Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

The aim of the present paper is to examine the contribution of evaluative conditioning (EC) to attitude formation theory in social psychology. This aim is pursued on two fronts. First, evaluative conditioning is analysed for its relevance to social psychological research. We show that conditioned attitudes can be acquired through simple co‐occurrences of a neutral and a valenced stimulus. Moreover, we argue that conditioned attitudes are not confined to direct contact with a valenced stimulus, but can be formed and dynamically (...) reformed indirectly, through association chains. Second, social research is examined in an effort to identify evaluative learning mechanisms. We suggest that several important phenomena in social psychology (e.g., ingroup favouritism, prejudice, name letter effect) are at least partly due to simple mechanisms of evaluative learning. The implications for attitude formation theory and for applied settings are discussed. (shrink)

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

Robots are increasingly envisaged as our future cohabitants. However, while considerable progress has been made in recent years in terms of their technological realization, the ability of robots to inter-act with humans in an intuitive and social way is still quite limited. An important challenge for social robotics is to determine how to design robots that can perceive the user’s needs, feelings, and intentions, and adapt to users over a broad range of cognitive abilities. It is conceivable that if robots (...) were able to adequately demonstrate this, humans would eventually accept them as social companions. We argue that the best way to achieve this is using a systematic experimental approach based on behavioral and physiological neuroscience methods such as motion/eye tracking, electroencephalography (EEG), or functional near-infrared spectroscopy (fNIRS) embedded in interactive human-robot paradigms. This approach requires understanding how humans interact with each other, how they perform tasks together and how they develop feelings of social connection over time, and using these insights to formulate design principles that make social robots attuned to the workings of the human brain. In this review, we put forward the argument that the likelihood of artificial agents being perceived as social companions can be increased by designing them in a way that they are perceived as intentional agents that activate areas in the human brain involved in social-cognitive processing. We first review literature related to social-cognitive mechanisms involved in human-human interactions, and high-light the importance of perceiving others as intentional agents to activate these brain areas. We then discuss how attribution of intentionality can positively affect human-robot interaction by (a) fostering feelings of social connection, empathy and prosociality, and by (b) enhancing performance on joint human-robot tasks. Lastly, we describe circumstances under which attribution of intentionality to robot agents might be disadvantageous, and discuss challenges associated with designing social robots that are inspired by neuroscientific principles. (shrink)

Illuminates childrens experiences of embodiment, inter-subjectivity, place, thing, time, and language through a dialogue between developmental research and ...

Anomie, a societal and anomia an individual characteristic is employed to understand the behaviour of people and more recently it has been used to explore and understand the moral behaviour of people at work. This article reports on research undertaken to explore the relationship between organisational interest, ethical ideologies, employment, religion and ethnic origin on work and nonwork anomia. An objective of this research was to ascertain whether participants that were not employed had lower levels of work-related anomia than those (...) that were employed. The sample consisted of students (N = 209) enroled in management degrees in a UK university. Results indicate that overall work anomia was statistically significant higher than nonwork anomia. Employment status had a significant effect on levels of nonwork anomia. Religion and ethnic origin were also found to have a significant effect on anomia levels. The findings indicate that the work context may be perceived as inherently anomie and this perception is then adjusted according to the actual experience at work. This may influence ethical behaviour and explain the ethical regression that is identified in the work context. (shrink)

The author investigates the notion of linguistic meaning in gender research. She approaches this basic problem by drawing upon two very different conceptions of language and meaning: that of the logician Gottlob Frege and that of the linguist Ferdinand de Saussure. Motivated by the controversial response the Anglo-American sex/gender debate received within the German context, the author focuses on the connection between this epistemological controversy among feminists and two discursive traditions of linguistic meaning , to show how philosophy of language (...) can contribute to current feminist debates. (shrink)

The paper deals with the position of a scholar in the society, as articulated in the philosophy of J. G. Fichte. It also offers a brief outline of the philosophies of education of the 18th and 19th centuries and their differences. It shows different interpretations of the concept of Bildung in German philosophy, which in that time became almost a “fashion”. The spirit of that time is reflected also in the idealist views of J. G. Fichte, especially those concerning education, (...) upbringing and personality development. (shrink)

The paper tries to explain the nature and meaning of education, as well as its role in human life. Education appears to be taken for granted. Nevertheless, we need to understand its nature and ontological background. Thus the paper aims at giving at least a partial answer to the question: What is education?

