Book reviewed in this article: The Needs of Strangers. By Michael Ignatieff. The Health Economy. By Victor Fuchs. Just Health Care. By Norman Daniels.

Objectives:Social isolation is increasing in aging societies and several studies have shown a relation with worse cognition in old age. However, less is known about the association in the oldest-old (85+); the group that is at highest risk for both social isolation and dementia. Methods:Analyses were based on follow-up 5 to 9 of the longitudinal German study on aging, cognition, and dementia in primary care patients (AgeCoDe) and the study on needs, health service use, costs, and health-related quality of life (...) in a large sample of oldest-old primary care patients (AgeQualiDe), a multi-center population-based prospective cohort study. Measurements included the Lubben Social Network Scale (LSNS-6), with a score below 12 indicating social isolation, as well as the Mini-Mental Status Examination (MMSE) as an indicator of cognitive function. Results:Dementia-free study participants (n = 942) were M = 86.4 (SD = 3.0) years old at observation onset, 68.2% were women. One third (32.3%) of them were socially isolated. Adjusted linear hybrid mixed effects models revealed significantly lower cognitive function in individuals with smaller social networks (β = 0.5, 95% CI = 0.3-0.7, p <.001). Moreover, changes in an individual's social network size were significantly associated with cognitive changes over time (β = 0.2, 95% CI = 0.1-0.4, p =.003), indicating worse cognitive function with shrinking social networks. Conclusion:Social isolation is highly prevalent among oldest-old individuals, being a risk factor for decreases in cognitive function. Consequently, it is important to maintain a socially active lifestyle into very old age. Likewise, this calls for effective ways to prevent social isolation. (shrink)

Background: Informed consent is a legal as well as ethical prerequisite in clinical research. For dementia research, informed consent can be a problem if subjects with dementia, whose capacity for understanding and thus also decision making might be limited, are to be exam- ined. This might result in exclusion of dementia patients from research, as capacity for understanding and decision making are often equated with the ability for rational decision making. However, this valuation has been criticized at times for attaching (...) too much impor- tance to the cognitive aspect of decision making. -/- Methods: This qualitative study investigates the actual consent procedure of a clini- cal research study in Germany with regard to dementia patients’ subjective and objective understanding of informed consent information. Research participants were ten dementia patients, who volunteered in two clinical research studies, as well as their caregivers. Data were collected by use of semi-structured interviews. -/- Results: It was determined that the patients’ comprehension of informed consent infor- mation was rather limited. However, a number of patients were quite aware of this. In con- trast, all caregivers claimed to have fully understood the provided information, while their objective comprehension was also incomplete. Several participants indicated that they did not attach much importance to the information given in the consent procedure and that their consent did not primarily depend on this information. Rather, participation in the research study for them seemed to be more of a problem-focused coping strategy for dealing with their diagnosis of dementia. -/- Conclusion: For research ethics these results raise the question whether the currently prevailing emphasis on the cognitive aspect of autonomous decision making, i.e., compre- hension, may be too one-sided, and to what extent the “volitional” aspect in giving consent should be given greater consideration. (shrink)

Ein Topos in institutionellen Stellungnahmen zu „Genome Editing am Menschen“ ist die Forderung nach einem Moratorium. Dieses soll einerseits dazu dienen, zu einer angemessenen Risikoabklärung zu gelangen, und andererseits einer gesellschaftlichen und ethischen Diskussion hinreichend Raum zu geben, um zu entscheiden, ob die vom Moratorium betroffenen Eingriffe überhaupt grundsätzlich erwünscht sind. Dabei scheint das Moratorium eine kompromisshafte Lösung zu sein, auf die sich die Mitglieder in weltanschaulich pluralen Ethikgremien verständigen können. Die Analyse der zu Genome Editing in den Jahren 2015 (...) bis 2018 verfassten Stellungnahmen zeigt jedoch ein deutlich komplexeres Bild: Was als konsensuale Kompromissformel erscheint, stellt sich als vielfach konflikthaftes Lösungsmodell dar. Umstritten ist in den unterschiedlichen Moratoriumsmodellen der Umfang (was alles ist vom Moratorium betroffen?), die Dauer (gibt es ein konkretes Datum, bis zu dem das Moratorium gilt?), der Zweck (dient es bloß der Risikoabschätzung oder auch der ethischen und/oder gesamtgesellschaftlichen Diskussion?) und die Frage, was für eine Maßnahme am Ende des Moratoriums getroffen werden soll. Zudem ist zwischen impliziten und expliziten Moratorien zu unterscheiden und zu untersuchen, was mit dem Moratoriumsvorschlag jeweils nicht verursacht werden soll (zum Beispiel die Grundlagenforschung einschränken). Am Ende der ethischen Analyse zeigt sich, dass mit klarer bestimmten Moratoriumsforderungen ein stärkeres Bewusstsein des Aufschub-Charakters dieser spezifischen Empfehlung einhergeht. So lässt sich auch das Ethos der Verantwortlichkeit – gegenüber jetzt Lebenden sowie künftigen Generationen – besser realisieren. (shrink)

