In this paper I outline the PAIR account of joint attention as a perceptual-practical, affectively charged intentional relation. I argue that to explain joint attention we need to leave the received understanding of propositions and propositional attitudes and the picture of content connected to it behind and embrace the notions of subject mode and position mode content. I also explore the relation between joint attention and communication.

Frege argued for the force-content distinction not only by appealing to the logical and fictional contexts which are most closely associated with the “Frege point", but also based on the fact that an affirmative answer to a yes-no question constitutes an assertion. Supposedly this is only intelligible if the question contains a forceless thought or proposition which an affirmative answer then asserts. Against this I argue that this fact more readily supports the view that questions operate on assertions and other (...) forceful acts themselves. Force is neither added to propositions as on the traditional view, nor is it cancelled as has recently been proposed. Rather higher-level acts such as questioning, but also e.g. conditionalizing, embed and present assertoric or directive acts that are forceful and committal, while suspending commitment to them. The Frege point confounds different varieties of force and the question whether something is merely presented for consideration with the question what is so presented. Force is representational: through assertoric and directive force indicators subjects non-conceptually present positions of theoretical or practical knowledge, while interrogative acts indicate positions of wondering which strive for such knowledge. (shrink)

Raimo Tuomela’s most important contribution to the philosophy of collective intentionality was his development of the notion of the we-mode. In my chapter I extend the notion of we-mode to that of role-mode, the mode in which individual and collective subjects feel, think and act as occupants of roles within groups and institutional structures. I focus on how being in role-mode is manifest in the minds of subjects and on the following points. First, I argue that both we-mode and role-mode (...) are best thought of as further modifications of I-consciousness, respectively we-consciousness. Second, role-mode is further characterized by the fact that subjects will take positions as role occupants that they won’t take as mere individuals, or we-mode group members, or in other roles. Third, such divergences are only possible against a background of agreements between positions taken in different modes. Fourth, such divergences are also grounded in decision making procedures and the accessibility and admissibility of sources of evidence. Fifth, role-mode goes all the way down, that is, it is also manifest in how subjects feel, move and comport themselves when they occupy their roles. To put it into fashionable jargon, it is embodied and enacted. (shrink)

In this paper I first introduce Tomasello’s notion of thought and his account of its emergence and development through differentiation, arguing that it calls into question the theory bias of the philosophical tradition on thought as well as its frequent atomism. I then raise some worries that he may be overextending the concept of thought, arguing that we should recognize an area of intentionality intermediate between action and perception on the one hand and thought on the other. After that I (...) argue that the co-operative nature of humans is reflected in the very structure of their intentionality and thought: in co-operative modes such as the mode of joint attention and action and the we-mode, they experience and represent others as co-subjects of joint relations to situations in the world rather than as mere objects. In conclusion, I briefly comment on what Tomasello refers to as one of two big open questions in the theory of collective intentionality, namely that of the irreducibility of jointness. (shrink)

BackgroundThe theory and practice of ethics consultations (ECs) in health care are still characterized by many controversies, including, for example, the practice of giving recommendations. These controversies are complicated by an astonishing lack of evidence in the whole field. It is not clear how often a recommendation is issued in ethics consultations and when and why this step is taken. Especially in a facilitation model in which giving recommendations is optional, more data would be helpful to evaluate daily practice, ensure (...) that this practice is in line with the overarching goals of this approach and support the development of standards.MethodsWe analyzed all consultations requested from an EC service working under a facilitation approach at a maximum-care university hospital in Germany over a period of more than 10 years. Our aim was to better understand why—and under what circumstances—some consultation requests result in a recommendation, whereas others can be sufficiently addressed solely by facilitated meetings. We especially wanted to know when and why clients felt the need for clear advice from the EC service while in other cases they did not. We compared ethics consultations in terms of the differences between cases with and without recommendations issued by the ethics consultants using χ2 difference tests and Welch’s t-test.ResultsA total of 243 ECs were carried out between September 2008 and December 2019. In approximately half of the cases, a recommendation was given. All recommendations were issued upon the request of clients. When physicians asked for an EC, the consultation was significantly more likely to result in a recommendation than when the EC was requested by any other party. ECs in cases on wards with ethics rounds resulted in comparably fewer recommendations than those in wards without ethics rounds. When interpersonal conflicts were part of the problem or relatives were present in the meeting, clients less frequently asked for a recommendation.ConclusionFrom the client’s point of view, there does not seem to be only one “right” way to provide ethics consultations, but rather several. While facilitated meetings are obviously appreciated by clients, there also seem to be situations in which a recommendation is desired (especially by physicians). Further empirical and theoretical research is needed to validate our single-center results and re-evaluate the role of recommendations in ethics consultations. (shrink)

Objective: Although a main principle of medical ethics and law since the 1970s, standards of informed consent are regarded with great scepticism by many clinicans.Methods: By reviewing the reactions to and adoption of this principle of medical ethics in neurosurgery, the characteristic conflicts that emerge between theory and everyday clinical experience are emphasised and a modified conception of informed consent is proposed.Results: The adoption and debate of informed consent in neurosurgery took place in two steps. Firstly, respect for patient autonomy (...) was included into the ethical codes of the professional organisations. Secondly, the legal demands of the principle were questioned by clinicians. Informed consent is mainly interpreted in terms of freedom from interference and absolute autonomy. It lacks a constructive notion of physician–patient interaction in its effort to promote the best interest of the patient, which, however, potentially emerges from a reconsideration of the principle of beneficence.Conclusion: To avoid insufficient legal interpretations, informed consent should be understood in terms of autonomy and beneficence. A continuous interaction between the patient and the given physician is considered as an essential prerequisite for the realisation of the standards of informed consent. (shrink)