The word 'bisexuality', unknown to the ancients, is used here in two senses to indicate an individual with male and female sex organs or who copulates with people of both sexes. The phenomenon of bisexuality is then analysed with reference to the Greek myth of Hermaphrodite, a 'bisexual' being, born of a nymph's love for a young man of divine descent: in the guise of a fable, the myth recounts the birth of a 'monster', who raises a question-mark over the (...) fundamental rule of the division between the sexes. As regards behaviour, the paper then shows that in both Greece and Rome bisexual behaviour was the rule for men. The concept of 'homosexuality', in contrast to heterosexuality, was not introduced till the Christian era, and then not without difficulty. Condemnation of the practice as 'against nature' began with the emperor Justinian in the 6th century. (shrink)

If one of the most important aims of education on military ethics is to strengthen moral competence, we argue that it is important to base ethics education on virtue ethics, the Socratic attitude and the process of ?living learning?. This article illustrates this position by means of the example of a ?train the trainer? course on military ethics for Non-Commissioned Officers (NCOs), which is developed at the Netherlands Defence Academy, and uses a number of examples both from its structure and (...) from experiences from its actual use. (shrink)

A previous paper in this Journal, ‘Must Managers Leave Ethics at Home? Economics and Moral Anomie in Organisational Decisions’1 explored the scope for moral decision making in organisations and developed the concept of moral anomie, the absence of moral awareness and judgement in organisational decisions. We suggested that the industrial economy developed within a framework of neoclassical economics and scientific enquiry to the exclusion of ethics. This paper reports on a subsequent exploratory research project in three disparate Australian organisations. It (...) sought to establish whether individuals acting in and for organisations find themselves able to exercise moral autonomy in making organisational decisions or are likely to make morally heteronomous or anomous decisions. (shrink)

Considered by many Taoists and non-Taoists alike to be an essential guide to living, Lao-tzu's Treatise on the Response of the Tao was written by the twelfth-century sage Le Ying-chang. Presenting foundational teachings and practices of the Action and Karma school of Taoism, it is replete with folk stories illustrating the teachings and an introductory essay that discusses the more esoteric meaning of the passages. Told with clarity and depth, these seminal Taoist teachings offer guidance on leading a balanced healthy (...) life. (shrink)

The easiest and most tempting solution of these problems is to dissolve them by pointing out the artificiality of the issues leading to these "third things." Though tempted, I am not convinced that Kant's philosophy can be treated thus as an exercise in a complicated solution of pseudo-problems. Also, I would thereby deprive myself of the uncomfortable and nagging sense of obscure importance which assails me—and many Kant students share this feeling—whenever I consider these points. I am prepared to admit (...) that the problems may be represented as artificial. But I want to maintain, with special emphasis on the Kantian schema, that a serious reconsideration repays the effort, even if it should force us to reconsider critically also some of Kant's systematic assumptions. (shrink)

Infants who suffer severe neglect fail to thrive emotionally as well as bodily. The absence of early coexistential structures that provide well-being leads to a narrowing of the child's perceptual and social developmental horizon. What is the nature of these early structures? In this essay, an ontology of well-being or housedness is elaborated through phenomenological reflections on breast-feeding and infant perception. Merleau-Ponty's ontology of the flesh makes a contribution to the ontology of well-being: it gives us a conceptual and evocative (...) language to describe human existence in its pre-verbal, syncretic, and non-dualistic manifestations. It also allows for a re-evaluation and re-interpretation of the results of current research in infant perception. Through the structures of infant perception we perceive the coexistential fit between infants, other human beings, and the world of things. An infant's fundamental housedness in the flesh is taken up and cultivated or destroyed by the child's social and cultural environment. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

