Limiting intensive care is paid increasing attention. In the echoing call for physicians’ ethical self‐restriction, it is easily overlooked, however, that ethics needs a critical epistemological analysis before it can suffice as an emergency brake to futile treatment. This analysis is provided by the present essay. The authors suggest that the difficulties of resolving moral dilemmas related to limiting intensive care may just be due to the unclarified epistemological status of moral claims. Even if normative ethics cannot prescribe right decisions, (...) but only draw conclusions from defined premises, the premises may or may not be true. Their intertwined descriptive and normative evidence is endorsed in an academic and political discourse. There will necessarily be various demands for rationality in prudent decisions between physicians, their patients and society. These demands are formulated dialogically through critical questions and justified answers. A good argument is the convincing one that, finally and ideally, leads to the absence of open objections. Thus, in the end the rightness of a given decision does not depend on axiomatic moral principles, but is comparative and conditional, as it is given in an omnilateral argument. Neither is it the democratic process of shared decision making that we should evaluate, but rather the argumentative state itself, when we judge the morality of health politics and clinical practice. (shrink)

_English summary_ This article investigates the impact of moral statistics on suicide in Denmark in the 19. century. Championed as a new European social science, moral statistics was able to reveal statistical regularity on social and moral issues – such as suicide. Statistics proved, firstly, that Denmark experienced one of the highest suicide rates in Europe. Secondly, as demonstrated in 1846 by the Danish physician C. J. Kayser, statistics uncovered that suicides over time occurred regularly in the case of frequency, (...) gender distribution, method of self-killing etc.. This new knowledge encouraged Danish statisticians and physicians to look for societal causes rather than the former theological focus on individual sin. The statistical representations of suicide paved the way for two different interpretations of suicide in the second half of the 19. century, one of which linked suicide rates to the evils of modernisation and secularisation of society, emphasizing drunkenness, alcoholism, and moral decline as causes of suicide. Another, less prevalent, explanation stressed the social and economic inequality of industrialisation as the cause of rising suicide rates. ‘The moral explanation’ prevailed and the official statistical reports as well as newspaper articles was clearly affected by the idea that the rising suicide rates of the 19. century reflected an attack on core values of bourgeois society; moral, sobriety and religion. This way suicide statistics was embedded in a broader social representation reflecting a fear of breakdown of traditional values in modern society. (shrink)

The World Health Organization has declared a world pandemic due to COVID-19. In response, most affected countries have enacted measures involving compulsory confinement and restrictions on free movement, which likely influence citizens' lifestyles. This study investigates changes in health risk behaviors with duration of confinement. An online cross-sectional survey served to collect data about the Spanish adult population regarding health behaviors during the first 3 weeks of confinement. A large sample of participants from all Spanish regions completed the survey. Binomial (...) logistic regressions adjusted for socioeconomic characteristics, body mass index, previous HRBs, and confinement context were conducted to investigate associations between the number of weeks confined and a set of six HRBs. When adjusted, we observed significantly lower odds of experiencing a higher number of HRBs than before confinement overall in a time-dependent fashion: OR 0.63; 95% CI: 0.49–0.81 for the second and OR 0.47; 95% CI: 0.36–0.61 for the third week of confinement. These results were equally consistent in all age and gender subgroup analyses. The present study indicates that changes toward a higher number of HRBs than before confinement, as well as the prevalence of each HRB except screen exposure, decreased during the first 3 weeks of COVID-19 confinement, and thus the Spanish adult population may have adapted to the new situational context by gradually improving their health behaviors. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

W E Andersen; Education and the Ethical Concept of a Person or Willie, and the Redoubtable Mr. Chips, Journal of Philosophy of Education, Volume 2, Issue 1, 30.

This paper discusses the uniqueness thesis, a core thesis in the epistemology of disagreement. After presenting uniqueness and clarifying relevant terms, a novel counterexample to the thesis will be introduced. This counterexample involves logical disagreement. Several objections to the counterexample are then considered, and it is argued that the best responses to the counterexample all undermine the initial motivation for uniqueness.

