits der groBen Entwiirfe......................................... 17 1. 2 Der genetische Strukturalismus im Kontext theoretischer Leitunterscheidungen................................................................................ ....... 20 1. 3 Konstitution als Problemstellung...................................................................... 27 2 Strukturgenetischer und radikaler Konstruktivismus........................... 33 2. 1 Die Erkenntnistheorie des Radikalen Konstruktivismus vor dem Hintergrund einer interaktionistischen strukturgenetischen Theoriestrategie.................................................................................... ........... 36 2. 1. 1 "Realitat" und "Wirklichkeit"........................................................................... 37 2. 1. 2 Konstruktivitat und AuBenwe1t: Piaget und von Glasersfeld............................. 41 2. 1. 3 Abgeschlossenheit, Rekursivitat und strukturelle Koppelung........................... 46 (...) 2. 2 Aquilibration und Adaption - Die differenztheoretische Ausgangslage des strukturgenetischen Konstruktivismus Piagets..................... 51 2. 3 Differenzerfahrung und die Entstehung des Neuen........................................... 54 2. 4 Der Status strukturgenetischer Fragestellungen vor dem Hintergrund des radikalen Konstruktivismus.................................................... 57 3 Soziale Konstitutions- und Systemtheorie.............................................. 62 3. 1 Die soziale Konstitutionshypothese.................................................................. 64 3. 2 Sprachzentrismus und Regelontologie.............................................................. 70 3. 3 Sinn als Grundbegriffund die Eigenstiindigkeit des Sozialen.......................... 72 3. 4 Das Problem der doppelten Kontingenz........................................................... 76 3. 5 Interpenetration und strukturelle Koppelung.................................................... 84 3. 6 Differenz und Identitat in der System- und sozialen Konstitutionstheorie......... 89 3. 7 Zwischenbilanz und Konsequenzen fur die Konzeption des Anfangsproblems 92 5 4 Die Konstitution der Subjekt-Objekt-Differenz: Das grundlegende Bezugsproblem des interaktionistischen Konstruktivismus...................................... 97 4. 1 Die Subjekt-Objekt-Differenzierung im genetischen Strukturalismus Piagets.................... 100 4. 1. 1 Die Ausgangskonstellation............................................ 102 4. 1. 2 1m Reich der Metaphem: Die Rolle der AuBenwelt und der Akkommodation........................................................................ 106 4. 1. 3 Die primaren und sekundaren Zirkularreaktionen im Blick des radikalen Konstruktivismus........................................................ III 4. 1. 4 Die Ausbildung der Subjekt-Objekt-Gegenlage.......................................... (shrink)

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive (...) alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual‐ or gender‐minority groups who likewise seek to pursue parenthood. We examine the history of access to current family‐building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual‐ or gender‐minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice. (shrink)

Settling the debate over conscientious refusal (CR) in liberal democracies requires us to develop a conception of the healthcare provider’s moral role. Because CR claims and resulting policy changes take place in specific sociopolitical contexts with unique histories and diverse polities, the _method_ we use for deriving the healthcare norms should itself be a democratic, context-dependent inquiry. To this end, I begin by describing some prerequisites—which I call _publicity conditions_—for any democratic account of healthcare norms that conflict or jibe with (...) CR. Next, drawing on Ronald Dworkin’s jurisprudence and Tom Beauchamp & James Childress’s approach to bioethical reasoning, I briefly introduce one method for generating healthcare norms that is faithful to the publicity conditions and has potential to constructively, and democratically, derive important boundaries for CR. Finally, I argue that many critics of CR fail to similarly ground their accounts of healthcare norms in healthcare professionals’ sociopolitical contexts, often relying instead on their own interpretation of a generally stateable healthcare norm. This leads to their misconstruing both the value judgments on which their own approaches rest and the public, political values that are often invoked in favor of CR. (shrink)

