This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception (...) of moral competence of non-ethicists; (3) gives insight into complementary styles of argumentation of ethicists and non-ethicists; and (4) contributes to the awareness of the problem of profession-building of (clinical) ethicists. (shrink)
This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher’s Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms “cosmetic surgery,” “ethnic*,” “ethics,” “Asia*,” and “Western*.” The study included all types of papers written in English that discuss the debate on rhinoplasty and blepharoplasty (...) in East Asians. No limit was put on date of publication. Combining both narrative and systematic review methods, a total of 31 articles were critically appraised on their contribution to ethical reflection founded on the debates regarding the surgical alteration of Asian features. Sources of knowledge were drawn from four main disciplines, including the humanities, medicine or surgery, communications, and economics. Focusing on cosmetic surgery perceived as a westernising practice, the key debate themes included authenticity of identity, interpersonal relationships and socio-economic utility in the context of Asian culture. The study shows how cosmetic surgery of ethnic features plays an important role in understanding female identity in the Asian context. Based on the debate themes authenticity of identity, interpersonal relationships, and socio-economic utility, this article argues that identity should be understood as less individualistic and more as relational and transformational in the Asian context. In addition, this article also proposes to consider cosmetic surgery of Asian features as an interplay of cultural imperialism and cultural nationalism, which can both be a source of social pressure to modify one’s appearance. (shrink)
The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one (...) ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated. (shrink)
In this article, the question is discussed if and how Healthcare Ethics Committees (HECs) should be regulated. The paper consists of two parts. First, authors from eight EC member countries describe the status quo in their respective countries, and give reasons as to the form of regulation they consider most adequate. In the second part, the country reports are analysed. It is suggested that regulation of HECs should be central and weak. Central regulation is argued to be apt to improve (...) HECs’ accountability, relevance and comparability. To facilitate biomedical citizenship and ethical reflection, regulation should at the same time be weak rather than strict. Independence of HECs to deliberate about ethical questions, and to give solicited and unsolicited advice, should be supported and only interfered with by way of exception. One exception is when circumstances become temporary adversarial to ethical deliberation in healthcare institutions. In view of European unification, steps should be taken to develop consistent policies for both Eastern and Western European countries. (shrink)
The use of placebos in randomised controlled trials is a subject of considerable ethical debate. In this paper we present a set of considerations to evaluate the ethics of placebo controlled trials that includes: social value of the study; need for a randomised controlled trial and placebo; standards of care; risks of harm due to administration of placebo and the harm benefit balance; clinical equipoise; and double standards. We illustrate the application of these considerations using a case study of a (...) large ongoing multicentre, placebo-controlled, double-blinded, randomised trial to determine primaquine anti-relapse efficacy in vivax malaria. There is an urgent need for primaquine anti-relapse studies in order to rationalise the management of a potentially fatal disease. An ethical justification for the use of the placebo arm is provided on the grounds that the actual current applied standard of care in most endemic places does not include primaquine. It has also been argued that there is clinical equipoise among the primaquine study arms and that the risk of harms of being in the placebo arm is the risk of having relapse, which is no more than not being included in the trial, and that there are no double standards. Based on our set of considerations, we conclude that a placebo arm is not only justified but imperative in this study. We propose that similar considerations should be prospectively applied to other placebo controlled trials and observational control arms where no treatment is offered. (shrink)
Kasm does not offer any concept of proof which is regulative for all metaphysics, for he is convinced that each metaphysical approach requires its own proper logic and methodology. Within this pluralistic framework he seeks to discern the structure of formal truth as expressed in the concept of proof inherent in various metaphysical approaches.--L. S. F.
This reply to Giles Scofield's critique of the authors' article in the June 2008 issue of the Kennedy Institute of Ethics Journal highlights two main topics. First, contrary to what Scofield suggests, using the terms "ethics" and "morality" interchangeably constitutes an oversimplification that blurs important distinctions. Second, in a representative democracy, ethical expertise and consultation need not generate a "tragic choice" of the kind Scofield has in mind.
Thomas L. Carson: Lying and Deception. Theory and Practice, Oxford Content Type Journal Article Pages 1-3 DOI 10.1007/s10677-011-9320-9 Authors Norbert Anwander, Humboldt-Universität zu Berlin, Institut für Philosophie, Unter den Linden 6, 10099 Berlin, Germany Journal Ethical Theory and Moral Practice Online ISSN 1572-8447 Print ISSN 1386-2820.
