ZusammenfassungDiagnostik und Klassifikation der akuten myeloischen Leukämie (AML) beruhen auf zytologischen und zytogenetischen Charakteristika. Eine Individualisierung der Diagnostik und Therapie wird für AML mit normalem Karyotyp (CN-AML) durch den Nachweis spezifischer Genmutationen zunehmend ermöglicht. In einem systematischen Literaturreview und Metanalyse wurde die Mutation FLT3-ITD bei CN-AML untersucht. Eine systematische Literaturrecherche aller Veröffentlichungen der Datenbanken Embase, Pubmed, Healthstar, BIOSIS, ISI Web of Knowledge und Cochrane wurde für den Zeitraum 2000 bis März 2012 im Hinblick auf die Mutation FLT3-ITD bei Patienten mit (...) CN-AML und einem Alter von 15–65 Jahren durchgeführt. Der Literaturrecherche folgte eine Literaturselektion, eine Datenextraktion und eine qualitative sowie quantitative Informationssynthese in Form einer Metaanalyse. Achtzehn Veröffentlichungen konnten in die qualitative Analyse zur CN-AML eingeschlossen werden. Daten von 3 Publikationen zum Gesamtüberleben mit insgesamt 1.203 Patienten gingen mit Bezug auf den Marker FLT3-ITD in die Metaanalyse ein. Für FLT3-ITD zeigte sich eine statistisch signifikante schlechtere Prognose mit einer hazard ratio von 2,19 für das Gesamtüberleben bei CN-AML. FLT3-ITD ist im Vergleich zum Wildtyp mit einer schlechteren Prognose in Bezug auf den Krankheitsverlauf bei AML assoziiert. Die Analyse von FLT3 sollte bei der AML berücksichtigt werden. (shrink)

Diagnostik und Klassifikation der akuten myeloischen Leukämie (AML) beruhen auf zytologischen und zytogenetischen Charakteristika. Eine Individualisierung der Diagnostik und Therapie wird für AML mit normalem Karyotyp (CN-AML) durch den Nachweis spezifischer Genmutationen zunehmend ermöglicht. In einem systematischen Literaturreview und Metanalyse wurde die Mutation FLT3-ITD bei CN-AML untersucht. Eine systematische Literaturrecherche aller Veröffentlichungen der Datenbanken Embase, Pubmed, Healthstar, BIOSIS, ISI Web of Knowledge und Cochrane wurde für den Zeitraum 2000 bis März 2012 im Hinblick auf die Mutation FLT3-ITD bei Patienten mit (...) CN-AML und einem Alter von 15–65 Jahren durchgeführt. Der Literaturrecherche folgte eine Literaturselektion, eine Datenextraktion und eine qualitative sowie quantitative Informationssynthese in Form einer Metaanalyse. Achtzehn Veröffentlichungen konnten in die qualitative Analyse zur CN-AML eingeschlossen werden. Daten von 3 Publikationen zum Gesamtüberleben mit insgesamt 1.203 Patienten gingen mit Bezug auf den Marker FLT3-ITD in die Metaanalyse ein. Für FLT3-ITD zeigte sich eine statistisch signifikante schlechtere Prognose mit einer hazard ratio von 2,19 für das Gesamtüberleben bei CN-AML. FLT3-ITD ist im Vergleich zum Wildtyp mit einer schlechteren Prognose in Bezug auf den Krankheitsverlauf bei AML assoziiert. Die Analyse von FLT3 sollte bei der AML berücksichtigt werden. (shrink)

Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and healthcare (...) continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

Simulations are used in very different contexts and for very different purposes. An emerging development is the possibility of using simulations to obtain a more or less representative reproduction of organs or even entire persons. Such simulations are framed and discussed using the term ‘digital twin’. This paper unpacks and scrutinises the current use of such digital twins in medicine and the ideas embedded in this practice. First, the paper maps the different types of digital twins. A special focus is (...) put on the concrete challenges inherent in the interactions between persons and their digital twin. Second, the paper addresses the questions of how far a digital twin can represent a person and what the consequences of this may be. Against the background of these two analytical steps, the paper defines first conditions for digital twins to take on an ethically justifiable form of representation. (shrink)