This book concerns the foundations of epistemic modality and hyperintensionality and their applications to the philosophy of mathematics. I examine the nature of epistemic modality, when the modal operator is interpreted as concerning both apriority and conceivability, as well as states of knowledge and belief. The book demonstrates how epistemic modality and hyperintensionality relate to the computational theory of mind; metaphysical modality and hyperintensionality; the types of mathematical modality and hyperintensionality; to the epistemic status of large cardinal axioms, undecidable propositions, (...) and abstraction principles in the philosophy of mathematics; to the modal and hyperintensional profiles of the logic of rational intuition; and to the types of intention, when the latter is interpreted as a hyperintensional mental state. Chapter \textbf{2} argues for a novel type of expressivism based on the duality between the categories of coalgebras and algebras, and argues that the duality permits of the reconciliation between modal cognitivism and modal expressivism. I also develop a novel topic-sensitive truthmaker semantics for dynamic epistemic logic, and develop a novel dynamic two-dimensional semantics. Chapter \textbf{3} provides an abstraction principle for epistemic (hyper-)intensions. Chapter \textbf{4} advances a topic-sensitive two-dimensional truthmaker semantics, and provides three novel interpretations of the framework along with the epistemic and metasemantic. Chapter \textbf{5} applies the fixed points of the modal $\mu$-calculus in order to account for the iteration of epistemic states in a single agent, by contrast to availing of modal axiom 4 (i.e. the KK principle). The fixed point operators in the modal $\mu$-calculus are rendered hyperintensional, which yields the first hyperintensional construal of the modal $\mu$-calculus in the literature and the first application of the calculus to the iteration of epistemic states in a single agent instead of the common knowledge of a group of agents. Chapter \textbf{6} advances a solution to the Julius Caesar problem based on Fine's `criterial' identity conditions which incorporate conditions on essentiality and grounding. Chapter \textbf{7} provides a ground-theoretic regimentation of the proposals in the metaphysics of consciousness and examines its bearing on the two-dimensional conceivability argument against physicalism. The topic-sensitive epistemic two-dimensional truthmaker semantics developed in chapters \textbf{2} and \textbf{4} are availed of in order for epistemic states to be a guide to metaphysical states in the hyperintensional setting. -/- Chapters \textbf{8-12} provide cases demonstrating how the two-dimensional hyperintensions of hyperintensional, i.e. topic-sensitive epistemic two-dimensional truthmaker, semantics, solve the access problem in the epistemology of mathematics. Chapter \textbf{8} examines the interaction between my hyperintensional semantics and the axioms of epistemic set theory, large cardinal axioms, the Epistemic Church-Turing Thesis, the modal axioms governing the modal profile of $\Omega$-logic, Orey sentences such as the Generalized Continuum Hypothesis, and absolute decidability. These results yield inter alia the first hyperintensional Epistemic Church-Turing Thesis and hyperintensional epistemic set theories in the literature. Chapter \textbf{9} examines the modal and hyperintensional commitments of abstractionism, in particular necessitism, and epistemic hyperintensionality, epistemic utility theory, and the epistemology of abstraction. I countenance a hyperintensional semantics for novel epistemic abstractionist modalities. I suggest, too, that observational type theory can be applied to first-order abstraction principles in order to make first-order abstraction principles recursively enumerable, i.e. Turing machine computable, and that the truth of the first-order abstraction principle for hyperintensions is grounded in its being possibly recursively enumerable and the machine being physically implementable. Chapter \textbf{10} examines the philosophical significance of hyperintensional $\Omega$-logic in set theory and discusses the hyperintensionality of metamathematics. Chapter \textbf{11} provides a modal logic for rational intuition and provides a hyperintensional semantics. Chapter \textbf{12} avails of modal coalgebras to interpret the defining properties of indefinite extensibility, and avails of hyperintensional epistemic two-dimensional semantics in order to account for the interaction between the interpretational and objective modalities and truthmakers thereof. This yields the first hyperintensional category theory in the literature. I invent a new mathematical trick in which first order structures are treated as categories, and Vopenka's principle can be satisfied because of the elementary embeddings between the categories and generate Vopenka cardinals while bypassing the category of Set in category theory. Chapter \textbf{13} examines modal responses to the alethic paradoxes. Chapter \textbf{14} examines, finally, the modal and hyperintensional semantics for the different types of intention and the relation of the latter to evidential decision theory. (shrink)

Part of the appeal of the biological approach to personal identity is that it does not have to countenance spatially coincident entities. But if the termination thesis is correct and the organism ceases to exist at death, then it appears that the corpse is a dead body that earlier was a living body and distinct from but spatially coincident with the organism. If the organism is identified with the body, then the unwelcome spatial coincidence could perhaps be avoided. It is (...) argued that such an identification would be a mistake. A living organism has a different part/whole relationship and persistence conditions than the alleged body. A case will be made that the concept ‘human body’ is a conceptual mess, vague in an unprincipled manner, and that an eliminativist stance towards dead bodies is the appropriate response. CiteULike Connotea Del.icio.us What's this? (shrink)

