This study aims to characterize the different types of certification in the Brazilian citriculture as well as analyze the major changes in the market. The paper also has the objective to discuss how social and environmental factors influence the demand for food certifications and the sustainability and ethics aspects in the field. Therefore, a literature review on the subject was carried out as well as a qualitative research using interviews with certifiers, governmental institutions, farmers, cooperatives and producer associations. The certification (...) is becoming mandatory for those working in foreign markets and for those working nationally; it can be a competitive differential. The organic certification in citriculture shows the highest number of growers. Companies with large areas of citrus and the orange juice processing industry are adhering to this certification in order to maintain themselves competitive in the market. There is an enormous potential of Brazilian citriculture certification, because the certified area is still less than 6 % of the total area. Certification reduces the asymmetry of information and consists of an important step towards sustainability although incapable of solely guaranteeing it. (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal (...) influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)

This paper examines Kirzner's contribution to the study of the equilibrating tendency in economics. By analyzing his interpretation of Jevons’ law of indifference, we participate in the debate on Kirzner association with neoclassicals when discussing the equilibrating tendency. A reconstruction of Kirzner’s use of Jevons’ law is conducted, considering his argumentative strategy when presenting the Austrian economics ideas to other professionals in the field. We conclude that Kirzner drew close to neoclassical economics to emphasize the relevance and uniqueness of Austrian (...) economics. By doing so, we highlight the main differences between the two currents of economic thought. (shrink)

ObjectiveThis study aims to evaluate the effectiveness of the MotivAir program—a phone-based intervention based on Motivational Interviewing principles and techniques—in enhancing adherence to Continuous Positive Airway Pressure therapy among patients with Obstructive Sleep Apnea Syndrome.MethodsA multicenter randomized controlled trial design with random allocation at the level of the individual will be conducted to compare the impact of the experimental program with a control group receiving usual care only in improving selected clinical and psychological parameters in the patients. A minimum sample (...) of 80 participants will be recruited in each center according to the inclusion criteria. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 180 days and will be delivered by a trained nurse. The impact of the MotivAir program on selected primary and secondary outcomes will be measured at baseline, and after 1-, 3-, and 6-month from CPAP initiation.DiscussionParticipants are expected to show an increased level of adherence to CPAP and to acquire the skills and self-confidence necessary to deal with the psychological consequences of their chronic condition. (shrink)

The cinema of Martin Scorsese has been analysed in connection with a wide range of themes and issues. In this paper, through a film-philosophical analysis, we aim to demonstrate how his filmography produces storyworlds pervaded by a tension similar to the one Søren Kierkegaard expressed in his existentialist writings. Indeed, one of the tenets of film-philosophy is that audio-visual media generate, in an affective and experiential manner, complex moral and ethical systems and existential viewpoints with which viewers interact in a (...) direct and creative way. Empathising with the self-sacrifice of the unlikely martyr played by Jake LaMotta or feeling the collapsing certainties of a missionary in seventeenth-century Japan are thus occasions to encounter particular conceptual personae. These characters embody specific iterations of Kierkegaardian knights of faith: existentialist figures whose doom takes in ambiguous film ecologies where the desire for wholesomeness constantly clashes with mortality and finitude. (shrink)

ObjectiveThis study aims to investigate the lived experience in patients with obstructive sleep apnea syndrome and comorbid obesity following after continuous positive airway pressure therapy made with the disease the device, and to identify barriers and facilitators to the use of CPAP to improve rehabilitation provision and aid in disease self-management.MethodsQualitative research was conducted using three focus groups with a representative sample of 32 inpatients undergoing a 1-month pulmonary rehabilitation program at the IRCSS Istituto Auxologico Italiano San Giuseppe Hospital, Verbania, (...) Italy. The focus groups were recorded on tape, and contemporaneous notes were made. The tapes were transcribed verbatim, and Interpretative Phenomenological Analysis was used to develop themes.ResultsSix main themes were extracted: Living the diagnosis as a shock; You should not sleep on it: the importance of prevention; The adjustment to CPAP; Barriers and facilitators to the use of CPAP; Three in a bed; and The relationship with the healthcare system.ConclusionResults of this study suggest potential avenues for interventions to increase adherence to CPAP, including the provision of information and continued support. Individual counseling providing strategies aimed at helping the person to cope with the emotional problem and relational difficulties associated with the use of CPAP, and at strengthening self-efficacy and self-management skills are also encouraged for optimal care during the rehabilitation program. (shrink)

