ZusammenfassungEin gelungenes Arzt-Patient-Verhältnis, das auf gegenseitigem Vertrauen und ärztlicher Verantwortung basiert, ist ein zentraler Bestandteil des Ideals der ärztlichen Profession. Aktuell wird vielfach von einem neuen „ökonomischen Paradigma“ in der Medizin gesprochen, das dieses Verhältnis vermeintlich unterminiert. Als ein wichtiges Merkmal dieses Paradigmas gilt das Verständnis vom Patienten als Kunden, der charakterisiert ist durch seine Selbstbestimmung bzw. Autonomie. Wie stellt sich die Kundenrolle nun aber bei vulnerablen Patientengruppen dar, die in ihrer Autonomie eingeschränkt sind, und was bedeutet dies wiederum für (...) das Arzt-Patient-Verhältnis? In dem vorliegenden Artikel wollen wir deshalb die Fragestellung verfolgen, ob sich ärztliche Verantwortung bzw. das Arzt-Patient-Verhältnis ändert, wenn sich der (vulnerable) Patient als Kunde begreift. Als Analysesetting dient die Palliativmedizin, da sie als Beispiel für eine besonders vulnerable Patientengruppe gelten kann. Als Basis der Argumentation werden die Ergebnisse einer qualitativen Studie herangezogen, welche die Einstellungen von Palliativpatienten zum Thema „der Patient als Kunde“ erhob sowie der Frage nachging, ob sich Palliativpatienten, speziell im Rahmen von medizinischen Entscheidungen, als selbstbestimmt begreifen. Die Studienergebnisse zeigen, dass Autonomie relational verstanden werden muss und dem Arzt eine entscheidende Rolle in der Ermöglichung von Patientenselbstbestimmung zukommt – ganz unabhängig von der Selbstattribuierung der Befragten als Kunde oder Patient. Anschließend werden diese Ergebnisse dahingehend analysiert, ob sie als Ausdruck einer Veränderung des Arzt-Patient-Verhältnisses und der ärztlichen Verantwortung gegenüber den Patienten zu werten sind. Hieraus folgernd wird nach den praktischen Implikationen für das Arzt-Patient-Verhältnis auf der Grundlage der „Ethics of Care“ gefragt sowie auf die individuelle Betreuungsnotwendigkeit, speziell von vulnerablen Patientengruppen, verwiesen. (shrink)

Ein gelungenes Arzt-Patient-Verhältnis, das auf gegenseitigem Vertrauen und ärztlicher Verantwortung basiert, ist ein zentraler Bestandteil des Ideals der ärztlichen Profession. Aktuell wird vielfach von einem neuen „ökonomischen Paradigma“ in der Medizin gesprochen, das dieses Verhältnis vermeintlich unterminiert. Als ein wichtiges Merkmal dieses Paradigmas gilt das Verständnis vom Patienten als Kunden, der charakterisiert ist durch seine Selbstbestimmung bzw. Autonomie. Wie stellt sich die Kundenrolle nun aber bei vulnerablen Patientengruppen dar, die in ihrer Autonomie eingeschränkt sind, und was bedeutet dies wiederum für (...) das Arzt-Patient-Verhältnis? In dem vorliegenden Artikel wollen wir deshalb die Fragestellung verfolgen, ob sich ärztliche Verantwortung bzw. das Arzt-Patient-Verhältnis ändert, wenn sich der (vulnerable) Patient als Kunde begreift. Als Analysesetting dient die Palliativmedizin, da sie als Beispiel für eine besonders vulnerable Patientengruppe gelten kann. Als Basis der Argumentation werden die Ergebnisse einer qualitativen Studie herangezogen, welche die Einstellungen von Palliativpatienten zum Thema „der Patient als Kunde“ erhob sowie der Frage nachging, ob sich Palliativpatienten, speziell im Rahmen von medizinischen Entscheidungen, als selbstbestimmt begreifen. Die Studienergebnisse zeigen, dass Autonomie relational verstanden werden muss und dem Arzt eine entscheidende Rolle in der Ermöglichung von Patientenselbstbestimmung zukommt – ganz unabhängig von der Selbstattribuierung der Befragten als Kunde oder Patient. Anschließend werden diese Ergebnisse dahingehend analysiert, ob sie als Ausdruck einer Veränderung des Arzt-Patient-Verhältnisses und der ärztlichen Verantwortung gegenüber den Patienten zu werten sind. Hieraus folgernd wird nach den praktischen Implikationen für das Arzt-Patient-Verhältnis auf der Grundlage der „Ethics of Care“ gefragt sowie auf die individuelle Betreuungsnotwendigkeit, speziell von vulnerablen Patientengruppen, verwiesen. (shrink)