As a continuation of the work of the third author in [5], we make further observations on the features of Galois cohomology in the general model theoretic context. We make explicit the connection between forms of definable groups and first cohomology sets with coefficients in a suitable automorphism group. We then use a method of twisting cohomology (inspired by Serre’s algebraic twisting) to describe arbitrary fibres in cohomology sequences—yielding a useful “finiteness” result on cohomology sets. Applied to the special case (...) of differential fields and Kolchin’s constrained cohomology, we complete results from [3] by proving that the first constrained cohomology set of a differential algebraic group over a bounded, differentially large, field is countable. (shrink)

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)

The present study examined what participants perceive of their hand movements when using a tool. In the experiments different gains for either the x-axis or the y-axis perturbed the relation between hand movements on a digitizer tablet and cursor movements on a display. As a consequence of the perturbation participants drew circles on the display while their covered hand movements followed either vertical or horizontal ellipses on the digitizer tablet. When asked to evaluate their hand movements, participants were extremely uncertain (...) about their trajectories. By varying the amount of visual feedback, findings indicated that the low awareness of one’s own movements originated mainly from an insufficient quality of the humans’ tactile and proprioceptive system or from an insufficient spatial reconstruction of this information in memory. (shrink)

Definition of the problemFrom an ethical point of view we analyse the ruling of the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G‑BA) of September 2019 to revise the guidelines about the coverage of noninvasive prenatal tests (NIPT) by mandatory health insurance, in order to include them under specified conditions. The decision contains four essential elements: a definition of the aim of NIPT testing (to avoid invasive testing), a criterion of access (test must be “necessary” for the pregnant woman to tackle (...) her individual situation), statements about the process of decision-making (after counselling by a physician and case by case) and a normative contextualization (termination of pregnancy under § 218 a German penal law) which is to be found in its explanations. There are tensions in the proposed model that oscillate about two axes: (1) The suffering that results from a possible birth of a child with trisomy or from not knowing about the genetic condition of the fetus can ultimately only be evaluated subjectively, from the perspective of the pregnant woman. (2) The meaning of an individual decision in the case-by-case model remains unclear because when judging about individual cases general points of view also need to be considered. However, we argue that the model of the G‑BA could be a sociopolitically and ultimately also ethically defensible pragmatic solution, exactly because of its paradoxes and its inherent flexibility. (shrink)

Magic est de ces livres étonnants, bouleversant tout ce que nous croyions savoir sur un sujet. A partir d'une interrogation sur l'apparition du concept de "lien social" chez Rousseau ou Durkheim, Laurent de Sutter propose une surprenante remise en cause du consensus régnant autour de l'idée de lien. Plutôt que de poursuivre l'investigation du côté de la sociologie, il suggère, pour comprendre ce qui nous lie, de regarder du côté d'un droit qui aurait retrouvé celle qui lui a toujours (...) été consubstantielle et que l'on a pourtant tenté de refouler, à savoir sa magie. Que se passerait-il si, en effet, le droit était la dernière manifestation de la magie dans un monde qui croyait pouvoir s'en passer? Telle est la question au coeur de ce bref essai érudit, spectaculaire et fascinant, passant avec une grâce provocante de Montesquieu à Giordano Bruno, des juristes romains à Gabriel Tarde, de Marcel Mauss aux inspirateurs du Code civil, de Giorgio Agamben à Quentin Meillassoux. (shrink)

Why law may be less important than we think.

Le livre que le lecteur tient entre les mains est un bréviaire de l'indifférence à la politique. Ce bréviaire, toutefois, ne vise aucune fin édificatrice, ni prosélyte. Il se contente d'être l'exposé fragmentaire d'un soupçon vague : que la politique ne rend pas heureux. Plutôt qu'y dépenser une énergie que nous n'avons pas, ne vaut-il pas mieux nous tourner vers d'autres horizons? Déambulant le long d'une plage des Pouilles, assis à la terrasse d'un café parisien, ou goûtant, depuis le balcon (...) d'un hôtel, la nuit londonienne, nous n'avons que l'embarras du choix. II suffit qu'une jeune fille croise notre chemin pour que la politique s'évanouisse comme un rêve d'hiver. (shrink)

"Pop'philosophie" : si l'on en croit la morgue méprisante que ce simple mot provoque, il s'agirait du nom d'une étrange maladie. Celle d'une philosophie se prostituant aux industries culturelles ou, pire, aux sirènes du populisme. Avec la pop' philosophie, on assisterait à la ruine de la philosophie tout court, devenue tantôt gadget pédagogique, tantôt tentative pathétique de capitaliser sur le glamour frelaté de la pop culture. Et si c'était faux? Pour Gilles Deleuze, en tout cas, rien n'était plus important que (...) l'invention d'une pop'philosophie qui sauverait la pensée de la correction professorale et de la pontification esthétique. Inventer une pensée véritablement anarchiste, enterrant la philosophie pour l'ouvrir à des devenirs inédits : tel était l'objectif qu'il donna au concept de pop'philosophie. Rien n'était moins simple ni plus ambitieux. Il est temps de comprendre en quoi."--Page 4 of cover. (shrink)

In this classic work David Bohm, writing clearly and without technical jargon, develops a theory of quantum physics which treats the totality of existence as an unbroken whole.

