Not all countries do their fair share in the effort of preventing dangerous climate change. This presents those who are willing to do their part with the question whether they should 'take up the slack' and try to compensate for the non-compliers' failure to reduce emissions. There is a pro tanto reason for doing so given the human rights violations associated with dangerous climate change. The article focuses on fending off two objections against a duty to take up the slack: (...) that it is unfair and ineffective. We grant that it is unfair if some have to step in for others but argue that this does not amount to a decisive objection under conditions of partial compliance. With regard to the charge of emission reductions being ineffective, we argue that the empirical case for this claim is missing and that even if it were not, there still remains the option of taking up the slack in other forms. (shrink)

Even though co‐parenthood is one of the most significant close personal relationships that people can have, there is relatively little philosophical work on the moral duties that co‐parents owe each other. This may be due to the increasingly questionable assumption, still common in our societies, that co‐parenthood arises naturally from marriage or romantic coupledom and thus that commitment to a co‐parent evolves from a commitment to a marital or romantic partner. In this article, we argue that co‐parenthood should be seen (...) as a relationship in its own right, which generates specific moral duties. Co‐parents should come to explicit agreements with each other regarding the most important areas of potential conflict between them. Such agreements may have to be renegotiated over time. We explore some possible non‐negotiable co‐parental duties such as the duties not to alienate the child from the other parent(s) and not to trap a co‐parent in a particularly vulnerable situation. We consider some legal and societal implications of our argument and, finally, suggest some pragmatic benefits of our proposal. (shrink)

Dieser Beitrag kritisiert aktuelle Vorschläge zur Einführung einer allgemeinen Dienstpflicht. Vier Argumente für einen verpflichtenden Dienst zugunsten der Allgemeinheit werden diskutiert und zurückgewiesen: Das paternalistische Argument, das sich auf den Nutzen der Dienstpflicht für die Dienstpflichtigen selbst beruft, scheitert aus prinzipiellen Erwägungen. Das sozialstaatliche Argument, das die Dienstpflicht durch ihre Rolle bei der Erfüllung sozialstaatlicher Aufgaben gerechtfertigt sieht, ist wenig überzeugend, solange es mildere Mittel gibt, diese Aufgaben zu erfüllen. Das Argument über Gemeinschaftlichkeit, das die Dienstpflicht mit einer Konzeption des (...) guten Lebens in Gemeinschaft begründet, scheitert an seiner Unvereinbarkeit mit einem vernünftigen Pluralismus der Lebensentwürfe. Und schließlich ist auch die These zurückzuweisen, dass eine allgemeine Dienstpflicht notwendig sei, um die gesellschaftlichen Voraussetzungen einer funktionierenden Demokratie zu gewährleisten. Eine Diskussion vermeintlicher Analogien beschließt den Aufsatz. (shrink)

In diesem Beitrag argumentiere ich, dass die Ermöglichung von Vereinbarkeit zwischen Erwerbsarbeit und Familienleben ein Erfordernis der Gerechtigkeit bildet. Eltern besitzen einen Anspruch auf Vereinbarkeit, der auf zwei Interessen gründet: Dem Interesse am Zugang zur Erwerbstätigkeit und dem Interesse an der Pflege der Eltern-Kind-Beziehung, durch die besondere Güter realisiert werden. Eine staatliche Politik der Vereinbarkeit lässt sich auch gegenüber denjenigen Gruppen rechtfertigen, die kein besonderes Interesse daran haben – gegenüber Erwachsenen, die keine Kinder haben, und gegenüber Eltern, die ein ‚Ernährermodell‘ (...) mit einer klaren Aufgabenteilung zwischen den Partnern bevorzugen. Eine entsprechende Politik muss allerdings die Dimension des Geschlechts beachten, um nicht zu einer Verschärfung der geschlechtsspezifischen Arbeitsteilung zu führen. (shrink)

Recent philosophical work on children and childhood has revealed many new questions concerning minors’ rights. This special issue of Moral Philosophy and Politics offers new contributions to the topics of paternalism, the nature of the right to parent and children’s voting. It also contains articles about the so far less explored questions of adolescents’ parental rights, minors’ rights against the harms of parental imprisonment, and their right to veto their own parents’ decision to relocate.