Institutions promoting republican freedom as non-domination are commonly believed to differ significantly from institutions promoting negative freedom as non-interference. Philip Pettit, the most prominent contemporary defender of this view, also maintains that these republican institutions are neutral between the different conceptions of the good that characterise a modern society. This paper shows why these two views are incompatible. By analysing the institutional requirements Pettit takes as constitutive of republican freedom, I show how they also promote negative freedom by reducing overall (...) interference. To avoid this result, republican institutions must be more restrictive and require that citizens conform to a life of political engagement. But then republican freedom will not be a neutral ideal. Rejecting negative freedom therefore means sacrificing neutrality. (shrink)

The revival of republicanism was meant to challenge the hegemony of liberalism in contemporary political theory on the grounds that liberals show insufficient concern with institutional protection against political misrule. This article challenges this view by showing how neorepublicanism, particularly on Philip Pettit’s formulation, demands no greater institutional protection than does political liberalism. By identifying neutrality between conceptions of the good as the constraint on institutional requirements that forces neorepublicanism into the liberal framework, the article shows that neutrality is what (...) neorepublicans must jettison to offer a tenable critique of liberalism. Only then can neorepublicans ensure greater protection against misrule by demanding that citizens participate more actively in politics. They can then also criticize liberalism for failing to appreciate the importance of such protection. (shrink)

Transparency has achieved a mythical status in society. Myths are not false accounts or understandings, but deep-seated and definitive descriptions of the world that ontologically ground the ways in which we frame and see the world around us. We explore the mythical nature of transparency from this perspective, explain its social-historical underpinnings and discuss its influence on contemporary organizations. In doing so, we also theorize in a more general sense about the relationship between myth, as a foundational understanding and description (...) of the world, and the constellation of metaphors, as specific ways of framing and seeing organizational reality, to which it gives rise. While observations and evidence can always be adduced to challenge a particular set of metaphors, the endogenous force of the myth may sustain the overall project. This process is explained with a detailed analysis of the transparency myth. (shrink)

Can groups really be agents or is group agency just a fiction? Christian List and Philip Pettit argue influentially for group-agent realism by showing how certain groups form and act on attitudes in ways they take to be unexplainable at the level of the individual agents constituting them. Group agency is therefore considered not a fiction or a metaphor but a reality we must account for in explanations of certain social phenomena. In this paper, I challenge this defence of group-agent (...) realism by showing how it is undermined by individual-level analysis of how individuals interact within groups. While group agency can be a useful fiction, real agents are at the individual level, not the collective level. (shrink)

Public reason liberals expect individuals to have justificatory reasons for their views of certain political issues. This paper considers how groups can, and whether they should, give collective public reasons for their political decisions. A problem is that aggregating individuals’ consistent judgments on reasons and a decision can produce inconsistent collective judgments. The group will then fail to give a reason for its decision. The paper considers various solutions to this problem and defends a deliberative procedure by showing how it (...) incentivizes information sharing and leads to outcomes most acceptable to the group members. (shrink)

Keine ausführliche Beschreibung für "Einführung in die Ethik" verfügbar.

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Throughout the history of social thought, there has been a constant battle over the true nature of society, and the best way to understand and explain it. This volume covers the development of methodological individualism, including the individualist theory of society from Greek antiquity to modern social science. It is a comprehensive and systematic treatment of methodological individualism in all its manifestations.

John Rawls thinks republicanism is compatible with his political liberalism. Philip Pettit insists that the two conflict in important ways. In this paper, I make sense of this dispute by employing David Chalmers’s method of elimination to reveal the meaning underlying key terms in Rawls’s political liberalism and Pettit’s republicanism. This procedure of disambiguating terms will show how the two theories defend the same institutional arrangement on the same grounds. The procedure thus vindicates Rawls’s view of the two theories being (...) compatible. The reason for this compatibility is that both theories are politicized—that is, they are constructed to attract the compliance of all reasonable members of a modern, pluralistic society. (shrink)