Oxford Philosophical Texts Series Editor: John Cottingham The Oxford Philosophical Texts series consists of authoritative teaching editions of canonical texts in the history of philosophy from the ancient world down to modern times. Each volume provides a clear, well laid out text together with a comprehensive introduction by a leading specialist, giving the student detailed critical guidance on the intellectual context of the work and the structure and philosophical importance of the main arguments. Endnotes are supplied which provide further commentary (...) on the arguments and explain unfamiliar references and terminology, and a full bibliography and index are also included. The series aims to build up a definitive corpus of key texts in the Western philosophical tradition, which will form a reliable and enduring resource for students and teachers alike. David Hume's aim in writing An Enquiry concerning Human Understanding was to introduce his philosophy to a European culture in which many educated people read original works of philosophy. He gives an elegant and accessible presentation of strikingly original and challenging views about the limited powers of human understanding, the attractions of scepticism, the compatibility of free will and determinism, and weaknesses in the foundations of religion. Hume's philosophy was highly controversial in the eighteenth century and remains so today. The text printed in this edition is that of the Clarendon critical edition of Hume's works. A substantial introduction by the editor explains the intellectual background to the work and surveys its main themes. The volume also includes detailed explanatory notes on the text, a glossary of terms, a full list of references, and a section of supplementary readings. (shrink)

Die breite Einführung nicht-invasiver pränataler Tests sowie die Ausweitung der Testziele über Trisomien hinaus machen es notwendig, Sinn und Ziel der pränatalen Diagnostik als emergente soziale Praxis grundsätzlich zu diskutieren. Wenn, wie angenommen wird, PND nicht zu eugenischen Zwecken, sondern zur Stärkung der Autonomie dienen soll, muss gefragt werden, welche Bedeutung die Entscheidungen haben, ein bestimmtes zukünftiges Kind zu gebären. Stephen Wilkinson hat vorgeschlagen, PND als eine Form „selektiver Reproduktion“ zu verstehen. In diesem Paper wird geprüft, ob die Charakterisierung der (...) Entscheidung nach PND als „Selektion“ zutrifft und welche moralischen Vorannahmen ihr zugrunde liegen.Es zeigt sich, dass das Konzept der „selektiven Reproduktion“ die Handlungen der PND inakkurat repräsentiert. Es beinhaltet zudem sowohl eine Abstrahierung als auch eine Distanzierung. Es nimmt an, dass Frauen und Paare entweder falls nötig mehrere Schwangerschaften planen, um ein gesundes Kind zu erzeugen, oder sich als Ausführende einer selektiven Strategie auf der Populationsebene verstehen. Die Einschränkung der ethischen Diskussion auf das Problem der Selektion verdeckt zwei wichtige Problemfelder, die die konflikthaltige Situation der PND aus der Perspektive der Frau oder des Paares charakterisieren: die Schwangerschaft als persönliche Beziehung und den Akt des Abbruchs der Schwangerschaft. Aufgrund seiner impliziten Normativität wird „selektive Fortpflanzung“ als sinnvolle Bezeichnung für die Praxis der PND zurückgewiesen. (shrink)

Religion, science, and naturalism -- Perception and religious experience -- Panexperientialism, freedom, and the mind-body relation -- Naturalistic, dipolar theism -- Natural theology based on naturalistic theism -- Evolution, evil, and eschatology -- The two ultimates and the religions -- Religion, morality, and civilization -- Religious language and truth -- Religious knowledge and common sense.

