Der Selbstbestimmungdes Patienten kommt in der modernen Debatte über das Gesundheitswesen eine zentrale Bedeutung zu. Selbstbestimmung ist aber ein voraussetzungsvoller Begriff, der für Patientengruppen wie Demenzbetroffene, deren Entscheidungs- und Einwilligungsfähigkeit nachlässt oder nicht mehr gegeben ist, eine Reihe von Fragen aufwirft. Auf der Grundlage der jeweiligen Symptomentwicklung der Demenzerkrankung und eigener Erfahrungen im Umgang mit Demenzbetroffenen wirdde rEntwicklungdes Willens in den verschiedenen Stadien der Demenz nachgegangen. Dabei wird den Dimensionen der Differenziertheit der Denkinhalte, der Beurteilungsbasis und der Entscheidungskonstanz eine besondere (...) Bedeutung zugemessen und für eine Graduierung der Selbstbestimmungsmöglichkeiten im Umgang mit Demenzbetroffenen plädiert. Wegen der Schwererkennbarkeit der oft verschlüsselten Willensbekundungen Demenzbetroffener wird der Willenswahrnehmung und dem Training der genauen Beobachtung, Einfühlung und Sensibilität im Umgang mit den Betroffenen großes Gewicht beigemessen. Als Ziel wird die jeweils weitestgehende Selbstbestimmung, im Verlaufe der Erkrankung auch Teilselbstbestimmung und schließlich Mitwirkung bei der individuellen Wohlbestimmung im Sinne eines Grundrechtsschutzes vertreten. (shrink)

Die jüngste höchstrichterliche Rechtsprechung zur Selbstbestimmung der Patienten und zur Normierung medizinischer Handlungen am Lebensende hat eine intensive Debatte ausgelöst. Das Urteil und die akademisch vorgetragene Kritik werden einer grundlegenden medizinethischen Analyse unterworfen. Sie betrifft die objektive Eingrenzung der Zulässigkeit einer Behandlungsbegrenzung und die Subsumtion des Wachkomas als irreversibel tödliches Grundleiden, das ärztliche Ermessen bei der Indikationsstellung, die normative Einordnung einer Ernährungstherapie am Lebensende und die Verbindlichkeit von Patientenverfügungen. Die medizinethische Kritik offenbart eine unzureichende Wahrnehmung medizinischer und medizinethischer professioneller Dokumente (...) und den Rückgriff auf medizinethisch veraltete Konzeptionen der Sterbehilfe durch das Gericht. Die Folge ist eine fehlerhafte Subsumtion der Wachkomapatienten in die Kategorie irreversibel tödlicher Erkrankungen und eine inhaltliche Schwächung der Verbindlichkeit von Patientenverfügungen. Beides bedarf dringend der Korrektur. (shrink)

Ein Leitmotiv der medizinethischen Auseinandersetzung mit der tiefen Hirnstimulation (THS) ist die Beschäftigung mit Fragen personaler Identität. Da es sich bei personaler Identität auch um ein Problem der theoretischen Philosophie handelt, wird in diesem Aufsatz nicht nur die praktische Frage nach der ethischen Legitimation der THS durch informierte Einwilligung gestellt und ein modifiziertes Legitimationskriterium für wesensändernde THS erarbeitet. Vielmehr wird zunächst versucht, das Problem, um das es in der Debatte um THS und personaler Identität geht, besser zu verstehen.

Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

Resnik’s argument relies upon an undefended and unjustified overvaluation of liberty. First, he overlooks some important arguments in favour of restrictions to liberty, and his consideration of the two he does review is unfair; second his account grossly overestimates the autonomy of our food choices; and lastly his mechanism for balancing liberty against other concerns involves an illicit double counting of the weight of individual liberty.

Combining the methodologies of art history, aesthetics and cultural history, this book opens up new ways of looking at the phenomenon of ruins.

