Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

Modern medicine, based on enormous progress in science and its applications, has lost dimensions of individualized treatment and compassion which traditionally were an essential part of physician’s service over the millennia in Eastern and Western cultures. Today diseases and symptoms, rather than persons, are treated, based on objective quality norms and inflexible payment schemes rather than the rather than persons. We present a checklist model for personalized health care, which has been successful in teaching and practice to reclaim lost territory (...) in treating patients as persons. (shrink)

Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus (...) supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients’ wishes, be made in light of commonly shared values, unless these violate the principle of “in dubio pro vita”. The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life. (shrink)

Einrichtungen der Altenpflege weisen spezifische ethische Spannungsfelder und ethische Fragestellungen auf. Das Strukturinstrument EMMA (Ethik Multiprofessionell Methodisch Anwenden) zur Moderation einer Ethik-Fallberatung wurde für den Einsatz in Einrichtungen der Altenpflege konzipiert. Inhaltlich werden die Besonderheiten dieses Settings unter Bezugnahme auf den Schlüsselbegriff Privatheit in den Mittelpunkt gestellt. EMMA eignet sich aufgrund seiner Kontextsensitivität darüber hinaus zum Einsatz in der Ethik-Fallberatung in unterschiedlichen außerklinischen Settings.

In den letzten Jahren hat sich eine Vielfalt unterschiedlicher Gremien zur Ethikberatung entwickelt: vom Konsil mit einem einzelnen Berater bis zum Ethikkomitee. In dem Band werden die Ethikberatung, ihre Entwicklung und Anwendung, sowie die Gründung von Gremien in Krankenhäusern, Pflegeeinrichtungen, Hospizen und von niedergelassenen Ärzten anhand von Fallbeispielen erläutert. Dabei schlagen die Autoren eine Brücke zwischen traditioneller philosophischer Ethik und anwendungsbezogener klinischer Ethik. Auch rechtliche Fragen werden erörtert.

Excerpt from Das Ethische System des Helvetius Beobachtung gegründeten Principien irgend einer Kunst oder Wissenschaft. Gehe der Philosoph nicht bei der Erfahrung in. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, (...) such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Economic principles and instruments have been introduced into the German welfare system. The European Union wants to realize an open market economy with free competition for the social services. In this situation Christian welfare organisations get in conflict with their churches and the ethics of Christianity. The concepts of »entrepreneurship diakonia« and »advocatory diakonia« are completed and criticized by the new concept of a »public diakonia of citizenship and community« on the basis of the ethical principles of charity, justice and (...) man’s dignity. According to that new concept »diaconics« and economics may learn from each other in a dialogue of reciprocity. (shrink)

ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Whereas present theories of transformative learning tend to focus on the rational and reflective actor, in this article it is suggested that spontaneous action may play a decisive role in transformative learning too. In the spontaneity of action, novelty finds its way into life, gains momentum, is respected by others and reflected by the actor. Such transformation processes are investigated both with the means of theoretical reflection and of empirical inquiry. Based on nine narrative interviews typical phases of transformative learning (...) processes are identified. Owing to the comparative nature of the study, it was also possible to develop an age‐related typology that overlaps certain phases of the transformation process. These empirical findings constitute the background against which the nexus of spontaneous action and transformative learning is reflected theoretically. Theories drawn upon include John Dewey's Pragmatism and George Herbert Mead's Social Pragmatism. Both scholars provide rich theoretical concepts for reflecting on the nature of that what so often eludes from the control of both educators and learners: the spontaneity of the beginning. (shrink)

Die Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Chapter. 1. Logical. Form. as. a. Level. of. Linguistic. Representation. What is the relation of a sentence's syntactic form to its logical form? This issue has been of central concern in modern inquiry into the semantic properties of natural ...

In defending his interest-relative account of knowledge in Knowledge and Practical Interests (2005), Jason Stanley relies heavily on intuitions about several bank cases. We experimentally test the empirical claims that Stanley seems to make concerning our common-sense intuitions about these bank cases. Additionally, we test the empirical claims that Jonathan Schaffer seems to make in his critique of Stanley. We argue that our data impugn what both Stanley and Schaffer claim our intuitions about such cases are. To account for these (...) results, one must develop a better conception of the connection between a subject's interests and her body of knowledge than those offered by Stanley and Schaffer. (shrink)

Recent empirical research seems to show that emotions play a substantial role in moral judgment. Perhaps the most important line of support for this claim focuses on disgust. A number of philosophers and scientists argue that there is adequate evidence showing that disgust significantly influences various moral judgments. And this has been used to support or undermine a range of philosophical theories, such as sentimentalism and deontology. I argue that the existing evidence does not support such arguments. At best it (...) suggests something rather different: that moral judgment can have a minor emotive function, in addition to a substantially descriptive one. (shrink)

While the enormous influence of Martin Heidegger's thought in Japan and China is well documented, the influence on him from East-Asian sources is much lesser known. This remarkable study shows that Heidegger drew some of the major themes of his philosophy--on occasion almost word for word--from German translations of Chinese Daoist and Zen Buddhist classics.

