The frequent occurrence of comorbidity has brought about an extensive theoretical debate in psychiatry. Why are the rates of psychiatric comorbidity so high and what are their implications for the ontological and epistemological status of comorbid psychiatric diseases? Current explanations focus either on classification choices or on causal ties between disorders. Based on empirical and philosophical arguments, we propose a conventionalist interpretation of psychiatric comorbidity instead. We argue that a conventionalist approach fits well with research and clinical practice and resolves (...) two problems for psychiatric diseases: experimenter’s regress and arbitrariness. (shrink)

This paper compares the ethical decisions and attitudes of business students and practitioners. Recent unpublished data from a national study of over 1600 students are contrasted with information reported previously. Students are found consistently to make less ethical choices than practitioners, and there is some indication that students are making less ethical choices in the 1980s than in the 1960s. In addition, both students and practitioners agree that buyers should beware, view the role of business more narrowly, and find fewer (...) incentives to behave ethically over time. Codes of ethics appear to be less influential than the individual's strong personal value system and one's superiors behaving ethically; support for codes is declining. The paper concludes with observations about the limitations and possibilities for survey research in this area drawing on other studies that used the same instrument utilized for this paper. Some implications for future research are suggested. (shrink)

The urgent need for solutions to critical environmental challenges is well attested, but often environmental problems are understood as fundamentally collective action problems. However, to solve to these problems, there is also a need to change individual behavior. Hence, there is a pressing need to inculcate in individuals the environmental virtues — virtues of character that relate to our environmental place in the world. We propose a way of meeting this need, by the judicious, safe, and controlled administration of “classic” (...) psychedelic drugs as a way to catalyze the development of environmental virtues – a form of moral bio-enhancement. Recent evidence shows that psychedelics can be given safely in controlled environments, and can induce vivid experiences of unity and connectedness. These experiences, in turn, can durably increase feelings of nature-relatedness and pro-environmental behaviors. Therefore, we argue that responsible psychedelic use can reliably catalyze the development of a key environmental virtue known as living in place. This is a “master environmental virtue” that subsumes the qualities of respect for nature, proper humility, and aesthetic wonder and awe. Our account advances the environmental virtues debate by introducing a relevant practical proposal, and advances the psychedelic moral enhancement debate by providing a much-needed conceptual framework. (shrink)

ABSTRACT Temporal dynamists argue that we should believe that there exists temporal passage because there being passage is the best explanation for the presence of our temporal phenomenology. Presentists argue that presentism is the best version of temporal dynamism. Therefore, conditional on us accepting temporal dynamism, we should accept presentism. In this paper it is argued that if we understand temporal passage as the presentist does, such an argument can succeed only if dualism is true. Thus, we conclude, either presentists (...) should embrace dualism, or they should reject any argument for presentism that proceeds via any such argument for temporal passage that proceeds via considerations of what best explains our temporal phenomenology. (shrink)

In psychiatry, many scientists desire to move from a classification system based on symptoms toward a system based on biological causes. The idea is that psychiatric diseases should be redefined such that each disease would be associated with specific biological causes. This desire is intelligible because causal disease models often facilitate understanding and identification of new ways to intervene in disease processes. In its attempt to move from syndromal to specific etiological definitions, psychiatry follows the trend of general medicine.Current psychiatric...

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

This paper compares the ethical decisions and attitudes of business students and practitioners. Recent unpublished data from a national study of over 1600 students are contrasted with information reported previously. Students are found consistently to make less ethical choices than practitioners, and there is some indication that students are making less ethical choices in the 1980s than in the 1960s. In addition, both students and practitioners agree that buyers should beware, view the role of business more narrowly, and find fewer (...) incentives to behave ethically over time. Codes of ethics appear to be less influential than the individual''s strong personal value system and one''s superiors behaving ethically; support for codes is declining. The paper concludes with observations about the limitations and possibilities for survey research in this area drawing on other studies that used the same instrument utilized for this paper. Some implications for future research are suggested. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

Andreu Nin defines fascism and analyses its class nature, challenging the notion that fascism’s aims match its rhetoric. While recruiting from among Italy’s middle classes, the petite bourgeoisie, it ultimately serves the big bourgeoisie objectively.

