When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

BackgroundThe bioethical debates concerning living donation and surrogacy revolve around similar ethical questions and moral concepts. Nevertheless, the ethical discourses in both fields grew largely isolated from each other.MethodsBased on a review of ethical, sociological and anthropological research this paper aims to link the ethical discourses on living kidney donation and surrogacy by providing a comparative analysis of the two practices’ relational dimension with regard to three aspects, i.e. the normative role of relational dynamics, social norms and gender roles, and (...) reciprocity. Based on this analysis, we derive conclusions for the framing of living organ donation and surrogacy in ethical theory and practice.ResultsFirst, our analysis emphasizes the relevance of acknowledging the complex relational implications of living kidney donation and surrogacy. Underestimating this relational dimension may not only lead to individual crises but endanger existing as well as newly emerging familial relationships. Second, we point out differences in the normative assessment of social norms and gender roles in the ethical debates about living kidney donation and surrogacy. In particular, we show how different evaluations of altruism affect the understanding of autonomy in both contexts. In addition, we sensitize for biased perceptions of gender roles. Finally, we argue that challenges resulting from unresolved reciprocity are an issue in living kidney donation and surrogacy independent of whether the exchange of body parts or bodily services is framed as a gift or commercial exchange. By pointing out the limits of financial compensation, we stress the relevance of non-material, relational rewards as potential remedy. (shrink)

Closed systems are mental artefacts whose structure can neither be explained in terms of innate dispositions nor in terms of the mechanism of natural selection and which stands in contradiction to the conditions of the possibility of information transfer. Kant takes the formal structure of pure mathematics as a guarantor for his reconstruction of a closed system of the subject's structures of knowledge a priori, thereby giving rise to the problem of a normative interface between interior system and exterior information (...) – a problem which is, in this form, not to be solved. By tracing the structure of generative grammar and formal logics back to innate modules, respectively, Chomsky and Fodor are creating the same interface problem, whose basic structure has not yet received the necessary attention. (shrink)

Deep brain stimulation as investigational intervention for symptomatic relief from Alzheimer disease has generated big expectations. Our aim is to discuss the ethical justification of this research agenda by examining the underlying research rationale as well as potential methodological pitfalls. The shortcomings we address are of high ethical importance because only scientifically valid research has the potential to be ethical. We performed a systematic search on MEDLINE and EMBASE. We included 166 publications about DBS for AD into the analysis of (...) research rationale, risks and ethical aspects. Fifty-eight patients were reported in peer-reviewed journals with very mixed results. A grey literature search revealed hints for 75 yet to be published, potentially enrolled patients. The results of our systematic review indicate methodological shortcomings in the literature that are both scientific and ethical in nature. According to our analysis, research with human subjects was performed before decisive preclinical research was published examining the specific research question at stake. We also raise the concern that conclusions on the potential safety and efficacy have been reported in the literature that seem premature given the design of the feasibility studies from which they were drawn. In addition, some publications report that DBS for AD was performed without written informed consent from some patients, but from surrogates only. Furthermore, registered ongoing trials plan to enroll severely demented patients. We provide reasons that this would violate Art. 28 of the Declaration of Helsinki, because DBS for AD involves more than minimal risks and burdens, and because its efficacy and safety are not yet empirically established to be likely. Based on our empirical analysis, we argue that clinical research on interventions of risk class III should not be exploratory but grounded on sound, preclinically tested, and disease-specific a posteriori hypotheses. This also applies to DBS for dementia as long as therapeutic benefits are uncertain, and especially when research subjects with cognitive deficits are involved, who may foreseeably progress to full incapacity to provide informed consent during the required follow-up period. (shrink)

The compositional analysis of sentences like “Tony has been happy since he’s been taking Prozac” becomes feasible through a combination of a maximal informativeness semantics for definite descriptions and an elided second “since” inside the “since”-clause.

