Australia’s punitive policy towards people seeking asylum deliberately causes severe psychological harm and meets recognised definitions of torture. Consequently, there is a tension between doctors’ obligation not to be complicit in torture and doctors’ obligation to provide best possible care to their patients, including those seeking asylum. In this paper, we explore the nature of complicity and discuss the arguments for and against a proposed call for doctors to boycott working in immigration detention. We conclude that a degree of complicity (...) is unavoidable when working in immigration detention, but that it may be ethically justifiable. We identify ways to minimise the harms associated with complicity and argue that it is ethical to continue working in immigration detention as long as due care and attention is paid to minimising the harms of complicity. (shrink)
The 2013 Rostock Symposium on Systems Biology and Bioinformatics in Aging Research was again dedicated to dissecting the aging process using in silico means. A particular focus was on ontologies, as these are a key technology to systematically integrate heterogeneous information about the aging process. Related topics were databases and data integration. Other talks tackled modeling issues and applications, the latter including talks focussed on marker development and cellular stress as well as on diseases, in particular on diseases of kidney (...) and skin. (shrink)
_Rediscovering Aesthetics_ brings together prominent international voices from art history, philosophy, and artistic practice to discuss the current role of aesthetics within and across their disciplines. Following a period in which theories and histories of art, art criticism, and artistic practice seemed to focus exclusively on political, social, or empirical interpretations of art, aesthetics is being rediscovered both as a vital arena for discussion and a valid interpretive approach outside its traditional philosophical domain. This volume is distinctive, because it provides (...) a selection of significant but divergent positions. The diversity of the views presented here demonstrates that a critical rethinking of aesthetics can be undertaken in a variety of ways. The contributions open a transdisciplinary debate from which a new field of aesthetics may begin to emerge. Contributors include: Claire Bishop, Diarmuid Costello, Paul Crowther, Arthur Danto, Nicholas Davey, Thierry de Duve, James Elkins, Francis Halsall, Michael Ann Holly, Julia Jansen, Michael Kelly, Robert Morris, Tony O'Connor, Peter Osborne, Adrian Piper, David Raskin, Carolee Schneemann, Richard Shiff, Wolfgang Welsch, and Richard Woodfield. (shrink)
Mit Beiträgen von Ursula Bittrich, Yves Bossart, Jan N. Bremmer, Thomas Buchheim, Christoph Horn, Ludger Jansen, Christoph Jedan, Geurt Henk van Kooten, Zbigniew Nerczuk, Matthias Perkams, Joachim Söder, Niko Strobach, Hartmut Westermann und Jula Wildberger.
Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...) conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)
In order to develop the ontology of tendencies for use in the representation of medical knowledge, tendencies are compared with other kinds of entities possessing the realizable-realization-structure, specifically: dispositions, propensities, abilities and virtues. The peculiarities of tendencies are discussed and a standard schema of tendency ascription is developed in order to represent the relations between the ascriptions of tendency tokens to particulars and the ascriptions of tendency types to universals. Two non-standard cases and their epistemic variants are discussed.
How much violence can a society expect its members to accept? A comparison between the language theories of Julia Kristeva and Jacques Lacan is the starting point for answering this question. A look at the early stages of language acquisition exposes the sacrificial logic of patriarchal society. Are those forces that restrict the individual to be conceived in a martial imagery of castration or is it possible that an existing society critically questions those points of socialization that leave their members (...) in a state of homelessness? The following considerations should help to distinguish between unavoidable and avoidable forms of violence. (shrink)
Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of this therapeutic (...) optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)
Like the doctrine of the categories in general, Aristotle’s category of the relative fulfils disparate functions: On the one hand, the category of the pros ti fulfils a dialectic or logical function that aims at the avoidance of fallacies. On the other hand, the category respects the peculiar mode of being of the relative. Taking these two different functions into consideration helps with the interpretation of Aristotle’s two definitions of the relative and his treatment of the properties of the relative (...) in Cat. 7, with the question whether corresponding relatives are of equal priority or ontologically independent, with the genus-species problem , and with the categorical classification of potency and act. (shrink)
In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)
Zuweilen werden der Geschichtsschreibung der Wissenschaftscharakter und historischen Aussagen die Wahrheitsfähigkeit abgesprochen. Ich werde erstens zeigen, dass Aussagen über Vergangenes nicht nur wahrheitsfähig sind, sondern dass einige Aussagen über Vergangenes tatsächlich wahr sind. Zweitens argumentiere ich dafür, dass weder die Gebundenheit an Quellen und die Möglichkeit des Irrtums, noch die Zeit- und Standortgebundenheit historischer Aussagen und eine eventuelle Werthaltigkeit historischer Urteile eine zwingende Gefahr für den Wissenschaftscharakter der Geschichtsschreibung sind. Sie stellen aber besondere Ansprüche an die wissenschaftlichen Tugenden, die ein (...) guter Historiker besitzen muss. Drittens zeige ich, dass die Suche nach historischer Wahrheit nicht nur möglich, sondern für ein funktionierendes gesellschaftliches Zusammenleben auch von größter Bedeutung ist. (shrink)
In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)
