The paper first defines palliative treatment and distinguishes it from symptomatic treatment. Then, the palliative situation is delineated as inseparably linked to the finitude of human life. Given the objectives of palliative treatment — responding to symptoms, damage to the patients' self-image, and the proximity of death — a subjective concept of disease is described, that is regarded as the focus of palliative treatment. The essence of the concept of disease is analysed as the patient's experience with a tendency of (...) reduction of her or his vitality. Palliative medicine is shown not to be symptom-oriented, but disease — directed as other domains of medicine. Implications and practical consequences, especially the status of objective findings, of this concept are discussed and therapeutic opportunities in the palliative situation reconsidered. (shrink)

Background: The experimental method to acquire knowledge about efficacy and efficiency of medical procedures is well established in evidence-based medicine. A method to attain evidence about the significance of diseases and interventions from the patients' perspectives taking into account their right to self-determination about their lives and bodies has however not been sufficiently characterized.Design: Identification of a method to acquire evidence about the clinical significance of disease and therapeutic options from the patients' perspectives.Arguments: Communication between patient and physician is analyzed (...) as the method to attain evidence about what is at stake for individual patients in disease and therapy. It is the method that enables physicians to directly take into account patients' disease experiences and their aims regarding treatments. These patients' perspectives in turn determine the clinical significance of diagnoses and therapeutic options, if patient-autonomy is taken seriously.Conclusions: A full account of evidence-based medicine needs to include experimentation and communication between physician and patient as equally important methods to attain evidence necessary to practice patient-oriented medicine. The communicative method is especially important for primary physicians as they direct patients within the medical system to have their medical problems most effectively and efficiently addressed. (shrink)

The paper attempts to give an account of the fallibility of medical judgments without recourse to the incompleteness of scientific knowledge. It is argued that because of the inexactness of observations and thus the existence of borderline cases any theory applied for explanation and predicition will produce some false results. This state of affairs is independent of the nature of a theory, i.e., it applies both for non-probabilistic and for probabilistic theories. Some epistemological issues and consequences with regard to a (...) better understanding of clinical reasoning are discussed and the view is compared with the theory of medical fallibility of Gorovitz and MacIntyre.1. (shrink)

The paper attempts to give an account of the fallibility of medical judgments without recourse to the incompleteness of scientific knowledge. It is argued that because of the inexactness of observations and thus the existence of borderline cases any theory applied for explanation and predicition will produce some false results. This state of affairs is independent of the nature of a theory, i.e., it applies both for non-probabilistic and for probabilistic theories. Some epistemological issues and consequences with regard to a (...) better understanding of clinical reasoning are discussed and the view is compared with the theory of medical fallibility of Gorovitz and MacIntyre.1. (shrink)

Synthetic biology is an emerging technology that aims to design and engineer DNA and molecular structures of single cell organisms. Existing organisms can be altered, novel organisms can be created. In doing so, synthetic biology makes use of specific technoscientific understandings of living beings. This volume sets out to explore and assess synthetic biology and its notions of life from philosophical, ethical, social, and legal perspectives. Contents Concepts, Metaphors, Worldviews.- Public Good and Private Ownership.Social and Legal Ramifications.- Opportunities, Risks, Governance. (...) Target Groups Scholars of sociology, philosophy, theory of science, history of science, biology, engineering Politicians and policymakers The Editor Dr. Joachim Boldt is Deputy Director at the Institut für Ethik und Geschichte der Medizin in Freiburg, Germany. (shrink)

The Historical Dictionary of Philosophy, the _Historisches Wörterbuch der Philosophie,_ is distinguished by its particular presentation of philosophical terms, ideas and concepts. Rather than providing mere defintions or descriptive and analytical explanantions the _HWPh_ strictly applies the critical method of history of concepts developed by the eminent German scholar and philosopher Joachim Ritter. By means of precise and detailed references it documents the origin, first occurrence, the historical evolution and the changes of meaning of each concept, from Ancient Greek (...) to contemporary philosophy. For the reader this presentation is of unique value: it makes traceable the importance of terms and concepts at certain periods or for a particular philosopher, as well as its changes and development of meaning. Voulmes 1–12 of the _HWPh_ comprises more than 17.000 text columns on 3.670 philosophical terms. The dictionary does not include articles on persons. Volume 13 includes, besides of a comprehensive introductory essay, three different indexes: - the Subject Index classifies the articles by disciplinary and systematic categories - the Main Index includes all philosophical keywords with more than 30.000 references to their occurrences in other articles and contexts - the Author Index lists all authors and their contributions The included CD-ROM allows full text research of the _HWPh's_ entire content. (shrink)