Sabine Hohl and Dominic Roser argue that states that emit their fair share of greenhouse gases have a duty to step in for states that emit more than their fair share. In this comment I ask two questions: First, given that Hohl and Roser are right, how relevant is the duty to step in for the polluters in practice? Second, is there such a duty on more non-ideal approaches than the one taken by Hohl and Roser (...) as well? I argue that the duty to step in for the polluters is not very relevant (because of considerations of demandingness and fairness) and that on more extremely non-ideal approaches there may be only a limited duty to take up the slack, or no such duty at all (because the duty must be weighed against other duties, and because states are poorly motivated to act in conformity with it). (shrink)

Something in the world tears away, jumps out, approaches... A world that approaches is a world that is alive and vivid. This applies not only to the existing natural world, but also to what humans create, which, in form the form of artifacts - from the hand-held ax to linguistic theory - also approaches design in terms of both object and challenge.

The question of what characterizes feelings of being alive is a puzzling and controversial one. Are we dealing with a unique affective phenomenon or can it be integrated into existing classifications of emotions and moods? What might be the natural basis for such feelings? What could be considered their specifically human dimension? These issues are addressed by researchers from various disciplines, including philosophy of mind and emotions, psychology, and history of art. This volume contains original papers on the topic of (...) feelings of being alive by Fiorella Battaglia, Eva-Maria Engelen, Joerg Fingerhut, Thomas Fuchs, Alice Holzhey-Kunz, Matthias Jung, Tanja Klemm, Riccardo Manzotti, Sabine Marienberg, Matthew Ratcliffe, Arbogast Schmitt, Jan Slaby, and Achim Stephan. (shrink)

The medical profession is observing a rising number of calls to action considering the threat that climate change poses to global human health. Theory-led bioethical analyses of the scope and weight of physicians’ normative duty towards climate protection and its conflict with individual patient care are currently scarce. This article offers an analysis of the normative issues at stake by using Korsgaard’s neo-Kantian moral account of practical identities. We begin by showing the case of physicians’ duty to climate protection, before (...) we succinctly introduce Korsgaard’s account. We subsequently show how the duty to climate protection can follow from physicians’ identity of being a healthcare professional. We structure conflicts between individual patient care and climate protection, and show how a transformation in physicians’ professional ethos is possible and what mechanisms could be used for doing so. An important limit of our analysis is that we mainly address the level of individual physicians and their practical identities, leaving out important measures to respond to climate change at the mesolevels and macrolevels of healthcare institutions and systems, respectively. (shrink)

Doctors occasionally make diagnoses in strangers outside of formal medical settings by using the medical skill of visual inspection, such as noticing signs of melanoma or the symptoms of hyperthyroidism. This may cause considerable moral unease and doubts on the side of the diagnosing physician. Such encounters force physicians to consider whether or not to intervene by introducing themselves to the stranger and offering an unsolicited medical opinion despite the absence of a formal doctor-patient relationship. A small body of literature (...) has addressed the topic of the unsolicited medical opinion, often with a primary focus on practical advice. This article seeks to establish an ethical-theoretical basis for physicians' ethical obligation to offer an unsolicited medical opinion when they make a diagnosis by visual inspection in a stranger outside of the formal medical context. Using a utilitarian approach, it is argued that, if it is in the physicians' power to prevent a possible loss of well-being, without thereby sacrificing anything of equal value, physicians have an ethical obligation to intervene. (shrink)