Trust is one of the big buzzwords in debates about the shaping of society, democracy, and emerging technologies. For example, one prominent idea put forward by the High‐Level Expert Group on Artificial Intelligence appointed by the European Commission is that artificial intelligence should be trustworthy. In this essay, we explore the notion of trust and argue that both proponents and critics of trustworthy AI have flawed pictures of the nature of trust. We develop an approach to understanding trust in AI (...) that does not conceive of trust merely as an accelerator for societal acceptance of AI technologies. Instead, we argue, trust is granted through leaps of faith. For this reason, trust remains precarious, fragile, and resistant to promotion through formulaic approaches. We also highlight the significance of distrust in societal deliberation, as it is relevant to trust in various and intricate ways. Among the fruitful aspects of distrust is that it enables individuals to forgo technology if desired, to constrain its power, and to exercise meaningful human control. (shrink)

Many philosophers have claimed that relying on the testimony of others in normative questions is in some way problematic. In this paper, I consider whether we should be troubled by deference in democratic politics. I argue that deference is less problematic in impure cases of political deference, and most non-ideal cases of political deference are impure. To establish the second point, I rely on empirical research from political psychology. I also outline two principled reasons why we should expect political deference (...) to be untroubling: political problems are difficult and require a division of epistemic labour; furthermore, there is value in exercising epistemic solidarity with those one shares an identity or interests with. (shrink)

This paper argues that the MBA, probably the most successful academic program of the last 50 years, negatively affects the theory and practice of management with regard to ethics through its pedagogy, structure, and its underlying epistemic assumptions. In particular I seek to demonstrate how the syllabus, the pedagogy and the epistemological assumptions of MBA programs together make managers/leaders unable and unwilling to deal with ethics. I also argue that while the what and the how play a very important role, (...) it was only the emergence of a radical philosophical underpinning that has put management education on a negative trajectory. The paper thus examines MBA education from a meta-level perspective, connecting the pedagogical model with epistemological beliefs. (shrink)

This paper argues that data-driven medicine gives rise to a particular normative challenge. Against the backdrop of a distinction between the good and the right, harnessing personal health data towards the development and refinement of data-driven medicine is to be welcomed from the perspective of the good. Enacting solidarity drives progress in research and clinical practice. At the same time, such acts of sharing could—especially considering current developments in big data and artificial intelligence—compromise the right by leading to injustices and (...) affecting concrete modes of individual self-determination. In order to address this potential tension, two key elements for ethical reflection on data-driven medicine are proposed: the controllability of information flows, including technical infrastructures that are conducive towards controllability, and a paradigm shift towards output-orientation in governance and policy. (shrink)

Bd. 1. Wertphilosophie und Ethik -- Bd. 2. Bathik und Ästhetik -- Bd. 3. Kulturphilosophie, Gesellschafts- und Staatslehre -- Bd. 4. Erkenntnistheorie und Ontologie -- Bd. 6. Die Enge des Bewusstseins.

The paper takes a fresh look at two essays that Adam Smith wrote at the very beginning of his career. In these essays, Smith explains his philosophy of science, which is social constructivist. A social constructivist reading of Smith strengthens the scholarly consensus that The Wealth of Nations needs to be interpreted in light of the general moral theory he explicates in The Theory of Moral Sentiments, as the two essays and TMS stress the importance of the same concepts: e.g., (...) moral imagination, the socially embedded individual, and humility. The connecting tissue between all three works is made up of sentiments and values. Smith regards the socially embedded human as the agent in all three realms, and humans are always driven by values. Smith not only conceives of economics as an applied moral philosophy, but also bases both research areas on a view of knowledge creation that stresses specific epistemic values. If mainstream economic theory wants to have any claim to Adam Smith, it would have to change not only what it argues but also how it argues. Economists would have to replace the language of mathematics with the language and logic of moral philosophy and give values centre stage. (shrink)

In both the public and the business world, in academe as well as in practice, the ideas of Adam Smith are regarded as the bedrock of modern economics. When present economic conditions and management practices are criticised, Adam Smith is referred to by defenders and detractors of the current status quo alike. Smith, it is believed, defined the essential terms of reference of these debates, such as the rational pursuit of self-interest on part of the individual and the resultant optimal (...) allocation of goods in free markets thanks to the workings of an “invisible hand.” In this article, we question whether this standard view of Smith, the economist, is tenable. We provide an extensive review of the extant secondary literature from economists, business ethicists, and philosophers, comparing their assessments to crucial elements of Smith’s theoretical system. As a result, we show that Smith, far from being an advocate of a value-free or even value-averse conception of economic transactions, stood for a virtue-based and values-oriented model of business. Accordingly, we argue current management education and the pedagogy of business ethics ought to be changed, and certain strategic conclusions drawn for business practice. (shrink)

Some authors have argued that legitimacy without authority is possible, though their work has not found much uptake in mainstream political philosophy. I provide an improved model how legitimate political institutions without authority are possible, the Transmission Model, which I couple with a thin substantive position, the Moral Value View. I defend the model against three common objections.