In this chapter, I clarify the notions of mental content and of concept. I present competing views on these notions and indicate my own position. I introduce content in terms of correctness conditions and distinguish several kinds of propositions, as well as non-propositional scenario content, with which perceptual content might be identified. I relate this discussion to a wide-spread commitment in philosophy of perception to respect the subject’s perceptual perspective in ascriptions of perceptual content. Then I compare views of concepts (...) as Fregean senses, as mental representations, and as cognitive abilities and investigate how they relate to the central idea that concepts are possessed by subjects. I suggest that our talk of concept possession and exercise is anchored in subjects’ abilities for re-identification and for general thought and in their inferential abilities. I clarify how possession and exercise of these three conceptual abilities relate. (shrink)

Goethe belongs to the phenomenological tradition for a number of reasons: He shared Husserl's deep mistrust of the mathematization of the natural world and the ensuing loss of the qualitative dimension of human existence; he understood that the phenomenological observer must free him/herself from sedimented cultural prejudices, a process which Husserl called the epoche; he experienced and articulated the new and surprising fullness of the world as it reveals itself to the patient and participatory phenomenological observer. Goethe's phenomenological sensibilities and (...) insights become more apparent when his work is brought into dialogue with Husserl's thinking. In turn Goethe challenges Husserlian phenomenology to a more careful investigation of the natural world and human participation within its order. Both Goethe and Husserl are searching for a science of the qualitative dimension of being. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (shrink)

This article explores Southern Saami reindeer herders’ experiences and contestations over state consultation and corporate dialogue during a conflict over the Øyfjellet wind energy project in Norway. Informed by a committed research approach and juxtaposition with findings from Indigenous peoples' territorial struggles in Latin-America, the article provides critical perspectives on governance practices in a Nordic-Saami green colonial context. The research draws on ethnography from a consultation meeting between Jillen Njaarke, the impacted reindeer herding community, and state authorities, as well as (...) diverse written material. The study suggests that the state- and corporate-led “dialogues” displaced the root cause of the conflict, revealed epistemic miscommunication, and perpetuated relations of domination which limited emancipatory effects for Jillen Njaarke. The premises and discourses underpinning the “dialogues” further reproduced racist notions which devalue ancestral Saami reindeer herding knowledges, practices, and landscape relations. These findings challenge dialogue as prescription of good governance and conflict resolution in a context where democracy and compliance with Indigenous peoples’ rights are perceived as high. (shrink)

Eva Simantoni-Bournia Un masque humain à Hyria de Naxos, nouveau témoignage de contacts chypriotes p. 119-132 Neuf tessons d'un masque en terre cuite représentant une figure masculine barbue presque grandeur nature, datés de la fin du VIIIe - début du VIIe siècle av. J.-C., ont été découverts en 1994 dans le sanctuaire d'Hyria à Naxos. Ce masque naxien doit son importance à la rareté de ce type d'objets, surtout à haute époque. Les masques en terre cuite du sanctuaire d'Orthia à (...) Sparte, les plus connus et les plus étonnants du monde grec, sont presque tous plus récents et la plupart relève d'une tradition stylistique différente. Les masques en terre cuite du Chypro-Géométrique I mis au jour dans les sanctuaires de Kition et de Salamine à Chypre constituent les parallèles les plus proches de l'exemplaire d'Hyria. Cet article propose que le masque barbu idéalisé d'Hyria était porté, lors d'une sorte de représentation (δρώμενον), par celui qui jouait le rôle de l'époux de la déesse de la fécondité vénérée avec Dionysos dans le grand sanctuaire naxien et identifiée à Ariane. La représentation — fréquente dans le culte de Dionysos — d'une sorte d'union rituelle dans les pratiques cultuelles d'Hyria est vraisemblable. Les contacts chypriotes, confirmés par notre masque, étayent le rapprochement de l'Ariane naxienne avec la grande déesse chypro-orientale, que nous avons proposé jadis sur la base des trouvailles du sanctuaire et à partir des témoignages littéraires. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