Mit den Fortschritten im Bereich der psychiatrisch-genetischen Forschung gehen auch intensive Diskussionen bezüglich der daraus erwachsenden Implikationen einher. Hoffnungen wie Befürchtungen gegenüber der neuen Technologie und deren Folgen werden gleichermaßen zum Ausdruck gebracht. Über die Einstellung der Bevölkerung und insbesondere der Patienten mit affektiven oder schizophrenen Erkrankungen und ihrer Angehörigen in Deutschland war bisher allerdings wenig bekannt. Daher führten wir im Rahmen des Deutschen Humangenomprojektes erstmals eine Studie durch, um die Einstellungen und ihre beeinflussenden Faktoren zu erfassen. Wir entwickelten einen (...) Fragebogen zur Erfassung der Erwartungen, Hoffnungen und Befürchtungen sowie der die Einstellung beeinflussenden Faktoren. Hiermit wurde eine repräsentative Stichprobe von 3077 Personen aus der Allgemeinbevölkerung am Telefon befragt. Weiterhin wurden mit 316 Patienten und 163 Angehörigen persönliche standardisierte Interviews anhand des Fragebogens durchgeführt. Die Mehrzahl der Befragten hatte eine positive Einstellung zu psychiatrisch-genetischer Forschung, äußerte jedoch gleichzeitig ethische Bedenken. Übereinstimmend waren die Befragten der Ansicht, dass Informationen aus genetischen Untersuchungen vertraulich behandelt werden sollten. Kleine, aber signifikante Unterschiede zwischen den Gruppen zeigten sich bezüglich der Einstellung zu präsymptomatischer genetischer Diagnostik. Unsere Ergebnisse weisen auf eine Ambivalenz der Befragten gegenüber der psychiatrisch-genetischen Forschung und Untersuchung hin: Neben einer überwiegend positiven Einstellung wurden auch moralische Bedenken geäußert. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 18 Heft: 1 Seiten: 125-132.

Given the technical feasibility, not only scientists but also moral philosophers approve of an intervention in the genetic basis of our intellectual dispositions. Among the features not related to illnesses, intelligence seems to be an especially promising candidate for genetic enhancement, for intelligence is valued in every culture. The paper presents some of the arguments for and against genetic enhancement of intelligence. The author analyses what kind of good increased intelligence is: an instrumental good for the wellbeing of mankind, a (...) positional good for a given society or an individual, or something that is appreciated by the individual subject because of the positive experience the subject has by making use of it. Since such experiences are not bad in themselves the means of genetic enhancement have to be assessed and compared with accepted practices like education. The author comes to the conclusion that there are morally significant differences between genetic enhancement and accepted practices to enhance intelligence. (shrink)

In den öffentlichen Debatten spielen das Alter und das Altern zunehmend wichtige Rollen. Der demographische Wandel, die alternde Gesellschaft und die daraus resultierenden Probleme und Fragen bedingen es, dass sich mit dem Thema nahezu alle akademischen Disziplinen befassen. Soll man in den Alterungsprozess eingreifen? Wie ist das Altern aufzufassen? Als Krankheit, die man „heilen“ kann oder als natürlichen Prozess, den man nicht beeinflussen sollte? Das Handbuch blickt aus einer weiten Perspektive auf die Lebensphase des höheren Alters wie auf das biologische (...) und soziale Phänomen des Alterns. Erträge der Gerontologie und der Biogerontologie wie auch der Geriatrie werden gebündelt und um eine anthropologische, kulturwissenschaftliche und kulturphilosophische sowie eine moralphilosophische und ethische Hinsicht erweitert. (shrink)