This chapter contains sections titled: Introduction What is Chemistry about? Is Chemistry Reducible to Physics? Are There Fundamental Limits to Chemical Knowledge? Is Chemical Research Ethically Neutral? Conclusion References.

This article presents and discusses different kinds of data documents, including data sets, data studies, data papers and data journals. It provides descriptive and bibliometric data on different kinds of data documents and discusses the theoretical and philosophical problems by classifying documents according to the DIKW model (data documents, information documents, knowl­edge documents and wisdom documents). Data documents are, on the one hand, an established category today, even with its own data citation index (DCI). On the other hand, data documents (...) have blurred boundaries in relation to other kinds of documents and seem sometimes to be understood from the problematic philosophical assumption that a datum can be understood as “a single, fixed truth, valid for everyone, everywhere, at all times”. (shrink)

Prolegomena to Pure Logic (1900) is the definitive statement of Husserl’s early logic. But what does it say that logic is? I argue that Husserl in the Prolegomena thinks logic is its own discipline, namely the “doctrine of science” (Wissenschaftslehre), but has two conflicting ideas of what that is. One idea—expressed by the book’s general argument, and which I call Husserl’s Austrian Semanticism about logic—is that the Wissenschaftslehre is the positive science explaining what science is (which turns out just to (...) be the study of meaning) plus the dependent art that, applying the science, teaches us how to scientifically know. The other idea—expressed by the book’s opening chapter, and which I call Husserl’s German Idealism about logic—is that the Wissenschaftslehre is the purely reflective self-knowing of science, independent of science’s positive expansion. These two ideas are incompatible. Thus, the Prolegomena is ambivalent on what logic is. But since the ambivalence only deepens the significance of Husserl’s early logic, the ambivalence should be embraced. (shrink)

It is now—at least loosely—acknowledged that most health and clinical outcomes are influenced by different interacting causes. Surprisingly, medical research studies are nearly universally designed to study—usually in a binary way—the effect of a single cause. Recent experiences during the coronavirus disease 2019 pandemic brought to the forefront that most of our challenges in medicine and healthcare deal with systemic, that is, interdependent and interconnected problems. Understanding these problems defy simplistic dichotomous research methodologies. These insights demand a shift in our (...) thinking from ‘cause and effect’ to ‘causes and effects’ since this transcends the classical way of Cartesian reductionist thinking. We require a shift to a ‘causes and effects’ frame so we can choose the research methodology that reflects the relationships between variables of interest—one-to-one, one-to-many, many-to-one or many-to-many. One-to-one (or cause and effect) relationships are amenable to the traditional randomized control trial design, while all others require systemic designs to understand ‘causes and effects’. Researchers urgently need to re-evaluate their science models and embrace research designs that allow an exploration of the clinically obvious multiple ‘causes and effects’ on health and disease. Clinical examples highlight the application of various systemic research methodologies and demonstrate how ‘causes and effects’ explain the heterogeneity of clinical outcomes. This shift in scientific thinking will allow us to find the necessary personalized or precise clinical interventions that address the underlying reasons for the variability of clinical outcomes and will contribute to greater health equity. (shrink)