We propose Rhythmic Relating for autism: a system of supports for friends, therapists, parents, and educators; a system which aims to augment bidirectional communication and complement existing therapeutic approaches. We begin by summarizing the developmental significance of social timing and the social-motor-synchrony challenges observed in early autism. Meta-analyses conclude the early primacy of such challenges, yet cite the lack of focused therapies. We identify core relational parameters in support of social-motor-synchrony and systematize these using the communicative musicality constructs: pulse; quality; (...) and narrative. Rhythmic Relating aims to augment the clarity, contiguity, and pulse-beat of spontaneous behavior by recruiting rhythmic supports and relatable vitality; facilitating the predictive flow and just-ahead-in-time planning needed for good-enough social timing. From here, we describe possibilities for playful therapeutic interaction, small-step co-regulation, and layered sensorimotor integration. Lastly, we include several clinical case examples demonstrating the use of Rhythmic Relating within four different therapeutic approaches. These clinical case examples are introduced here and several more are included in the Supplementary Material. A suite of pilot intervention studies is proposed to assess the efficacy of combining Rhythmic Relating with different therapeutic approaches in playful work with individuals with autism. Further experimental hypotheses are outlined, designed to clarify the significance of certain key features of the Rhythmic Relating approach. (shrink)

In this comment we take up two points made by Douglas Hollan in his article “Emerging Issues in the Cross-Cultural Study of Empathy,” and discuss their possible philosophical implications. Hollan‘s concept of complex empathy may give rise to the idea that we can learn about other people’s beliefs via empathy, which is something we do not believe is possible. Furthermore, Hollan’s description of possible negative effects of empathy, such as manipulations of a person on the basis of knowledge about their (...) emotions, might pose a problem for proponents of care ethics, who generally start from the assumption that empathy fosters altruistic behavior. (shrink)

Este ensayo intenta persuadir a su lector a adoptar una manera específica de acercarse a la filosofía de Wittgenstein y superar, así, la tradicional bisegmentación de la misma. La propuesta consiste en releer la obra wittgensteineana desde los textos provenientes de los años 1929 a 1933/35 como centro de atención y punto de partida, a fin de poder visualizar la continuidad orgánica del pensamiento en cuestión. Se muestra que sólo el mensaje epistemológico de aquellos “textos transitorios” revela la paulatina modificación (...) de la idea de contextualidad en tanto que única vía hacia la perspicuidad epistémico-conceptual, meta declarada del propio Wittgenstein.Palabras llave: Perspicuidad; contextualidad; epistemología wittgensteineana; continuidad de la filosofía wittgensteineana.This essay seeks to persuade its reader to adopt a specific manner of approaching Wittgensteinian philosophy, overcoming in this way the bi-segmentation traditionally applied to it. What is suggested is a re-reading of Wittgenstein’s work, focussing on, and taking as a starting point, the texts which date from the period 1929-1933/35, in order to visualize the organic continuity of the thought in question. It is shown that only the epistemological message of those “transitional texts” reveals the gradual modification of the idea of contextuality, this being the sole approach towards epistemic-conceptual perspicuity, the professed goal of Wittgenstein himself.Palabras llave: Perspicuity; contextuality; Wittgensteinian epistemology; continuity of Wittgensteinian philosophy. (shrink)

Partiendo de dos complejos nocionales pertenecientes a la filosofía de Ludwig Wittgenstein -el de espacio lógico y el de ver aspectos-, se muestra que en ambos acercamientos se insinúa la disponibilidad de certezas cimentadoras del diálogo humano con el entorno, que la visión de aspectos se subordina a los espacios lógicos involucrados, y que el resultante mecanismo de normas epistémicas vale para toda diversificación -gramatical o cultural- de cosmovisiones. De este modo se re- vela un conjunto de factores epistémico-conceptuales los (...) cuales determinan las relaciones tanto intra como interculturales y posibilitan la coexistencia armónica de diferentes visiones del mundo. (shrink)

