Durch Migrationsprozesse und zunehmenden Pluralismus ist in Deutschland das Thema „kulturelle Diversität“ in der Medizin aktueller denn je. In der medizinischen Fachliteratur und im gesellschaftlichen Diskurs wird vermehrt von interkulturellen Konflikten im Kontakt zwischen Arzt und Patient berichtet, was die Frage nach der Rolle von Interkultureller Kompetenz für die klinische Praxis aufwirft. Zunächst widmet sich der Beitrag kritisch den verschiedenen Auffassungen des Begriffs „Kultur“ im medizinischen Kontext, um anschließend eine Methode der interkulturellen Philosophie als eine Möglichkeit für eine kultursensitive Ethik (...) zu skizzieren. Anschließend wird aufgezeigt, welche Schwierigkeiten mit dem Begriff der Interkulturellen Kompetenz verbunden sind und weshalb die Autoren diesen trotzdem als unerlässlich für die Wahrnehmung potentieller Konfliktfelder als auch für den Umgang mit diesen erachten. Schließlich werden derzeitige Entwicklungen in der medizinischen Ausbildung sowie konkrete Beispiele für eine kultursensible Ethikberatung illustriert. Es zeigt sich, dass international zahlreiche Ausgestaltungen Interkultureller Kompetenz in Form von Leitfäden und konkreten Schulungsmodulen existieren, aber auch, dass es in Deutschland an konkreten Umsetzungen in der Breite mangelt und die Zusammenarbeit wissenschaftlicher Disziplinen sowie der betroffenen Institutionen derzeit noch ausbaufähig ist. (shrink)
ZusammenfassungAus einer ethischen Perspektive analysieren wir die vom Gemeinsamen Bundesausschuss im September 2019 für Deutschland vorgelegte Änderung der Mutterschaftsrichtlinien, welche die Finanzierung der nicht-invasiven Pränataldiagnostik durch die gesetzlichen Krankenversicherungen unter bestimmten Bedingungen vorsieht. Die Regelung enthält vier wesentliche Elemente: eine Zielbestimmung, ein Zugangskriterium, Aussagen zum Entscheidungsprozess und eine in ihren Begründungen enthaltene normative Kontextualisierung.Es zeigen sich Spannungen, die um zwei Achsen oszillieren: Das befürchtete Leiden aufgrund der Geburt eines Kindes mit Trisomie oder dem Nichtwissen darüber kann letztlich nur subjektiv, aus (...) der Perspektive der Schwangeren beurteilt werden. Die Bedeutung der Einzelfallentscheidung bleibt unklar, weil für die Beurteilung von Einzelfällen auch allgemeine Gesichtspunkte maßgeblich sein müssen. Gerade in seiner Paradoxie und Flexibilität könnte, wie wir argumentieren, das Modell des G‑BA aber eine gesellschaftspolitisch haltbare und ethisch letztlich vertretbare pragmatische Lösung darstellen.Definition of the problem From an ethical point of view we analyse the ruling of the German Federal Joint Committee of September 2019 to revise the guidelines about the coverage of noninvasive prenatal tests by mandatory health insurance, in order to include them under specified conditions. Arguments The decision contains four essential elements: a definition of the aim of NIPT testing, a criterion of access, statements about the process of decision-making and a normative contextualization which is to be found in its explanations. Conclusion There are tensions in the proposed model that oscillate about two axes: The suffering that results from a possible birth of a child with trisomy or from not knowing about the genetic condition of the fetus can ultimately only be evaluated subjectively, from the perspective of the pregnant woman. The meaning of an individual decision in the case-by-case model remains unclear because when judging about individual cases general points of view also need to be considered. However, we argue that the model of the G‑BA could be a sociopolitically and ultimately also ethically defensible pragmatic solution, exactly because of its paradoxes and its inherent flexibility. (shrink)