Research on the influence of industry on chemical regulation has mostly been conducted within the framework of the production of ignorance. This special issue extends this research by looking at how industry asserts its interests––not just in the scientific sphere but also at other stages of policy-making and regulatory process––with a specific focus on the types of tools or instruments industry has used. Bringing together sociologists and historians specialized in Science and Technology Studies, the articles of the special issue study (...) the arenas in which instruments and practical guidelines for public policy are negotiated or used. The aim is to observe the devices in the making or in action, from the selection of actors to the production of thresholds, criteria, and other technical regulations. The introduction highlights how industry influence on expertise and regulation is undoubtedly far more pervasive and multifarious than has been conceptualized to date by social scientists. Putting this issue back at the heart of both the STS and social sciences research agendas is increasingly urgent and could lead to new inquiries able to highlight these logics even more widely, using fresh empirical examples. (shrink)

This book consolidates emerging research on Aristotle's science and ethics in order to explore the extent to which the concepts, methods, and practices he developed for scientific inquiry and explanation are used to investigate moral phenomena. Each chapter shows, in a different way, that Aristotle's ethics is much more like a science than it is typically represented. The upshot of this is twofold. First, uncovering the links between Aristotle's science and ethics promises to open up new and innovative directions for (...) research into his moral philosophy. Second, showing why Aristotle thinks ethics can never be fully assimilated to the model of science will help shed new light on his views about the limits of science. The volume thus promises to make a significant contribution to our understanding of the epistemological, metaphysical, and psychological foundations of Aristotle's ethics. (shrink)

The importance of fairness in machine learning models is widely acknowledged, and ongoing academic debate revolves around how to determine the appropriate fairness definition, and how to tackle the trade-off between fairness and model performance. In this paper we argue that besides these concerns, there can be ethical implications behind seemingly purely technical choices in fairness interventions in a typical model development pipeline. As an example we show that the technical choice between in-processing and post-processing is not necessarily value-free and (...) may have serious implications in terms of who will be affected by the specific fairness intervention. The paper reveals how assessing the technical choices in terms of their ethical consequences can contribute to the design of fair models and to the related societal discussions. (shrink)

Since Rorty, the crisis of method and interests in philosophy has been at the forefront of metaphilosophy. In this book, Kai Nielsen, one of the most prominent critics of philosophy-as-usual, examines critically the most important claims made on behalf of philosophy. After rejecting as chimerical the ambitious claims of traditional, especially foundational, epistemology and metaphysics, he presents the case for a more modest view of what philosophy can accomplish.Nielsen insists that philosophy must be devoted to actual problems of (...) real people in everyday life. Influenced substantively by Dewey and more methodologically by Rawls, he carves out a defensible terrain for philosophy to inhabit—a terrain cleared of the more extravagant but implausible claims made by traditional philosophy.Nielsen has been a major voice in debates about the scope of philosophy, and this latest work of his will be an important contribution to the “end of philosophy debate.”. (shrink)

Background Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of (...) the global research projects on health system responses to VAW. Methods We used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW. Results We developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs’ rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research. Conclusions The process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics. (shrink)

