Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus (...) supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients’ wishes, be made in light of commonly shared values, unless these violate the principle of “in dubio pro vita”. The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life. (shrink)

Modern medicine, based on enormous progress in science and its applications, has lost dimensions of individualized treatment and compassion which traditionally were an essential part of physician’s service over the millennia in Eastern and Western cultures. Today diseases and symptoms, rather than persons, are treated, based on objective quality norms and inflexible payment schemes rather than the rather than persons. We present a checklist model for personalized health care, which has been successful in teaching and practice to reclaim lost territory (...) in treating patients as persons. (shrink)

In den letzten Jahren hat sich eine Vielfalt unterschiedlicher Gremien zur Ethikberatung entwickelt: vom Konsil mit einem einzelnen Berater bis zum Ethikkomitee. In dem Band werden die Ethikberatung, ihre Entwicklung und Anwendung, sowie die Gründung von Gremien in Krankenhäusern, Pflegeeinrichtungen, Hospizen und von niedergelassenen Ärzten anhand von Fallbeispielen erläutert. Dabei schlagen die Autoren eine Brücke zwischen traditioneller philosophischer Ethik und anwendungsbezogener klinischer Ethik. Auch rechtliche Fragen werden erörtert.

Einrichtungen der Altenpflege weisen spezifische ethische Spannungsfelder und ethische Fragestellungen auf. Das Strukturinstrument EMMA (Ethik Multiprofessionell Methodisch Anwenden) zur Moderation einer Ethik-Fallberatung wurde für den Einsatz in Einrichtungen der Altenpflege konzipiert. Inhaltlich werden die Besonderheiten dieses Settings unter Bezugnahme auf den Schlüsselbegriff Privatheit in den Mittelpunkt gestellt. EMMA eignet sich aufgrund seiner Kontextsensitivität darüber hinaus zum Einsatz in der Ethik-Fallberatung in unterschiedlichen außerklinischen Settings.

ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Die Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

Whereas present theories of transformative learning tend to focus on the rational and reflective actor, in this article it is suggested that spontaneous action may play a decisive role in transformative learning too. In the spontaneity of action, novelty finds its way into life, gains momentum, is respected by others and reflected by the actor. Such transformation processes are investigated both with the means of theoretical reflection and of empirical inquiry. Based on nine narrative interviews typical phases of transformative learning (...) processes are identified. Owing to the comparative nature of the study, it was also possible to develop an age‐related typology that overlaps certain phases of the transformation process. These empirical findings constitute the background against which the nexus of spontaneous action and transformative learning is reflected theoretically. Theories drawn upon include John Dewey's Pragmatism and George Herbert Mead's Social Pragmatism. Both scholars provide rich theoretical concepts for reflecting on the nature of that what so often eludes from the control of both educators and learners: the spontaneity of the beginning. (shrink)

Excerpt from Das Ethische System des Helvetius Beobachtung gegründeten Principien irgend einer Kunst oder Wissenschaft. Gehe der Philosoph nicht bei der Erfahrung in. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, (...) such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Economic principles and instruments have been introduced into the German welfare system. The European Union wants to realize an open market economy with free competition for the social services. In this situation Christian welfare organisations get in conflict with their churches and the ethics of Christianity. The concepts of »entrepreneurship diakonia« and »advocatory diakonia« are completed and criticized by the new concept of a »public diakonia of citizenship and community« on the basis of the ethical principles of charity, justice and (...) man’s dignity. According to that new concept »diaconics« and economics may learn from each other in a dialogue of reciprocity. (shrink)

The burgeoning science of ethics has produced a trend toward pessimism. Ordinary moral thought and action, we’re told, are profoundly influenced by arbitrary factors and ultimately driven by unreasoned feelings. This book counters the current orthodoxy on its own terms by carefully engaging with the empirical literature. The resulting view, optimistic rationalism, shows the pervasive role played by reason, and ultimately defuses sweeping debunking arguments in ethics. The science does suggest that moral knowledge and virtue don’t come easily. However, despite (...) the heavy influence of automatic and unconscious processes that have been shaped by evolutionary pressures, we needn’t reject ordinary moral psychology as fundamentally flawed or in need of serious repair. Reason can be corrupted in ethics just as in other domains, but a special pessimism about morality in particular is unwarranted. Moral judgment and motivation are fundamentally rational enterprises not beholden to the passions. (shrink)

Chapter. 1. Logical. Form. as. a. Level. of. Linguistic. Representation. What is the relation of a sentence's syntactic form to its logical form? This issue has been of central concern in modern inquiry into the semantic properties of natural ...