Este trabajo trata de probar la incompatibilidad entre el principio de verificación neopositivista, y las ideas de Wittgenstein acerca del método de verificación como criterio de significatividad. Se muestra que el concepto wittgensteineano de verificación apunta a un saber moverse en un espacio lógico que, en virtud de su multiplicidad, resulta ser pertinente para una proposición dentro de un contexto determinado. Así, un "método de verificación" es -para Wittgenstein- una manera de localizar un camino para ver conexiones pertinentes, y no (...) una estrategia deductiva que se supone garantice, en su último paso, un contacto decisivo con la realidad.Palabras llave: Verificación; método; espacio lógico; multiplicidad; Wittgenstein; Neopositivismo.This essay attempts to prove the incompatibility between the neopositivist verification principle and Wittgenstein’s ideas concerning the method of verification as a criterion of significance. It is shown that the Wittgensteinian concept of verification points to an ability to move in a logical space which, by virtue of its multiplicity, turns out to be pertinent for a proposition within a certain context. Thus, a "method of verification" is -according to Wittgenstein- a way of locating a path to see pertinent connections, and not a deductive strategy which is supposed to guarantee, in its last phase, a decisive contact with reality.Palabras llave: Verification; method; logical space; multiplicity; Wittgenstein; Neopositivism. (shrink)

Este ensayo se enfrenta a la conocida tendencia del siglo XX de declarar la “muerte de la epistemología”. A tal fin se presenta una relectura de los textos wittgensteineanos de principios de los años 30, evidenciando la epistemología paraláctica que éstos encaminan. Posibles objeciones se contestan mediante un diálogo ficticio con un imaginario epistemólogo tradicional. Se concluye que la lección de Wittgenstein consiste en hacernos experimentar tanto la fragilidad de nuestras certezas y saberes como su riqueza, dentro de un espacio (...) vital constituido simultáneamente por la experiencia humana y el mundo .Palabras clave: “Muerte de la epistemología”, epistemología paraláctica, certezas y saberes, espacio vital, Wittgenstein.This essay confronts the well-known 20th century tendency of declaring the “death of epistemology.” A summarized re-reading of Wittgenstein’s texts from the early 1930s is presented, illustrating the parallactic epistemology to which those texts point. Possible objections are answered by means of a fictitious dialogue with an imaginary traditional epistemologist. The conclusion is that Wittgenstein’s lesson consists of making us experience the fragility as well as the richness of our certainties and knowledge within a vital space simultaneously constituted by human experience and the world .Key words: “Death of epistemology,” parallactic epistemology, certainties and knowledge, vital space, Wittgenstein. (shrink)

Este trabajo trata de ilustrar el paralelismo existente –no obstante ciertas diferencias de enfoque y de conceptualización– entre el pensamiento wittgensteineano de principios de los años 30 y la teoría del conocimiento de C.I. Lewis. El punto de comparación es la noción de experiencia en tanto que trato epistémico con los objetos. Según la lectura sugerida, nuestra vida epistémica se desarrolla –bajo el denominador común de nuestra conciencia de pertinencias conceptuales– como un dinámico juego entre certezas (vitales) y tentativas de (...) conocimiento (racional). Ciertamente, habría que añadir que, debido a su dependencia contextual, estos factores se caracterizan tanto por su provisionalidad como por su naturaleza intercambiable. (shrink)

Las "investigaciones gramaticales" de Wittgenstein presentan un muy peculiar aporte a la discusión acerca de la vivencia y la conceptualización del tiempo. Partiendo de una diferenciación entre las manifestaciones conceptuales de dos maneras esencialmente distintas de registrar la realidad empírica (el lenguaje de la "experiencia inmediata" y el lenguaje "físico"), las concernientes consideraciones wittgensteineanas desembocan en la idea de que también disponemos de dos vías de registro temporal y, en consecuencia, de dos modos de relacionar tiempo y memoria. El presente (...) artículo trata de aclarar esta curiosa concepción, la cual apunta a un desdoblamiento de la temporalidad en lo que Wittgenstein llama "tiempo-memoria" y "tiempo-información", conectados gracias a una doble dimensionalidad del "instante presente". (shrink)

to appear in Lisa Matthewson (ed.), Cross-linguistic perspectives on the semantics of quantification, Elsevier.