Whether regarded as a perplexing object, a morally captivating force, an ineffable entity beyond language, or an inescapably embodied human practice, music has captured philosophically inclined minds since time immemorial. In turn, musicians of all stripes have called on philosophy as a source of inspiration and encouragement, and scholars of music through the ages have turned to philosophy for insight into music and into the worlds that sustain it. In this Handbook, contributors build on this legacy to conceptualize the rich (...) interactions of Western music and philosophy as a series of meeting points between two vital spheres of human activity. They draw together key debates at the intersection of music studies and philosophy, offering a field-defining overview while also forging new paths. Chapters cover a wide range of musics and philosophies, including concert, popular, jazz, and electronic musics, and both analytic and continental philosophy. (shrink)

Addressing the end-of-philosophy debate and the challenge it presents to contemporary philosophy, this book draws on Wittgenstein, Quine, Davidson, Habermas and Foucault, among others. It develops the implications of Richard Rorty's arguments in particular.

Many scientists and doctors hope that affordable genome sequencing will lead to more personalized medical care and improve public health in ways that will benefit children, families, and society more broadly. One hope in particular is that all newborns could be sequenced at birth, thereby setting the stage for a lifetime of medical care and self‐directed preventive actions tailored to each child's genome. Indeed, commentators often suggest that universal genome sequencing is inevitable. Such optimism can come with the presumption that (...) discussing the potential limits, cost, and downsides of widespread application of genomic technologies is pointless, excessively pessimistic, or overly cautious. We disagree. Given the pragmatic challenges associated with determining what sequencing data mean for the health of individuals, the economic costs associated with interpreting and acting on such data, and the psychosocial costs of predicting one's own or one's child's future life plans based on uncertain testing results, we think this hope and optimism deserve to be tempered.In the analysis that follows, we distinguish between two reasons for using sequencing: to diagnose individual infants who have been identified as sick and to screen populations of infants who appear to be healthy. We also distinguish among three contexts in which sequencing for either diagnosis or screening could be deployed: in clinical medicine, in public health programs, and as a direct‐to‐consumer service. Each of these contexts comes with different professional norms, policy considerations, and public expectations. Finally, we distinguish between two main types of genome sequencing: targeted sequencing, where only specific genes are sequenced or analyzed, and whole‐exome or whole‐genome sequencing, where all the DNA or all the coding segments of all genes are sequenced and analyzed.In a symptomatic newborn, targeted or genome‐wide sequencing can help guide other tests for diagnosis or for specific treatment that is urgently needed. Clinicians use the infant's symptoms (or phenotype) to interrogate the sequencing data. These same complexities and uncertainties, however, limit the usefulness of genome‐wide sequencing as a population screening tool. While we recognize considerable benefit in using targeted sequencing to screen for or detect specific conditions that meet the criteria for inclusion in newborn screening panels, use of genome‐wide sequencing as a sole screening tool for newborns is at best premature. We conclude that sequencing technology can be beneficially used in newborns when that use is nuanced and attentive to context. (shrink)

This paper seeks to analyse small‐ and medium‐sized enterprise (SME) managers' representations of corporate social responsibility (CSR) and CSR communication in a corporate communication perspective. The basic question is: how strategic is CSR communication in SMEs? Corporate communication and CSR theories are used to establish an ideal typology of CSR concepts informing an analysis of qualitative data in the form of interviews with three middle managers in two Danish SMEs. A CSR communication model published earlier by the authors is challenged (...) from a SME perspective. Results from an Internet‐based questionnaire survey of 1071 SMEs pave the way for the analysis. Our analysis shows that SME managers clearly have an inside‐out approach to CSR, with a strong emphasis on the internal (corporate culture) dimension. However, SMEs and/or SME managers tend not to communicate externally about the CSR activities of the company. Based on these findings, the paper argues that CSR communication in SMEs is challenged by the global economy and is under revision. The contribution of the paper is to provide an insight into SMEs' present stage in relation to a possible future approach to strategic CSR communication. The paper also reminds us that SMEs have no interest in turning their local and authentic practice into a forced marketing and branding exercise, leaving them with an artificial picture of who they are and strive to be in the future. They should keep on acting locally but force themselves to think globally. (shrink)