As the pre-eminent Enlightenment philosopher, Kant famously calls on all humans to make up their own minds, independently from the constraints imposed on them by others. Kant's focus, however, is on universal human reason, and he tells us little about what makes us individual persons. In this book, Katharina T. Kraus explores Kant's distinctive account of psychological personhood by unfolding how, according to Kant, we come to know ourselves as such persons. Drawing on Kant's Critical works and on (...) his Lectures and Reflections, Kraus develops the first textually comprehensive and systematically coherent account of our capacity for what Kant calls 'inner experience'. The novel view of self-knowledge and self-formation in Kant that she offers addresses present-day issues in philosophy of mind and will be relevant for contemporary philosophical debates. It will be of interest to scholars of the history of philosophy, as well as of philosophy of mind and psychology. (shrink)

This article advocates a new interpretation ofinner experience– the experience that one has of one’s empirical-psychological features ‘from within’ – in Kant. It argues that for Kant inner experience is the empirical cognition of mental states, but not that of a persistent mental substance. The schema of persistence is thereby substituted with the regulative idea of the soul. This view is shown to be superior to two opposed interpretations: the parity view that regards inner experience as empirical cognition of a (...) mental object on a par with outer experience and the disparity view that denies altogether that inner experience is empirical cognition. (shrink)

Kant’s theory of cognition centrally builds on his conception of self-consciousness and the transcendental use of the phrase “I think”: the ability to add the phrase “I think” to a representation is a necessary condition of the ability to cognize objects. The paper argues that “I think”, rather than denoting the content of a predicative judgement, is typically an expression of the subject’s thinking. It expresses a kind of self-consciousness that, without assertively representing the subject itself, indicates that representational contents (...) are unified in a single consciousness of a single subject. Our aim is thus to develop and defend an expressivist interpretation of Kant’s “I think”. (shrink)

This paper examines whether Kant’s Critical philosophy offers resources for a conception of empirical psychology as a theoretical science in its own right, rather than as a part of applied moral philosophy or of pragmatic anthropology. In contrast to current interpretations, this paper argues that Kant’s conception of inner experience provides relevant resources for the theoretical foundation of scientific psychology, in particular with respect to its subject matter and its methodological presuppositions. Central to this interpretation is the regulative idea of (...) the soul, which supplies principles of systematicity at different levels. Firstly, the idea defines the way in which we must reflect on mental beings, i.e., those beings that fall in the domain of psychology. Secondly, it provides a principle for the unification of a systematic body of psychological laws. In consequence, by approaching the object of psychology from the perspective of the self-conscious subject, who––in virtue of being capable of inner experience––first constitutes a psychological reality, Kant’s theory offers an attractive alternative to reductionist conceptions of psychology. (shrink)

Kant's theory of cognition centrally builds on his conception of self‐consciousness and the transcendental use of the phrase “I think”: the ability to add the phrase “I think” to a representation is a necessary condition of the ability to cognize objects. The paper argues that “I think”, rather than denoting the content of a predicative judgement, is typically an expression of the subject's thinking. It expresses a kind of self‐consciousness that, without assertively representing the subject itself, indicates that representational contents (...) are unified in a single consciousness of a single subject. Our aim is thus to develop and defend an expressivist interpretation of Kant's “I think”. (shrink)

This paper shows why Kant's critique of empirical psychology should not be read as a scathing criticism of quantitative scientific psychology, but has valuable lessons to teach in support of it. By analysing Kant's alleged objections in the light of his critical theory of cognition, it provides a fresh look at the problem of quantifying first-person experiences, such as emotions and sense-perceptions. An in-depth discussion of applying the mathematical principles, which are defined in the Critique of Pure Reason as the (...) constitutive conditions for mathematical-numerical experience in general, to inner sense will demonstrate why it is in principle possible to justify a quantitative structure of psychological judgments on the grounds of Kant's critical thinking. In conclusion, it will propose how Kant's critique could be used in a constructive way to develop first steps towards a transcendental foundation of psychological knowledge. (shrink)

