To guide treatment decisions for incompetent patients who have no advance directives, health care institutions should look to the preferences of their own communities of patients. That is the best way to ensure that incompetent patients' wishes will be followed.

Death in the Clinic fills a gap in contemporary medical education by explicitly addressing the concrete clinical realities about death with which practitioners, patients, and their families continue to wrestle. Visit our website for sample chapters!

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Suppose a meeting had been called among chief medical officers, chief administrative officers, and other leaders from a range of health-related institutions in this country. The question posed for this meeting was simple but unusual: Arethestructuresofourorganizations,systems,andinstitutionsethical? Though it was a question reminiscent for a few of the focus some time before on whether the conduct of individuals in their organization was ethical, this question seemed more demanding. Is it reasonable to consider structures or arrangements as ethical or not; or in (...) other words, is ethics an applicable attribute of organizations? And if it is reasonable to speak of an ethics of organizations, by what method might one discern any kind of an answer? And what of the informal connections that link different organizations … how can they be evaluated? (shrink)

The traditional Western understanding of life and death as a strict dichotomy is challenged by a more descriptively accurate model of life's progressive cessation. Dying can be defined by a bounded zone of residual states of life that fits better with moral intuition and more sensitively guides action toward the dying.

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

Nous en parlons à peine et leur nom nous échappe. La philosophie les a toujours négligées ; même la biologie les considère comme une simple décoration de l'arbre de la vie. Et pourtant, les plantes donnent vie à la Terre : elles fabriquent l'atmosphère qui nous enveloppe, elles sont à l'origine du souffle qui nous anime. Les végétaux incarnent le lien le plus étroit et élémentaire que la vie puisse établir avec le monde. Sous le soleil et les nuages, en (...) se mêlant à l'eau et au vent, leur existence est une interminable contemplation cosmique. Ce livre part de leur point de vue - celui des feuilles, des racines et des fleurs - pour comprendre le monde non plus comme une simple collection d'objets, ou un espace universel contenant toute chose, mais bien comme l'atmosphère générale, le climat, un lieu de véritable mélange métaphysique. (shrink)

Dans la première partie de L'unique fondement possible d'une démonstration de l'existence de Dieu (1763), Kant propose un argument de type ontologique qu'il avait déjà formulé dans ses écrits de 1755. La présente contribution voudrait examiner continuité et changements dans les différentes formulations. Contrairement à ce que soutiennent d'autres chercheurs, j'entends montrer que l'argument de Kant se présente, dès le départ, comme une alternative à celui des auteurs de la tradition wolffienne. Cette innovation comporte certaines difficultés théoriques qui apparaissent clairement (...) dans le texte de 1763. Tout en confirmant la conviction que l'argument ontologique de la tradition wolffienne n'est pas démonstratif, Kant estime ne pas disposer d’un argument alternatif complet, mais seulement de son fondement. (shrink)

La nozione di ‘fenomenotecnica’, introdotta da Gaston Bachelard negli anni 30, gode di forte interesse tra gli storici delle scienze, che la usano per insistere sulla mediazione tecnico-sociale dei fatti scientifici. In filosofia, sul fondo dell’attuale trionfale ritorno a un nuovo realismo epistemologico, l’idea di fenomenotecnica è stata relegata tra i relitti del ‘costruttivismo’. L’articolo difende una lettura diversa della ‘fenomenotecnica’: al di là del ruolo che Bachelard gli attribuiva nella costruzione dei fatti scientifici, il concetto permette di ripensare la (...) connessione intrinseca tra esperienza e tecnicità. I fenomeni non sono semplicemente dati; bisogna renderli visibili, tramite specifiche tecniche dell’apparire. Una tale premessa porta non solo a ripensare il ruolo che si attribuisce alla dimensione tecnica nell’estetica, ma anche alla ‘aisthesis’ in seno alle operazioni tecniche. (shrink)

Un bambino di quattro anni nascosto sotto il tavolo in cucina, nell'attesa degli eventi che diventeranno poi la sua vita. È questa la prima immagine che appare a Emanuele Severino quando, errando tra i ricordi, riavvolge i fili della propria esistenza. Errando, appunto, perché il ricordo è di per sé falso e distratto. Tra aneddoti e suggestioni, riaffiorano l'infanzia a Brescia e gli anni della guerra; la scomparsa del fratello Giuseppe, arruolatosi come "volontario" sul fronte francese, e l'incontro con Esterina, (...) "la ragazza più bella di Brescia", che diventerà sua moglie ed è lo sfondo di queste pagine; gli studi universitari a Pavia e l'insegnamento alla Cattolica di Milano, a seguito del "maestro" Gustavo Bontadini; la controversia con la Chiesa, che nel 1970 proclamò l'incompatibilità delle sue posizioni con quelle della dottrina cattolica; il rapporto con i figli; la stesura delle sue opere e le conversazioni filosofiche con gli amici. Emanuele Severino, con uno sguardo delicato e ironico, ripercorre la sua vita, illuminando luoghi, volti ed esperienze, perché "ciò che se ne va scompare per un poco. Ma poi, tutto ciò che è scomparso riappare". (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Dans le dernier quart du xix e siècle, l’ambition d’une philosophie scientifique inspire la Psychologie vom empirischen Standpunkt de Franz Brentano. Appelée à refonder sur des bases empiriques l’univers de l’être, cette forme nouvelle de psychologie réactualiserait ainsi, en un sens, un certain héritage de la métaphysique ancienne. Et Brentano parviendrait à assembler dans une même vision systématique les sources de la pensée grecque, en particulier aristotélicienne, et moderne. Mais peut-on vraiment considérer Brentano comme un aristotélicien en raison de son (...) projet psychologique? La question est bien connue et comme Franco Volpi, entre autres, le soutient, il semblerait que l’orientation épistémologique de la psychologie brentanienne ne trouve pas dans l’aristotélisme son véritable motif directeur. Une autre lecture est toutefois possible à nos yeux, si nous considérons qu’à aucun moment Brentano ne prétend faire de la psychologie un moyen pour revenir à Aristote. C’est notre hypothèse de recherche qui nous conduit à lire avec la plus grande attention le traité de 1867, Die Psychologie des Aristoteles : le recours à Aristote resterait alors nécessaire pour comprendre le projet d’une nouvelle psychologie qui n’oublie pourtant pas sa vocation métaphysique. (shrink)