There are group-actions, and if actions are intentional, there should also be group-intentions. Who has got these intentions? The groups? This seems to be the natural answer. But then: Groups do not have a mind or brain of there own to form any mental attitude. Different kinds of individualistic analyses of group-intentions have been suggested in the literature. On the one hand there are suggestions to reduce group intentions to a complex of different Iattitudes. John Searle, on the other hand, (...) suggests a special social kind of attitudes, namely we-intentions. We-intentions are being had by individual persons, though they have the form “We intend to do such-and-such”. However, because of the fallibility of Searlian we-intentions and the possibility of ignorance this concept is of no help: We-intentions are neither necessary nor sufficient for group-intentions. In this respect, Margaret Gilbert’s approach is much more successful, though it covers only a special case, namely small-scale informal groups. I suggest a generalised solution in order to cover also large-scale and formal groups. (shrink)
Given the assertion of a relation between two types, like: “Epidermis has part some Keratinocyte”, we define silent change as any kind of change of the instance-relata of the relation in question that does not change the truth-value of the respective type-level assertion. Such assertions are notoriously difficult to model in OWL 2. To address this problem, we distinguish different modes of type-level relatedness giving rise to this problem and describe a conservative extension to the BFO top-level ontology that allows (...) expressing these modes. (shrink)
After a short sketch of Lowe’s account of his four basic categories, I discuss his theory of formal ontological relations and how Lowe wants to account for dispositional predications. I argue that on the ontic level Lowe is a pan-categoricalist, while he is a language dualist and an exemplification dualist with regard to the dispositional/categorical distinction. I argue that Lowe does not present an adequate account of disposition. From an Aristotelian point of view, Lowe conflates dispositional predication with hôs epi (...) to poly statements about what is normally or mostly the case. (shrink)
Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)
It is often claimed that the intentions of physicians are multiple, ambiguous, and uncertain—at least with respect to end-of-life care. This claim provides support for the conclusion that the principle of double effect is of little or no value as a guide to end-of-life pain management. This paper critically discusses this claim. It argues that proponents of the claim fail to distinguish two different senses of “intention,” and that, as a result, they are led to exaggerate the extent to which (...) clinical intentions in end-of-life contexts are ambiguous and uncertain. It argues further that physicians, like others who make life and death decisions, have a duty to get clear on what their intentions are. Finally, it argues that even if the principle of double effect should be rejected, clinical intentions remain ethically significant because they condition the meaning of extraordinary clinical interventions, such as that of palliative sedation. (shrink)
The term “exploitation” has gained wide currency in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer’s path-breaking work on the topic (Wertheimer 1999, 2011). Wertheimer presented a clear and compelling non-Marxist account of the concept of exploitation—one that stressed the connection between exploitation and unfair distributive outcomes. On this account, when one party exploits another, she takes advantage of the other to gain unfairly. A number of contemporary bioethicists (...) have accepted Wertheimer’s account of exploitation and have proceeded to apply it to a range of issues in research ethics (Hawkins and Emanuel 2008; Miller and Brody .. (shrink)
Background: The intentions of clinicians are widely considered to be relevant to the ethical assessment of their actions. A better understanding of the psychological factors that influence the ascription of intentions in clinical practice is important for improving the self-understanding of clinical decision-making and, ultimately, the ethics of clinical care. Drawing on empirical research on intentionality that has been done in other contexts, this is the first study to test whether the “asymmetric effect” of intention ascription is exhibited by respondents (...) when presented with clinical decision-making scenarios. Objective: To assess how individuals attribute intentions to clinical actors in clinical decision-making scenarios. Methods: A total of 149 first and second year medical students was randomly assigned to two groups. Subjects in each group read two scenarios and submitted anonymous responses to questions regarding each scenario. Results: The asymmetric effect was strongly exhibited by the responses given to scenario 2, but it was not exhibited by the responses given to scenario 1. Conclusion: The present study provided evidence for the view that people’s ascription of intentions to others is influenced by their previous evaluative judgement of the conduct in question. (shrink)
Digitalization has become a cornerstone of competitiveness in the industrial arena, especially in the cases of small lot sizes with many variants in the goods produced. Managers of industrial facilities have to handle the complexity that comes along with Industry 4.0 in diverse dimensions to leverage the potentials of digitalization for their sites. This article describes major drivers of this complexity in current industrial automation to outline the environment of today’s challenges for managers of this technical transition—and shows how managed (...) industrial security services can contribute to stabilize the industrial system. An outlook is given to future automation scenarios as well as the major concepts involved in their protection. (shrink)