This article explores the ways in which ultrasound screening influences the temporal dimensions of prevention in the obstetrical management of pregnancy. Drawing on praxeographic perspectives and empirically based on participant observation of ultrasound examinations in obstetricians’ offices, it asks how ultrasound scanning facilitates anticipatory modes of pregnancy management, and investigates the entanglement of different notions of time and temporality in the highly risk-oriented modes of prenatal care in Germany. Arguing that the paradoxical temporality of prevention—acting now in the name of (...) the future—is intensified by ultrasound screening, I show how the attribution of risk regarding foetal growth in prenatal check-ups is based on the fragmentation of procreative time and ask how time standards come into play, how pregnancy is located in calendrical time, and how notions of foetal time and the everyday life times of pregnant women clash during negotiations between obstetricians and pregnant women about the determination of the due date. By analysing temporality as a practical accomplishment via technological devices such as ultrasound, the paper contributes to debates in feminist STS studies on the role of time in reproduction technologies and the management of pregnancy and birth in contemporary societies. (shrink)

Although consolation is one of the classic religious subjects it plays no role in the current debate about religious emotions. One reason for this neglect could be that this debate is mostly based on classical emotions such as joy and fear, love and hope, and that consolation is not understood as an emotion. This paper tries to show that consolation in fact can and should be seen as an emotion. After naming and refuting some reasons that speak against taking consolation (...) to be an emotion, I will explain how consolation can be positively conceptualized as an emotion within a recent theory of emotions. It will be decisive to see that the experience of consolation can be understood not only hedonistically-qualitatively, but also intentionally. This structural conception allows for a differentiated description of various types of consolation as an emotion, also, in the tradition of William James, of a secular as well as a religious form of consolation. (shrink)

This text reconstructs the Kohlberg/Gilligan controversy between a male ethics of justice and a female ethics of care. Using Karl-Otto Apel's transcendental pragmatics, the author argues for a mediation between both models in terms of a reciprocal co-responsibility. Against this backdrop, she defends the circular procedure of an exclusively argumentative-reflexive justification of a normative ethics. From this it follows for feminist ethics that it cannot do without either of the two types of ethics. The goal is to assure the evaluative (...) variety of different types of an ethics of the good without endangering the normative boundaries of a deontological discourse ethics. (shrink)

In this chapter, I discuss arguments for the claim that a subject can both have an experience with a certain content and not be in possession of all the concepts needed to specify this content. If she does not possess all the relevant concepts, then she cannot exercise them. So, she can undergo such an experience without being required to exercise all the concepts needed to specify its content. The argument from memory experience goes back to Martin (Philos Rev 101:745763, (...) 1992). Since we can extract new information from memories of previous experiences when we acquire new concepts, the content of these previous experiences cannot have been fully conceptual. The argument from animal and infant perception presupposes that some subjects who lack concepts of any kind nonetheless have perceptual experiences with the same kind of content as human perception. So, the content of human perception must be nonconceptual just like the perceptual contents of these subjects. The third argument, the argument from concept acquisition (Roskies, Philos Phenomenol Res 76:633659, 2008; Noûs 44:112134, 2010), shows that we cannot explain how subjects acquire some of their first concepts, particularly perceptual-demonstrative concepts, unless we assume that experience content is nonconceptual. The question of whether a subject can have a conscious perceptual experience only if she is able to cognitively appreciate its content is a recurrent theme in the chapter; it is answered in the negative by Modest Nonconceptualism. (shrink)

In this paper, I discuss the conceptualist claim that we cannot speak of perceptual content unless we assume it is objective content. The conceptualist argues that only conceptual content can meet the requirement of being objective, so that the view that perceptual experience has nonconceptual content is not tenable. I start out by presenting the argument from objectivity as it can be found in McDowell. I then present the following objections: First, perceptual objectivity cannot be due to the perceiver’s conception (...) of objectivity; and second, even nonconceptual capacities of the individual cannot and need not be appealed to in order to account for objective perceptual content. (shrink)