In the leadership literature of the past 100 years or so, rhetoric has been a topic for a long time and ethics was introduced some 30 years ago. However, the three topics, leadership, rhetoric, and ethics, have not been connected. This is astonishing because when ethical leadership made its comeback, scholars acknowledged the debt that ethical leadership owes to Aristotelian ideas. For Aristotle, leadership, ethics, and rhetoric were inseparable: without ethics, there could neither be good leadership nor rhetoric, and rhetoric (...) was the bridge from leader to follower and back. Aristotle is known as the practical philosopher and we argue that closing this major lacuna in leadership theory, would be beneficial for practice too and would help prevent Theranos-like scandals. The lacuna lies in what some call a Machiavellian view of leadership and rhetoric: both are regarded as amoral tools to achieve given ends. Aristotle would bristle at that idea. Both, leadership and rhetoric, to be good, must aim at the noble. The noble is not dictated by a heroic despot nor by a selfless saint but is understood by a leader because s/he is a socially embedded individual. We argue that leadership should be understood as personal development, that organisational rules must not inhibit virtue, that leadership is more about listening than talking, that synthesising that which is heard is central, and finally, that the common, not the collective, good is the goal of leadership. (shrink)

This paper argues that economics, over the past 200 years, has become steadily more anti-philosophical and that there are three stages in the development of economic thought. Adam Smith intended economics to be a descriptive social science, rooted in an understanding of the moral and psychological processes of an individual’s decision-making and its connection to society in general. Yet, immediately after Smith’s death, economists made a clean cut and invented a totally new discipline: they switched towards a physicalist understanding of (...) human nature. Humans, like atoms, follow a natural law: they are driven by an emotion (defined as a non-emotion, rationality), namely selfishness. Thus economics became a ‘natural’ science. In the 20th century, the second reinterpretation removed all traces of humanity from the study of economics and declared economics to be a formal science like mathematics and logics. The actor in Phase 3 economics is homo economicus syntheticus, a postulate whose only connection to real humanity is the word homo. The paper asks what the results of this dramatic relocation are and why Phase 3 economics still claims descent from Smithian economics, despite the massive differences. (shrink)

Adam Smith’s is often falsely portrayed as having argued that radical selfishness is a force for the good and that this “invisible hand’ is his market mechanism. This paper argues that Smith’s real market mechanism, the sympathy manoeuvre, is a viable alternative to Schumpeterian and mainstream models of innovation in economics and also could help build a firmer theoretical basis for other approaches such as Responsible Innovation. To Smith all human activity was social and must be understood and explained in (...) terms of the sentiments involved. Discovery, for instance, is driven by three sentiments (wonder, surprise, admiration), economic activities by sympathetic imagination, the need for exchange, the need to better one’s position in life, and the need for gratitude. Through sympathetic imagination, his famous model of the impartial spectator, Smith elegantly connects the individual and society. Smith’s innovation process is thus an exercise in social construction and not a destructive process based on radical selfishness. The paper argues that this social innovation process is a viable alternative to the extant approaches that are essentially asocial and amoral (economism) or ideologically normative (Responsible Innovation). (shrink)

It is very timely and highly important to think the relationship between theological and philosophical ethics. In this issue, Michael McCarthy et al. make a plea for a stronger dialogue...

One of the most common arguments in favour of the state's authority is that without the coordinating hand of political institutions, we could not achieve important moral benefits. I argue that if we understand authority correctly, then coordination cannot even in principle establish that coordinators have political authority.

Political instrumentalism claims that the right to rule should be distributed such that justice is promoted best. Building on a distinction made by consequentialists in moral philosophy, I argue that instrumentalists should distinguish two levels of normative thinking about legitimacy, the critical and applied level. An indirect instrumentalism which acknowledges this distinction has significant advantages over simpler forms of instrumentalism that do not.

CST is widely disregarded in the academic and public discourse. This essay argues that this is the case for two related reasons. Firstly, CST is based on the pre-Enlightenment approach to moral philosophy, virtue ethics, while the mainstream in business ethics favours the rule-based approaches consequentialism and deontology and their variants. Secondly, mainstream approaches also have adopted a positivist epistemology where theories represent the Truth that must not be questioned: they have become ideologies. This paper argues that CST, mainly through (...) the virtue ethical doctrine of the mean, is saved from having become an ideology and is much closer to the ideal of science as a self-questioning system than the mainstream in business ethics. This essay explains this counter-intuitive conclusion by tracing the history of CST and embedding it in an epistemic discussion and then suggesting what business ethics could take from CST to regain the all-important discursiveness it once had. (shrink)