In defending his interest-relative account of knowledge in Knowledge and Practical Interests (2005), Jason Stanley relies heavily on intuitions about several bank cases. We experimentally test the empirical claims that Stanley seems to make concerning our common-sense intuitions about these bank cases. Additionally, we test the empirical claims that Jonathan Schaffer seems to make in his critique of Stanley. We argue that our data impugn what both Stanley and Schaffer claim our intuitions about such cases are. To account for these (...) results, one must develop a better conception of the connection between a subject's interests and her body of knowledge than those offered by Stanley and Schaffer. (shrink)

I draw on neurobiological evidence to defend the rationalist thesis that moral judgments are essentially dependent on reasoning, not emotions (conceived as distinct from inference). The neuroscience reveals that moral cognition arises from domain-general capacities in the brain for inferring, in particular, the consequences of an agent’s action, the agent’s intent, and the rules or norms relevant to the context. Although these capacities entangle inference and affect, blurring the reason/emotion dichotomy doesn’t preferentially support sentimentalism. The argument requires careful consideration of (...) the empirical evidence (from neuroimaging to psychopathology) and philosophical analysis of the commitments of rationalism versus sentimentalism in ethics. (shrink)

Recent empirical research seems to show that emotions play a substantial role in moral judgment. Perhaps the most important line of support for this claim focuses on disgust. A number of philosophers and scientists argue that there is adequate evidence showing that disgust significantly influences various moral judgments. And this has been used to support or undermine a range of philosophical theories, such as sentimentalism and deontology. I argue that the existing evidence does not support such arguments. At best it (...) suggests something rather different: that moral judgment can have a minor emotive function, in addition to a substantially descriptive one. (shrink)

We chart how neuroscience and philosophy have together advanced our understanding of moral judgment with implications for when it goes well or poorly. The field initially focused on brain areas associated with reason versus emotion in the moral evaluations of sacrificial dilemmas. But new threads of research have studied a wider range of moral evaluations and how they relate to models of brain development and learning. By weaving these threads together, we are developing a better understanding of the neurobiology of (...) moral judgment in adulthood and to some extent in childhood and adolescence. Combined with rigorous evidence from psychology and careful philosophical analysis, neuroscientific evidence can even help shed light on the extent of moral knowledge and on ways to promote healthy moral development. (shrink)

At least since the middle of the twentieth century, philosophers have tended to identify weakness of will with akrasia—i.e. acting, or having a disposition to act, contrary to one‘s judgments about what is best for one to do. However, there has been some recent debate about whether this captures the ordinary notion of weakness of will. Richard Holton (1999, 2009) claims that it doesn’t, while Alfred Mele (2010) argues that, to a certain extent, it does. As Mele recognizes, the question (...) about an ordinary concept here is one apt for empirical investigation. We evaluate Mele’s studies and report some experiments of our own in order to investigate what in the world the ordinary concept of weakness of will is. We conclude that neither Mele nor Holton (previously) was quite right and offer a tentative proposal of our own: the ordinary notion is more like a prototype or cluster concept whose application is affected by a variety of factors. (shrink)

Moral, social, political, and other “nonepistemic” values can lead to bias in science, from prioritizing certain topics over others to the rationalization of questionable research practices. Such values might seem particularly common or powerful in the social sciences, given their subject matter. However, I argue first that the well-documented phenomenon of motivated reasoning provides a useful framework for understanding when values guide scientific inquiry (in pernicious or productive ways). Second, this analysis reveals a parity thesis: values influence the social and (...) natural sciences about equally, particularly because both are so prominently affected by desires for social credit and status, including recognition and career advancement. Ultimately, bias in natural and social science is both natural and social— that is, a part of human nature and considerably motivated by a concern for social status (and its maintenance). Whether the pervasive influence of values is inimical to the sciences is a separate question. (shrink)