A partir de algunos motivos presentes en Poesie in forma di rosa, La Divina Mimesis y, sobre todo, Petrolio, atenderemos algunos motivos de la propuesta estética de Pasolini en relación con la crítica de lo político. Lo que inicialmente parece una crítica o semiología de la sociedad y lo político se revela, con el tiempo, como un problema artístico en el cual el arte es en sí político y lo político es en sí artístico. Este asunto no es más que (...) el de la forma tal y como aparece en las mencionadas obras del poeta. (shrink)

_The Contradictions of Modern Moral Philosophy_ is a highly original and radical critique of contemporary moral theory. Paul Johnston demonstrates that much recent moral philosophy is confused about the fundamental issue of whether there are correct moral judgements. He shows that the standard modern approaches to ethics cannot justify - or even make much sense of - traditional moral beliefs. Applied rigorously, these approaches suggest that we should reject ethics as a set of outdated and misguided claims. Rather than facing (...) up to this conclusion, most recent moral philosophy consists of attempts to find some ways of preserving moral beliefs. This places a contradiction at the heart of moral philosophy. As a resilt it is often impossible to tell whether a contemporary philosopher ultimately rejects or endorses the idea of objective right and wrong. On the basis of a Wittgenstein approach Paul Johnston puts forward an alternative account of ethics that avoids this contradiction and recognises that the central issues of ethics cannot be resolved by conceptual analysis. He then uses this account to highlight the contradictions of important contemporary moral theorists such as Bernard Williams, Alasdair MacIntyre, Thomas Nagel and Charles Taylor. (shrink)

ABSTRACT Many people now believe that human reproductive cloning – once sufficiently safe and effective – should be permitted on the grounds that it will allow the otherwise infertile to have children that are biologically closely related to them. However, though it is widely believed that the possession of a close genetic link to our children is morally significant and valuable, we argue that such a view is erroneous. Moreover, the claim that the genetic link is valuable is pernicious; it (...) tends to give rise to highly undesirable consequences, and therefore should be combated rather than pandered to. The emphasis on the genetic is unwarranted and unfortunate; rather than giving us moral reason to support reproductive cloning in the case of infertility, the fact that cloning requests are likely to be motivated by the genetic argument gives us reason to oppose its availability. (shrink)

Everything and every word about spirituality have already been said but the practical utility of spiritual wisdom in day to day life to achieve success and live a blissful life is lacking. Spiritual wisdom not only shows us the path of salvation and freedom but also helps us to figure out the solutions for every problem in all walks of human life and civilization. Spirituality is a well-defined, scientific way to get any goal in life whether it is for justified (...) worldly desires or to fulfil the urge of salvation with a blissful route. The book is an important read for the present generation, i.e. our youth as well as the persons those who want to touch the divinity within. Due to the universal nature of Spiritual Wisdom, it is bound to be on the shelves of the coming generation as spiritual science is not something that can be restricted to any one generation. The book itself contains the aura of mysticism and a touch of the great teaching taken from the scriptures. The book will teach how spiritual wisdom may change a person’s life. (shrink)

A caveat: The topic of abortion is both highly controversial and extremely complex, and I certainly cannot hope to address all of its important ethical aspects in the brief notes that follow. Readers are urged to consult a good annotated bibliography such as the one compiled by James DeHullu for references to more extensive scholarly treatments of abortion.

A relatively high incidence of unsatisfactory review decisions is widely recognised and acknowledged as ‘the peer review problem’. Factors contributing to this problem are identified and examined. Specific examples of unreasonable rejection are considered. It is concluded that weaknesses of the ‘peer review’ system are significant and that they are well known or readily recognisable but that necessary counter-measures are not always enforced. Careful management is necessary to discount hollow opinion or error in review comment. Review and referee functions should (...) be quite separate. (shrink)