The first part of the paper is mainly descriptive. Starting from a short historical sketch of the European construction process, from the initial Treaty of Rome to the actual Treaty of the European Union, the changing trade-offs between the environmental and the economic domain will be overviewed. We will focus on a pragmatic examination of the texts, in their dynamic historical evolution.The second part is evaluative. Examining the fifth Environmental Action Programme more in detail, we will try to determine for (...) which environmental ethics the E.U. stands, as confronted with the alternative paradigm defended by environmentalists and the Green Group in the European Parliament. Is the environmental issue a unifying or a dividing factor in the contrasting cultural landscape of the Old Continent? I think probably Cortona is an excellent place to ask such a speculative question, because we are not far away from Assisi, where a successful Interfaith Meeting on the Environment was organised by the W.W.F. in 1986. (shrink)

Many people who claim to genuinely care about nature still seem reluctant to ascribe intrinsic value to it. Environmentalists, nature friendly people in general, and even environmental activists, often hesitate at the idea that nature possesses value in its own right—value that is not reducible to its importance to human or other sentient beings. One crucial explanation of this reluctance is probably the thought that such value—at least when attached to nature—would be mysterious in one way or another, or at (...) least very difficult to account for. In addition, Bryan Norton’s influential convergence hypothesis states that, from a practical point of view, it makes no or little difference whether we ascribe intrinsic value to nature, given the depth and variety of instrumental value it possesses. In this paper, I argue that people who genuinely care about nature cannot avoid ascribing intrinsic value (in a certain sense) to it, if they want to be able to consistently defend the kind of claims about protecting nature they arguably want to make, i.e., claims to the effect that we ought to protect for instance nature areas and species. The cost of denying intrinsic value in nature is the cost of giving up a crucial resource to philosophically defend such claims. (shrink)

Positive political theorists typically deny the possibility of collective agents by understanding aggregation problems to imply that groups are not rational decision-makers. This view contrasts with List and Pettit’s view that such problems actually imply the necessity of accounting for collective agents in explanations of group behaviour. In this paper, I explore these conflicting views and ask whether positive political theorists should alter their individualist analyses of groups like legislatures, political parties, and constituent assemblies. I show how we fail to (...) appreciate the significance of strategic voting and agenda control by treating groups as agents. I, therefore, conclude that positive political theorists should cling to their individualist approach and maintain that groups are not agents. (shrink)

The present narrative review addresses issues concerning the defining criteria and conceptual underpinnings of pain catastrophizing. To date, the concept of pain catastrophizing has been extensively used in many clinical and experimental contexts and it is considered as one of the most important psychological correlate of pain chronicity and disability. Although its extensive use, we are still facing important problems related to its defining criteria and conceptual understanding. At present, there is no general theoretical agreement of what catastrophizing really is. (...) The lack of a consensus on its definition and conceptual issues has important consequences on the choice of the pain management approaches, defining and identifying problems, and promoting novel research. Clinical and research work in absence of a common theoretical ground is often trivial. It is very surprising that clinical and experimental work has grown extensively in the past years, without a common ground in the form of a clear definition of pain catastrophizing and overview of its conceptual basis. Improving the efficacy and efficiency of pan catastrophizing related treatments requires an understanding of the theoretical construct. So far, most interventions have only demonstrated modest effects in reducing pain catastrophizing. Therefore, clarifying the construct may be an important precursor for developing more targeted and effective interventions, thereby easing some of the burden related to this aspect of pain. In our review, we have extracted and de-constructed common elements that emerge from different theoretical models with the aim to understand the concept of catastrophizing, which components can be modulated by psychological interventions, and the general role in pain processing. The analysis of the literature has indicated essential key elements to explain pain catastrophizing: emotional regulation, catastrophic worry, rumination, behavioral inhibition and behavioral activation systems, and interoceptive sensitivity. The present paper attempts to integrate these key elements with the aim to re-compose and unify the concept within a modern biopsychosocial interpretation of catastrophizing. (shrink)

According to group-agent realism, treating groups as agents with their own intentional states, irreducible to those of the group members, helps us explain and predict the groups’ behavior. This pap...

Name der Zeitschrift: Semiotica Jahrgang: 2018 Heft: 224 Seiten: 269-293.