Determinism seems to rule out a robust sense of options but also prevent our choices from being a matter of luck. In this way, free will seems to require both the truth and falsity of determinism. If the concept of free will is coherent, something must have gone wrong. I offer a diagnosis on which this puzzle is due at least in part to a tension already present in the very idea of free will. I provide various lines of support (...) for this hypothesis, including some experimental data gathered by probing the judgments of non-specialists. (shrink)

Contrary to assumptions that changes in brain networks are possible only during crucial periods of development, research in the past decade has supported the idea of a permanently plastic brain. Novel experience, altered afferent input due to environmental changes and learning new skills are now recognized as modulators of brain function and underlying neuroanatomic circuitry. Given findings in experiments with animals and the recent discovery of increases in gray and white matter in the adult human brain as a result of (...) learning, the old concept of cognitive reserve, that is the ability to reinforce brain volume in crucial areas and thus provide a greater threshold for age-dependent deficits, has been reinforced. The challenge we face is to unravel the exact nature of the dynamic structural alterations and, ultimately, to be able to use this knowledge for disease management. Understanding normative changes in brain structure that occur as a result of environmental changes and demands is pivotal to understanding the characteristic ability of the brain to adapt. (shrink)

[Emerging Scholar Prize Essay for Spindel Supplement] Some philosophers and psychologists have evaluated psychological egoism against recent experimental work in social psychology. Dan Batson (1991; forthcoming), in particular, argues that empathy tends to induce genuinely altruistic motives in humans. However, some argue that there are egoistic explanations of the data that remain unscathed. I focus here on some recent criticisms based on the idea of self-other merging or "oneness," primarily leveled by Robert Cialdini and his collaborators (1997). These authors argue (...) that the putatively altruistic subjects are acting on ultimately egoistic motives because empathic feelings for someone in distress tend to cause them to blur the distinction between themselves and the other. Employing a conceptual framework for the debate, I argue that the self-other merging explanation fails to explain the empathy-helping relationship on primarily non-empirical grounds, regardless of the empirical results Cialdini and colleagues report. (shrink)

Taking up Kimberlé Crenshaw's conclusion that black feminist theorists seem to continue to find themselves in many ways “speaking into the void” (Crenshaw 2011, 228), even as their works are widely celebrated, I examine intersectionality critiques as one site where power asymmetries and dominant imaginaries converge in the act of interpretation (or cooptation) of intersectionality. That is, despite its current “status,” intersectionality also faces epistemic intransigence in the ways in which it is read and applied. My aim is not to (...) suggest that intersectionality cannot (or should not) be critiqued, nor do I maintain that celebratory applications/interpretations are immune from epistemic distortion when it comes to interpreting intersectionality. Rather, my goal is to demonstrate that critiques of intersectionality are one important site to examine hermeneutic marginalization and interpretive violence; the politics of citation; and the impact of dominant expectations or established social imaginaries on meaning-making. In so doing, I aim to consider more fully how entrenched ways of thinking are frequently relied upon to interpret and critique intersectionality, even as these are often the very frameworks that intersectionality theorists have identified as highly problematic tools of misrepresentation, erasure, and violation. This slippage away from intersectionality's outlooks, whether in critical or laudatory contexts, is a pivotal site of epistemic negotiation we must examine more closely. (shrink)

Gopal Sreenivasan’s “hybrid theory” states that a moral duty is directed toward an individual because her interests justify the assignment of control over the duty. An alternative “plain theory” states that the individual’s interests justify the duty itself. I argue that a strong moral status constraint explains Sreenivasan’s instrumentalization objection to a Razian plain theory but that his own model violates this constraint. I suggest how both approaches can be reformulated to satisfy the constraint, and I argue that a reformulated (...) plain theory can also avoid an insufficiency objection. The hybrid approach consequently has no clear advantage over the plain approach. (shrink)

Reconsidering Difference has a twofold task, the primary one critical and the secondary one reconstructive. The critical task is to show that these various privilegings are philosophical failures.

Provides an overview of the theory of psychological egoism—the thesis that we are all ultimately motivated by self-interest. Philosophical arguments for and against the view are considered as well as some empirical evidence.

We criticize the following views: only the rapist is responsible since only he committed the act; no one is responsible since rape is a biological response to stimuli; everyone is responsible since men and women contribute to the rape culture; and patriarchy is responsible but no person or group. We then argue that, in some societies, men are collectively responsible for rape since most benefit from rape and most are similar to the rapist.

We attempt here to trace the evolution of Frege’s thought about truth. What most frames the way we approach the problem is a recognition that hardly any of Frege’s most familiar claims about truth appear in his earliest work. We argue that Frege’s mature views about truth emerge from a fundamental re-thinking of the nature of logic instigated, in large part, by a sustained engagement with the work of George Boole and his followers, after the publication of Begriffsschrift and the (...) appearance of critical reviews by members of the Boolean school. (shrink)

It is a characteristically Fregean thesis that the sense expressed by an expression is the linguistic meaning of that expression. Sense can play this role for Frege since it meets fundamental desiderata for meaning, that it be universal and invariantly expressed and objectively the same for everyone who knows the language. It has been argued,1 however, that, as a general thesis about natural languages, the identi cation of sense and meaning cannot be sustained since it is in con ict with (...) another characteristically Fregean thesis, that sense uniquely determines reference. The argument is quite simple and can be outlined as follows. Assume the two theses we have just stated. (shrink)

A care deficit is clearly evident in global cities such as London and is attributable to an ageing population, the increased employment of native-born women, prevalent gender ideologies that continue to exempt men from much reproductive work, as well as the failure of the state to provide viable alternatives. However, while it is now acknowledged that migrant women, and to a lesser extent, migrant men, step in to provide care in cities such as London, there is less research on how (...) this shapes the nature, politics and ethics of care. Drawing upon empirical research with low-paid migrant workers employed as domiciliary care providers in London, this paper explores the emergence of a distinct migrant ethic of care that is critically shaped by the caring work that migrant women and men perform. (shrink)