The concepts of disease, illness and sickness capture fundamentally different aspects of phenomena related to human ailments and healthcare. The philosophy and theory of medicine are making manifold efforts to capture the essence and normative implications of these concepts. In parallel, socio-empirical studies on patients’ understanding of their situation have yielded a comprehensive body of knowledge regarding subjective perspectives on health-related statuses. Although both scientific fields provide varied valuable insights, they have not been strongly linked to each other. Therefore, the (...) article aims to scrutinise the normative-ethical implications of patient perspectives in building a bridge to the empirical ethics debates. Three potential fields of tension between the illness and the disease perspective are presented. Consequently, findings from empirical research examining patient perspectives on illness are displayed and the practical implications and associated ethical issues which arise are discussed. This leads to the conclusion that an explicit and elaborate empirical-ethical methodology is needed to deal appropriately with the complex interaction between patients’ views and the medico-professional view of disease. Kon’s four-stage model of normative-empirical collaboration is then applied against the background of empirical data on patient perceptions. Starting from this exemplary approach, the article suggests employing empirical-ethical frameworks for further research on the conceptual and normative issues, as they help to integrate perspectives from the philosophy of medicine with socio-empirical research. The combination of theoretical and empirical perspectives suggested contributes to a more nuanced discussion of the normative impact of patients’ actual understanding of illness. Further empirical research in this area would profit from explicitly considering potential ethical issues to avoid naturalistic fallacies or crypto-normative conclusions that may compromise healthcare practice. Vice versa, medico-theoretical debates could be enriched by integrating subjective views of those people who are immediately affected. (shrink)

The human-centered AI approach posits a future in which the work done by humans and machines will become ever more interactive and integrated. This article takes human-centered AI one step further. It argues that the integration of human and machine intelligence is achievable only if human organizations—not just individual human workers—are kept “in the loop.” We support this argument with evidence of two case studies in the area of predictive maintenance, by which we show how organizational practices are needed and (...) shape the use of AI/ML. Specifically, organizational processes and outputs such as decision-making workflows, etc. directly influence how AI/ML affects the workplace, and they are crucial for answering our first and second research questions, which address the pre-conditions for keeping humans in the loop and for supporting continuous and reliable functioning of AI-based socio-technical processes. From the empirical cases, we extrapolate a concept of “keeping the organization in the loop” that integrates four different kinds of loops: AI use, AI customization, AI-supported original tasks, and taking contextual changes into account. The analysis culminates in a systematic framework of keeping the organization in the loop look based on interacting organizational practices. (shrink)

The au pair program in general is still known as a form of cultural exchange program and a good possibility for young women to spend a year abroad, although it has undergone great changes during the last 10 years. This article argues that due to different socio-economic and cultural processes in Western postindustrial societies as well as in the eastern and southern parts of the world the au pair program is becoming a form of domestic work with quite similar working (...) and living conditions to that of live-in migrant domestic workers. This article which is based on two empirical studies on the globalizing au pair business in Eastern and Western Europe as well in the United States looks into the motivations and expectations, the living conditions and interactions between the au pairs and the employer families and contrasts these findings with the discourse of the au pair agencies still advertising au pair as a form of cultural exchange. In doing so the paper can show that it is the still dominant image of au-pair as a cultural exchange program (disarticulating the work aspect) that leaves the young au pair women even more vulnerable to exploitation: ‘big sisters’ are the best domestic servants. This article draws attention to the racialized economization of the private sphere and care work, the inherent traps and exploitative features of this very specific work place. (shrink)

Interprofessionelles Lernen von Auszubildenden der Pflegeberufe sowie Medizinstudierenden bietet vielfältige Chancen für die zukünftige Zusammenarbeit mit dem Ziel einer qualitativ hochwertigen Versorgung von Patient*innen. Expert*innengremien fordern daher eine frühzeitige Integration von interprofessionellen Lehr- und Lernformaten, um effektive und nachhaltige Verbesserungen in der Praxis erreichen zu können. In Deutschland wird interprofessionelle Lehre in der grundständigen Ausbildung der zwei Professionen in wachsendem Umfang in ausgewählten Fächern – obligat oder fakultativ – eingesetzt. Der Bereich der Ethik im Gesundheitswesen wird dabei bislang jedoch kaum (...) berücksichtigt. Der Beitrag untersucht die Situation interprofessioneller Ethiklehre in Deutschland und beleuchtet deren Möglichkeiten und Grenzen vor dem Hintergrund eines Pilotprojektes. (shrink)

Definition of the problem Interprofessional learning of nursing trainees and medical students offers numerous opportunities for future cooperation aiming to provide high-quality care for patients. Arguments Expert panels, therefore, demand early integration of interprofessional teaching and learning structures in order to be able to achieve effective and sustainable improvements in practice. In Germany, interprofessional learning formats are increasingly used in undergraduate education of the two professions in selected—compulsory and optional—themes and courses. Conclusion So far, the field of health care ethics (...) has scarcely been taken into consideration. The article examines the situation of interprofessional ethics teaching in Germany and highlights its opportunities and limitations against the background of a pilot project. (shrink)