The research described here contributes to the extant empirical research on business ethics education by examining outcomes drawn from the literature on positive organizational scholarship (POS). The general research question explored is whether a course on ethical decision-making in business could positively influence students’ confidence in their abilities to handle ethical problems at work (i.e., moral efficacy), boost the relative importance of ethics in their work lives (i.e., moral meaningfulness), and encourage them to be more courageous in raising ethical problems (...) at work even if it is unpopular (i.e., moral courage). Specifically, the study used a rigorous quasi-experimental pretest–posttest research design with a treatment (N = 30) and control group (N = 30) to investigate whether a graduate-level course in business ethics could influence students’ levels of moral efficacy, meaningfulness, and courage. Findings revealed that participants in the business ethics treatment course experienced significant positive increases in each of the three outcome variables as compared to the control group. The largest increase was in moral efficacy, followed by moral courage, and finally, moral meaningfulness. These findings are discussed in the context of the current research on business ethics education and POS. Implications for future research are discussed. (shrink)

While the enormous influence of Martin Heidegger's thought in Japan and China is well documented, the influence on him from East-Asian sources is much lesser known. This remarkable study shows that Heidegger drew some of the major themes of his philosophy--on occasion almost word for word--from German translations of Chinese Daoist and Zen Buddhist classics.

Determinism seems to rule out a robust sense of options but also prevent our choices from being a matter of luck. In this way, free will seems to require both the truth and falsity of determinism. If the concept of free will is coherent, something must have gone wrong. I offer a diagnosis on which this puzzle is due at least in part to a tension already present in the very idea of free will. I provide various lines of support (...) for this hypothesis, including some experimental data gathered by probing the judgments of non-specialists. (shrink)

How can we make moral progress on factory farming? Part of the answer lies in human moral psychology. Meat consumption remains high, despite increased awareness of its negative impact on animal welfare. Weakness of will is part of the explanation: acceptance of the ethical arguments doesn’t always motivate changes in dietary habits. However, we draw on scientific evidence to argue that many consumers aren’t fully convinced that they morally ought to reduce their meat consumption. We then identify two key psychological (...) mechanisms—motivated reasoning and social proof—that lead people to resist the ethical reasons. Finally, we show how to harness these psychological mechanisms to encourage reductions in meat consumption. A central lesson for moral progress generally is that durable social change requires socially-embedded reasoning. (shrink)

[Emerging Scholar Prize Essay for Spindel Supplement] Some philosophers and psychologists have evaluated psychological egoism against recent experimental work in social psychology. Dan Batson (1991; forthcoming), in particular, argues that empathy tends to induce genuinely altruistic motives in humans. However, some argue that there are egoistic explanations of the data that remain unscathed. I focus here on some recent criticisms based on the idea of self-other merging or "oneness," primarily leveled by Robert Cialdini and his collaborators (1997). These authors argue (...) that the putatively altruistic subjects are acting on ultimately egoistic motives because empathic feelings for someone in distress tend to cause them to blur the distinction between themselves and the other. Employing a conceptual framework for the debate, I argue that the self-other merging explanation fails to explain the empathy-helping relationship on primarily non-empirical grounds, regardless of the empirical results Cialdini and colleagues report. (shrink)

The main message of Neuroethics is that neuroscience forces us to reconceptualize human agency as marvelously diverse and flexible. Free will can arise from unconscious brain processes. Individuals with mental disorders, including addiction and psychopathy, exhibit more agency than is often recognized. Brain interventions should be embraced with cautious optimism. Our moral intuitions, which arise from entangled reason and emotion, can generally be trusted. Nevertheless, we can and should safely enhance our brain chemistry, partly because motivated reasoning crops up in (...) everyday life and in the practice of neuroscience itself. Despite serious limitations, brain science can be useful in the courtroom and marketplace. Recognizing all this nuance leaves little room for anxious alarmism or overhype and urges an emphasis on neurodiversity. The result is a highly opinionated tour of neuroethics as an exciting field full of implications for philosophy, science, medicine, law, and public policy. (shrink)

Gegen das Streben der Moderne nach Widerspruchsfreiheit, Ordnung und Einheit aktiviert die Postmoderne die Begriffe Differenz, Widerstreit und Ambivalenz. Dieser Wandel lat auch die Bildungsphilosophie nicht unberuhrt. In diesem Buch wird untersucht, welche Auswirkungen postmoderne Ideen auf Bildungsphilosophie und -praxis haben konnen. Im Zentrum der Auseinandersetzung steht die Kritik an der modernen Identitats- und Subjektkategorie und der Versuch, diese aus postmoderner Sicht neu zu bestimmen und gewinnbringend auf die Erwachsenenbildung zu beziehen.