Joseph Krulic intervenant sur la logique de longue durée des affrontements dans les Balkans récuse le lieu commun des « haines ancestrales » au profit d’une analyse des violences de longue durée entre les communautés, mais aussi à l’intérieur des communautés (notamment en Serbie), à partir de l’examen du système international et d’une comparaison entre périodes de calme et périodes de troubles. Il a manqué dans l’espace balkanique une double régulation traditionnelle de la violence : d’une part, la régulation impériale (...) après la guerre de Trente Ans instaurant la paix comme non-guerre et instituant une guerre légale et limitée entre États ; d’autre part, la régulation par le droit par l’intermédiaire de la conjonction des théories de la souveraineté et de la raison d’État assurant un monopole étatique de la violence doublé d’un processus de « civilisation » (selon les théories de Norbert Elias). J. Krulic définit ainsi la balkanisation comme un effet d’un mélange de violence sociétale, de résidu d’empire, de déficit d’État et de prolifération étatique. (shrink)
This article argues that by the time of the Groupe des Dix’s dissolution in 1976, at least some of its members had departed significantly from the intellectual framework inherited from America’s Cybernetics Group. Focusing on two key publications of 1977, Edgar Morin’s La méthode, tome 1 : la nature de la nature and Michel Serres’s La naissance de la physique dans le texte de Lucrèce. Fleuves et turbulences, I show how the group’s two most philosophically oriented thinkers both broke with (...) the “paradigm of the artificial machine” characteristic of cybernetics, developing in its place a new understanding of Nature centred on the figure of the vortex and the concept of self-production. This renewed understanding of Nature in turn entails an attempt to re-think the foundations of the life, human and artificial sciences via an original articulation of physics, philosophy and poetics. Dans cet article, nous montrons qu’au moment de la dissolution du Groupe des Dix en 1976, certains de ses membres avaient partiellement rompu avec la pensée cybernétique – héritée du Cybernetics Group américain – qui informait ses débuts. Une analyse de deux textes importants datant de 1977, La méthode, tome 1 : la nature de la nature d’Edgar Morin et La naissance de la physique dans le texte de Lucrèce. Fleuves et turbulences de Michel Serres, montre comment les deux penseurs les plus philosophiques du groupe ont su surmonter ce que Morin appelle « le paradigme de la machine artificielle » propre à la cybernétique pour développer une compréhension de la nature centrée sur la figure du tourbillon et sur le concept d’autoproduction. Chez Morin, cette pensée renouvelée de la nature s’appuie sur la pensée présocratique de la physis, et chez Serres sur la pensée lucrétienne de la natura. Nous montrons également que l’on peut interpréter les démarches de Morin et de Serres comme une tentative de dépasser la métaphysique, laquelle, de Platon à Norbert Wiener, comprend la nature par analogie avec la technique et donc comme fondée par un acte de la volonté. La compréhension renouvelée de la nature qui émerge dans les textes de Morin et de Serres implique également un nouveau fondement des sciences du vivant, de l’homme et de l’artificiel, qui prendra forme grâce à une articulation originale de la physique, de la philosophie et de la poétique. (shrink)
L'auteur montre comment N. Elias critique à la fois la sociologie classique, qui emprunte aux sciences naturelles la théorie évolutionniste, et la sociologie moderne, qui rejette la notion d'évolution. Il analyse comment N. Elias propose une sociologie évolutionnaire à travers le concept de processus configurationnel qui abolit l'opposition classique individu-société. Dans ce cadre, la notion d'évolution appartient elle aussi au processus évolutionnaire.The author shows how N. Elias criticizes, at one and the same time, the classical sociology using the evolutionistic theoiy (...) coming from the natural sciences, and the modern sociology rejecting the notion of evolution. He analyses how N. Elias propounds an . evolutionary sociology through the concept of configurationalprocess which eliminates the classical individual-society opposition. In this framework the notion of evolution itself has to be seen as belonging to the evolutionaiy process. (shrink)
Avant de peser les limites du pouvoir politique, l'auteur développe la thèse selon laquelle une société humaine doit réfléchir sur l'instance qui devrait être considérée comme souveraine. La réflexion sur le rapport entre puissance politique et puissance juridique est dérivée. Si le pouvoir politique constituait seul l'attribut de la souveraineté, alors les règles de la société seraient toujours bien faites. Dans une société idéale la seule force directrice des règles suffit sans force coercitive.
The article deals with the reception of Hölderlin in the George-circle, especially the editorial and scientific work of Norbert von Hellingrath. At the end the consequences of this approach until our days are discussed especially with Martin Heidegger.
Norbert Elias has notably influenced the historiography of the Early Modern Period since the 1970s. In the course of the borrowing of his concepts by different disciplines, the uniqueness of these concepts was nevertheless altered. This article aims to show that Elias' 'Sociology of configurations' proposed an original point of view on Longue Durée in history. It thus suggests: 1) to re-evaluate the historical dimension of Elias' sociology; 2) to question eventual contributions to present-day research to the history of (...) medicine and health. (shrink)
The history of the relationship between Christian theology and the natural sciences has been conditioned by the initial decision of the masters of the "first scientific revolution" to disregard any necessary explanatory premiss to account for the constituting organization and the framing of naturally occurring entities. Not paying any attention to hierarchical control, they ended-up disseminating a vision and understanding in which it was no longer possible for a theology of nature to send questions in the direction of the experimental (...) sciences, as was done in the past between theology and many philosophically-based thought-systems. Presenting the history of some hinge-periods in the development of the Western-world sciences, this book first sets out to consider the conceptual revolution which has, in the 20th Century, related consciousness, physical laws and levels of organization, in order to show that a new chance existed then for theology. This discourse was invited to revise its language to open it up to the quest for meaning which we find on the periphery of the project of the experimental sciences. The Century-old reflection on the foundations of probability had prepared the ground for the introduction of the concept of information, at first linked to an effort aimed at maximizing the efficiency of electromagnetic communications. Taking the full measure of the questions that information theory poses to the biological sciences, this work attempts to identify the areas of convergence setting the stage for general systems theory, while it also tries to identify the insufficiencies of this recent vision and to highlight the questions left unanswered. Re-reading some of the traditional proofs of God's existence from the order of the world, relying on some pioneering insights of Ludwig von Bertalanffy and Norbert Wiener, the author brings those proofs and insights in contact with the fascinating initial project of cybernetics and the elements of a "mythical" nature which, from its inception, it could never entirely eliminate. This book ends with the confrontation between the conceptually most extended regulation factors in the history of Western thought. It articulates the poetic utopia concerned with an immediate grasp of the world in its "deictic" character with the concurrent one aimed at the domination over matter and energy expressed by technology's driving rational utopia. (shrink)