This article presents a series of experiments which were conducted among native speakers of German to determine the influence of different types of German generics on the cognitive inclusion of women. Results indicate that the inclusion of women is higher with ‘non-sexist’ alternatives than with masculine generics, a tendency which was consistent across different studies. The different alternatives, however, showed different effects which also varied depending on the context. These results are discussed with regard to their practical consequences in situations (...) such as nominating women and men for awards or political offices. (shrink)

We are extremely grateful for the insightful and thought-provoking commentaries on our feature article.1 We have distilled four themes emerging from the commentaries, and we would also like to address one misunderstanding of our argument that has appeared. In our article, we explicitly acknowledge that major decisions relevant for climate protection take place at the mesolevels and macrolevels of healthcare, a point raised again in some of the commentaries.2–4 Climate protection is a societal issue, and we thank these authors for (...) the concrete proposals of potential models to guide action. Yet, to us, it still makes sense to reflect simultaneously on the responsibilities that physicians have themselves. Without wanting to put the main responsibility on them, we argue it is important to start thinking about the scope of action that physicians actually have (or not have). As we have argued the need for climate action comes ever more into focus of society, we wanted to explore whether the professional ethics of the medical professionals needs to be amended. Our argument is that this is the case, based on the reasons that climate change has a big health impact while simultaneously the health system has a strong climate impact. Based on the World Medical Association (WMA) Declaration of Geneva the focus on the individual patient is clear, but this and other important codices do also include a public health perspective. The (model) Professional Code for Physicians in Germany, for example, states in its first article that ‘Physicians serve the health of …. (shrink)

Im Zuge des „empirical turn“ der Medizin- und Bioethik ist von verschiedenen Autoren in den vergangenen Jahren die Idee einer „evidenzbasierten Ethik“ diskutiert worden. Die Analogie zwischen evidenzbasierter Medizin und „evidenzbasierter Ethik“ soll in diesem Beitrag kritisch diskutiert und dabei gezeigt werden, dass der Ausdruck „evidenzbasierte Ethik“ irreführend ist. Zentraler Ausgangspunkt der Kritik ist die unterschiedliche Bedeutung, die empirische Informationen für das medizinisch-klinische Urteil zum einen und das ethische Urteil in der Medizin zum anderen haben. Im medizinisch-klinischen Urteil können mit (...) Hilfe empirischer Informationen hypothetische Handlungsnormen generiert werden, welche auf den der Medizin inhärenten Zwecksetzungen basieren. Bei Fragen der Ethik in der Medizin hingegen sind die Handlungsziele selbst Gegenstand des Urteils; diese aber können allein aus empirischem Wissen heraus nicht zureichend bestimmt werden. Die Diskussion um die Möglichkeit einer „evidenzbasierten Ethik“ eröffnet weiterhin aufschlussreiche Perspektiven in Bezug auf empirische Forschung und den Umgang mit empirischen Informationen in der Angewandten Ethik und das Aufgabenfeld der Medizinethik. (shrink)