The 1948 constitution of the World Health Organization (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. It was a bold and revolutionary health idea to gain international consensus in a period characterized by fervent anti-communism. This article explores the genealogy of the health definition and demonstrates how it was possible to expand the scope of health, redefine it as ‘well-being’, and overcome ideological resistance to progressive and (...) international health approaches. The first part of the article demonstrates how the health definition was composed through a trajectory of draft ideas from scholars in the history of medicine, as well as political actors working to promote national health insurance. The definition was authored by League of Nations veteran Raymond Gautier, but secretly drew heavily on medical historian Henry E. Sigerist’s controversial book Socialized Medicine in the Soviet Union (1937). The second part analyses how it was possible to resist the ideological pushback against the WHO and secure US ratification. The WHO’s progressive constitution was not simply a deviation from dominant health ideas, but a direct outcome of the entrenched health conflict. The genealogy is based on original archival material from international organizations and US government archives. The article contributes to understandings of the political controversies surrounding the WHO and to scholarship on understandings of health. It also illustrates how influential health ideas cross the boundaries between politics and health sciences, as well as the boundaries between domestic health policy and global health. (shrink)

This article demonstrates the broad applicability of the concept of symbol in human communication, beyond but including verbal language. The starting point is Charles Sanders Peirce’s understanding of symbolicity as signification grounded on habits. The goal is to be able to conceptualize mediality in general and media interrelations, particularly in relation to symbolicity. Informed by a multimodal view on media, the author provides a systematic overview of symbolicity within the context of communication among human minds structured around two crossing parameters: (...) symbols being limited or widespread among people and symbols not being part of or being part of systems – languages. Based on this overview, I clarify the role of culture in language notions and conceptualize language in relation to mediality. I also suggest a way of more precisely describing similarities and differences between languages and media types, without either conflating or totally separating the two concepts. Finally, I investigate how the dependence of language and media type conceptions on culture affects the idea of intermediality. Together, these investigations and conceptualizations promote a more comprehensive understanding of symbolicity in general and a deeper knowledge of the role of symbolicity in human communication, including verbal language, and intermedial relations involving all kinds of different media types. (shrink)

Guided by the concept of bullshit, broadly defined as a deceptive form of rhetoric intended to distract and/or persuade, we examine how fabrications and false statements— when crafted and distributed by the president of the United States—impact not only foreign policy making and implementation but also erode democratic norms. Unconstrained by reality, and seemingly driven more by celebrity and showmanship than a genuine desire to govern, we argue that President Trump’s penchant for bullshit is part of a concerted strategy to (...) sideline critics while simultaneously undermining the ongoing investigations into the Trump campaign’s alleged collusion with the Russian government. (shrink)

In her latest book _Spying Through a Glass Darkly: The Ethics of Espionage and Counter-Intelligence_, Cécile Fabre suggests that the deception of third parties during an infiltration operation can be justified as a foreseen but unintended side effect. In this essay, I criticize this view. Such deception, I argue, is better justified paternalistically as a means of preventing third parties from becoming wrongful threats. In the second part of the article, I show that Fabre ignores an important moral complication in (...) deception operations where agents intentionally allow others to be harmed as a means of protecting a secret. I argue that intentionally allowing harm to others as a means is a particularly problematic mode of agency which must be addressed in a normative account of espionage. (shrink)

The essays deal with the aesthetic and aesthetics; Bourdieu's critique of aesthetics form and content in the arts, musical formalism, the nature and value of literature, Heidegger's philosophy of art, postmodernism and history, Lyotard and the sublime, and the challenge of evolutionary psychology to the humanities.

Religionspsychologie wird in Deutschland zumeist im Bereich der Praktischen Theologie und Religionspädagogik betrieben und stellt kein eigenständiges psychologisches Teilfach dar. Theorien der religiösen Entwicklung sind daher häufig von ihrem theologischen Kontext beeinflusst. Gängige Modelle religiöser Entwicklung nimmt Allolio-Näcke in diesem Band aus psychologischer Perspektive in den Blick und entwirft erstmals seit 30 Jahren eine eigene kulturpsychologische Theorie religiöser Entwicklung. Ein historischer Rahmen, der die Entstehung der Religionspsychologie nachzeichnet und sie im wissenschaftlichen Kanon verortet, rundet den Band ab.

