Germany has just started a public debate on priority-setting, rationing and cost-effectiveness due to the cost explosion within the German health care system. To date, the costs for German health care run at 11,6 % of its Gross Domestic Product (GDP, 278,3 billion €) that represents a significant increase from the 5,9 % levels present in 1970. In response, the German Parliament has enacted several major and minor legal reforms over the last three decades for the sake of cost containment (...) and maintaining stability of the health care system. The Statutory Health Insurance—SHI (Gesetzliche Krankenversicherung—GKV) is based on the fundamental principle of solidarity and provides an ethical and legal framework for implementing equity, comprehensiveness and setting the principles and rules for financing and providing health care services and benefits. Within the SHI system, several major actors can be identified: the Federal Ministry of Health, the 16 state ministries of health, the Federal Joint Committee (G-BA), the physicians (with their associations) and the hospitals (with their organizations) on the provider side, and the sickness funds with their associations on the purchasers’ side. This article reviews the structure and complexities of the German health care system with its major players and participants. The focus will be put on relevant ethical, legal and economic aspects for prioritization, rationalization, rationing and cost-effectiveness of medical benefits and services. In conclusion, this article pleads for open discussion on the challenging subject of priority-setting instead of accepting the implicit and non-transparent rationing of medical services that currently occurs at many different levels within the health care system, as it stands today. (shrink)

When the complete human genomehas been sequenced, everyone of us will becomea potential candidate for genetic counselingand testing. Within a short period of timeeveryone will obtain his personal geneticpassport identifying deleterious andsusceptibility genes. With the availability ofpresymptomatic tests for late-onset disordersand the possibilities of prevention andtreatment, the conflict between directivenessand non-directiveness will dominate thecounseling setting. Despite general consent onproviding genetic information in a nondirectivefashion to preserve value neutrality andenhance client's autonomy, there is no acceptedcommon definition of what non-directivenessreally is or (...) ought to be. The article tries toelaborate some aspects which might be fruitfuland clarifying in the complex issues involvedin the black box of genetic counseling. (shrink)

In a world that has become increasingly dependent upon employee ownership, commitment, and initiative, organizations need leaders who can inspire their␣employees and motivate them individually. Love, forgiveness, and trust are critical values of today’s organization leaders who are committed to maximizing value for organizations while helping organization members to become their best. We explain the importance of love, forgiveness, and trust in the modern organization and identify 10 commonalities of these virtues.

The problem of academic dishonesty in Business Schools has risen to the level of a crisis according to some authors, with the incidence of reports on student cheating rising to more than half of all the business students. In this article we introduce the problem of academic integrity as a holistic issue that requires creating a␣cultural change involving students, faculty, and administrators in an integrated process. Integrating the extensive literature from other scholars, we offer a ten-step model which can create (...) a positive culture for academic integrity. The successful implementation of a well-crafted academic integrity program can have a positive impact on business schools and improve the reputation of tomorrow’s business leaders. (shrink)

. American businesses and corporate executives are faced with a serious problem the loss of public confidence. Public criticism, increased government controls, and growing expectations for improved financial performance and accountability have accompanied this decline in trust. Traditional approaches to corporate governance, typified by agency theory and stakeholder theory, have been expensive to direct and have focused on short-term profits and organizational systems that fail to achieve desired results. We explain why the organizational governance theories are fundamentally, inadequate to build (...) trust. We advance a conceptual framework based on stewardship theory characterized by “covenantal relationships” and argue that design of governance mechanisms using a covenantal approach is more effective in building trust in organizations. A covenantal relationship is a specialized form of a relational contract between an employee and his or her organization. We argue that regardless of incentives and control mechanisms carefully designed through contractual mechanisms, in the absence of covenantal relationships it is extremely difficult to build trust within organizations. We propose that organizations are more likely to build trust – both at the organizational level and at the interpersonal level – when they create reinforcing and integrated systems that honor implied duties of “covenantal relationships.”. (shrink)