What does it entail to study the climate crisis from – or consistently with – a critical realist perspective? The paper addresses this question in three steps. First, it considers the boundaries of critical realism in relation to climate crisis research. In this context it identifies climate science as a field that in important respects resonates implicitly with critical realism. Conversely, a book by human ecologist Andreas Malm is introduced as an example of a work that, while sympathetic to critical (...) realism, in key respects contradicts core features of it. Second, to illustrate what an analysis of the crisis informed by critical realism can look like, the paper brings into focus the main causes of the climate crisis – including the capitalist growth imperative, neoliberalism, and consumer culture. Finally, the status quo project, the green growth project and the degrowth project are identified as fundamentally different ways of approaching the climate crisis. (shrink)

Abstract:There can be ethical understanding of organizational policy issues and that is important. However, there can be policy understanding about what the organization should do without understanding of individual level responsibility. There can be cognitive understanding of both policy and individual level ethics responsibilities and that is important. However, there can be cognitive understanding without affective, emotive concern. Intellectual understanding without affective concern can lead to understanding without motivation. There can be cognitive understanding and affective concern and that is important, (...) but not enough. There can be cognitive understanding and affective concern without effective political method. An action-learning approach to organizational ethics can join cognitive understanding of policy and individual level issues with both affective concern and effective political method. Joining of cognitive understanding, affective concern, and effective political method can stimulate and enable ethical character. (shrink)

Abstract:There can be ethical understanding of organizational policy issues and that is important. However, there can be policy understanding about what the organization should do without understanding of individual level responsibility. There can be cognitive understanding of both policy and individual level ethics responsibilities and that is important. However, there can be cognitive understanding without affective, emotive concern. Intellectual understanding without affective concern can lead to understanding without motivation. There can be cognitive understanding and affective concern and that is important, (...) but not enough. There can be cognitive understanding and affective concern without effective political method. An action-learning approach to organizational ethics can join cognitive understanding of policy and individual level issues with both affective concern and effective political method. Joining of cognitive understanding, affective concern, and effective political method can stimulate and enable ethical character. (shrink)