The biggest research programme within business ethics is arguably Corporate Social Responsibility and all its related streams (Corporate Citizenship, Social Justice, etc.) While there seems to be widespread agreement that business ethics is situated between the amoral or even immoral view of Milton Friedman as explicated in his 1970 New York Times paper, and the moral view expounded by R. Edward Freeman, this essay challenges that view. Friedman, maybe owed to his flamboyant writing style and crude and purely rhetorical oversimplifications (...) has been misinterpreted to advocate for managers to be completely amoral maximisers of profitability. This misinterpretation has become common wisdom, despite him clearly stating that the law and the moral standards of surrounding society must limit profit-seeking behaviour. Freeman's stakeholder theory, on the other hand, is seen as being on the other end of the continuum, arguing for selflessness—another misinterpretation, as I argue with Ed Freeman's help. Instead, I suggest that both Friedman and Freeman represent the virtuous mean of the business ethics continuum and not its extremes because they both base their theories on the idea of the free and socially embedded individual. The two vicious ends of the continuum are inhabited by the unreal, atomised, completely a-social and selfish individual on the one end, and by the equally unreal collectivised self-less individual on the other. The mainstream in business ethics has declared the collective and selfless end to be the ideal that must guide practice and research. The selfish and the selfless strawmen have prevented a proper debate in business ethics for too long. (shrink)

In the article ‘Represent Me: Please! Towards an Ethics of Digital Twins in Medicine’, I analysed and tried to better understand the main ethical challenges associated with Digital Twins. For those who are just entering the debate with this article: DT is a metaphor for a bundle of artificial intelligence driven simulation technologies that constantly, in real time and ad personam simulate single or multiple parts of the body and make predictions about future health states based on these simulations. My (...) argument addresses the need to look at the breadth of challenges through a perspective of representation. From such a take, key consequences can be drawn for the further development of such technologies, the required means of control and not least the way to think about the interaction between humans and ‘their’ simulations. I am very grateful for the subsequent suggestions, criticisms and further arguments, which have helped me to elaborate my arguments more clearly and have led to a substantial advancement of the debate and the discussion about ethical questions in dealing with DT. Jenny Blumenthal-Barby,1 Deborah Lupton,2 Jenny Krutzinna,3 Janina Loh,4 Brent Mittelstadt,5 Sven Nyholm,6 Daniel Tigard7 and Max Tretter8 have made excellent points, which, in the following, I will not be able to reply to individually and in detail. In this response, I will try to bundle the open points and questions along the comments and considerations mentioned above and attempt to outline their significance for an ethics of DT. Four challenges seem to be central. A first point addresses anthropological issues. It is concerned …. (shrink)

Corporate/collective moral responsibility is a thorny topic in business ethics and this paper argues that this is due a number of unacknowledged and connected epistemic issues. Firstly, CSR, Corporate Citizenship and many other research streams that are based on the assumption of collective and/or corporate moral responsibility are not compatible with Kantian ethics, consequentialism, or virtue ethics because corporate/collective responsibility violates the axioms and central hypotheses of these research programmes. Secondly, in the absence of a sound theoretical moral philosophical foundation, (...) business ethicists have based their ideas on legal and political epistemologies, yet still claim to be ethics-based. Thirdly, research is often driven by an intention to prove that a specific social goal is right, not by open and critical inquiry. Finally, today, corporate/collective moral responsibility is widely accepted as the Truth as most researchers are unaware of any issues because they are untrained in philosophy. The paper identifies the confusion about the epistemic basis as a major impediment for delivering a thick concept of the role of corporations as moral agents. Thus, the paper does not argue against corporate or collective agency as such, but points out an obvious but forgotten paradox: corporate and collective personhood cannot, at the moment at least, be epistemologically grounded in the field in which business ethics claims to operate: moral philosophy. (shrink)

With this introduction we aim to illuminate Western Europe's place on the map of Cold War science and, specifically, to draw attention to the differences in and the diversity of Western European Cold War science in comparison to the United States. By discussing narratives of Cold War science in small states and asking how they fit into the European condition, we suggest that the fact of being a small state affects the conditions for and the scope of Cold War science. (...) As a whole, this special issue also emphasizes the importance of the spatial dimension; that is, the significant dependence of Cold War science on geographical relations and geopolitical interests. (shrink)