How can school education best bring about moral improvement? Socrates believed that the unexamined life was not worth living and that the philosophical examination of life required a collaborative inquiry. Today, our society relegates responsibility for values to the personal sphere rather than the social one. I will argue that, overall, we need to give more emphasis to collaboration and inquiry rather than pitting students against each other and focusing too much attention on ‘teaching that’ instead of ‘teaching how’. I (...) will argue that we need to include philosophy in the curriculum throughout the school years, and teach it through a collaborative inquiry which enables children to participate in an open society subject to reason. Such collaborative inquiry integrates personal responsibility with social values more effectively than sectarian and didactic religious education. (shrink)

Although trustworthiness has been described as a source of competitive advantage, its value extends to organizational governance and wealth creation. We identify the importance of the commitment—compliance continuum in the decision to trust and note that trustworthiness is a subjective perception viewed through each person's mediating lens. That lens and each person's interpretation of the social contract impact one's commitment to cooperate. We suggest five propositions that integrate trustworthiness, governance, and wealth creation.

Trust within a secular or organizational context is much like the concept of faith within a religious framework. The purpose of this article is to identify parallels between trust and faith, particularly from the individual perspective of the person who perceives a duty owed to him or her. Betrayal is often a subjectively derived construct based upon each individual's subjective mediating lens. We analyze the nature of trust and betrayal and offer insights that a wise believer might use in understanding (...) his or her relationship with the divine. We suggest that the parallels between trust and faith involve a willingness to relinquish one's power or control in the expectant hope that our needs will be met. Betrayal, however, is often profoundly misunderstood. (shrink)

How can materialists begin to do justice to the experiencing subject? Some materialists, whom I call ?structuralists?, believe that the brain sciences offer at least the distant prospect of a materialist psychology with an experiencing subject. Others, and notably those materialists who are functionalists, believe that this faith is misplaced, and offer us instead a functional psychology. I argue, briefly, that functionalism cannot deliver the goods, and go on to elaborate and defend the structuralist claim that consciousness or experience is (...) the formation of content conceived as that laying down of traces commonly assumed to be involved in perception and cognition. (shrink)

Organizational governance has historically focused around the perspective of principals and managers and has traditionally pursued the goal of maximizing owner wealth. This paper suggests that organizational governance can profitably be viewed from the ethical perspective of organizational followers - employees of the organization to whom important ethical duties are also owed. We present two perspectives of organizational governance: Principal Theory that suggests that organizational owners and managers can often be ethically opportunistic and take advantage of employees who serve them (...) and Principle Theory that focuses on guiding principles that are sometimes taken too far in organizations. In introducing these two new organizational governance perspectives, we offer insights into the value of rethinking ethical duties owed to organizational followers. (shrink)

The ability of leaders to be perceived as trustworthy and to develop authentic and effective relationships is largely a function of their personal identities and their self-awareness in understanding and making accommodations for their weaknesses. The research about self-deception confirms that we often practice denial regarding our identities without being fully aware of the ethical duties that we owe to ourselves and to others. This article offers insights about the nature of identity and selfawareness, specifically examining how self-deception can create (...) barriers to self-awareness within both a personal and a business context. (shrink)

In this paper an economics approach to assessing community values in health care priority setting is examined. The approach is based on the concept of ‘willingness to pay’ (WTP). Eighty two parents were interviewed with regard to three aspects of provision of child health services. For each aspect a choice of two courses of action was presented. Parents were asked which course of action they preferred and what was the maximum amount of money they would be prepared to pay for (...) this rather than their less preferred option. WTP responses are acceptable to the majority of respondents and appear to ‘behave’ in accordance witha priori expectations. A method of assessing the influence of ability to pay on preferences and WTP is outlined. Preferences and WTP do not appear to have been unduly distorted by ability to pay. Use of WTP data does have the potential to provide health care purchasers and providers with information on intensity as well as direction of the preferences of members of the community. (shrink)