With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global researchers were confronted with major challenges. The German National Pandemic Cohort Network (NAPKON) was launched in fall 2020 to effectively leverage resources and bundle research activities in the fight against the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the setup phase of NAPKON as an example for multicenter studies in Germany, highlighting challenges and optimization potential in connecting 59 university and nonuniversity study sites. We examined the ethics application (...) process of 121 ethics submissions considering durations, annotations, and outcomes. Study site activation and recruitment processes were investigated and related to the incidence of SARS-CoV-2 infections. For all initial ethics applications, the median time to a positive ethics vote was less than two weeks and 30 of these study sites (65%) joined NAPKON within less than three weeks each. Electronic instead of postal ethics submission (9.5 days (Q1: 5.75, Q3: 17) vs. 14 days (Q1: 11, Q3: 26), p value = 0.01) and adoption of the primary ethics vote significantly accelerated the ethics application process. Each study center enrolled a median of 37 patients during the 14-month observation period, with large differences depending on the health sector. We found a positive correlation between recruitment performance and COVID-19 incidence as well as hospitalization incidence. Our analysis highlighted the challenges and opportunities of the federated system in Germany. Digital ethics application tools, adoption of a primary ethics vote and standardized formal requirements lead to harmonized and thus faster study initiation processes during a pandemic. (shrink)

Kraus’s book is a rich and systematic examination of Kant’s account of the different dimensions of the metaphysics, epistemology and phenomenology of the ‘self’ that pertains to human subjectivity. Here I explore some of the different meanings that Kraus associates with the term ‘self’ on Kant’s behalf, asking for further clarification as to her interpretation of the terms ‘subject’ (‘the I’), ‘soul’ and ‘person’, in particular. I also raise some critical questions concerning Kraus’s account of the nature (...) and limitations of the ‘real’ use of the concept of the soul in particular, in light of passages throughout the Critical period in which Kant seems to allow for a relatively unproblematic application of the term to whatever being it is that possesses the various psychical faculties – a being which he also seems to allow is an object of experience (and hence cognition). (shrink)

These remarks focus on Kraus’s claim that for Kant the category of substance cannot apply to the soul but that instead we can and should apply a merely regulative idea of the soul. While granting Kraus’s contention that we require an idea of the soul in order to investigate inner experience, I argue that the category of substance nonetheless applies to the soul, but that the notion of the soul as entirely non-corporeal is a regulative idea. To explore (...) this contention, I closely examine two crucial passages Kraus uses to argue against parity between inner and outer sense. (shrink)

Katharina Kraus’ Kant on Self-Knowledge and Self-Formation is a masterful work on Kant’s theoretical philosophy and an important contribution to the philosophy of mind. Navigating critical problems regarding self-consciousness and inner sense relevant to contemporary debates on phenomenal content and the transparency of experience, Kraus’ book serves as an indispensable resource for Kant scholarship.

Kraus’s book is both deep and wide-ranging. My comments focus on her account of Kant on self-awareness – both a priori and empirical apperception. Basic to her account is what she calls the hylomorphism of mental faculties in Kant. Kraus distinguishes her ‘reflexive’ account of apperception from both ‘logical’ and ‘psychological’ accounts. An inevitable question is: Does Kant think we have an empirical cognition of the self? Kraus seems to want to say yes, but I question this (...) answer. Cognition requires both intuition and conception. My claim is that it requires intuition in both space and time, but inner empirical self-awareness is apparently in time only. Kant’s Refutation of Idealism in B, as developed later in the Kiesewetter essays, makes awareness of our body essential to time determination. (shrink)

According to conventional wisdom, Kant demolished the traditional idea of the soul in his Critique of Pure Reason. By denying the human mind any theoretical or intuitive knowledge of the soul as an immaterial substance and referring this idea to an illusory tendency of the mind, he efficiently tore down a longstanding metaphysical discipline called rational psychology. Katherina Kraus’s aim is to challenge this conventional reading. In her new book Kant on Self-Knowledge and Self-Formation, she claims that Kant’s true (...) intention was to transform rather than demolish the idea of the immaterial soul. Her main argument, nourished by a close reading of the Critique of Pure Reason, is that despite this transformation... (shrink)

I raise three related objections to aspects of Katharina Kraus’s interpretation in Kant on Self-Knowledge and Self-Formation. First, I reject her claim that representations count as merely subjectively valid for Kant if they represent objects from the contingent perspective of a particular subject. I argue that Kant in fact describes consciousness of subjectively valid representations as consciousness of one’s own perceptions rather than of the objects perceived, and therefore that it plays a bigger role in his account of (...) self-consciousness than Kraus allows. Second, whereas Kraus argues that the transcendental unity of apperception structures the content of any consciousness that is possible for a subject, I note that Kant also allows for a merely empirical unity of apperception, which he describes as in principle different from transcendental unity. Finally, I raise some worries for Kraus’s suggestion that we can be aware of the activity of thinking through inner sense. (shrink)

European Journal of Philosophy, Volume 29, Issue 3, Page 679-682, September 2021.