Das Wiskott-Aldrich-Syndrom (WAS), ein genetisch bedingter Immundefekt mit klinischer Manifestation im Kleinkindalter, wird voraussichtlich in näherer Zukunft erstmals versuchsweise durch eine somatische Gentherapie behandelt werden. Im vor- liegenden Beitrag werden die wichtigsten medizinisch-naturwissenschaftlichen Fakten dieses Krankheitsbildes sowie die bisherigen Erfahrungen mit somatischen Gentherapien bei anderen Immunmangelsyndromen ausführlich dargestellt. Sodann erfolgt eine ethische Analyse eines möglichen gentherapeutischen Eingriffs bei WAS-Patienten, bei der die spezifischen Aspekte des Wiskott-Aldrich-Syndroms – insbesondere die fast ausschließliche Betroffenheit von Kindern sowie die unterschiedlich aussichtsreiche Alter- nativoption einer (...) allogenen Knochenmarktransplantation–wesentliche Aspekte der Beurteilung sind. Im Ergebnis zeigt sich, dass ein gentherapeutischer Eingriff im vorliegenden Fall nicht im Rahmen einer Forschungsstudie, d.h. als Humanexperiment, gerechtfertigt werden kann, sondern allein als individueller Heilversuch. Gleichwohl las- sen die besonderen Risiken und die Innovativität eines solchen Eingriffs es notwendig erscheinen, diesen Heilversuch – anders als andere Heilbehandlungen mit bislang unerprobten Mitteln – in streng kontrollierter Form durchzuführen. Der neuartige Gedanke eines kontrollierten individuellen Heilversuchs zeichnet sich daher für den vorliegenden Fall, und womöglich auch für vergleichbare risikoreiche Behandlungsansätze namentlich im Bereich der Gentherapie, als geeignetes Instrument der Konzeption und Beurteilung ab. (shrink)

Essays in Memory of Richard Helgerson: Laureations brings together new essays by leading literary scholars of the British and European middle ages and early modern period who have been influenced by the groundbreaking scholarship of Richard Helgerson. The contributors evince the ongoing impact of Helgerson's work in critical debates including those of nationalism, formal analysis, and literary careerism.

Widowhood is common in old age, can be accompanied by serious health consequences and is often linked to substantial changes in social network. Little is known about the impact of social isolation on the development of depressive symptoms over time taking widowhood into account. We provide results from the follow-up 5 to follow-up 9 from the longitudinal study AgeCoDe and its follow-up study AgeQualiDe. Depression was measured with GDS-15 and social isolation was assessed using the Lubben Social Network Scale (LSNS-6). (...) The group was aligned of married and widowed people in old age and education through entropy balancing. Linear mixed models were used to examine the frequency of occurrence of depressive symptoms for widowed and married elderly people depending on the risk of social isolation. Our study shows that widowhood alone does not lead to an increased occurrence of depressive symptoms. However, "widowed oldest old", who are also at risk of social isolation, have significantly more depressive symptoms than those without risk. In the group of "married oldest old", women have significantly more depressive symptoms than men, but isolated and non-isolated do not differ. Especially for people who have lost a spouse, the social network changes significantly and increases the risk for social isolation. This represents a risk factor for the occurrence of depressive symptoms. (shrink)

In recent years, a number of theorists have developed approaches to social cognition that highlight the centrality of social interaction as opposed to mindreading (e.g. Gallagher and Zahavi 2008 ; Gallagher 2001 , 2007 , 2008 ; Hobson 2002 ; Reddy 2008 ; Hutto 2004 ; De Jaegher 2009 ; De Jaegher and Di Paolo 2007 ; Fuchs and De Jaegher 2009 ; De Jaegher et al. 2010 ). There are important differences among these approaches, as I will discuss, (...) but they are united by their commitment to the claim that various embodied and extended processes sustain social understanding and interaction in the absence of mindreading and thus make mindreading superfluous. In this paper, I consider various ways of articulating and defending this claim. I will argue that the options that have been offered either fail to present an alternative to mindreading or commit one to a radical enactivist position that I will give reasons for being skeptical about. I will then present an alternative and moderate version of interactionism, according to which the embodied and extended processes that interactionists emphasize actually complement mindreading and may even contribute as an input to mindreading. (shrink)

Vorwort der Herausgeber mit Schriftenverzeichnis Albert Mues - H. SEubert: Transzendentalphilosophie und Metaphysik heute. EIne Skizze - M. SCherbaum: Philosophie als Lebensform - oder: Die Krise des Nihilismus und die Validitat transzendentaler Argumentation. SYstematische Reflexionen zu Letztbegrundung, Grenze und Bedeutung von Philosophie - M. GErten: Der Charakter der Transzendentalphilosophie als fundamentaler Geltungsreflexion. HIstorische und systematische uberlegungen mit besonderem Blick auf den spaten Fichte - L. MOckl: Zur logischen Position der Hypothese - I. RAdrizzani: Die Zeitfiguration in der Transzendentalphilosophie. REinhard Lauths (...) Appositionslehre als Aktualisierung von Fichtes Zeitmodell - K. POllok: Kants Begriff der Normativitat im Kontext der fruhneuzeitlichen Philosophie - C. LOtz: Gewissen und Widerstand - M. FUchs: "Freiheit, die sich Dasein gibt". INdividuum und Staat bei Platon und Hegel - B. DIeckmann: Reich der Freiheit und Kreuzestheologie. OPfer bei Johann Gottlieb Fichte - W. KLausnitzer: Christentum versus Islam. uBerlegungen zum Thema der Gewalt in beiden Religionen - M. FAmula: Zwischen Grenzenlosigkeit und Ausgrenzung. LIebe als Kultivierungsprozess in Adalbert Stifters Brigitta. (shrink)