According to Kant our cognitive capacities result from synthetic functions _a priori, forming a complete and invariable system implemented into the human mind. From a Darwinian perspective such capacities are to be understood as genetic traits favored by selection, thus they are the variable components of contingent systems only. Kant intermingles two kinds of apriority: (1) Apriority as a result of inborn traits--judgments on this ground have only probability, not necessity; (2) Apriority as a result of the intentional construction of (...) closed systems--judgments on this ground have necessity, but they are not universal constituents of the human mind. (shrink)

A review of the scientific method. In the scientific method, results must be capable of being reproduced to be valid.

Name der Zeitschrift: Der Islam Jahrgang: 93 Heft: 2 Seiten: 371-373.

2021 jährte sich zum zwanzigsten Mal die Einführung des Lebenspartnerschaftsgesetzes und damit der Eingetragenen Lebenspartnerschaft als das erste Rechtsinstitut für gleichgeschlechtliche Paare. 2017 löste die Ehe die Lebenspartnerschaft ab, allerdings nicht mit allen Rechten einer Ehe wie zwischen heterosexuellen Personen. Der Aushandlungsprozess zur sogenannten Ehe für alle ist insbesondere für religionswissenschaftliche Fragestellungen erkenntnisreich. Am Beispiel des Diskurses um die Einführung der gleichgeschlechtliche Ehe in Deutschland 2015 und dem Referendum in Irland als diskursivem Ereignis zeigt die Autorin, wie politische Akteur*innen in (...) einem zeitgenössischen Deutungskampf um die Bedeutung von Ehe wetteifern und dabei mit der Diskursprämisse einer angenommenen Moderne die Dichotomie von religiös vs. säkular sowie weitere Narrative von und über Religion(en) zur Selbst- und Fremdpositionierungen sowie für ihre Koalitions- und Oppositionsbildungen einsetzen. Die Analyse verwendet einen zeit-, akteurs- und arenaspezifischen Ansatz und verknüpft methodologisch die Wissenssoziologische Diskursanalyse (WDA) mit einem religionswissenschaftlichen Erkenntnisinteresse. (shrink)

Two ways to locate a modal claim in time • Time of Modality vs. Time of Prejacent • Condoravdi’s (2002) terminology: – temporal orientation – temporal perspective but which is which? 2 Time of modality..

Theories of epistemology make reference—via the perspective of an observer—to the structure of information transfer, which generates reality, of which the observer himself forms a part. It can be shown that any epistemological approach which implies the participation of tautological structural elements in the information transfer necessarily leads to an antinomy. Nevertheless, since the time of Aristotle the paradigm of mathematics—and thus tautological structure—has always been a hidden ingredient in the various concepts of knowledge acquisition or general theories of information (...) transfer. We hold that Darwin’s Evolutionary Theory is the first scientific theory which consistently presupposes a non-tautological structure for the information transfer and, at the same time, keeps it strictly distinct from the tautological metric of scientific observation. The consequences of this technique—namely the dissociation of information from intentionality—have not yet been fully drawn. (shrink)

Language development is not completed when children enter primary school. As the comprehension of connectives (such as although, despite) is important for understanding and producing academic texts and, thus, relevant for school success, we investigated its development and influential factors across primary school age on the basis of a newly developed and validated test instrument. Drawing on a German sample of N = 627 children (57.6 % language minority learners) in Grades 2 to 4, results of growth curve models showed (...) students’ initial level of the comprehension of connectives to be negatively related to its growth rate. Additional analyses revealed this association to be due mainly to parental socioeconomic status (SES) rather than children’s language background. Particularly, parental SES and children’s receptive grammar impacted initial level as well as growth rate of connective comprehension. Our results indicate the need for early and continuous sensitization of children for the register of academic language especially in the group of children from low socioeconomic background. (shrink)

The connections between Wittgenstein’s philosophy and the pragmatist tradition are often alluded to, but seldom thoroughly explored. It is commonly assumed that Wittgenstein was scarcely acquainted with such authors as Charles Sanders Peirce or John Dewey (a false idea, as we shall see), even though he had a rather extended knowledge of the philosophy of William James. Nevertheless, the converging features between Wittgenstein and pragmatism are quite striking: we shall hardly need to mention...