Stakeholder participation is an increasingly popular ingredient within environmental management and decision-making. While much has been written about its purported benefits, a question that has been largely neglected is whether decision-making informed through stakeholder participation is actually likely to yield decisions that are morally justified in their own right. Using moral methodology as a starting point, we argue that stakeholder participation in environmental decision-making may indeed be an appropriate means to produce morally justified decisions, the reason being that such participation (...) may constitute an efficient way to satisfy the standard requirements on moral reasoning and moral justification. This finding also emphasizes the importance of identifying those settings most conducive to allowing different stakeholders to both challenge each other’s arguments and to adopt each other’s perspectives in order to make effective use of participation in environmenta... (shrink)

Researchers have recently provided proof of concept for uterus transplantation, giving rise to a discussion about priority setting. This article analyses whether absolute uterine‐factor infertility (AUFI), the main indication for uterus transplantation, gives rise to a healthcare need and the extent to which such a need places justified claims on public funding in a needs‐based welfare system. It is argued that, regardless of the concept of health to which one subscribes, there is a healthcare need for uterus transplantation in women (...) with AUFI. The provision of alternative ways of addressing this need, such as surrogacy and adoption, reduces its severity. Hence, where such alternatives are publicly funded, uterus transplantation is unlikely to become cost‐effective. However, where surrogacy and adoption are not publicly funded, uterus transplantation should be given a similar priority level to other assisted reproductive technologies. In these circumstances, public funding for uterus transplants may well be justified, particularly in well‐funded healthcare system with relatively generous cost‐effectiveness thresholds. (shrink)

In health care priority setting different criteria are used to reflect the relevant values that should guide decision-making. During recent years there has been a development of value frameworks implying the use of multiple criteria, a development that has not been accompanied by a structured conceptual and normative analysis of how different criteria relate to each other and to underlying normative considerations. Examples of such criteria are unmet need and severity. In this article these crucial criteria are conceptually clarified and (...) analyzed in relation to each other. We argue that disease-severity and condition-severity should be distinguished and we find the latter concept better reflects underlying normative values. We further argue that unmet need does not fulfil an independent and relevant role in relation to condition-severity except for in some limited situations when having to distinguish between conditions of equal severity. (shrink)

This article argues that Kant’s attack on the ars oratoria in §53 of the Critique of the Power of Judgement is directed against eighteenth-century school rhetoric, in particular against the ‘art of speech’ (Redekunst) of Johann Christoph Gottsched. It is pointed out that Kant suggests a revision of Gottsched’s conception of ‘true eloquence’, which was the predominant rhetorical ideal at the time. On this basis, and in response to recent discussions on ‘Kantian rhetoric’, Kant’s own ideal of speech is adressed. (...) It emerges that he favours a culture of speech embedded in moral cultivation, which excludes any disciplinary form of rhetoric. (shrink)

In a recent paper Lee Walters criticizes a number of philosophers – including Gundersen – for committing a ‘failure in the argumentative strategy’ when they attempt to amend the standard Lewis semantics for counterfactuals in order to avoid the so‐called principle of Conjunction Conditionalization. In this article we defend a Gundersen‐style probability‐based semantics against Walter's major misgivings: that it is not logically conservative, that it is committed to the Connection Hypothesis, and that it cannot deal satisfactory with irrelevant semi‐factuals.

How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze (...) Juth’s argument and observe that we already do compensate for indirectly operative factors, both outside and within cost-effectiveness evaluations, for formal equality reasons. Based on this we argue that we have reason to set cost-effectiveness thresholds to integrate equity concerns also including formal equality considerations. We find no reason not to compensate for group size to the extent we already compensate for other factors. Moreover, groups size implying a systematic disadvantage also on a global scale, i.e. taking different aspects of the health condition of patients suffering from rare diseases into account, will provide strong reason for why group size is indeed relevant to compensate for. (shrink)