Quantum mechanical measurements on a physical system are represented by observables - Hermitian operators on the state space of the observed system. It is an important question whether all observables may be realized, in principle, as measurements on a physical system. Dirac’s influential text ( [1], page 37) makes the following assertion on the question: The question now presents itself – Can every observable be measured? The answer theoretically is yes. In practice it may be very awkward, or perhaps even (...) beyond the ingenuity of the experimenter, to devise an apparatus which could measure some particular observable, but the theory always allows one to imagine that the measurement can be made. This Letter re-examines the question of whether it is possible, even in principle, to measure every quantum mechanical observable. Unexpectedly, ideas from com-. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 13.1 (2005) 5-19 [Access article in PDF] Didactology as a Field of Theory and Research in Music Education Frede V. Nielsen Danish University of Education, Copenhagen Two problem areas which both concern the question of music pedagogy as a field of theory and research are addressed in this paper. The first one concerns the question of the normative and prescriptive versus the descriptive (...) and analytical aspects of music pedagogy. The second is about the theory of and the criteria for the selection of content in music education. In order to address these problems it is necessary to formulate certain preconditions, each of which comprises important distinctions. Preconditions and Problem Areas German pedagogical tradition features the term Didaktik, and when the area in question is placed in relation to an educational subject, such as music, the word and the concept of Fachdidaktik (subject-oriented Didaktik) arises. In Scandinavian countries corresponding concepts can be found.1Two features of the German concept of Didaktik should be emphasized. First, it denotes both the theory and science and the planning and decision-making of teaching and learning. Thus it refers to the theoretically oriented as well [End Page 5] as the practically directed concerns in pedagogy. Second, from the point of view of disciplines, Didaktik is part of the discipline of pedagogy, but there are diverging conceptions and theories of how it is to be delimited in relation to other subsections of pedagogy (such as teaching methodology). Roughly speaking, there exists a narrow or specific conception of Didaktik, which is first and foremost concerned with the question of the content, aim, and rationale of teaching and learning, together with the criteria for the selection of content, and a wide conception, according to which practically all problems regarding teaching and learning are viewed as didaktisch (including questions of teaching methods, forms of organization, and the choice of media).Significant arguments can be put forward in favor of the specific concept of Didaktik because it provides the opportunity (and actually the compulsion) to focus distinctly and separately on the fundamental issue of educational content and its selection. From this specific point of view, Didaktik can be defined as dealing with the theory and science, together with planning and decision-making, about the rationale, aim, and content of teaching and learning. The most central didactic question may then be formulated in this way: What is essential to learn, and therefore to teach, and why? In the present context it is important to note that this definition comprises both a descriptive/analytical and a prescriptive/normative determination of Didaktik. Hence arises the first of the problem areas I intend to address in greater detail, that is, the question of the normative and prescriptive character of pedagogy versus its descriptive, analytical, and scientific standing (in the present case that part of pedagogy which I have termed Didaktik).Several types of high-level rationale for the selection of teaching/learning content can be established. For general education in a subject like music (yet with application to other subjects as well) I have formulated four such types, which I also refer to as paradigms.2 Here I use the word "didactics" in the sense of the German Didaktik. The first type I call "basic subject didactics" in which the point of departure is the subject itself and its structure, in our case the subject of music. There is more on this point below. The second type is "ethno-didactics" in which the point of departure is pupil culture and the everyday experience of the pupils or criteria arising out of current local culture. It represents a micro-cultural position in post-modern style. The third type is "challenge didactics" in which the point of departure is the great social problems, such as environmental issues, global North-South relations, conditions of democracy, or for that matter terrorism. This position may be said to have a macro-cultural, problem-oriented, and inter-disciplinary bias. A theory of social criticism is a frequent theoretical anchoring point... (shrink)

Background:Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints.Objectives:To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil.Method:Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. (...) The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models.Ethical considerations:Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande.Findings:The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000).Conclusion:The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician. (shrink)

To claim that companies should not discriminate on the basis of race, gender or religion seems almost as trivial as stating that they should not use forced labor or dump radioactive waste into the local river. Among other things, non-discrimination seems to imply that companies recognize and respect a range of religious preferences, including allowing religious clothing, e.g., by allowing Muslim women to wear headscarves. However, many companies do not believe that employees generally should be allowed to wear the kind (...) of clothes they please. In this paper, we discuss the asymmetry between the status of religious and secular clothing. We conclude that religious exemptions to dress codes can discriminate wrongfully. To solve this problem, companies should not ban religious clothing. Instead, companies should liberalize their dress codes, so that employees would be allowed to wear secular and religious types of clothing on an equal footing. (shrink)

The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...) applications, health equity, and justice considerations of the distributive, formal and social types. The outcomes of these analyses demonstrate that there are ethically compelling reasons for emergency departments to adopt an ethics-informed, policy-based approach to the longitudinal care and management of living-at-risk, frequent users of emergency departments. From a formal justice perspective, the development and uses of such an approach are justified by a demonstrable relevant difference between living-at-risk, frequent users of emergency departments and other persons and groups of patients who visit emergency departments. We propose an example of such a policy-based approach. Examples of possible, pragmatic applications of this approach, which help ensure that aREDFUs who present to the ED are managed in a fair and optimally consistent manner, are provided for the consideration of an urban emergency department’s policymaking working group. (shrink)