These comments are my contribution to the author-meets-critics session on Katharina Kraus' recently published Kant on Self-Knowledge and Self-Formation, at the APA Pacific meeting. In my comments, I challenge Kraus' characterization of my fictionalism concerning the idea of the soul, and contend for the importance of transcendental illusion in that idea's function of guiding the empirical investigation of inner appearances.

This volume brings together contributions from distinguished scholars in the history of philosophy, focusing on points of interaction between discrete historical contexts, religions, and cultures found within the premodern period. The contributions connect thinkers from antiquity through the Middle Ages and include philosophers from the three major monotheistic faiths-Judaism, Islam, and Christianity. By emphasizing premodern philosophy's shared textual roots in antiquity, particularly the writings of Plato and Aristotle, the volume highlights points of cross-pollination between different schools, cultures, and moments in (...) premodern thought. Approaching the complex history of the premodern world in an accessible way, the editors organize the volume so as to underscore the difficulties the premodern period poses for scholars, while accentuating the fascinating interplay between the Greek, Hebrew, Arabic, and Latin philosophical traditions. The contributors cover many topics ranging from the aims of Aristotle's cosmos, the adoption of Aristotle's Organon by al-Farabi, and the origins of the Plotiniana Arabica to the role of Ibn Gabirol's Fons vitae in the Latin West, the ways in which Islamic philosophy shaped thirteenth-century Latin conceptions of light, Roger Bacon's adaptation of Avicenna for use in his moral philosophy, and beyond. The volume's focus on "source-based contextualism" demonstrates an appreciation for the rich diversity of thought found in the premodern period, while revealing methodological challenges raised by the historical study of premodern philosophy. Contextualizing Premodern Philosophy: Explorations of the Greek, Hebrew, Arabic, and Latin Traditions is a stimulating resource for scholars and advanced students working in the history of premodern philosophy. (shrink)

A recent wave of academic and popular publications say that utopia is within reach: Automation will progress to such an extent and include so many high-skill tasks that much human work will soon become superfluous. The gains from this highly automated economy, authors suggest, could be used to fund a universal basic income (UBI). Today's employees would live off the robots' products and spend their days on intrinsically valuable pursuits. I argue that this prediction is unlikely to come true. Historical (...) precedent speaks against it, but the main problem is that the prediction fundamentally misunderstands how capitalism works—its incentives to increase or decrease production, its principles of income allocation, and the underlying conception of merit. (shrink)

Meta-emotions are emotions about emotions, such as, for example, shame about anger. An important subset of meta-emotions constitutes a special case of co-experienced emotions, in which one emotion is directed at another emotion experienced by a subject at the same time. By making us reflectively aware of our own first-order emotions and suggesting an evaluation of them, meta-emotions enable reflection on our own emotional sensibility. In this paper, I explore the roles of meta-emotions in the context of affective empathy. I (...) show that, whereas meta-emotions on the side of the target person increase the complexity of empathy’s success conditions, meta-emotions on the side of the empathiser expand the role of meta-emotions for self-reflection and give rise to parallel phenomena of other-directed reflection. Exploring the roles of meta-emotions in the context of affective empathy allows us to better understand the significance of meta-emotions, as well as the functions of affective empathy. (shrink)

In Virtue, Piety and the Law Katharina Ivanyi examines Birgivī Meḥmed Efendī's (d. 981/1573) al-Ṭarīqa al-muḥammadiyya, a major work of pietist exhortation and advice, composed by the sixteenth-century Ottoman jurist, Ḥadīth scholar and grammarian, who would articulate a style of religiosity that had considerable reformist appeal into modern times. Linking the cultivation of individual virtue to questions of wider political, social and economic concern, Birgivīplayed a significant role in the negotiation and articulation of early modern Ottoman Ḥanafīpiety. Birgivī's deep (...) mistrust of the passions of the human soul led him to prescribe a regime of self-surveillance and control that was only matched in rigor by his likewise exacting interpretation of the law in matters of everyday life, as much as in state practices, such as the cash waqf, Ottoman land tenure and taxation. (shrink)