Im Zuge des „empirical turn“ der Medizin- und Bioethik ist von verschiedenen Autoren in den vergangenen Jahren die Idee einer „evidenzbasierten Ethik“ diskutiert worden. Die Analogie zwischen evidenzbasierter Medizin und „evidenzbasierter Ethik“ soll in diesem Beitrag kritisch diskutiert und dabei gezeigt werden, dass der Ausdruck „evidenzbasierte Ethik“ irreführend ist. Zentraler Ausgangspunkt der Kritik ist die unterschiedliche Bedeutung, die empirische Informationen für das medizinisch-klinische Urteil zum einen und das ethische Urteil in der Medizin zum anderen haben. Im medizinisch-klinischen Urteil können mit (...) Hilfe empirischer Informationen hypothetische Handlungsnormen generiert werden, welche auf den der Medizin inhärenten Zwecksetzungen basieren. Bei Fragen der Ethik in der Medizin hingegen sind die Handlungsziele selbst Gegenstand des Urteils; diese aber können allein aus empirischem Wissen heraus nicht zureichend bestimmt werden. Die Diskussion um die Möglichkeit einer „evidenzbasierten Ethik“ eröffnet weiterhin aufschlussreiche Perspektiven in Bezug auf empirische Forschung und den Umgang mit empirischen Informationen in der Angewandten Ethik und das Aufgabenfeld der Medizinethik. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NEWMAN'S PSYCHOLOGICAL DISCOVERY: THE ILLATIVE SENSE (Continued) VI THE FACULTIES OF COGNITION AND APPETITION Since the Grammar of Assent gives us a phenorhenological analysis of the art of thinking and often refers to the influence of other faculties in our reasoning processes, it will be very instructive to examine what the author holds about our faculties of cognition and appetition. This will make us better acquainted with the nature (...) of the illative sense. I. THE SENSES 1. The External Senses and their Objects. We had already arrived at the conclusion that Newman rejects the mere subjectivity of our knowledge. When he writes about this matter he explicitly deals with sensation or sensuous cognition. Although he takes exception to the word "immediate perception," 1 we may nevertheless call him an adherent of direct or immediate realism according to Scholastic terminology, because he emphatically excludes the intervention of a reasoning process from sense perception and uses the term "mediate perception" only to express the instrumentality of experience. In this meaning our perception of external objects is mediate or indirect indeed.2 The fact is that as early as 1839 he wrote in his University Sermons: "Of the material we have direct knowledge through the senses"3 and in 1843: "The senses are direct, immediate, and ordinary informants, and act spontaneously without any will or effort on our part."4 On the importance of sense perception for our mental activities he writes in a series of hitherto unpublished notes, entitled Elements of Thought:6 "I grant or I assume that the soul would not think without some external stimulus; that if it were cut off from all communication from the external world, it would pass this life in a sort of torpor... But then, as soon as it is roused, it reflects upon itself, and thereby gains a number of ideas..." 1. See supra V, 14.2. Supra V, 14.3. P. 205. 4.P. 303 ; cf. Gramm., p. 260. 5.See the unpublished Philosophical Papers, note Fcbr. 24, 1859. 40 DR. ZENO, OJM. CAP.41 Apart from the passages already referred to, Newman nowhere enlarges on the doctrine about the senses. He does not speak about the distinctions between sensible objects; he does not explain the difference between sensation and perception, and uses those terms promiscuously.6 There are no statements on the subject which contradict current Scholastic notions, although sometimes his vague terminology may be an occasion for misunderstandings. For instance, some passages in connection with "images" and "impressions," when read apart from the context, would appear to imply that he identifies them with the Scholastic species a sensibili accepta. However, we shall show further on that. Newman means something quite different. He deals with these species and the so-called sensibilia per acci· dens by the way when describing our knowledge of God7 and teaching that we have evidence of the presence of individuals or substances in the phenomena which occur to our senses. We picture those things to ourselves in those phenomena. They are like pictures, he says, but at the same time "they give us no exact measure or character of the unknown things beyond them." "Therefore when we speak of our having a picture of the things which are perceived through the senses, we mean a certain representation, true as far as it goes, but not adequate." 2. The Internal Senses and their Objects. Newman nowhere gives a distinction between external and internal senses, but nevertheless he speaks about those faculties of the mind which by the Scholastics are called the internal senses. These philosophers distinguish a common sense or rather a central sense (sensus communis), which unites the impressions of the external senses into one whole, makes us conscious of the conditions of our body and notifies to us the sensations of our external as well as internal senses; — the imagination or the faculty which preserves and reproduces things perceived; — the sensuous memory, i. e., the power to retain and to reproduce sense images; — and the vis aestimativa or the instinctive faculty, which discovers without any intellectual means, what is good and what is bad for our welfare. 6.It would seem that he generally... (shrink)