To claim that companies should not discriminate on the basis of race, gender or religion seems almost as trivial as stating that they should not use forced labor or dump radioactive waste into the local river. Among other things, non-discrimination seems to imply that companies recognize and respect a range of religious preferences, including allowing religious clothing, e.g., by allowing Muslim women to wear headscarves. However, many companies do not believe that employees generally should be allowed to wear the kind (...) of clothes they please. In this paper, we discuss the asymmetry between the status of religious and secular clothing. We conclude that religious exemptions to dress codes can discriminate wrongfully. To solve this problem, companies should not ban religious clothing. Instead, companies should liberalize their dress codes, so that employees would be allowed to wear secular and religious types of clothing on an equal footing. (shrink)

The problem this article is concerned with is the failure ofmany large organizations in formerly socialist countries and inpublic sectors of market economies to make effective, peaceful,and ethical transformation from command to market responsiveorganization and privatization. There are at least threeimportant behavioral causes of this problem. First, organizationtransformation is blocked because the organization tries tochange "all at once" before the organization has learned how toact successfully in a new for the organization environment as amarket responsive instead of a command organization (...) (Churchman,1971; Quinn, 1980; Nystrom and Starbuck, 1984; Mintzberg andWaters, 1985; Mintzberg, 1994; Goldman, 1994). Second,organization transformation is blocked because "all at oncechange" stimulates so much fear and political opposition thatchange is politically not possible (Argyris and Schon, 1974;Argyris, 1990; Goldman, 1994; Sachs, 1992). Third, organizationtransformation is blocked because the "guardian" ethics syndromeof command organization is less appropriate for market responsiveorganization than a "commercial" ethics syndrome (Jacobs, 1992;Harris, 1995). Gradual intrapreneurship (Burgelman, 1983; Nielsenet al., 1985) can serve as a peaceful and ethical transitionstrategy. Intrapreneurship can help bridge some of thecontradictions between "commercial" vs. "guardian" ethicssyndromes (Jacobs, 1992; Nielsen, 1996). (shrink)

Kap. Rhythmus Ce texte est une section du livre de C. Nielsen, Zeitatomistik und “Wille zur Macht”. Annäherungen an Nietzsche, Tübingen, Attempto, 2014, 134 S. Nous remercions chaleureusement Cathrin Nielsen de nous avoir autorisé à le reproduire ici. Das griechische Wort rhythmos bedeutet zunächst, ähnlich wie schema und tropos, lediglich das Moment der Distinktion und impliziert darin so etwas wie die Abstandnahme einer einförmigen Bewegung von sich selbst. Erst Platon verbindet ihn mit - Philosophie.

ZusammenfassungEinhergehend mit den Fortschritten in der Reanimationsmedizin beschäftigen sich seit den 80er Jahren viele Studien mit der prognostischen Güte von reanimations- und patientenbezogenen Akutmarkern. Generell sollen Prognosemarker die Vorhersagbarkeit des Heilungspotenzials erlauben, sie besitzen dadurch eine Steuerfunktion für das weitere Therapiekonzept. Die Wertigkeit dieser Prädiktoren verändert sich jedoch, wenn sie als Determinanten bei Non-Treatment-Entscheidungen herangezogen werden. Dies aus zwei Gründen: 1. Nach Sichtung der Literatur und eingedenk eigener Studienresultate fehlt bislang ein 100%- sicherer Prognose-Algorithmus für Patienten im posthypoxischen Koma. 2. (...) Der komatöse Patient kann an der Beurteilung der Prognoseaussagen selbst nicht teilnehmen. Es stellt sich somit die Frage: Dürfen Prognosemarker unser moralisches Handeln an der Grenze des Lebens leiten? Die Autoren bejahen diese Frage und sehen eine adäquat moralische Handlungsoption in der Durchführung einer diskurs-pragmatischen Patientenkonferenz. Den Prognosemarkern kommt hier eine Stellvertreterfunktion im Sinne eines „stillen Patientenargumentes“ zu, wodurch die potenzielle Dialogfähigkeit des Patienten als moralisches Anspruchsobjekt gewahrt wird. Im Rahmen einer diskursiven Erörterung wird dann der Einfluss der Prognosedaten an der Entscheidung gewichtet. (shrink)