Deep brain stimulation is an invasive technique designed to stimulate certain deep brain regions for therapeutic purposes and is currently used mainly in patients with neurodegenerative disorders, such as Parkinson’s disease. However, DBS is also used increasingly for other experimental applications, such as the treatment of psychiatric disorders, weight reduction. Apart from its therapeutic potential, DBS can cause severe adverse effects, some that might also have a significant impact on the patient’s personality and autonomy by the external stimulation of DBS (...) which effects lie beyond the individual’s control and free will. The article’s purpose is to outline the procedures of DBS currently used in therapeutic and experimental applications and to discuss the ethical concerns regarding this procedure. It will address the clinical benefit-risk-ratio, the particular ethics of research in this field, and the ethical issues raised by affecting a patient’s or an individual’s personality and autonomous behaviour. Moreover, a potential ethical guideline, the Ulysses contract is discussed for the field of clinical application as well as the question of responsibility. (shrink)

Zusammenfassung. Inzwischen ist „Dolly” mehrfach durch die Klonierungen anderer Säugetiere hinreichend bestätigt worden. Im Januar 1999 sollen Koreanische Forscher sogar den ersten menschlichen Embryo kloniert haben. Im folgenden werden zunächst biologisch-technische Grundlagen aktueller Klonierungstechnologien des Embryo-Splittings und der Zellkerntransplantation vorgestellt. Anschließend folgt eine kurze ethische Bewertung der Klonierung beim Menschen, wobei das Klonen als ein Verstoß gegen die Menschenwürde klassifiziert wird. Seit der Verabschiedung des Embryonenschutzgesetzes (ESchG) im Januar 1991 sind jetzt über neun Jahre vergangen. In Anbetracht der wissenschaftlichen Erkenntnisse (...) und des technischen Fortschrittes auf dem Gebiet der Reproduktionsmedizin in den letzten Jahre meldet das ESchG nicht nur zunehmenden Interpretationsbedarf an, sondern weist auch z.T. gravierende Strafbarkeitslücken auf. Mit dem vorliegenden Beitrag soll ein Stück weit eine auf der Basis des naturwissenschaftlichen Fortschritts fundierte ethisch-rechtliche Diskussion insbesondere vor dem Hintergrund des in die Jahre gekommenen deutschen ESchG angeregt werden. (shrink)

Definition of the problem: Recently, ”Dolly” has been confirmed by cloning several other mammals. In January 1999 it was even reported that Korean researchers first of all had cloned the first human embryo. In the following article some basic biological and technical aspects of modern cloning strategies, such as embryo splitting and nuclear transplantation, will be described. Subsequently, a short critical analysis will discuss the ethical problem of cloning human beings. Since the German Embryo Protection Act from January 1991 substantial (...) progress in cloning technology has been made, so that the principal question now is whether the Act is still sufficient to forbid human cloning or whether it should be revised. Arguments and conclusion: With advanced technical progress human cloning now seems to be possible. From the ethical point of view, the cloning of human beings should be rejected, as it offends the fundamental value of human dignity. On the other hand, the German Embryo Protection Act is antiquated and does not provide the required protection. This article may stimulate further discussion in the fields of ethics and jurisdiction, especially regarding to the Embryo Protection Act. (shrink)

Doing philosophy encourages us to explore beneath the surface of things. It challenges us to ask questions and go beyond easy, obvious answers. Doing philosophy with children is exciting. It is surprising, challenging, awe-inspiring and fun.

This book explores the implications of agonistic democratic theory for political practice. Fuat Gürsözlü argues that at a time when political parties exacerbate political division, political protesters are characterized as looters and terrorists, and extreme partisanship and authoritarian tendencies are on the rise, the agonistic approach offers a much-needed rethinking of political practice to critically understand challenges to democracy and envision more democratic, inclusive, and peaceful alternatives. Inspired by Chantal Mouffe’s agonistic theory and drawing on insights of other prominent (...) agonistic scholars, Gürsözlü offers a distinctive approach that develops the connections between the agonistic approach and political practice. His main claim is that approaching democratic politics from an agonistic perspective changes the way we understand the nature of democratic society, the place of political protest in democracy, the nature of adversarial engagement, and the democratic function of political parties. The book also advances an account of agonistic peace that is best fitted to the pluralistic and inherently conflictual nature of democratic societies. This book should be of interest to anyone working in the field of contemporary political theory, political philosophy, peace studies, and philosophy of peace. (shrink)