In recent years, a number of approaches to social cognition research have emerged that highlight the importance of embodied interaction for social cognition (Reddy, How infants know minds, 2008; Gallagher, J Conscious Stud 8:83–108, 2001; Fuchs and Jaegher, Phenom Cogn Sci 8:465–486, 2009; Hutto, in Seemans (ed.) Joint attention: new developments in psychology, philosophy of mind and social neuroscience, 2012). Proponents of such ‘interactionist’ approaches emphasize the importance of embodied responses that are engaged in online social interaction, and which, (...) according to interactionists, present an alternative to mindreading as a source of social understanding. We agree that it is important to take embodied interaction seriously, but do not agree that this presents a fundamental challenge to mainstream mindreading approaches. Drawing upon an analogy between embodied interaction and the exercise of expert skills, we advocate a hierarchical view which claims that embodied social responses generally operate in close conjunction with higher-level cognitive processes that play a coordinative role, and which are often sensitive to mental states. Thus, investigation of embodied responses should inform rather than conflict with research on mindreading. (shrink)

This article examines various positions within science studies on scientific hegemony. After discussing the work of Stephan Fuchs and the “ epistemological chicken” debate, it proceeds to take issue with the claim that science is both locally accomplished and hegemonic. It offers the suggestion that critical accounts would better reconsider the ethos of their audience rather than simply worry about the objectivism of their own representations of science.

Problems and choices -- Who shall live? -- The physician : the captain of the team -- The hospital : the house of hope -- Drugs : the key to modern medicine -- Paying for medical care.

Since the beginning of business research and teaching, the basic assumptions of the discipline have been intensely debated. One of these basic assumptions concerns the behavioral aspects of human beings, which are traditionally represented in the construct of homo economicus. These assumptions have been increasingly challenged in light of findings from social, ethnological, psychological, and ethical research. Some publications from an integrative perspective have suggested that homo economicus embodies to a high degree dark character traits, particularly related to the construct (...) of psychopathy, representing individuals who are extremely self-centered and ruthless, without feelings of remorse or compassion. While a growing body of research notes such a similarity on a more or less anecdotal basis, this article aims to explore this connection from a more rigorous perspective, bridging insights from psychological, economic, and business research to better understand the potentially dark traits of homo economicus. The analysis shows that homo economicus is not simply some kind of psychopath, but specifically a so-called subclinical or Factor 1 psychopath, who is also referred to as a “corporate psychopath” in business research. With such an analysis, the paper adds an additional perspective and a deeper psychological level of understanding as to why homo economicus is often controversially debated. Based on these insights, several implications for academic research and teaching are discussed and reflected upon in light of an ethics of virtue and care. (shrink)

Dieser Band behandelt umfassend und systematisch die Frage des Patientenwillens: die historischen und philosophischen Grundlagen des Willensbegriffs, die Beziehung von Autonomie und Wille und praktische Fragen der Bioethik und des Biorechts. Die Herausgeber: PD Dr. Marko Fuchs lehrt Philosophie an der Universität Bamberg. Dr. Martin Hähnel lehrt Philosophie an der Universität Bremen und ist Koordinator des BMBF-Verbundvorhabens "Verantwortungsvoller Umgang mit Künstlicher Intelligenz in der Medizin" (VUKIM) Dr. Danaë Simmermacher lehrt Philosophie an der Martin-Luther-Universität Halle-Wittenberg.

This introductory text is a critical theory toolkit on how to how to make use of Karl Marx's ideas in media, communication and cultural studies. Karl Marx's ideas remain of crucial relevance, and in this short, student-friendly book, leading expert Christian Fuchs introduces Marx to the reader by discussing fifteen of his key concepts and showing how they matter for understanding the digital and communicative capitalism that shapes human life in 21st century society. Key concepts covered include: the dialectic, (...) materialism, commodities, capital, capitalism, labour, surplus-value, the working class, alienation, means of communication, the general intellect, ideology, socialism, communism, and class struggles. Students taking courses in Media, Culture and Society; Communication Theory; Media Economics; Political Communication and Cultural Studies will find Fuchs' concise introduction an essential guide to Marx. (shrink)

This book defends a form of ethical intuitionism, according to which (i) there are objective moral truths; (ii) we know some of these truths through a kind of immediate, intellectual awareness, or "intuition"; and (iii) our knowledge of moral truths gives us reasons for action independent of our desires. The author rebuts all the major objections to this theory and shows that the alternative theories about the nature of ethics all face grave difficulties.