Direct-to-consumer advertising of healthcare products refers to a variety of marketing practices based on a combination of information and promotion strategies directed at consumers through different media such as radio and television broadcasts, newspaper and magazine ads, and, more recently, through the Internet. The principal form of marketing used by the pharmaceutical industry is the distribution of free samples to physicians but DTCA is an increasing part of global promotional spending for prescription drugs. Latest estimates suggest that DTCA now represents (...) an annual $3.2 billion enterprise for the U.S. pharmaceutical industry. Findings from the literature show that these substantial efforts are geared toward the newer pharmaceuticals for chronic conditions with huge market potentials. The lion's share is going to the 20 most prescribed pharmaceuticals. (shrink)

This paper argues that the definition of food justice must be defined in more participatory terms. Current accounts of food justice tend to emphasize distributional inequalities. However, there is broad recognition that these distributional inequalities are the result of participative inequalities and that the participation of marginalized groups in advocacy plays an important role in creating just food systems. In addition, thinking of food justice in more participative terms also suggests a more well-rounded and comprehensive approach to dealing with inequalities (...) within the food system. One manner in which the concept of food justice can be redefined to better capture the importance of participative justice is by considering what is required for informed consent. (shrink)

Der Klimawandel ist die globale Krise unserer Gegenwart. Mit Blick auf die sich hieraus ergebenen Handlungsoptionen und -zwänge stellt der verantwortliche Umgang mit Energie sicher einen der zentralen Bereiche dar. Unsere ethische Verantwortung betrifft dabei beides: Erzeugung und Verbrauch von Energie gleichermaßen. Der vorliegende Band verfolgt zwei Ziele: Erstens soll ein interdisziplinärer Dialog ermöglicht und die dafür notwendigen fachlichen Reflexionen angestoßen werden. Keine Einzeldisziplin kann auf die komplexen Probleme des Klimawandels oder die mit dem Terminus Energieverantwortung angezeigten Herausforderungen alleine eine (...) plausible Antwort geben. Vielmehr müssen die Wissenschaften ein gemeinsames Verständnis der Probleme entwickeln, um auch interdisziplinär geteilte Antworten bereitstellen zu können. Zweitens soll dies in transdisziplinärer Perspektive erfolgen. Das bedeutet, die von der Gesellschaft an die Wissenschaft herangetragenen Fragen und Problemstellungen ernst zu nehmen, aufzugreifen und Antworten zu formulieren, die auch außerhalb der wissenschaftlichen Diskurse als Antworten auf diese Fragen und Problemstellungen verstanden werden können. (shrink)

Appeals to the moral value of nature and naturalness are commonly used in debates about technology and the environment and to inform our approach to the ethics of technology and the environment more generally. In this paper, I will argue, firstly, that arguments from nature, as they are used in debates about new technologies and about the environment, are misinterpreted when they are understood as attempting to put forward categorical objections to certain human activities and, consequently, their real significance is (...) often overlooked. Secondly, arguments from nature, particularly as they are used in the context of debates over the use of new technologies, can be understood as appealing to human nature as a way to determine human limitations. Thirdly, arguments from nature can inform our discussion of what it is to be a human being or a person, and this kind of discussion can, in turn, inform our ethical deliberations in such areas of bioethics as euthanasia, abortion, etc. Finally, I conclude that a proper understanding of these arguments can help in establishing which virtues and which vices relate to our relationship with the non-human world—that is, which character dispositions are relevant to an environmental virtue ethics, with human nature as its foundation. A proper understanding of the argument from nature provides the basis for a ‘virtuously anthropocentric’ environmental ethics. (shrink)

Der Band widmet sich der Frage, wer verantwortlich ist für einen ethisch angemessenen Umgang mit Energie. Dazu sollen zunächst im ersten Teil die normativen Grundlagen von Energieverantwortung skizziert werden. Im zweiten Teil werden mögliche Spannungsfelder identifiziert, die in verschiedenen gesellschaftlichen, wirtschaftlichen und politischen Dimensionen bestehen. Im abschließenden dritten Teil wird die Perspektive auf Probleme erweitert, die durch die Implementierung energieverantwortlicher Maßnahmen und Bestrebungen entstehen. So leistet der Band eine Ordnung der Fragen rund um Energieverantwortung sowie die Darstellung, Bewertung und Lösung (...) konkreter Handlungsprobleme im Feld der Energie-Nachhaltigkeit. (shrink)

What might a modern environmental or technological virtue or vice look like? That is, what virtues or vices might relate to our environmental place in the world, rather than our social place in the world? This question is particularly pressing in light of the unique chal­lenges presented by the current environmental and technological milieu. A recurring theme that arises in response to advances in certain technologies, particularly technologies that are seen in some way as “interfering in nature,” is that humans (...) are indulging in the vice of hubris, often referred to by the phrase “playing God.” Taking the notion of hubris as a starting point, the notion of “living in place” can be developed as a primary environmental and technological virtue, with reference to Heidegger’s analysis of the role of technology in human life. A pre-eminent environmental and technological virtue—living in place—can be understood in the light of Heidegger’s notion of “poetic dwelling,” where the role of human art and technology, rather than being primarily to dominate or manipulate nature, is to bring the natural world “into being.”. (shrink)