ZusammenfassungMit der Vielzahl von Daten aus genetischen Untersuchungsverfahren wächst das Problem von „Zufallsbefunden“, d. h. von zufällig erhobenen Nebenbefunden, die mit der ursprünglichen Fragestellung nicht in Verbindung stehen und dennoch eine Bedeutung für Gesundheit und Reproduktionsverhalten der untersuchten Person selbst oder ihrer Anverwandten haben. In Ermangelung nationaler oder internationaler Richtlinien greifen die Autoren die aktuelle Diskussion um den Umgang mit genetischen Zufallsbefunden in Behandlungs- und Forschungskontext auf. Dabei nehmen sie auf die für Deutschland relevanten rechtlichen und ethischen Rahmenbedingungen Bezug. Nach (...) Gendiagnostikgesetz (GenDG) muss in Deutschland im Rahmen eines Behandlungsvertrages auf die Möglichkeit von Zufallsbefunden hingewiesen werden. Es ist Bestandteil der Aufklärung und Einwilligung, inwieweit Zufallsbefunde mitgeteilt werden, wobei das Recht auf Nichtwissen und der Schutz nicht-einwilligungsfähiger Personen berücksichtigt werden müssen. Im Forschungskontext greift das GenDG nicht, aber auch hier sollte über mögliche Zufallsbefunde aufgeklärt werden, wenngleich eine Rückmeldung nicht zwingend, aber bei Befunden mit hohem klinischen Nutzen ethisch geboten sein kann. Folgende Aspekte sind im Umgang mit Zufallsbefunden zu berücksichtigen: 1) Art und Umfang der Aufklärung und Einwilligung bei einer unüberschaubaren Zahl von möglichen Befunden. 2) Einordnung der klinischen Bedeutung einer genetischen Veränderung im Sinne von gesichertem, wahrscheinlichem, möglichem oder fraglichem/unbekanntem klinischen Nutzen. 3) Prozessierung des Informationsrückflusses für Gegenwart und Zukunft. 4) Ressourcenplanung im Hinblick auf die klinische Validierung, die Erläuterung von Befunden und den Transfer in die klinische Praxis. Im Umgang mit genetischen Zufallsbefunden besteht erheblicher empirisch-ethischer Forschungs- und politischer Regelungsbedarf. Zeitgleich ist es unabdingbar, die Wahrnehmung und das Verständnis der untersuchten Personen sowie die Grundhaltung gegenüber Zufallsbefunden im Rahmen von Studien zu beleuchten und entsprechende Bildungs- und Kommunikationswerkzeuge zu entwickeln. (shrink)

Mit der Vielzahl von Daten aus genetischen Untersuchungsverfahren wächst das Problem von „Zufallsbefunden“, d. h. von zufällig erhobenen Nebenbefunden, die mit der ursprünglichen Fragestellung nicht in Verbindung stehen und dennoch eine Bedeutung für Gesundheit und Reproduktionsverhalten der untersuchten Person selbst oder ihrer Anverwandten haben. In Ermangelung nationaler oder internationaler Richtlinien greifen die Autoren die aktuelle Diskussion um den Umgang mit genetischen Zufallsbefunden in Behandlungs- und Forschungskontext auf. Dabei nehmen sie auf die für Deutschland relevanten rechtlichen und ethischen Rahmenbedingungen Bezug. Nach (...) Gendiagnostikgesetz (GenDG) muss in Deutschland im Rahmen eines Behandlungsvertrages auf die Möglichkeit von Zufallsbefunden hingewiesen werden. Es ist Bestandteil der Aufklärung und Einwilligung, inwieweit Zufallsbefunde mitgeteilt werden, wobei das Recht auf Nichtwissen und der Schutz nicht-einwilligungsfähiger Personen berücksichtigt werden müssen. Im Forschungskontext greift das GenDG nicht, aber auch hier sollte über mögliche Zufallsbefunde aufgeklärt werden, wenngleich eine Rückmeldung nicht zwingend, aber bei Befunden mit hohem klinischen Nutzen ethisch geboten sein kann. Folgende Aspekte sind im Umgang mit Zufallsbefunden zu berücksichtigen: 1) Art und Umfang der Aufklärung und Einwilligung bei einer unüberschaubaren Zahl von möglichen Befunden. 2) Einordnung der klinischen Bedeutung einer genetischen Veränderung im Sinne von gesichertem, wahrscheinlichem, möglichem oder fraglichem/unbekanntem klinischen Nutzen. 3) Prozessierung des Informationsrückflusses für Gegenwart und Zukunft. 4) Ressourcenplanung im Hinblick auf die klinische Validierung, die Erläuterung von Befunden und den Transfer in die klinische Praxis. Im Umgang mit genetischen Zufallsbefunden besteht erheblicher empirisch-ethischer Forschungs- und politischer Regelungsbedarf. Zeitgleich ist es unabdingbar, die Wahrnehmung und das Verständnis der untersuchten Personen sowie die Grundhaltung gegenüber Zufallsbefunden im Rahmen von Studien zu beleuchten und entsprechende Bildungs- und Kommunikationswerkzeuge zu entwickeln. (shrink)