Algorithmic predictions are promising for insurance companies to develop personalized risk models for determining premiums. In this context, issues of fairness, discrimination, and social injustice might arise: Algorithms for estimating the risk based on personal data may be biased towards specific social groups, leading to systematic disadvantages for those groups. Personalized premiums may thus lead to discrimination and social injustice. It is well known from many application fields that such biases occur frequently and naturally when prediction models are applied to (...) people unless special efforts are made to avoid them. Insurance is no exception. In this paper, we provide a thorough analysis of algorithmic fairness in the case of insurance premiums. We ask what “fairness” might mean in this context and how the fairness of a premium system can be measured. For this, we apply the established fairness frameworks of the fair machine learning literature to the case of insurance premiums and show which of the existing fairness criteria can be applied to assess the fairness of insurance premiums. We argue that two of the often-discussed group fairness criteria, independence (also called statistical parity or demographic parity) and separation (also known as equalized odds), are not normatively appropriate for insurance premiums. Instead, we propose the sufficiency criterion (also known as well-calibration) as a morally defensible alternative that allows us to test for systematic biases in premiums towards certain groups based on the risk they bring to the pool. In addition, we clarify the connection between group fairness and different degrees of personalization. Our findings enable insurers to assess the fairness properties of their risk models, helping them avoid reputation damage resulting from potentially unfair and discriminatory premium systems. (shrink)

National governments have failed spectacularly to mitigate anthropogenic climate change and a sustainable approach to mitigation remains out of sight. This circumstance alone demonstrates t...

The discussion in Perspectives on Psychological Science about criteria for scholarly merit shows a potential bias of quantitative measurements compared with informed judgments of scholarly merits. This comment argues for a selection procedure that is open for qualitative arguments.

What are consequential world problems? As “grand societal challenges”, one might define them as problems that affect a large number of people, perhaps even the entire planet, including problems such as climate change, distributive justice, world peace, world nutrition, clean air and clean water, access to education, and many more. The “Sustainable Development Goals”, compiled by the United Nations, represent a collection of such global problems. From my point of view, these problems can be seen as complex. Such complex problems (...) are characterized by the complexity, connectivity, dynamics, intransparency, and polytely of their underlying systems. These attributes require special competencies for dealing with the uncertainties of the given domains, e.g., critical thinking. My position is that it is not IQ, but complex problem-solving competencies for dealing with complex and dynamic situations, that is important for handling consequential global problems. These problems require system competencies, i.e., competencies that go beyond analytical intelligence, and comprise systems understanding as well as systems control. Complex problem-solving is more than analytic intelligence. (shrink)

Complex problem solving (CPS) emerged in the last 30 years in Europe as a new part of the psychology of thinking and problem solving. This paper introduces into the field and provides a personal view. Also, related concepts like macrocognition or operative intelligence will be explained in this context. Two examples for the assessment of CPS, Tailorshop and MicroDYN, are presented to illustrate the concept by means of their measurement devices. Also, the relation of complex cognition and emotion in the (...) CPS context is discussed. The question if CPS requires complex cognition is answered with a tentative “yes.”. (shrink)

This scarce antiquarian book is a selection from Kessinger Publishing's Legacy Reprint Series. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment to protecting, preserving, and promoting the world's literature. Kessinger Publishing is the place to find hundreds of thousands of rare and hard-to-find books with something of interest for everyone!

Background Metaphors are central to the human understanding of complex issues; through the immediate associations they evoke and frame problems and suggest solutions. Our suggestion of Music in the Park as a metaphor for health systems reform brings to the forefront the environmentally diverse but bounded spaces of health services that offer a variety of attractors within their confines, while pushing into the background organizational and economic concerns.Reflections Parks, like health services, are embedded in their local landscape, serving their communities, (...) but most importantly parks are public spaces, publically funded, ideally offering universal access and equity and to be shared by all who want to go there.Music, like health, is tangible, technical and scientific, yet ultimately experiential and based on meaning. While it encompasses a wide range of styles and approaches, music making requires as its most important skill active listening which brings with it to be ‘in the moment’, to take personal risks and to draw energy and inspiration from the participants. Hence ‘audiences’ are equally active participants because music only has meaning if it internally resonates with the listener and only can exist in what is a co-constructed experience.Conclusions Music in the Park is a metaphor for primary health care systems based on shared values of experts and unique local communities. Health professionals are players in this arena, who develop and practise the full range of their skills in response to individual and community needs and preferences. Their leadership works through inspiration and empowerment, making patients ‘co-producers’ of their own health and ‘co-shapers’ of their health services. (shrink)