Recent empirical work on the concept of intentionality suggests that people’s assessments of whether an action is intentional are subject to uncertainty. Some researchers have gone so far as to claim that different people employ different concepts of intentional action. These possibilities have motivated a good deal of work in the relatively new ﬁeld of experimental philosophy. The ﬁndings from this empirical research may prove to be relevant to medical ethics. -/- In this article, we address this issue head on. (...) We ﬁrst describe a study we conducted on intention ascription. Drawing on recent work in experimental philosophy, we investigated the possibility that the ascription of intentions to clinical actors in clinical settings is inﬂuenced by prior judgments about the goodness or badness of the consequences of the action in question. Our study was modeled on experimental studies in other contexts that have shown that people, when presented with a range of scenarios, are more likely to classify a side effect of an action as intended if the side effect is negative or reﬂects poorly on the actor than if it is positive or reﬂects well on the actor. We investigated whether this asymmetry in intention ascriptions was also present among physicians who were asked to ascribe intentions to clinical actors in certain well-deﬁned clinical scenarios. After describing the study and its results, we discuss its implications for medical ethics. (shrink)
In this paper I trace Husserl’s transformation of his notion of phantasy from its strong leanings towards empiricism into a transcendental phenomenology of imagination. Rejecting the view that this account is only more incompatible with contemporary neuroscientific research, I instead claim that the transcendental suspension of naturalistic (or scientific) pretensions precisely enables cooperation between the two distinct realms of phenomenology and science. In particular, a transcendental account of phantasy can disclose the specific accomplishments of imagination without prematurely deciding upon a (...) particular scientific paradigm for its experimental investigation; a decision that is best left to the sciences themselves. (shrink)
: Some commentators have recently proposed that "clinical equipoise," although widely accepted, is not necessary for morally acceptable research on human subjects. If this concept is rejected, however, we may find that trials not in the best medical interests of their subjects--bad deal trials--could be justified. To avoid exploiting participants, we must find a way to distribute the risks fairly, even if it means embracing radical changes in the way clinical research is conducted.
In Republic X, the “problem of the irrational part” is this: Greek tragedy interacts with non-reasoning elements of the soul, affecting audiences in ways that undermine their reasoned views about virtue and value. I suggest that the common construal of Socrates’s critique of Greek tragedy is inadequate, in that it belies key elements of Plato’s audience psychology; specifically, the crucial role of the spirited part and the audience’s cognitive contribution to spectatorship. I argue that Socrates’s emphasis on the audience’s cognitive (...) contribution to spectatorship allows him to anticipate a non-authoritarian solution to the problem of the irrational part. (shrink)
: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, (...) it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. (shrink)
The so-called materially valid inferences have come to new prominence through the work of Robert Brandom. This paper introduces a fragment of a logic of concepts that does not reduce concepts to their extensions. Concept logic and ist semantics allow us to represent the conceptual knowledge used in material inferences and thus suggests a way to deal with them.
Although many studies have revealed the importance of study skills for students' first?year performance and college retention, the extent of the impact of study skills preparation on students' academic achievement is less clear. This paper explores the impact of pre?university study skills preparation on students' first?year study experiences, academic achievement and persistence. The setting for this study is a large law school in the Netherlands which attracts students from more than 100 schools for secondary education. The results show that the (...) perceived study skills preparation concerning time management and learning skills does have a positive impact on college students' first?year study behaviour and academic achievement. However, the study also shows that the impact of perceived college preparation is far less important for college retention than other factors such as satisfaction about the chosen degree programme and tutorial attendance. (shrink)
In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based on Jones’s theory of (...) ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)
Taking Thomas Aquinas's interpretation of the prologue of St John's gospel (in his Lectura super loannem Evangelium) as example, I first discuss eight differences between medieval biblical interpretation and modern exegesis, especially Aquinas's frequent use of philosophical opinions in interpreting the Bible, taken mostly from Aristotle. Second, I account for these differences by reconstructing Aquinas's hermeneutics, hinging, as is shown, upon the assumption that scripture was authored by God infallible and, therefore, only contains true statements. From this starting point Aquinas (...) is lead to a holistic hermeneutics: The interpretation of a biblical statement can be judged on only within the context of an entire theory of God, the world, and of the interpretation of the other biblical statements. Thirdly, this view is discussed systematically and critically. (shrink)
In recent years, many states in the United States have passed legislation requiring laboratories to report the names of patients with low CD4 cell counts to their state Departments of Health. This name reporting is an integral part of the growing number of “HIV Reporting and Partner Notification Laws” which have emerged in response to recently revised guidelines suggested by the National Centers for Disease Control (CDC). Name reporting for patients with low CD4 cell counts allows for a more accurate (...) tracking of the natural history of HIV disease. However, given that this test is now considered to be an “indicator” of HIV, should it be subject to the same strict consent required for HIV testing? While the CDC has recommended that each state develop its own consent requirements for CD4 cell testing, most states have continued to rely on the presumed consent standards for CD4 cell testing that were in place before the passage of name reporting statutes. This allows physicians who treat patients who refuse HIV testing to order a CD4 cell blood analysis to gather information that is indicative of their patient’s HIV status. This paper examines the ethical and legal issues associated with the practice of “conscientious subversion” as it arises when clinicians use CD4 cell counts as a surrogate for HIV testing. (shrink)