BackgroundThe UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer’s disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, (...) which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the ‘spatial intervention study’ of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. MethodsPeople with a suspected or confirmed diagnosis of dementia in Alzheimer’s disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed.DiscussionThe results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice.Trial registration: DRKS00030799. (shrink)

Hertwig and Ortmann suggest paying participants contingent upon performance in order to increase the thoroughness they devote to a decision task. We argue that monetary incentives can yield a number of unintended effects including distortions of the subjective representation of the task and impaired performance. Therefore, we conclude that performance-contingent payment should not be generally employed in judgment and decision research.

BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

This research replicates Bhattacharjee et al. :1167–1184, 2013) moral decoupling model and extends the original along the dimensions of theory, method, and context. Adopting a branding perspective and focusing on the corporate domain rather than the public figures investigated by Bhattacharjee and colleagues, this research examines the proposition that consumers dissociate judgments of morality from judgments of performance to justify purchasing from companies deemed to act immorally. The original study is further extended by applying the model in a different cultural (...) context and employing a more realistic stimulus to establish external and ecological validity. The results of the replication generally support the original findings, in particular, under conditions of higher product involvement, a theoretical extension. (shrink)

Math difficulties manifest across various domain-specific and domain-general abilities. However, the existing cognitive profile of MD is incomplete and thus not applicable in typical settings such as schools or clinics. So far, no review has applied inclusion criteria according to DSM or ICD, summarized domain-specific abilities or examined the validity of response time scores for MD identification. Based upon stringent clinical criteria, the current meta-analysis included 34 studies which compared cognitive performances of a group with MD and a group without (...) MD. Criteria according to DSM and ICD were applied to identify MD. Effect sizes for 22 abilities were estimated and separated by their level and type of scoring. A cognitive profile of MD was identified, characterized by distinct weaknesses in: computation, number sense, and visual-spatial short-term storage [AC]. No particular strength was found. Severity of MD, group differences in reading performance and IQ did not significantly moderate the results. Further analyses revealed that effects are larger when dealing with numbers or number words than with quantities, MD is not accompanied by any weakness in abilities typically assigned to reading, and weaknesses in visual-spatial short-term storage emphasize the notion that number and space are interlinked. The need for high-quality studies investigating domain-general abilities is discussed. (shrink)

Hertwig and Ortmann suggest paying participants contingent upon performance in order to increase the thoroughness they devote to a decision task. We argue that monetary incentives can yield a number of unintended effects including distortions of the subjective representation of the task and impaired performance. Therefore, we conclude that performance-contingent payment should not be generally employed in judgment and decision research.

This volume gathers together for the first time are all the key texts in a crucial debate in modern philosophy, centered on Leibniz's famous 1695 essay, the "New System of the Nature of Substances and their Communication," in which he introduced his strikingly original theory of metaphysics. His "system" became increasingly famous and drew him into discussion and development of these ideas, both in public and in private, with a variety of thinkers, most notably the great French philosopher Pierre Bayle. (...) Woolhouse's and Francks's new English edition gives the only full representation of this debate, and will therefore be essential reading for anyone who wishes to gain a proper understanding of Leibniz's philosophy and its intelletual context. All the texts are newly translated and extensively annotated; many appear in English for the first time. (shrink)

ZusammenfassungDer Einsatz von Psychopharmaka im Altenpflegeheim unterliegt aufgrund institutioneller und struktureller Besonderheiten dieses Versorgungsbereiches, aber auch aufgrund der großen Abhängigkeit und Vulnerabilität eines großen Teils der Altenpflegeheimbewohner in besonderer Weise der Gefahr, in inadäquater und missbräuchlicher Weise durchgeführt zu werden. Die Beachtung der ethischen Grundprinzipien des Wohltuns und des Nichtschadendürfens sowie des Respekts vor der Autonomie der Bewohner (bzw. der Patienten) sollte für alle an der Versorgung unmittelbar und mittelbar Beteiligten handlungsleitend sein. Zum Schutz der Heimbewohner, aber auch mit dem (...) Ziel die Versorgungsqualität in diesem Bereich nachprüfbar zu verbessern, werden in diesem Beitrag Kriterien zur Definition einer inadäquaten bzw. adäquaten Anwendung von Psychopharmaka explizit formuliert, sowie deren Implementierung in prozessorientierte Handlungsalgorithmen und Behandlungsleitlinien vorgeschlagen. Darüber hinaus sollen die Möglichkeiten und Grenzen nicht-pharmakologischer, psychologischer Interventionen als Alternative zur Psychopharmakamedikation diskutiert und hinsichtlich ihrer ethischen Implikationen reflektiert werden. (shrink)

