Bioethicists tend to focus on the individual as the relevant moral subject. Yet, in highly complex and socially differentiated healthcare systems a number of social groups, each committed to a common cause, are involved in medical decisions and sometimes even try to influence bioethical discourses according to their own agenda. We argue that the significance of these collective actors is unjustifiably neglected in bioethics. The growing influence of collective actors in the fields of biopolitics and bioethics leads us to pursue (...) the question as to how collective moral claims can be characterized and justified. We pay particular attention to elaborating the circumstances under which collective actors can claim ‘collective agency.’ Specifically, we develop four normative-practical criteria for collective agency in order to determine the conditions that must be given to reasonably speak of ‘collective autonomy’. For this purpose, we analyze patient organizations and families, which represent two quite different kinds of groups and can both be conceived as collective actors of high relevance for bioethical practice. Finally, we discuss some practical implications and explain why the existence of a shared practice of trust is of immediate normative relevance in this respect. (shrink)

Because it is often argued that surrogacy should not be treated as contractual, the question arises in which terms this practice might then be couched. In this article, I argue that a phenomenology of surrogacy centering on the notion of trust provides a description that is illuminating from the moral point of view. My thesis is that surrogacy establishes a complex and extended reproductive unit––the “surrogacy triad” consisting of the surrogate mother, the child, and the intending parents––whose constituents are bound (...) together by mutual trustful commitments. Even though a trust-based approach does not provide an ultimate answer to whether surrogacy should be sanctioned or prohibited, it allows for at least some practical suggestions. In particular, I will argue that, under certain conditions, surrogacy is tenable within familial or other significant relationships, and I will stress the necessity of acknowledging the new relationships and moral commitments that result from this practice. (shrink)

BackgroundThe bioethical debates concerning living donation and surrogacy revolve around similar ethical questions and moral concepts. Nevertheless, the ethical discourses in both fields grew largely isolated from each other.MethodsBased on a review of ethical, sociological and anthropological research this paper aims to link the ethical discourses on living kidney donation and surrogacy by providing a comparative analysis of the two practices’ relational dimension with regard to three aspects, i.e. the normative role of relational dynamics, social norms and gender roles, and (...) reciprocity. Based on this analysis, we derive conclusions for the framing of living organ donation and surrogacy in ethical theory and practice.ResultsFirst, our analysis emphasizes the relevance of acknowledging the complex relational implications of living kidney donation and surrogacy. Underestimating this relational dimension may not only lead to individual crises but endanger existing as well as newly emerging familial relationships. Second, we point out differences in the normative assessment of social norms and gender roles in the ethical debates about living kidney donation and surrogacy. In particular, we show how different evaluations of altruism affect the understanding of autonomy in both contexts. In addition, we sensitize for biased perceptions of gender roles. Finally, we argue that challenges resulting from unresolved reciprocity are an issue in living kidney donation and surrogacy independent of whether the exchange of body parts or bodily services is framed as a gift or commercial exchange. By pointing out the limits of financial compensation, we stress the relevance of non-material, relational rewards as potential remedy. (shrink)

The human body and its parts are widely perceived as matters beyond commercial usage. This belief is codified in several national and European documents. This so-called ‘no-property rule’ is held to be the default position across the countries of the European Union. However, a closer look at the most pertinent national and European documents, and also current practices in the field, reveals a gradual model of commercialisation of human tissue. In particular, we will argue that the ban on commercialisation of (...) body material is not as strict as it may appear at first sight, leaving room for the commercial practice of tissue procurement and transfer. We argue for more transparent information for patients and tissue donors, an intensified ethical debate on commercialisation practices, and a critical review of current normative principles. (shrink)

ZusammenfassungIn der ethischen Debatte um die Forschung mit Biobanken wird selten zwischen verschiedenen Biomaterialien differenziert. Vor diesem Hintergrund widmet sich die vorliegende qualitative Interviewstudie erstmals den praktischen Herausforderungen, die sich bei der Sammlung von postmortal gewonnenem menschlichem Gehirngewebe zu Forschungszwecken aus Sicht von in diese Praxis involvierten Experten in Deutschland stellen. Im Zentrum der ethischen Analyse stehen Herausforderungen der Spenderrekrutierung, der Kommunikation über eine Gehirnspende sowie der informierten Zustimmung. Unsere Ergebnisse relativieren zum einen die Annahme eines sogenannten Spendermangels, insofern insbesondere (...) Kliniker eine Gatekeeper-Rolle bei der Spendergewinnung innehaben. Deren Einstellungen sollten daher als ein die Praxis unmittelbar beeinflussender Faktor stärker berücksichtigt werden; zudem sollten im Wissen um bestehende moralische Vorbehalte Ansätze zur Verbesserung der professionellen Kommunikation entwickelt werden. Bezüglich der Regelung der Einwilligung in postmortale Forschungsspenden wurde in unserem Sample das Bemühen deutlich, den ethischen Vorrang der Organspende nicht zu gefährden und die Postmortalspende vor Assoziationen mit der Organspende zu bewahren. Zur Sicherung des Vertrauens in die Forschung sowie der Autonomie von Spendern befürworteten die Experten nicht nur die Anwendung einer Zustimmungsregelung, sondern auch ein den Familienangehörigen explizit eingeräumtes Recht, einer Gehirnspende selbst dann zu widersprechen, wenn der Verstorbene seine Zustimmung erteilt hat. Die Erfahrung zeigt, dass eine offene Kommunikation über das Erfordernis eines familiären Konsenses zu einer hohen Akzeptanz des Spenderwillens in der Praxis führt. Daher könnte ein solcher, auf den Dialog von Spender und Angehörigen zu Lebzeiten bauender Ansatz auch instruktiv für die Realisierung von Spenden im Kontext der Organspende sein. (shrink)