This study investigated the relationship between dream lucidity, i.e., a dreamer’s insight to the ongoing dream, and attention by considering lucidity as a trait. We examined the ways in which lucidity correlates with the orienting, alerting, and conflict components of the attentional network. A total of 77 participants rated the lucidity of their dreams over 7 consecutive days with the LuCiD scale and then completed the attentional network task. A negative correlation between trait lucidity and the conflict score of the (...) ANT was found for 49 participants whose responses were faster when an alerting signal was presented. This result suggested that, with a prerequisite that the presence of cues facilitates subsequent information processing, the greater a person’s trait lucidity, the more efficiently he or she is capable of resolving conflicts. (shrink)

Drawing on a scene in J.M.G. Le Clézio's novel Terra Amata, which tells the story of the instincts of a small boy, the minute sensoria of some bugs and a cosmic catastrophe, this essay demonstrates the ambivalence around insects in animal studies, their contingent location in psychoanalysis and the conundrums they place in ethical philosophy. By reading Le Clézio's tale through Uexküll, Freud, Dodds and Stengers we argue for more nuanced, imbricated and critical connections between ethology, psychoanalysis and ethics. These (...) connections become imperatives in the face of the current environmental crisis, where we urgently need to attend to co-affecting relations that are too distant or proximate, tiny or vast to register as familiar sentient states or ethical feelings. In the process we demonstrate the performative dimensions of what we call the entomological imagination – present in the strange proximity of child and bugs, the powerful unthinking god, the indifference of the insects to human commands, and the infinitesimal catastrophe in Le Clézio's story – that facilitates an epistemic fluidity required for a contemporary understanding of ecologies. (shrink)

This chapter provides a broad overview of the relationship between climate change and environmental justice. It provides (1) a brief review of the concept of environmental justice, (2) discussion about how environmental justice applies to climate change, and (3) several examples of how environmental justice has been integrated into climate governance.

“Arguments from nature” are used, and have historically been used, in popular responses to advances in technology and to environmental issues—there is a widely shared body of ethical intuitions that nature, or perhaps human nature, sets some limits on the kinds of ends that we should seek, the kinds of things that we should do, or the kinds of lives that we should lead. Virtue ethics can provide the context for a defensible form of the argument from nature, and one (...) that makes proper sense of its enduring role in debates concerning our relationship to technology and the environment. However, the notion of an ethics founded upon an account of the essential features of human nature is controversial. On the one hand, contemporary biological science no longer defines species by their essential characteristics, so from a biological point of view there just are no essential characteristics of human beings. On the other hand, it might be argued that humans have, in some sense, “transcended our biology,” so an understanding of humans as a biological species is extraneous to ethical questions. In this article, I examine and defend the argument from nature, as a way to ground an ethic of virtue, from some of the more common criticisms that are made against it. I argue that, properly interpreted as an appeal to an evaluative account of human nature, the argument from nature is defensible with the context of virtue ethics and, in this light, I show how arguments from nature made in popular responses to technological and environmental issues are best understood. (shrink)

This chapter contains sections titled: The Complex Unity Endurance Helps Knowing When to Let Go Following Your Example Imitation is the Highest Form of… Notes.

There is currently a gap between assessment and intervention in the literature concerned with climate change and food. While intervention is local and context dependent, current assessments are usually global and abstract. Available assessments are useful for understanding the scale of the effects of climate change and they are ideal for motivating arguments in favor of mitigation and adaptation. However, adaptation projects need assessments that can provide data to support their efforts. This requires the adoption of a more local and (...) context-sensitive approach to assessments. I suggest that Community-Based Participatory Research has the potential to be a tool for such an approach. (shrink)

Dorion Sagan observes that pioneering ethologist Jakob von Uexküll tends to be read in contrasting ways, as a “humble naturalist” pre-empting current research in biosemiotics, animal perception and agency; and as a “biologist-shaman,” gesturing to a transcendental realm where the life-worlds of animals interconnect in a vast symphony of nature. In both cases the tools of the laboratory are thought to generate complete pictures of the invertebrates that Uexküll studies, in unity with their environments. As Giorgio Agamben points out, these (...) experiments form part of an abstract mechanism that produces the human, by isolating instinctual life as an object for study and management from social and ethical modes of existence. What these readings neglect to consider is that Uexküll imagines his experiments through a Picture Book frame. We argue that for Uexküll there is always something fabulous and child-like about the enterprise of reconstructing the subjective environments of the small animals he works with. Drawing on Bernard Stiegler, we propose the Picture Book as a particular technics, or tertiary memory, that cultivates modes of attention that are associated with childhood and are open to the emergence of partial objects and relations. Considered through the Picture Book frame, the Umwelten of insects and other small animals are no longer fixed but are drawn and redrawn in partial expressive ways, through the uncanny picturing – or what Brian Massumi would call “semblances” – of different configurations of animal, technology, human relations. By considering the Picture Book as a technic for ecological thought and imagination, our paper will explore how the small creatures that Uexküll describes might enable the emergence of new ethical sensibilities and relations. (shrink)

22 contributions from art and architecture historians on the perceptions and transformation in the arts and architecture in relation to "urban spaces". This book explores the convergence of aesthetic/artistic/architectural relations between different sciences, the complexity of knowledge, systems, and how the artistic practices of various kinds propose methods of study and analysis for urban understanding and perception phenomena which transform modes human sensitivity through technological interfaces.