Der Einsatz von Psychopharmaka im Altenpflegeheim unterliegt aufgrund institutioneller und struktureller Besonderheiten dieses Versorgungsbereiches, aber auch aufgrund der großen Abhängigkeit und Vulnerabilität eines großen Teils der Altenpflegeheimbewohner in besonderer Weise der Gefahr, in inadäquater und missbräuchlicher Weise durchgeführt zu werden. Die Beachtung der ethischen Grundprinzipien des Wohltuns und des Nichtschadendürfens sowie des Respekts vor der Autonomie der Bewohner (bzw. der Patienten) sollte für alle an der Versorgung unmittelbar und mittelbar Beteiligten handlungsleitend sein. Zum Schutz der Heimbewohner, aber auch mit dem (...) Ziel die Versorgungsqualität in diesem Bereich nachprüfbar zu verbessern, werden in diesem Beitrag Kriterien zur Definition einer inadäquaten bzw. adäquaten Anwendung von Psychopharmaka explizit formuliert, sowie deren Implementierung in prozessorientierte Handlungsalgorithmen und Behandlungsleitlinien vorgeschlagen. Darüber hinaus sollen die Möglichkeiten und Grenzen nicht-pharmakologischer, psychologischer Interventionen als Alternative zur Psychopharmakamedikation diskutiert und hinsichtlich ihrer ethischen Implikationen reflektiert werden. (shrink)

ZusammenfassungDer Einsatz von Psychopharmaka im Altenpflegeheim unterliegt aufgrund institutioneller und struktureller Besonderheiten dieses Versorgungsbereiches, aber auch aufgrund der großen Abhängigkeit und Vulnerabilität eines großen Teils der Altenpflegeheimbewohner in besonderer Weise der Gefahr, in inadäquater und missbräuchlicher Weise durchgeführt zu werden. Die Beachtung der ethischen Grundprinzipien des Wohltuns und des Nichtschadendürfens sowie des Respekts vor der Autonomie der Bewohner sollte für alle an der Versorgung unmittelbar und mittelbar Beteiligten handlungsleitend sein. Zum Schutz der Heimbewohner, aber auch mit dem Ziel die Versorgungsqualität (...) in diesem Bereich nachprüfbar zu verbessern, werden in diesem Beitrag Kriterien zur Definition einer inadäquaten bzw. adäquaten Anwendung von Psychopharmaka explizit formuliert, sowie deren Implementierung in prozessorientierte Handlungsalgorithmen und Behandlungsleitlinien vorgeschlagen. Darüber hinaus sollen die Möglichkeiten und Grenzen nicht-pharmakologischer, psychologischer Interventionen als Alternative zur Psychopharmakamedikation diskutiert und hinsichtlich ihrer ethischen Implikationen reflektiert werden. (shrink)

Plato's dialogues frequently criticize traditional Greek myth, yet Plato also integrates myth with his writing. Daniel S. Werner confronts this paradox through an in-depth analysis of the Phaedrus, Plato's most mythical dialogue. Werner argues that the myths of the Phaedrus serve several complex functions: they bring nonphilosophers into the philosophical life; they offer a starting point for philosophical inquiry; they unify the dialogue as a literary and dramatic whole; they draw attention to the limits of language and the limits of (...) knowledge; and they allow Plato to co-opt cultural authority as a way of defining and legitimating the practice of philosophy. Platonic myth, as a species of traditional tale, is thus both distinct from philosophical dialectic and similar to it. Ultimately, the most powerful effect of Platonic myth is the way in which it leads readers to participate in Plato's dialogues and to engage in a process of self-examination. (shrink)

t. 1. Apo ton prōto skeptomeno anthrōpo mechri ton 6. aiōna M.Ch. -- t. 2. Apo ton 7. aiōna M.Ch. mechri to sēmera.

We propose a formal framework for interpretable machine learning. Combining elements from statistical learning, causal interventionism, and decision theory, we design an idealised explanation game in which players collaborate to find the best explanation for a given algorithmic prediction. Through an iterative procedure of questions and answers, the players establish a three-dimensional Pareto frontier that describes the optimal trade-offs between explanatory accuracy, simplicity, and relevance. Multiple rounds are played at different levels of abstraction, allowing the players to explore overlapping causal (...) patterns of variable granularity and scope. We characterise the conditions under which such a game is almost surely guaranteed to converge on a optimal explanation surface in polynomial time, and highlight obstacles that will tend to prevent the players from advancing beyond certain explanatory thresholds. The game serves a descriptive and a normative function, establishing a conceptual space in which to analyse and compare existing proposals, as well as design new and improved solutions. (shrink)

Ariès traces Western man's attitudes toward mortality from the early medieval conception of death as the familiar collective destiny of the human race to the modern tendency, so pronounced in industrial societies, to hide death as if it were an embarrassing family secret.