BackgroundPublic involvement activities are promoted as measures for ensuring good governance in challenging fields, such as biomedical research and innovation. Proponents of public involvement activities include individual researchers as well as non-governmental and governmental organizations. However, the concept of ‘public’ in public involvement deserves more attention by researchers because it is not purely theoretical: it has important practical functions in the guidance, evaluation and translation of public involvement activities.DiscussionThis article focuses on collective agency as one property a public as a (...) small group of participants in a public involvement activity could exhibit. It introduces a prominent theoretical approach to collective agents as one specific kind of social entities and demonstrates how this approach can be applied to current practice in public involvement activities. A brief discussion of different types of representation as they are used in the existing literature on this topic is also included because representation and collective agency can be closely related to each other. Suggestions and ideas that are derived from this reasoning include the proposal to use a ‘validity check’ for the generation of collective agents as a regular element of certain types of public involvement activities, the consequences of combining collective agency and representativeness as a further property a public could exhibit, and standards for reporting the content of public involvement activities in scientific publications.SummaryThis article discusses the importance of the concept of ‘public’ in public involvement activities, with a focus on biomedical research and innovation. It introduces various practically relevant ideas that are based on a theoretical analysis of collective agency as an important property a public can possess. (shrink)

This volume represents the state of the art in research on the controversial Muslim legal scholar, theologian and man of letters Ibn azm of Cordoba (d. 456/1064), who is widely regarded as one of the most brilliant minds of Islamic Spain.

The One Health approach is a prominent paradigm for research and healthcare practice and increasingly applied in various fields. Theoretical and normative implications of the approach, however, remain underexposed so far, leading to conceptual incoherencies and uncertainties in the application of the concept. This article sheds light on two particularly influential theoretical flaws inherent to the One Health approach. The first difficulty relates to the question of whose health is considered in the One Health paradigm: humans and animals are obviously (...) situated on a different level than the environment, so that the individual, population, and ecosystem dimensions need to be considered. The second theoretical flaw is related to the question of which concept of health can be meaningfully referred to when speaking of One Health. This problem is addressed by analyzing four key theoretical conceptions of health from the philosophy of medicine (well‐being, natural functioning, capacity of achieving vital goals, and homeostasis and resilience) regarding their suitability for the aims of One Health initiatives. It appears that none of the concepts analyzed fully meets the demands of an equitable consideration of human, animal, and environmental health. Potential solutions lie in accepting that one concept of health is more appropriate for some entities than for others and/or forgoing the idea of a uniform conception of health. As a result of the analysis, the authors conclude that theoretical and normative assumptions underlying concrete One Health initiatives should be made more explicit. (shrink)

Mit seiner Sportwetten-Grundsatzentscheidung vom 28. Marz 2006 hat das Bundesverfassungsgericht die verfassungsrechtlichen Rahmenbedingungen fur das Glucksspielwesen in Deutschland prazisiert und den Gesetzgeber mit dessen Neuregelung beauftragt. Zum 1. Januar 2008 ist ein neues Glucksspielrecht in Deutschland in Kraft getreten. Allein die Ziele der Suchtvermeidung und Suchtbekampfung rechtfertigen Glucksspielmonopole, durch die private Glucksspielanbieter vom deutschen Glucksspielmarkt ausgeschlossen werden. Damit rucken neben okonomischen und rechtlichen Fragengerade auchdie Erkenntnisse der Glucksspielsucht-Forschung in den Mittelpunkt des Interesses. Dem versucht dieses interdisziplinar angelegte Buch Rechnung zu (...) tragen, indem namhafte Wissenschaftler und Praktiker - Okonomen, Juristen, Suchtfachleute - das Glucksspielwesen umfassend analysieren. Die Autoren beziehen Position und verdeutlichen die unterschiedlichen Sichtweisen und Interessenlagen zum Thema. Das Buch gibt dem Leser zugleich eine Idee von der geschichtlichen Dimension und der Bedeutung des Glucksspiels fur den Einzelnen und die Gesellschaft insgesamt.". (shrink)