Historically, scientists in training have learned the rules of ethical conduct by the example of their advisors and other senior scientists and by practice. This paper is intended to serve as a guide for the beginning scientist to some fundamental principles of scientific research ethics. The paper focuses less on issues of outright dishonesty or fraud, and more on the positive aspects of ethical scientific behavior; in other words, what a scientist should do to maintain a high level of ethical (...) conduct in research.There are a number of fairly specific rules, guidelines, or commonly accepted operating principles that have evolved for the ethical conduct of science. In order to discuss this code of ethics, this paper is divided into sections dealing with specific areas of scientific ethics. These areas are: data collection and storage, ownership of data, confidentiality, communication, authorship, collaboration, the peer review system, and rules of dealing with ethical complaints. Illustrative case histories are presented to provide examples of the type of ethical dispute or problem being discussed. If scientific trainees learn the accepted rules of behavior that govern the conduct of science, ethical problems that arise out of ignorance, misunderstanding, or poor communication can be avoided. (shrink)

In diesem Artikel geht es um die Beziehungen zwischen der von Jürgen Habermas entwickelten Diskursethik und den Studierendenseminaren, die der Ulmer Arbeitskreis „Ethik in der Medizin“ veranstaltet. Zunächst erfolgt eine Darstellung der Kernaussagen der philosophischen Diskursethik. Sie liefert eine formale Argumentationsprozedur, mit der es möglich ist, die Legitimität strittig gewordener Normen im Diskurs zu prüfen. Anschließend wird das in Ulm von Baitsch und Sponholz entwickelte Modell der Seminare „Ethische Entscheidungskonflikte im ärztlichen Alltag“ vorgestellt. Da sich die Ulmer Seminare unter anderem (...) auf die Diskursethik als theoretischen Hintergrund berufen, werden die Gemeinsamkeiten und Unterschiede beider Konzepte untersucht. Der Hauptunterschied ist der zwischen einem Begründungs- und einem Anwendungsdiskurs. Gemeinsam sind den Ansätzen die grundsätzlich kognitivistische Einstellung und die „Spielregeln“ des Diskurses. (shrink)

The similarity of documents in a large database of published Fractals articles was examined for redundancy. Three different text matching techniques were used on publisheds to identify redundancy candidates, and predictions were verified by reading full text versions of the redundancy candidate articles. A small fraction of the total articles in the database was judged to be redundant. This was viewed as a lower limit, because it excluded cases where the concepts remained the same, but the text was altered substantially.Far (...) more pervasive than redundant publications were publications that did not violate the letter of redundancy but rather violated the spirit of redundancy. There appeared to be widespread publication maximization strategies. Studies that resulted in one comprehensive paper decades ago now result in multiple papers that focus on one major problem, but are differentiated by parameter ranges, or other stratifying variables. This ‘paper inflation’ is due in large part to the increasing use of metrics (publications, patents, citations, etc) to evaluate research performance, and the researchers’ motivation to maximize the metrics. (shrink)

The paper uses the Offenders' Social Reintegration Project, run between 1988 and 1998 by the Aristotle University of Thessaloniki, Greece, to discuss the characteristics of new forms of action research and to reflect on the main debates within action research literature. Firstly, new forms of action research dealing with community issues tend to take place within complex systems, aiming to bring potential partners together and to facilitate the development of networks of organisations. Networking presupposes a more open-ended mode of research (...) and opens the question of participation of the social groups concerned. The varying and changing degrees of participation within the Project are described with reference to the role of the researchers and the discrepancy between formal and informal partnerships. Secondly, the relation between research and action is dealt with via a discussion of the different types of knowledge produced in the course of the Project and their appropriateness for informing and evaluating practice. The implications of these arguments for the scientific status of action research and the paradigm within which it can be located are also addressed. Thirdly, the paper discusses the role of the various institutional contexts in shaping and constraining possible types of research and action. Finally, the type of change pursued by action research projects is considered with reference to the ongoing debate within action research literature on the role of politics, leading to the acknowledgement of the inevitable implication of political negotiations and power in any initiative towards social change. (shrink)

The ability to reason independently from one's own goals or beliefs has long been recognised as a key characteristic of the development of formal operational thought. In this article we present the results of a study that examined the correlates of this ability in a group of 10-year-old children ( N = 61). Participants were presented with conditional and relational reasoning items, where the content was manipulated such that the conclusion to the arguments were either congruent, neutral, or incongruent with (...) beliefs, and either logically valid or logically invalid. Participants also received a measure of working memory capacity (the counting span task) and a measure of inhibitory control (the stop signal task). Indices of belief bias and logical reasoning on belief-based problems were predicted independently by both measures. In contrast logical reasoning on belief neutral problems was predicted by working memory alone. The findings suggest that executive functions play a key role in the development of children's ability to decontextualise their thinking. (shrink)