Capital punishment—the legally authorized killing of a criminal offender by an agent of the state for the commission of a crime—stands in special need of moral justification. This is because execution is a particularly severe punishment. Execution is different in kind from monetary and custodial penalties in an obvious way: execution causes the death of an offender. While fines and incarceration set back some of one’s interests, death eliminates the possibility of setting and pursuing ends. While fines and incarceration narrow (...) one’s routes to happiness, death eliminates its possibility. Not surprisingly, there is much debate about the moral permissibility of capital punishment. This entry maps the terrain of this debate. The first section discusses justifications of the death penalty as they appear in major theories of punishment. The second section surveys moral objections to execution that apply to most justifications. The third addresses procedural criticisms, which do not target the morality of execution so much as the justice of its implementation. (shrink)

In Seeing Things as They Are (Searle 2015), Searle developed a direct realist’s theory of perception. According to direct realism, physical objects are directly and immediately perceived. Searle claims that Berkeley’s theory of perception goes against direct realism. For Searle, Berkeley’s theory suggests that only subjective experiences (ideas) are directly and immediately perceived, not physical objects. Contrary to Searle, G. S. Pappas claims that Berkeley’s theory of perception is consistent with the view that physical objects are immediately perceivable (Pappas 1982; (...) Pappas 1987). Given the conflicting interpretations of Berkeley’s theory of perception, this paper attempts to defend Searle’s position on Berkeley’s theory of perception. It refutes Pappas’ interpretation by arguing that he is inconsistent with Berkeley’s theses of ontological phenomenalism and heterogeneity thesis. (shrink)

In this original work of cultural criticism, Allen S. Weiss explores the meaning of radio to the modern imagination.

Purpose. To examine the existential anthropology of G. Marcel and E. Minkowski, in order to demonstrate the necessity of distinguishing the universal-spiritual, as human in human being, apart from the individual-existential in him, and to reveal the hierarchical correlation of biosocial, existential and spiritual spheres in personality. Theoretical basis. Within existential philosophy the author differentiates two separate traditions and proceeds from the insufficiency of the distinction of existential sphere, proposed by phenomenological tradition, showing the necessity of its correlation with the (...) spiritual sphere as a sphere of humanity, proposed by non-phenomenological tradition of G. Marcel and E. Minkowski. Originality. The author presents the anthropological conception of G. Marcel and E. Minkowski, in which human personality is understood as unity of individual-existential and universal-spiritual, which requires a special trans-empirical field of culture, which contains senses, images and symbols of humanity. Also, the author presents the recent developments of existential thinkers in distinguishing existential and spiritual dimensions, both not reducible to the physical and social dimensions. Conclusions. In both existential traditions, the specifically human was founded as a trans-biological and trans-social phenomenon, which appears as indefinable and non-predetermined. But in first tradition, humanity is understood as an existence, as a unique individuality, "project", variant of humanity, equivalent to other variants, and universal is understood as a community of human condition in the world. While in the second tradition, the universal is understood as spiritual. Thus, horizontal level of our private existence, as the process of movement from birth to death, is supplemented by vertical of human, universal ideals and images. Humanity appears as a task, on the way to which human being transcends beyond the limits of his individual "self" to the "super-individual", through inclusion into spiritual community, into universal culture. (shrink)

From the concrete experience of war, Michael S. Yandell constructs a phenomenology of “negative revelation” in which false or distorted claims of goodness and justice disintegrate and become meaningless, adding depth to the term moral injury.

The foundation of the Christian counselling movement -- Christian counselling in the UK -- The aims of Christian counselling -- Integrating psychological and biblical truth -- Sigmund Freud--the founding father of psychotherapy -- The individual psychology of Alfred Adler -- Abraham Maslow--the man with new age tendencies -- Carl Rogers--a man who believed in himself -- Albert Ellis--the aggressive atheist -- The Bible's verdict on psychological 'truth' -- The case against Larry Crabb -- Self-esteem: the secular foundation -- Self-esteem and (...) the Christian counselling movement -- Self-esteem dogma in the light of scripture. (shrink)