ZusammenfassungDurch Migrationsprozesse und zunehmenden Pluralismus ist in Deutschland das Thema „kulturelle Diversität“ in der Medizin aktueller denn je. In der medizinischen Fachliteratur und im gesellschaftlichen Diskurs wird vermehrt von interkulturellen Konflikten im Kontakt zwischen Arzt und Patient berichtet, was die Frage nach der Rolle von Interkultureller Kompetenz für die klinische Praxis aufwirft. Zunächst widmet sich der Beitrag kritisch den verschiedenen Auffassungen des Begriffs „Kultur“ im medizinischen Kontext, um anschließend eine Methode der interkulturellen Philosophie als eine Möglichkeit für eine kultursensitive Ethik (...) zu skizzieren. Anschließend wird aufgezeigt, welche Schwierigkeiten mit dem Begriff der Interkulturellen Kompetenz verbunden sind und weshalb die Autoren diesen trotzdem als unerlässlich für die Wahrnehmung potentieller Konfliktfelder als auch für den Umgang mit diesen erachten. Schließlich werden derzeitige Entwicklungen in der medizinischen Ausbildung sowie konkrete Beispiele für eine kultursensible Ethikberatung illustriert. Es zeigt sich, dass international zahlreiche Ausgestaltungen Interkultureller Kompetenz in Form von Leitfäden und konkreten Schulungsmodulen existieren, aber auch, dass es in Deutschland an konkreten Umsetzungen in der Breite mangelt und die Zusammenarbeit wissenschaftlicher Disziplinen sowie der betroffenen Institutionen derzeit noch ausbaufähig ist. (shrink)
Pendant les ann?es 1970, Gilles Deleuze?labore avec F?lix Guattari et Claire Parnet les concepts d'agencement et de diagramme: au moins jusqu'? Mille plateaux, agencement et diagramme - rebaptis?s machine concr?te et machine abstraite -, constitueront le soubassement th?orique de l'ensemble du travail de Deleuze. Or, l'id?e de diagramme doit beaucoup au Foucault de Surveiller et punir avec lequel Deleuze m?ne un dialogue th?orique ininterrompu pendant ces ann?es-l?: elle cristallise pour lui un enjeu de taille, celui de penser la mutation des (...) structures historiques hors des sch?mas dominants du structuralisme et du marxisme. Deleuze, penseur du devenir, se confrontant? Foucault, historien-g?n?alogiste des transformations: au coeur de cette confrontation sur le diagramme, surgissent deux conceptions distinctes de la mutation que Deleuze s'efforce de concilier dans son livre sur Foucault. Sedamdesetih godina dvadesetog veka Zil Delez, zajedno s Feliksom Gatarijem i Kler Parne, razvija koncepte uredjenja i dijagrama: barem do Hiljadu ravni uredjenje i dijagram - prekrsteni potom u stvarnu i apstraktnu masinu - sacinjavali su istureni teorijski temelj celokupnog Delezovog dela. Ideja dijagrama mnogo duguje Fukou iz doba Nadziranja i kaznjavanja, s kojim Delez u tim godinama, vodi neprekidni teorijski dijalog. Ona za njega predstavlja veliki ulog jer je trebalo misliti mutacije istorijskih struktura izvan vladajucih sema strukturalizma i marksizma. Delez se, kao mislilac buduceg suprotstavlja Fukou, istoricaru-genealogicaru promena: u sredistu te rasprave oko dijagrama pojavljuju se dve razlicite koncepcije mutacije koje Delez nastoji da pomiri u svojoj knjizi o Fukou. (shrink)
Este artículo busca demostrar que, a partir de los lineamientos presentes en el capítulo II del reciente _Reprise du donné_ es posible proponer cuatro niveles de hermenéutica que nos permiten resolver algunos de los problemas de la fenomenología marioniana lúcidamente planteados por Christina Gschwandtner.
Die Nachzeichnung der Verschmelzung von Leben und Lehre im Wirken des großen Philosophen ist für Cassirer eine zentrale ideengeschichtliche Aufgabe, denn: 'Descartes gehört zu jenen Denkern, bei denen Leben und Werk in völligem Einklang miteinander stehen. Der Gedanke selbst ist es, der hier das Leben formt und der seinen Inhalt und seine Eigenart bestimmt.' Und die Auseinandersetzung mit Descartes' Leben und Leistung 'führt wie von selbst und mit sachlicher Notwendigkeit zu [...] einer allgemeinen Bestimmung dessen, was man als die Aufgabe (...) und das Wesen der Philosophie versteht'.Im ersten Teil seines 1939 im Exil erschienenen Descartes-Buches beschreibt Cassirer den Rang und die zeitbedingte Grenze der theoretischen Leistung, im zweiten Teil die Stellung Descartes' in seinem Jahrhundert unter besonderer Betonung der praktischen Vernunft Descartes, seiner Ethik. (shrink)
The development of photodynamic therapy and anti-vascular endothelial growth factor agents have revolutionized the treatment of retinal diseases, transforming the retina subspecialty by ushering in an age of pharmacological treatments for a wide range of diseases, including age-related macular degeneration.