We propose that institutions consider establishing a position of “Ombudsman for Research Practice”. This person would assume several roles: as asounding board to those needing confidential consultation about research issues — basic, applied or clinical; as afacilitator for those wishing to pursue a formal grievance process; and as aneducator to distribute guidelines and standards, to raise the consciousness regarding sloppy or irregular practices in order to prevent misconduct and to promote the responsible conduct of research. While there are compelling features (...) to this position, many complex issues need to be considered and resolved. We invite readers to respond to questions we raise in the text. (shrink)

Yoga is the spiritual science for holistic development of physical, mental and spiritual aspect of living being. Ayurveda believes an interrelationship between psyche and body and thus if psyche is effected leads to an adverse effect on body and vice versa. Ayurveda is a science of living being which has its broad aim of living healthy life and curing of ailments. The instability of inner psyche (manas) is controlled through yoga. Bhagwat geeta emphasizes yoga as the state of sama sthiti (...) or equilibrium in actions. Acharya Patanjali’s yoga darshan has an impact on Ayurveda and later hatha yoga pradeepika and gheranda samhita’s various yogasana, kriya, mudra, bandha and pranayama were used as a part of treatment. The yogic concept of health and disease enables us to understand that the cause of physical disorder is result of higher levels of psyche (manas).Ayurveda believes that pragya paradh is root cause to diseases and thus pragyashodhan is very important. Ayurveda emphasis yoga and is a way to achieve atma gyana throughpragya shodhana. Ayurveda has given definition of yoga, powers of yogi, scope of yoga, its implication in attainment to highest stage of moksha. Ayurveda and yogic methods can beapplied for preventive, promotive and rehabilitatory health of human being. (shrink)

In den USA haben sich im Wesentlichen drei verschiedene Organisationsformen klinischer Ethikberatung entwickelt: der einzelne Berater, das große Komitee und das Beratungsteam teilweise mit Rückbindung an ein größeres Komitee. Bislang gibt es jedoch weder empirische Daten noch ein Ergebnis der anfänglichen theoretischen Diskussion, ob es ein favorisiertes Modell für die klinische Ethikberatung geben sollte und welches dieses sei. Dieser Artikel argumentiert, dass die Vorzüge, Nachteile und die Erfolgsfaktoren der verschiedenen Organisationsformen in Abhängigkeit von der Zielsetzung klinischer Ethikdienste (KED) bewertet werden (...) müssen. Diese Zielsetzung kann auf einem Spektrum vom „Patientenanwalt“ bis zum „Gewissen der Institution“ angesiedelt sein. Die Zielsetzung bestimmt dabei Aufgabenschwerpunkte, Zusammensetzung, die favorisierte Organisationsform und wünschenswerte Standards. Die Untersuchung stützt sich zum einen auf die Analyse von Interviews mit fünf Vorsitzenden klinischer Ethikkomitees von Harvard Lehrkrankenhäusern in Boston, die jeweils etwa 20 Jahre Erfahrung in klinischer Ethikberatung mit den drei unterschiedlichen Modellen gemacht haben. Zum anderen basiert sie auf der Rezeption der Literatur und empirischen Studien zu KEDs in den USA und Deutschland. Insgesamt scheint das Konsilteam mit Rückbindung an ein Komitee am besten geeignet, die Behandlung einzelner Patienten und das ethische Bewusstsein einer ganzen Organisation zu verbessern. Es vereint die Vorteile der anderen beiden Modelle auf sich, ohne unter deren Schwächen zu leiden. (shrink)