In this paper, we provide a re-interpretation of qualitative and quantitative modeling from a representationalist perspective. In this view, both approaches attempt to construct abstract representations of empirical relational structures. Whereas quantitative research uses variable-based models that abstract from individual cases, qualitative research favors case-based models that abstract from individual characteristics. Variable-based models are usually stated in the form of quantified sentences. This syntactic structure implies that sentences about individual cases are derived using deductive reasoning. In contrast, case-based models are (...) usually stated using context-dependent existential sentences. This syntactic structure implies that sentences about other cases are justifiable by inductive reasoning. We apply this representationalist perspective to the problems of generalization and replication. Using the analytical framework of modal logic, we argue that the modes of reasoning are often not only applied to the context that has been studied empirically, but also on a between-contexts level. Consequently, quantitative researchers mostly adhere to a top-down strategy of generalization, whereas qualitative researchers usually follow a bottom-up strategy of generalization. Depending on which strategy is employed, the role of replication attempts is very different. In deductive reasoning, replication attempts serve as empirical tests of the underlying theory. Therefore, failed replications imply a faulty theory. From an inductive perspective, however, replication attempts serve to explore the scope of the theory. Consequently, failed replications do not question the theory per se, but help to shape its boundary conditions. We conclude that quantitative research may benefit from a bottom-up generalization strategy as it is employed in most qualitative research programs. Inductive reasoning forces us to think about the boundary conditions of our theories and provides a framework for generalization beyond statistical testing. In this perspective, failed replications are just as informative as successful replications, because they help to explore the scope of our theories. (shrink)

The New Testament, while rejecting any superficial connection between illness and sin, does not reject a possible connection between illness and a person's relationship with God. An example can be seen in the story of the young blind man who was healed. His blindness does not result from any fault he or his parents had committed but apparently from God's wish to reveal his own healing power. The inner blindness of the Pharisees is a different type of blindness far more (...) difficult to heal. The blind young man was actually healed, not only in body but also in soul. Such miraculous healings are rare nowadays. However, if one takes a closer look at modern genetics and psycho-neuro-immunological findings, one may come to a better understanding of how miracle healings are linked to man's inner life and therefore also to his religiousness. Many diseases have genetic backgrounds. Defective genes, however, do not necessarily lead to subsequent illness. Genes have to be switched on or off. Only activated genes trigger pathological change. The human brain and all of man's thinking and feeling are intimately connected with such activations. We may thus conclude that both inner life and religious outlook on life are relevant to the origin and development of diseases. (shrink)

Some European countries legally recognise a “right to roam”—a right to freely traverse across land, even if privately owned. Political philosophers have paid little attention to the right, and have often conceptualised property rights to include strong claim-rights to exclude others. I offer an account of the right to roam, and consider whether it can be philosophically justified on a left-liberal account of property. After finding a defence in terms of the interests served by the right lacking, I suggest that (...) the most promising defence of the right to roam is that it serves as a symbolic reminder of a fundamental type of social equality. (shrink)

There has been little debate in political philosophy about whether the intentions of governments matter to the legitimacy of their policies. This paper fills this gap. First, I provide a rigorous statement of political anti-intentionalism, the view that intentions do not matter to political legitimacy. I do so by building on analogous debates in moral philosophy. Second, I sketch some strategies to defend political anti-intentionalism, which I argue are promising and available to a wide range of theories of legitimacy. Third, (...) I show that the distinction has implications for debates surrounding neutrality and political liberalism. (shrink)

In this paper we ask whether approximation for abstract argumentation is useful in practice, and in particular whether reasoning with grounded semantics – which has polynomial runtime – is already an approximation approach sufficient for several practical purposes. While it is clear from theoretical results that reasoning with grounded semantics is different from, for example, skeptical reasoning with preferred semantics, we investigate how significant this difference is in actual argumentation frameworks. As it turns out, in many graphs models, reasoning with (...) grounded semantics actually approximates reasoning with other semantics almost perfectly. An algorithm for grounded reasoning is thus a conceptually simple approximation algorithm that not only does not need a learning phase – like recent approaches – but also approximates well – in practice – several decision problems associated to other semantics. (shrink)

The aim of this article is to refute the aphorism “There is no arguing about taste”. On the one hand, judgements of taste arise from individual feelings, on the other hand, they claim to be universally valid. The question of whether there can be sensible dispute about taste arises from this conflict between subjectivity and universality. The article shows how sensible dispute is possible without denying the subjective character of the judgement. Dispute leads to an explication of the standard that (...) determined the individual judgement of taste. Based on this, three stages of sensible dispute open up: adjustment of the standard, improvement of the standard, and idealisation of the standard. Thus, the article demonstrates not only that it is possible to argue about taste in a sensible way, but also on which levels such a dispute can take place. (shrink)