The philosophical work of Jean-Luc Marion has opened new ways of speaking about religious convictions and experiences. In this exploration of Marion’s philosophy and theology, Christina M. Gschwandtner presents a comprehensive and critical analysis of the ideas of saturated phenomena and the phenomenology of givenness. She claims that these phenomena do not always appear in the excessive mode that Marion describes and suggests instead that we consider degrees of saturation. Gschwandtner covers major themes in Marion’s work—the historical event, art, (...) nature, love, gift and sacrifice, prayer, and the Eucharist. She works within the phenomenology of givenness, but suggests that Marion himself has not considered important aspects of his philosophy. (shrink)
How do people decide which claims should be considered mere beliefs and which count as knowledge? Although little is known about how people attribute knowledge to others, philosophical debate about the nature of knowledge may provide a starting point. Traditionally, a belief that is both true and justiﬁed was thought to constitute knowledge. However, philosophers now agree that this account is inadequate, due largely to a class of counterexamples (termed ‘‘Gettier cases’’) in which a person’s justiﬁed belief is true, but (...) only due to luck. We report four experiments examining the effect of truth, justiﬁcation, and ‘‘Gettiering’’ on people’s knowledge attributions. These experiments show that: (1) people attribute knowledge to others only when their beliefs are both true and justiﬁed; (2) in contrast to contemporary philosophers, people also attribute knowledge to others in Gettier situations; and (3) knowledge is not attributed in one class of Gettier cases, but only because the agent’s belief is based on ‘‘apparent’’ evidence. These ﬁndings suggest that the lay concept of knowledge is roughly consistent with the traditional account of knowledge as justiﬁed true belief, and also point to a major difference between the epistemic intuitions of laypeople and those of philosophers. (shrink)
In recent years, most political theorists have agreed that shame shouldn't play any role in democratic politics because it threatens the mutual respect necessary for participation and deliberation. But Christina Tarnopolsky argues that not every kind of shame hurts democracy. In fact, she makes a powerful case that there is a form of shame essential to any critical, moderate, and self-reflexive democratic practice. Through a careful study of Plato's Gorgias, Tarnopolsky shows that contemporary conceptions of shame are far too (...) narrow. For Plato, three kinds of shame and shaming practices were possible in democracies, and only one of these is similar to the form condemned by contemporary thinkers. Following Plato, Tarnopolsky develops an account of a different kind of shame, which she calls "respectful shame." This practice involves the painful but beneficial shaming of one's fellow citizens as part of the ongoing process of collective deliberation. And, as Tarnopolsky argues, this type of shame is just as important to contemporary democracy as it was to its ancient form. Tarnopolsky also challenges the view that the Gorgias inaugurates the problematic oppositions between emotion and reason, and rhetoric and philosophy. Instead, she shows that, for Plato, rationality and emotion belong together, and she argues that political science and democratic theory are impoverished when they relegate the study of emotions such as shame to other disciplines. (shrink)
In this paper, I present and explore some ideas about how factive emotional states and factive perceptual states each relate to knowledge and reasons. This discussion will shed light on the so-called ‘perceptual model’ of the emotions.
In his “Space, supervenience and substantivalism”, Le Poidevin proposes a substantivalism in which space is discrete, implying that there are unmediated spatial relations between neighboring primitive points. This proposition is motivated by his concern that relationism suffers from an explanatory lacuna and that substantivalism gives rise to a vicious regress. Le Poidevin implicitly requires that the relationist be committed to the “only x and y ” principle regarding spatial relations. It is not obvious that the relationist is committed to this (...) principle in such a context. An additional motivation for Le Poidevin's argument, that space should be considered to be discrete, is that he believes that substantivalists are committed to a vicious regress. I show that the regress is in fact not of the vicious variety. These two main arguments show that Le Poidevin's suggestion that we drop the density postulate for space is unnecessary. (shrink)
This unique collection brings together internationally recognized scholars of film, philosophy, and the philosophy of perception and aesthetics, as well as many established philosophers working on the Film as Philosophy problem. It also includes several young scholars working currently in the philosophy and film genre. It is especially poised to be used in university undergraduate and graduate courses, but appeals to the larger, more general audience as well as to those working in these particular areas of specialization. Philosophy in motion...