Just hearing the names of Brentano and Plato put together is enough to highlight the queerness of a matching which finds almost no evidence in critical literature. The study of the texts in which Brentano explicitly deals with Plato, in particular in his lectures on the history of Greek philosophy, does not change much of the negative impression that emerges from a general overview: the place of Plato in the history of philosophy depends, for Brentano, on Aristotle or, better, on (...) the accomplishment of Greek philosophy occurs in Aristotle’s work. We shall turn our attention towards the of certain relevant problems in order to open up, if possible, a less negative prospect for the relationship of Brentano to Plato: not so much directly by examining Platonic philosophy from a Brentanian point of view as by considering the concrete solution that Brentano provides to some Aristotelian questions. To put it differently, we shall take into account not so much what Brentano says of Plato, as what Brentano does with Aristotle, by tracking the Platonizing traces that can be found in the Brentanian commentary to Aristotle’s categories, the philosophical consequences of which seem to be reflected in Brentano’s overall philosophical project. (shrink)

A partir de uma análise da obra de Francis Kaplan L'Étique de Spinoza et Ia méthode Géométrique, complementada com análises de comentadores clássicos do Espinosismo, como por exemplo, Victor Delbos e Harry Austryn Wolfson, entre outros, o autor procura traçar um historial da utilização do método ou da ordem geométrica, por parte de diversos pensadores, visando apontar, reconhecer ou apenas supor, uma possível influência sobre Bento de Espinosa. /// Starting from Francis Kaplan's analysis in his work L'Étique de Spinoza et (...) Ia méthode Géométrique, complemented with classic commentator's of spinozisme, as for example, Victor Delbos and Harry Austryn Wolfson, the author of the present article attempts to trace a report of the use of the geometrical method or of the geometric order, on the part of several thinkers, seeking to reveal, to recognize or just to suggest, a possible influence on Benedictus de Spinoza. (shrink)

Dans l’Allemagne du xix e siècle, l’édition intégrale du Corpus aristotelicum de l’Académie des sciences de Berlin constitue la condition ayant rendu historiquement possible le « retours à Aristote », dont l’une des figures majeures est sans doute A. F. Trendelenburg. Suivant comme fil conducteur les rapports grammaticaux inhérents aux différentes parties de la proposition, Trendelenburg, le premier, s’engage à démontrer l’ordre sous-jacent au nombre des catégories, laissé pourtant indéterminé par Aristote. Le but est, pour l’essentiel, de découvrir le point (...) de contact originaire entre la pensée, le langage et l’être, en opposition frontale aux résultats de l’idéalisme allemand. C’est donc le lien entre logique et métaphysique qui est au centre de l’exégèse philosophique que Trendelenburg livre aux pages de l’ Aristoteles Kategorienlehre en 1846, sur laquelle nous portons notre attention afin de rétablir les lignes directrices d’un projet dont l’originalité a souvent été confinée aux hypothèses prétendument improductives d’une grammaire spéculative ou délaissée en faveur d’autres épigones du lignage aristotélicien – de Brentano à Heidegger. (shrink)

Pourquoi recourir à la pensée de Dietrich Bonhoeffer pour formuler une contribution philosophique au problème de la tolérance? Et, de surcroît, en dialogue avec la phénoménologie? Homme de pensée et d’action, Bonhoeffer n’est, à proprement parler, ni un phénoménologue ni un penseur de la tolérance. Il est, toutefois, légitime d’envisager sa lutte contre le totalitarisme, tant sur le plan théologique que politique, comme un cas limite susceptible de relever du questionnement sur la nature et la portée de la tolérance elle-même. (...) Et cela en raison du paradoxe auquel Bonhoeffer s’expose dans la tentative de putsch visant l’élimination du Führer à laquelle il participe : la violation non seulement de la loi, mais d’un commandement divin – « tu ne tueras pas » – que Bonhoeffer justifie au nom de sa foi en Dieu. Notre hypothèse de lecture nous conduit dès lors à consacrer une attention particulière à sa thèse d’habilitation, Akt und Sein, où Bonhoeffer formule une critique originale de la phénoménologie notamment heideggérienne, inspirée par la theologia crucis de tradition luthérienne : renonçant à toute tentative d’autodétermination, l’homme, pour Bonhoeffer, ne peut se comprendre que par une ouverture radicale à la transcendance qui coïncide, en dernière instance, avec la dimension authentiquement personnelle de l’homme lui-même ainsi que de la relation entre l’homme et Dieu. (shrink)

In this paper we argue that Pareyson’s notion of formativity is germane to the notion of self–transcendence recently put forward in the vast domain of the sciences of the self–organization of complex systems. Following Jean–Pierre Dupuy’s approach, we will not apply this notion to the analysis of Pareyson’s theory; we will, instead, show— by referring to thenumerous topoi where often surprisingly precise parallelisms, onvergences and semantic identities are to be found—that, though being largely independent in their genesis, the logics of (...) the two notions are already consistent with each–other. As a result, we will claim that Pareyson’s theory of the work of art is best understood as a study on the integration of different layers of organizational closures. (shrink)