The influence of pragmatism—and of Dewey in particular—upon Lipman’s conception of the classroom Community of Inquiry is pervasive. The notion of the Community of Inquiry is directly attributable to Peirce, while Dewey maintained that inquiry should form the backbone of education in a democratic society, conceived of as an inquiring community. I explore the ways in which pragmatic conceptions of truth and meaning are embedded in the Community of Inquiry, as well as looking at its Deweyan moral and social commitments. (...) I show that Peirce’s and Dewey’s notions of truth are in perfect alignment with the philosophical Community of Inquiry, as is Dewey’s tie between meaning and ideas that bring our inquiries to a satisfactory conclusion. The Deweyan notion that moral values are justified by their utility in solving problems in social life is also to be found in the Community of Inquiry, as arguably is his view that moral values are to be regarded as working values that face the tribunal of experience in much the same way as hypotheses in science. Again, the focus in the classroom on open inquiry into issues and problems, the active participation of the students in building upon one another’s ideas, the sense of shared responsibility, and the growth and development of the intellectual and social powers of the individual, all mirror Dewey’s pragmatic conception of democracy. Given this allegiance, it may be argued that the Community of Inquiry faces a pragmatic problem of its own. While it aims to be a philosophically open encounter with all kinds of issues and ideas, pragmatic conceptions are so constitutive of it that they may skew the pitch philosophically. I also address this issue. (shrink)

Recent evidence readily confirms that ethical conduct in human interaction has declined in the context of business, but also in virtually every phase of life. An alarming number of government leaders at all levels have demonstrated by their conduct that their primary goal is the pursuit of self-interest for themselves, their party, and their constituents - regardless of whether the choices they make are in the long-term best interests of those whom they are obligated to serve. Academic institutions and their (...) leaders similarly seem to be either tied to past assumptions and traditions that seem, or blatantly out of touch with the needs of their students and the communities that they serve. Increasingly, college and university academic programs are being taught by part-time and temporary faculty who are paid less than their elementary and high school counterparts who lack their educational preparation, level of knowledge, or responsibility in preparing students for their chosen careers. Non-governmental organizations also struggle to earn the respect of the public, and their trustworthiness has been called into question as chief executive officers and staff receive high salaries, but lack accountability for achieving results or acting with integrity. Those who work in the media are as a group no longer trusted to provide an objective and unbiased assessment of the news. Even religious institutions are under attack and their leaders are being asked to be accountable to the standards which their doctrines advocate. Implicit in ethical conduct is the responsibility to identify the far goals of human achievement - rather than short-term interests that undermine long-term value creation and outcomes that best serve society. Abraham Maslow has wisely noted that the pursuit of efficiency must be evaluated in terms of the specific goals intended to be achieved, but the ramifications of individual and collective actions often seem to be out of focus, misdirected, and short-sighted. (shrink)

The question of Turkey's membership in the EU has been the subject of debates about the cosmopolitan future of Europe. Using the concept of cosmopolitanism as developed by Beck, Habermas, and Delanty, this article argues that the possibility of an antiontological and multicultural cosmopolitan European community will largely depend on how Europe answers the question of whether Turkey should be granted membership in the EU. Turkey forces a debate on three crucial areas that are directly related to the cosmopolitan future (...) of Europe: (a) Europe's geopolitical place in the global world, (b) postnational forms of a European public sphere, and (c) European identity. The potential for a multicultural and pluralistic cosmopolitanism is a two-way street, and while Turkey's membership will have a transformative impact on the EU, the membership process will also have a similar impact on Turkish democracy and modernity. (shrink)

Collection of stories for children aged 8 to 12, designed to encourage children to raise questions about philosophical topics such as the nature of truth, to explore different points of view, and to initiate discussions about time, change and environment. A teacher resource/activity book is also available. The authors are members of the Philosophy for Children movement. The editor is a senior lecturer in the school of philosophy at the University of New South Wales. He is a former president of (...) the Philosophy for Children Association of NSW and foundation chairperson of the Federation of Australian Philosophy for Children Associations. (shrink)