Microaggressions are a new moral category that refers to the subtle yet harmful forms of discriminatory behavior experienced by members of oppressed groups. Such behavior often results from implicit bias, leaving individual perpetrators unaware of the harm they have caused. Moreover, microaggressions are often dismissed on the grounds that they do not constitute a real or morally significant harm. My goal is therefore to explain why microaggressions are morally significant and argue that we are responsible for their harms. I offer (...) a conceptual framework for microaggressions, exploring the central mechanisms used for identification and the empirical research concerning their harm. The cumulative harm of microaggressions presents a unique case for understanding disaggregation models for contributed harms, blame allocation, and individual responsibility within structural oppression. Our standard moral model for addressing cumulative harm is to hold all individual contributors blameworthy for their particular contributions. However, if we aim to hold people responsible for their unconscious microaggressions and address cumulative harm holistically, this model is inadequate. Drawing on Iris Marion Young's social connection model, I argue that we, as individual perpetrators of microaggressions, have a responsibility to respond to the cumulative harm to which we have individually contributed. (shrink)
This book is an unusually readable and lucid account of the development of Derrida's work, from his early writings on phenomenology and structuralism to his most recent interventions in debates on psychoanalysis, ethics and politics. Christina Howells gives a clear explanation of many of the key terms of deconstruction - including differance, trace, supplement and logocentrism - and shows how they function in Derrida's writing. She explores his critique of the notion of self-presence through his engagement with Husserl, and (...) his critique of humanist conceptions of the subject through an account of his ambivalent and evolving relationship to the philosophy of Sartre. The question of the relationship between philosophy and literature is examined through an analysis of the texts of the 1970s, and in particular Glas, where Derrida confronts Hegel's totalizing dialectics with the fragmentary and iconoclastic writings of Jean Genet. The author addresses directly the vexed questions of the extreme difficulty of Derrida's own writing and of the passionate hostility it arouses in philosophers as diverse as Searle and Habermas. She argues that deconstruction is a vital stimulus to vigilance in both the ethical and political spheres, contributing significantly to debate on issues such as democracy, the legacy of Marxism, responsibility, and the relationship between law and justice. Comprehensive, cogently argued and up to date, this book will be an invaluable text for students and scholars alike. (shrink)
Positive emotions are highly valued and frequently sought. Beyond just being pleasant, however, positive emotions may also lead to long-term benefits in important domains, including work, physical health, and interpersonal relationships. Research thus far has focused on the broader functions of positive emotions. According to the broaden-and-build theory, positive emotions expand people’s thought–action repertoires and allow them to build psychological, intellectual, and social resources. New evidence suggests that positive emotions—particularly gratitude—may also play a role in motivating individuals to engage in (...) positive behaviors leading to self-improvement. We propose and offer supportive evidence that expressing gratitude leads people to muster effort to improve themselves via increases in connectedness, elevation, humility, and specific negative states including indebtedness. (shrink)
This book provides an introduction to the emerging field of Continental philosophy of religion by treating the philosophical thought of its most important representatives, including its appropriations by several thinkers in the US. Part I provides a context to the field by looking at the religious aspects of the thought of Martin Heidegger, Emmanuel Lévinas, and Jacques Derrida. It contends that although the work of these thinkers is not apologetic in nature, it prepares the ground for the more religiously motivated (...) work of more recent thinkers by giving religious language and ideas some legitimacy in philosophical discussions. Part II devotes a chapter to each of the contemporary French thinkers who articulate a phenomenology of religious experience: Paul Ricoeur, Jean-Luc Marion, Michel Henry, Jean-Louis Chrétien, Jean-Yves Lacoste and Emmanuel Falque. This part argues that their respective philosophies can be read as an apologetics of sort, namely as making arguments for the coherence of thought about God and the viability of religious experience, though each does so in a different fashion and to a different degree. Part III considers the three major thinkers who have popularized and extended this phenomenology in the US context: Merold Westphal, John D. Caputo, and Richard Kearney. The book thus both provides an introduction to important contemporary thinkers many of whom have not yet received much treatment in English and also argues that their philosophies can be read as providing an argument for Christian faith. (shrink)
Through a wide-ranging international collection of papers, this volume provides theoretical and historical insights into the development and application of phenomenological sociology and ethnomethodology and offers detailed examples of research into social phenomena from these standpoints. All the articles in this volume join together to testify to the enormous efficacy and potential of both phenomenological sociology and ethnomethodology.