Human reproduction in the age of reprogenetics raises fundamental ethical and political questions. Critics of so-called liberal eugenics like Jürgen Habermas have sparked an ethical debate on whether selective genetic manipulation might undermine the natural basis of the moral self-conception and autonomy of future generations. Contrary to this perception, the authors of this article argue for a dialectic understanding of the moral challenges arising from human natality: Freedom and dependency, sociality and human embodiment, autonomy and relatedness likewise determine our human (...) existence as moral beings. As an answer to these challenges, the authors develop a dialectic understanding of parenthood in the age of reprogenetics, thereby transcending present debates of modern reproductive medicine. (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)

A realist view of numbers often rests on the following thesis: statements like ‘The number of moons of Jupiter is four’ are identity statements in which the copula is flanked by singular terms whose semantic function consists in referring to a number (henceforth: Identity). On the basis of Identity the realists argue that the assertive use of such statements commits us to numbers. Recently, some anti-realists have disputed this argument. According to them, Identity is false, and, thus, we may deny (...) that the relevant statements commit us to numbers. The present paper argues that the correct linguistic analysis of the relevant number statements supports the anti-realist view that Identity is false. However, as will further be shown, pace the anti-realist, this analysis does not establish that such statements do not commit us to numbers after all. (shrink)

This paper argues that certain expressions of practical necessity – like ‘I have to do this, I do not have a choice’ or ‘Here I stand, I can do no other’ – allow an insight into deep structures of personality and self-understanding. They point at a limit where someone would have to ‘become another person’ (in his own view), if he was forced to an alternative decision, because of neglecting ground-projects and convictions, which are essential for his self-conception. This limit (...) is marked by a loss of autonomy and authenticity. The paper discusses why and in how far expressions of personal necessities seem to have a special value and authority as they call forth the respect of the other towards an individual personality, even though this does not exclude that there may also be a necessity of self-reform. (shrink)

Lassen sich für die Kunst noch begriffliche Grenzen ziehen? Oder ist sie in einer Zeit, in der alles Kunst sein kann, letztlich an ihr Ende gelangt? In diesem Spannungsfeld bewegen sich die kunsttheoretischen Schriften des amerikanischen Philosophen Arthur C. Danto. Einerseits hat er unablässig die These verfochten, die Entwicklung der Kunst sei mit künstlerischen Strömungen wie der Pop Art an ihr Ende gelangt. Andererseits hat er um eine überzeugende Konturierung des Kunstbegriffs gerungen und eine der vielversprechendsten Kunstphilosophien des 20. Jahrhunderts (...) vorgelegt. Erstmals werden hier Dantos Schriften zur Bestimmung des Kunstbegriffs sowie zum Ende der Kunst zusammengelesen. Die Autorin nimmt die begrifflichen und zeitlichen Grenzen der Kunst in den Blick und fragt zugleich nach einer produktiven Bestimmung dieser 'Enden' innerhalb des nicht stillzustellenden Fortschreitens künstlerischer Praxis. (shrink)

In many cases collectively desirable projects can be carried out only after considerable social conflict because the unequal distribution of burden and benefit from such projects leads to local Opposition. From an economic perspective this problem can (and should) be resolved by compensating those who are negatively affected. Using a fictitious example, the author demonstrates that compensation packages will ( a) increase the collective welfare, (b) have a positive redistributive effect, and ( c) contribute to unblocking negotiation standstills that result (...) from local veto. In actual practice, however, compensation offers will often be rejected by those affected. In order to increase the acceptability of compensation, it is important that all the possibilities to limit and restitute damage be explored before consideration is given to acceptable forms of substitution or compensation. The search for adequate means of substitution and compensation requires the inclusion of all parties affected. Therefore alternative dispute resolution provides an ideal framework for such a process. (shrink)

The study examines how multinational organizations implement the concept of ethics and compliance programs into their businesses and the extent to which these programs were geared to the 2004 Amendments. The study explores the applicability of the 2004 Amendments and analyzes the instruments organizations use to successfully develop and maintain these programs. By including research from various fields, a theoretical framework was developed for implementing an ethics and compliance program that takes into account the 2004 Amendments.

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)

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)