A central claim of Deleuze's reading of Bergson is that Bergson's distinction between space as an extensive multiplicity and duration as an intensive multiplicity is inspired by the distinction between discrete and continuous manifolds found in Bernhard Riemann's 1854 thesis on the foundations of geometry. Yet there is no evidence from Bergson that Riemann influences his division, and the distinction between the discrete and continuous is hardly a Riemannian invention. Claiming Riemann's influence, however, allows Deleuze to argue that quantity, in (...) the form of ‘virtual number’, still pertains to continuous multiplicities. This not only supports Deleuze's attempt to redeem Bergson's argument against Einstein in Duration and Simultaneity, but also allows Deleuze to position Bergson against Hegelian dialectics. The use of Riemann is thereby an important element of the incorporation of Bergson into Deleuze's larger early project of developing an anti-Hegelian philosophy of difference. This article first reviews the role of discrete and continuous multiplicities or manifolds in Riemann's Habilitationsschrift, and how Riemann uses them to establish the foundations of an intrinsic geometry. It then outlines how Deleuze reinterprets Riemann's thesis to make it a credible resource for Deleuze's Bergsonism. Finally, it explores the limits of this move, and how Deleuze's later move away from Bergson turns on the rejection of an assumption of Riemann's thesis, that of ‘flatness in smallest parts’, which Deleuze challenges with the idea, taken from Riemann's contemporary, Richard Dedekind, of the irrational cut. (shrink)

Es besteht kein Mangel an ausgezeichneten Werken zur Logik und zur Ontologie. Allerdings wird in ihnen in der Regel weder die Logik ontologisch voraussetzungslos entwickelt noch die Ontologie in einem ausreichenden Zusammenhang mit der Logik entfaltet. An dieser Stelle mochte die Untersuchung ansetzen. Sie versucht Logik und Ontologie unter syntaktischen, semantischen und pragmatischen Gesichtspunkten darzulegen, indem sie auf der einen Seite ontologische Setzungen, die bei der Entfaltung der Logik in der Regel vorgenommen werden, vermeidet und auf der anderen Seite logische (...) Zusammenhange, die bei der Entfaltung der Ontologie in der Regel ungenutzt bleiben, heranzieht. (shrink)

Was ist der Mensch? Das ist die Kernfrage dieses Buches, die aus philosophischer Sicht bearbeitet wird. Es wird dafür argumentiert, dass der Mensch mehr ist als eine sehr komplexe Ansammlung materieller Elementarteilchen, die einfach nach den normalen Gesetzen der Physik miteinander zusammenwirken. Stattdessen muss man Menschen zusätzlich spezifisch menschliche Eigenschaften zuschreiben, die nicht vollständig aus den körperlichen Eigenschaften heraus erklärbar sind. Sie verfügen über Bewusstsein und können in einem gewissen Umfang frei handeln. Das sind psycho-physische Phänomene, die mit den Gesetzen (...) der Physik nicht vollständig erfasst werden können. Deswegen ist der Materialismus wahrscheinlich falsch, wenngleich er nicht definitiv widerlegbar ist. Die beste Antwort auf das uralte Leib-Seele-Problem ist der Polare Dualismus, ein Eigenschaftsdualismus, der die Welt als grundsätzlich psycho-physisch auffasst. Psycho-physische Zusammenhänge sind keine nachträgliche Verbindung zweier eigenständiger Seinsbereiche, sondern stehen in einem polaren Verhältnis zueinander. Keiner der Bereiche ist ohne den anderen denkbar, aber es kann auch keiner auf den jeweils anderen zurückgeführt werden. (shrink)

In natural kind debates, Boyd's famous Homeostatic Property Cluster theory (HPC) is often misconstrued in two ways: Not only is it thought to make for a normative standard for natural kinds, but also to require the homeostatic mechanisms underlying nomological property clusters to be uniform. My argument for the illegitimacy of both overgeneralizations, both on systematic as well as exegetical grounds, is based on the misconstrued view's failure to account for functional kinds in science. I illustrate the combination of these (...) two misconstruals with recent entries into the natural kind debate about emotions. Finally, I examine and reject Stich's "Kornblith-Devitt method" as a potential justification of these misconstruals. (shrink)