The work of French philosopher and theologian Jean-Luc Marion has been recognized as among the most suggestive and productive in the philosophy of religion today. In Reading Marion, Christina M. Gschwandtner provides the first comprehensive introduction to Marion's large and conceptually dense corpus. Gschwandtner gives particular attention to Marion's early work on Descartes and follows thematic threads through to his most recent publications on charity and eroticism. She explores in detail three prominent topics in Marion's thought: the desire to (...) overcome metaphysics, his reflections on the divine, and his reconsideration of the relation of the self to the other in love. Gschwandtner reveals Marion's thought as a unified whole and provides context for his theological and phenomenological writings. Readers at all levels will find insight into the work of one of the world's most provocative thinkers. (shrink)
We construct a model for the level by level equivalence between strong compactness and supercompactness in which below the least supercompact cardinal κ, there is a stationary set of cardinals on which SCH fails. In this model, the structure of the class of supercompact cardinals can be arbitrary.
Every day situations arising in health care contain ethical issues influencing care providers' conscience. How and to what extent conscience is influenced may differ according to how conscience is perceived. This study aimed to explore the relationship between perceptions of conscience and stress of conscience among care providers working in municipal housing for elderly people. A total of 166 care providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire containing the Perceptions of (...) Conscience Questionnaire and the Stress of Conscience Questionnaire. A multivariate canonical correlation analysis was conducted. The first two functions emerging from the analysis themselves explained a noteworthy amount of the shared variance (25.6% and 17.8%). These two dimensions of the relationship were interpreted either as having to deaden one's conscience relating to external demands in order to be able to collaborate with coworkers, or as having to deaden one's conscience relating to internal demands in order to uphold one's identity as a `good' health care professional. (shrink)
Nagel, San Juan, and Mar report an experiment investigating lay attributions of knowledge, belief, and justification. They suggest that, in keeping with the expectations of philosophers, but contra recent empirical findings [Starmans, C. & Friedman, O. (2012). The folk conception of knowledge. Cognition, 124, 272–283], laypeople consistently deny knowledge in Gettier cases, regardless of whether the beliefs are based on ‘apparent’ or ‘authentic’ evidence. In this reply, we point out that Nagel et al. employed a questioning method that biased participants (...) to deny knowledge. Moreover, careful examination of participants’ responses reveals that they attributed knowledge in Gettier cases. We also note that Nagel et al. misconstrue the distinction between ‘apparent’ and ‘authentic’ evidence, and use scenarios that do not feature the structure that characterizes most Gettier cases. We conclude that NS&M’s findings are fully compatible with the claim that laypeople attribute knowledge in Gettier cases in general, but are significantly less likely to attribute knowledge when a belief is generated based on apparent evidence. (shrink)
In this paper, I revisit the Davidsonian thesis that all reasons are causes. Drawing on a better taxonomy of reasons than the one Davidson provides, I argue that this thesis is either indefensible or uninteresting.