The Triumph of Liberal Democratic Peace and the Dangers of Its Success” provides an overview of the “liberal democratic peace theory” that is associated with Kant and has been developed by Doyle and other contemporary scholars. The chapter examines the problem of wars that are fought in the name of democracy and the way that the liberal democratic peace theory can end up encouraging military interventions. It argues that a careful understanding of the Kantian democratic peace theory can resist the (...) urge to intervene. It employs Galtung’s notion of cultural violence to provide a critique of interventionist peace action. It concludes by advising that we work to find a way to build bridges between democracies and non-democracies. (shrink)

The current article deals with the ethics and practice of physician-assisted suicide (PAS) and dying. The debate about PAS must take the important legal and ethical context of medical acts at the end of life into consideration, and cannot be examined independently from physicians’ duties with respect to care for the terminally ill and dying. The discussion in Germany about active euthanasia, limiting medical intervention at the end of life, patient autonomy, advanced directives, and PAS is not fundamentally different in (...) content and arguments from discussions led in other European countries and the United States. This must be emphasized, since it is occasionally claimed that in Germany a thorough discussion could not be held with the same openness as in other countries due to Germany’s recent history. Still, it is worthwhile to portray the debate, which has been held intensively both among experts and the German public, from the German perspective. In general, it can be stated that in Germany debates about questions of medical ethics and bioethics are taking place with relatively large participation of an interested public, as shown, for instance, by the intense recent discussions about the legalisation of advanced directives on June 18 2009, the generation and use of embryonic stem cells in research or the highly difficult challenges for the prioritizing and rationing of scarce resources within the German health care system. Hence, the current article provides some insights into central medical and legal documents and the controversial public debate on the regulation of end-of-life medical care. In conclusion, euthanasia and PAS as practices of direct medical killing or medically assisted killing of vulnerable persons as “due care” is to be strictly rejected. Instead, we propose a more holistically-oriented palliative concept of a compassionate and virtuous doctor-cared dying that is embedded in an ethics of care. (shrink)

The lack of conceptual analysis within cognitive science results in multiple models of the same phenomena. However, these models incorporate assumptions that contradict basic structural features of the domain they are describing. This is particularly true about the domain of mathematical cognition. In this paper we argue that foundational theoretic aspects of psychological models for language and arithmetic should be clarified before postulating such models. We propose a means to clarify these foundational concepts by analyzing the distinctions between metric and (...) linguistic compositionality, which we use to assess current models of mathematical cognition. Our proposal is consistent with the scientific methodology that determines that careful conceptual analysis should precede theoretical descriptions of data. 2012 APA, all rights reserved). (shrink)

Au sein de la littérature vietnamienne où l’amitié est quasi-absente, se distingue l’œuvre de Phan Hồn Nhiên dont les personnages sont en quête de cette forme d’affection. Notre article s’interroge sur la spécificité de l’exercice amical chez l’écrivaine née en 1972. Comment articule-t-elle ce lien fondé sur la durée, au caractère éphémère des échanges, caractéristique de notre époque? Comment tient-elle compte des effets de la mondialisation? Comment le thème de l’amitié lui permet-il de renouveler la question de la condition de (...) l’individu contemporain et de sa pratique des relations interpersonnelles? (shrink)

Au sein de la littérature vietnamienne où l’amitié est quasi-absente, se distingue l’œuvre de Phan Hồn Nhiên dont les personnages sont en quête de cette forme d’affection. Notre article s’interroge sur la spécificité de l’exercice amical chez l’écrivaine née en 1972. Comment articule-t-elle ce lien fondé sur la durée, au caractère éphémère des échanges, caractéristique de notre époque? Comment tient-elle compte des effets de la mondialisation? Comment le thème de l’amitié lui permet-il de renouveler la question de la condition de (...) l’individu contemporain et de sa pratique des relations interpersonnelles? (shrink)