Human identity is a complex process linked to the subject and his environment, both constantly evolving. Personality is developed and changed throughout lifetime, but it has a core that remains constant. Thus a person can secure his continuity; he recognizes himself and is recognized by the others as time goes by. In fact, we are all the same, even after experiencing changes and years later. The constitution of the other and the self are – from the phenomenological point of view (...) – two components of the same process, which is the origin of the subjectivity of self and the objectivity of me. These are conditions for the identity’s construction, a continuous process that takes place throughout time. Human tendency to the community emerges with priority from the above definition. That deep desire of being part of a social group interprets others as constituent of the identity of the self. “Having an identity” actually means not only a set of characteristics noticed by ourselves after actions done or the “image” of us, but also to be recognized by the rest of society. Therefore, community turns out in the ultimate horizon that responds to an individual’s recognition need. The recognition of self by me is linked to the issue of the recognition of self through the other until mutual recognition as reciprocal act is reached. Hence, “gift” becomes an emblem of mutual recognition, highlighting the relational and inter-subjective structure of the person. The identity development goes through the mutual recognition experience and gift. Somebody who gives himself recognizes the others and simultaneously, participates in his constitution and his self-understanding. (shrink)

Psychological continuity theories have been the dominant theories of personal identity over time, and the phenomenal approach has largely been neglected because of the bridge problem. I propose a hybrid account of the persistence of the self that draws on both psychological and phenomenal influences while avoiding the problems that both theories face in their 'pure' form. Such a hybrid theory retains the benefits of a phenomenal account of intra-streamal unity, and provides a better account of inter-streamal unity with the (...) use of a psychological-continuity theory. (shrink)

Unter ‚Akzeptabilität‘ versteht man einerseits „gerechtfertigte Akzeptanzfähigkeit“ und andererseits „intersubjektive Angemessenheit“; Letztere wird in diesem Beitrag als praktische Kohärenz und soziale Verhältnismäßigkeit gefasst. Damit stellt das Konzept ethischer Akzeptabilität ein Angebot der praktischen Philosophie für den gesellschaftlichen Diskurs zur Akzeptabilitätsüberprüfung bereit. Als kritische Reflexionsinstanz geht es der Philosophie dabei weder um Akzeptanzbeschaffung noch um die Ermittlung möglicher oder erwartbarer Akzeptanz. Philosophische Politikberatung fokussiert als Ethik auf die Qualität der Gründe von Handlungen oder Handlungszielen von politischen Institutionen oder Personen.

Echo phonology was originally proposed to account for obligatory coordination of manual and mouth articulations observed in several sign languages. However, previous research into the phenomenon lacks clear criteria for which components of movement can or must be copied when the articulators are so different. Nor is there discussion of which nonmanual articulators can echo manual movement. Given the prosodic properties of echoes (coordination of onset/offset and of dynamics such as speed) as well as general motoric coordination of various articulators (...) in the human body, we expect that the mouth is not the only nonmanual articulator involved in echo phonology. In this study, we look at a fixed set of lexical items across 36 sign languages and establish that the head can echo manual movement with respect to timing and to the axis/axes of manual movement. We propose that what matters in echo phonology is the visual percept of temporally coordinated movement that repeats a salient movement property in such a way as to give the visual impression of a copy. Our findings suggest that echoes are not obligatory motor couplings of two or more articulators but may enhance phonological distinctions that are otherwise difficult to see. (shrink)

Brooks convincingly makes the case that the current arguments for climate mitigation and adaptation fail. Each of the arguments discussed by Brooks appeals to end-state solutions that are some combination of poorly defined, inadequate, inappropriate, or are impossible. Thus, those arguments provide us with relatively limited guidance regarding what we should do about climate change. I hope to extend Brooks’ article by providing a rough sketch of how we might think about responding to climate change that does not depend upon (...) achieving a particular end state. (shrink)

Data about flow rate, fishing intensity, and expenditures made by anglers can be used to capture some of the recreational value of waterways in economic terms in a way that avoids a number of the weaknesses of the most commonly used tools such as the contingent valuation method. Furthermore, recreational fishing may spur more economic activity than competing uses of riverine flows such as agriculture. This suggests that potential opportunity cost in regards to recreation ought to be a factor considered (...) in management decisions. (shrink)