In certain contemporary theories of the politics of shame, shame is considered a pernicious emotion that we need to avoid in, or a salutary emotion that serves as an infallible guide to, democratic deliberation. The author argues that both positions arise out of an inadequate notion of the structure of shame and an oversimplistic opposition between shame and shamelessness. Plato's dialogue, the Gorgias, actually helps to address these problems because it supplies a deeper understanding of the place of shame in (...) democratic politics in ways that address our contemporary dilemmas. It does this first, by avoiding the simple opposition between shame and shamelessness and secondly, by articulating three different kinds of "politics of shame" that can characterize democratic deliberations. Finally, Plato's treatment of shame extends upon contemporary ethical and psychoanalytic notions of shame in ways that are directly relevant to the our contemporary political situation. (shrink)
In several lectures, interviews and essays from the early 1980s, Michel Foucault startlingly argues that he is engaged in a kind of critical work that is similar to that of Immanuel Kant. Given Foucault's criticisms of Kantian and Enlightenment emphases on universal truths and values, his declaration that his work is Kantian seems paradoxical. I agree with some commentators who argue that this is a way for Foucault to publicly acknowledge to his critics that he is not, as some of (...) them charge, attempting a total critique of Enlightenment beliefs and values, but is instead attempting to transform them from within. I argue further that Foucault's self-professed Kantianism can also productively be read as a means of encouraging change in his intellectual audience, a call to courage to take up the thread of Enlightenment thought that Foucault finds in Kant's essay, `What is Enlightenment?': that of directing one's philosophical efforts towards questioning and transforming one's own present in its historical specificity, for the sake of promoting the values of freedom and autonomy therein. Though much of Kant's philosophical work is focused on that which lies outside of history, Foucault locates in some of it a concern for what is happening here and now that, I argue, he encourages his audience to take up for themselves through tracing his own intellectual lineage to Kant. In so doing, he encourages contemporary philosophers to consider the value and effects of their work on the present social and political contexts in which they live. (shrink)
In the Bhagavad-Gita, Krishna lays out three paths of yoga as the means to achieve human perfection: the path of self-less action, the path of knowledge, and the path of devotion. In this paper I will argue for an interpretation of the Gita in which the path of devotion is the last step that leads to moksha. This is not to claim that bhakti yoga is more important than karma and jnana yoga, but rather that the latter two are more (...) elementary. In order to practice bhakti yoga, one must first have practiced karma and jnana yoga. All three forms of yoga are equally important—but there is a prioritized order in which they are to be practiced. On my reading, bhakti is more than having an intense feeling of love for God, because practicing devotion to God is an intellectual love of God that entails an intuitive understanding of the essence of things. My approach is to cross-examine the concept of human perfection as discussed in the Gita and Spinoza’s Ethics. Human perfection is characterized in both texts as a total liberation from being guided by things external to oneself other than one’s own nature. In other words, the aim of life is to liberate oneself by acquiring the right kind of knowledge. The freer one becomes and the more knowledge that one has, the more perfect one becomes. Thus, Spinoza’s idea of the “free man” resembles the self-realized agent in the Gita, because a human being becomes more “perfect” when he expresses God’s power to a greater degree. Bhakti yoga is the last step on the path to attain knowledge of God because in bhakti yoga, one employs the method of intuition to grasp God’s essence. As such, unlike karma and jnana yoga, the knowledge acquired in bhakti yoga is not empirical. In the Gita, rational devotion is a single act of both the mind and the heart, which, in turn, will lead to the practice of self-less actions. (shrink)
In the long-running debate on the interest of the dead, Joan C. Callahan argues against such interests and although Søren Holm for practical reasons is prepared to consider posthumous interests, he does not see any moral basis to support such interests. He argues that the whole question is irresolvable, yet finds privacy interests where Tutankhamen is concerned. Callahan argues that there can be reasons to hold on to the fiction that there are posthumous interests, namely if it is comforting for (...) the living and instrumental for society. Thus, despite arguing against the position that the dead have any interests or for any moral basis for such interests, these “interests” are still taken into consideration in the end. This shows the unsatisfactory basis of their positions and indicates the tenacity of the moral intuition that the dead can have moral claims on the living. One example of a posthumous interest is the interest in one’s good name. Here we argue that it is an interest of moral significance. This implies that if individuals restrict use of their sample when they are still alive, those restrictions apply after their death. Further, it implies that one should be concerned with the reputation of historic persons. Research that defeats these interests calls for justification. We have suggested two lines of thinking along which such a discussion could go: investigating the truth-value of the good name and the relevance of bringing it into possible disrepute. (shrink)
This paper argues that advertisements have been wrongly conceived as appealing to the irrational. Advertisements contain a structure of argumentation, but often far more complex than would initially appear. Advertisements give reasons for consumers to choose products, voters to elect a candidate, or citizens to alter their behavior. The way they do so is to best explained in terms of their argumentative structure.
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