Patients at the end of their life who express a wish to die sometimes explain their wish as the desire not to be a burden to others. This feeling needs to be investigated as an emotion with an intrinsically dialogical structure. Using a phenomenological approach, two key meanings of the feeling of being a burden to others as a reason for a wish to die are identified. First, it is an existential suffering insofar as it contains the perception of a (...) plight so desperate that it can only be relieved by the end of the patient’s existence. Second, it is an empathic concern that implies caring about those who bear the burden of caring for the person at the end of their life. It is therefore a moral emotion, encompassing a series of difficulties, including the subjective perception of a stark imbalance between giving and taking, the adequacy of the representation of the caregiver burden in the patient’s mind, and the danger of diminishing the worth of one’s life out of shame or self‐denigration. R. D. Laing’s terminology of crossed perspectives in interexperience is used to systematically distinguish the actual caregiver burden, the patient’s view of the caregiver burden, the stress for the patient in feeling that s/he is a burden to the caregiver, and the caregiver’s view of the patient’s stress. The sense of being a burden implies the belief that the caregiver feels burdened, and the fear that this burden could become unbearable. (shrink)

ZusammenfassungZumindest bei bestimmten Gruppen kann die Aneuploidietestung im Rahmen der PID für die Schwangerschaft medizinisch sinnvoll sein. Die gegenwärtige Rechtslage in Deutschland scheint die PID auf eine Chromosomenfehlverteilung im Embryo nicht auszuschließen; diese Testung muss aber im Einzelfall begründet und von der Frau bei einer PID-Ethikkommission beantragt werden. Der Artikel untersucht die Frage aus ethischer und rechtlicher Sicht, ob prinzipielle Gründe dagegen stehen, dass die zuständigen Ethikkommissionen Anträgen auf die Durchführung von Aneuploidietests zustimmen. Es können drei verschiedene Fallkonstellationen unterschieden werden, (...) in denen Aneuploidietests Teil von unterschiedlichen Handlungen werden und entsprechend unterschiedliche ethische Implikationen aufweisen: Das Ziel der IVF kann (i) der Aneuploidietest selbst sein, oder (ii) die IVF kann eine indizierte Unfruchtbarkeitsbehandlung sein, bei der man auch PID und Aneuploidietests durchführen kann, oder (iii) die PID ist indiziert zur Vermeidung einer Erbkrankheit oder Chromosomenschädigung und Aneuploidie kann in dieser Situation ein Zufalls- oder ein Zusatzbefund werden. Ethische Argumente, die grundsätzlich gegen eine Zulässigkeit von Aneuploidietests sprechen könnten, sind die Vermeidung einer Diskriminierung von Menschen mit Aneuploidien und der Embryonenschutz. Sie könnten gegen das Fallszenario (i) erhoben werden, aber nicht gegen (ii) und (iii). Es gibt aber mindestens drei ethische Argumente, die für die Zulässigkeit sprechen: die „gute Praxis“ der IVF, die Pflicht gegenüber dem entstehenden Kind und die Mitsprache des Paares. Ergebnis: Es ist aus rechtlichen und ethischen Gründen nicht ausgeschlossen und deshalb in Deutschland durch die zuständigen PID-Kommissionen offen zu diskutieren, ob Aneuploidietests in der PID möglich werden. (shrink)

In this innovative study, Lea David critically investigates the relationship between human rights and memory, suggesting that, instead of understanding human rights in a normative fashion, human rights should be treated as an ideology. Conceptualizing human rights as an ideology gives us useful theoretical and methodological tools to recognize the real impact human rights has on the ground. David traces the rise of the global phenomenon that is the human rights memorialization agenda, termed 'Moral Remembrance', and explores what (...) happens once this agenda becomes implemented. Based on evidence from the Western Balkans and Israel/Palestine, she argues that the human rights memorialization agenda does not lead to a better appreciation of human rights but, contrary to what would be expected, it merely serves to strengthen national sentiments, divisions and animosities along ethnic lines, and leads to the new forms of societal inequalities that are closely connected to different forms of corruptions. (shrink)

Liberal thinkers of the eighteenth and nineteenth centuries were alert to the political costs and human cruelties involved in European colonialism, but they also thought that European expansion held out progressive possibilities. In Progress, Pluralism, and Politics David Williams examines the colonial and anti-colonial arguments of Adam Smith, Immanuel Kant, Jeremy Bentham, and L.T. Hobhouse. Williams locates their ambivalent attitude towards European conquest and colonial rule in a set of tensions between the impact of colonialism on European states, the (...) possibilities of progress in distant and diverse places, and the relationship between universalism and cultural pluralism. In so doing he reveals some of the central ambiguities that characterize the ways that liberal thought has dealt with the reality of an illiberal world. Of particular importance are appeals to various forms of universal history, attempts to mediate between the claims of identity and the reality of difference, and the different ways of thinking about the achievement of liberal goods in other places. Pointing to key elements in still ongoing debates within liberal states about how they should relate to illiberal places, Progress, Pluralism, and Politics enriches the discussion on political thought and the relationship between liberalism and colonialism. (shrink)

Thus, Meyers provides a valuable account, not only of current medical attitudes, but also of relevant case and statute law as it stands at present.