Providing information to consumers in the form of food labels about modern systems of animal farming is believed to be crucial for increasing their awareness of animal suffering and for promoting technological change towards more welfare-friendly forms of husbandry (CIWF, 2007). In this paper we want to explore whether and how food labels carrying information about the lives of animals are used by consumers while shopping for meat and other animal foods. In order to achieve this, we draw upon a (...) series of focus group discussions that were held in Italy as part of a large EU funded project (Welfare Quality®). In the focus group discussions we addressed how, when or if, claims made about the lives of animals on food labels intervened in what the participants bought and ate. We contend that such labels bring the lives of animals to the forefront and act as new ‘subjectifiers’ (Latour, Citation2005: 212) that offer a new tool for becoming an ‘ethically competent consumer’, who cares about the lives of animals while shopping for food. However, this offer is not always easily accommodated within existing competences and previous commitments, as it requires a reassessment of existing, and often intimate, practices of shopping, cooking and eating. We argue that new labels carrying welfare claims, with their intention of increasing market transparency, produce two contrasting outcomes: they open new spaces of action, which offer an opportunity for investing in new competences and for engaging with animal welfare issues, in short, they allow an ‘ethically competent consumer’ to emerge, but they also produce another outcome, or a collateral casualty (Bauman, Citation2007), namely the ethically non-competent consumer. ‘In daily matters, be competent’ (From How to live ethically, the Tao Te Ching). (shrink)

A team of renowned philosophers and a new generation of thinkers come together to offer the first book-length examination of the relationship between philosophical anthropology and animal studies.

Decriminalising Abortion in the UK. What would it Mean, edited by Sally Sheldon and Kaye Wellings (Profess...

Sarah A. Mattice develops a comparative intervention in contemporary metaphilosophy. Drawing on resources from hermeneutics, cognitive linguistics, aesthetics, and Chinese philosophy, she explores how philosophical language is deeply intertwined with the definition and practice of the discipline.

In recent years drastic shifts in the paradigms of politics, economics and technologies have occurred throughout the world. The shifts in these three fields are all related. It is our responsibility to investigate these shifts from the aspects of society and mankind for the prosperity of future generations. For this, societies should share with each other their wisdom and knowledge in an effort to plan for the future.

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

_The Contradictions of Modern Moral Philosophy_ is a highly original and radical critique of contemporary moral theory. Paul Johnston demonstrates that much recent moral philosophy is confused about the fundamental issue of whether there are correct moral judgements. He shows that the standard modern approaches to ethics cannot justify - or even make much sense of - traditional moral beliefs. Applied rigorously, these approaches suggest that we should reject ethics as a set of outdated and misguided claims. Rather than facing (...) up to this conclusion, most recent moral philosophy consists of attempts to find some ways of preserving moral beliefs. This places a contradiction at the heart of moral philosophy. As a resilt it is often impossible to tell whether a contemporary philosopher ultimately rejects or endorses the idea of objective right and wrong. On the basis of a Wittgenstein approach Paul Johnston puts forward an alternative account of ethics that avoids this contradiction and recognises that the central issues of ethics cannot be resolved by conceptual analysis. He then uses this account to highlight the contradictions of important contemporary moral theorists such as Bernard Williams, Alasdair MacIntyre, Thomas Nagel and Charles Taylor. (shrink)

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im deutschen Gesundheitswesen in Zukunft weiter verschärfen. Soll nicht nur kurzfristig akuten Sparzwängen ausgewichen werden, steht – wie in verschiedenen Ländern bereits geschehen – auch Deutschland auf Dauer eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Eines der seit einiger Zeit häufig öffentlich zitierten Kriterien der Verteilung von Mitteln in der Gesundheitsversorgung ist die Eigenverantwortung von Patienten. Deren Berücksichtigung in der Allokation (...) von Ressourcen birgt allerdings zahlreiche Probleme. Der vorliegende Beitrag untersucht die gerechtigkeitstheoretischen Grundlagen und die praktischen Probleme bzw. die möglichen Konsequenzen von Eigenverantwortung als Verteilungskriterium im Gesundheitswesen. Auf der Grundlage eines alternativen gerechtigkeitstheoretischen Vorschlags werden drei Möglichkeiten skizziert, Eigenverantwortung von Patienten im deutschen Gesundheitswesen in gerechter Weise stärker zu betonen. (shrink)

The idea of the Inner is central to our concept of a person and yet is far from being philosophically understood. This book offers a comprehensive account of Wittgenstein's work on the subject and presents a forceful challenge to contemporary views. Written in a non-technical and accessible style, it throws new light both on Wittgenstein's work and on the problem of the Inner self.