The Frege point to the effect that e.g. the clauses of conditionals are not asserted and therefore cannot be assertions is often taken to establish a dichotomy between the content of a speech act, which is propositional and belongs to logic and semantics, and its force, which belongs to pragmatics. Recently this dichotomy has been questioned by philosophers such as Peter Hanks and Francois Recanati, who propose act-theoretic accounts of propositions, argue that we can’t account for propositional unity independently of (...) the forceful acts of speakers, and respond to the Frege point by appealing to a notion of force cancellation. I argue that the notion of force cancellation is faced with a dilemma and offer an alternative response to the Frege point, which extends the act-theoretic account to logical acts such as conditionalizing or disjoining. Such higher-level acts allow us to present forceful acts while suspending commitment to them. In connecting them, a subject rather commits to an affirmation function of such acts. In contrast, the Frege point confuses a lack of commitment to what is put forward with a lack of commitment or force in what is put forward. (shrink)

BackgroundEthics consultation is recognized as an opportunity to share responsibility for difficult decisions in prenatal medicine, where moral intuitions are often unable to lead to a settled decision. It remains unclear, however, if the general standards of ethics consultation are applicable to the very particular setting of pregnancy.Main textWe sought to analyze the special nature of disagreements, conflicts and value uncertainties in prenatal medicine as well as the ways in which an ethics consultation service (ECS) could possibly respond to them (...) and illustrated our results with a case example. Ethics facilitation and conflict mediation, currently, have no broadly consented normative framework encompassing prenatal diagnosis and therapy as well as reproductive choice to draw on. Even so, they can still be helpful instruments for ethically challenging decision-making in prenatal medicine provided two additional rules are respected: For the time being, ECSs should (a) refrain from issuing content-heavy recommendations in prenatal medicine and (b) should not initiate conflict mediations that would involve the pregnant woman or couple as a conflict party.ConclusionIt seems to be vital that ethics consultants as well as health care professionals acknowledge the current limitations and pitfalls of ethics consultation in prenatal medicine and together engage in the advancement of standards for this particularly complex setting. (shrink)

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses (...) to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

In addition to the Frege point, Frege also argued for the force-content distinction from the fact that an affirmative answer to a yes-no question constitutes an assertion. I argue that this fact more readily supports the view that questions operate on and present assertions and other forceful acts themselves. Force is neither added to propositions as on the traditional view, nor is it cancelled as has recently been proposed. Rather higher level acts such as questioning, but also e.g. conditionalizing, embed (...) assertive or directive acts that are forceful and committal, while suspending commitment to them. The Frege point confounds different varieties of force and the question whether something is merely presented for consideration with the question what is so presented. Force is representational: through assertoric and directive force indicators subjects non-conceptually present positions of theoretical or practical knowledge, while interrogative acts indicate positions of wondering which strive for such knowledge. (shrink)

Harry S. Broudy has studied the utility of general education through the development and testing of his Newspaper Test of the Uses of Schooling (NPT). The results of research with a new version of the NPT are reported in this essay and some options for future research are presented. The results of the study indicate that continued development and testing of the NPT will prove important. Promising new versions of the test are suggested for future research to pursue, including a (...) Hypertest version. Additional instruments and research strategies are also suggested that could be used to broaden the "search for evidence" of the uses of schooling. (shrink)

Although training in self-regulated learning is effective in improving performance, human trainers can reach only a few people at a time. We developed a web-based training for potentially unlimited numbers of participants based on the process model of SRL by Schmitz and Wiese. A prior study observed positive effects on self-reported SRL and self-efficacy. In the present randomized controlled trial, we investigated an improved version of the web-based training, augmented by the application of peer feedback groups. Prospective university students (...) in an online mathematics preparation course were assigned randomly to one of four experimental conditions: Group D, group TD, group TDP, and group C. Complete data was obtained for 136 participants. The learning diary was intended to trigger goal setting, planning, and self-motivation in the morning and reflection in the evening. The web-based training consisted of three lessons with videos, presentations, self-tests, and exercises. In the peer feedback condition, participants were randomly assigned to groups of five persons each and used a bulletin board to discuss pre-defined topics related to the content of the web-based training. Outcome measures included a test of declarative SRL knowledge, an SRL questionnaire, a general self-efficacy scale, log file data, and a mathematics test. Results showed positive effects for the web-based training, particularly when combined with peer feedback on both SRL knowledge and SRL questionnaires, self-efficacy, and on objective time-investment, but not on the mathematics test. The learning diary did not exhibit positive effects. We conclude that additional peer-feedback seems to be a useful supplement to web-based trainings with comparably low organizational costs. (shrink)

Modern nursing evolved out of a war. Today’s nurses not only work in war zones but the profession as a whole needs to consider its responsibility in caring for victims of conflict and what its international duty is in preventing wars. This means that nurses must be informed of the devastation caused by conflict not only in countries where conflicts and war take place but also world-wide. Nurses’ responsibility is to prevent illness and alleviate suffering, which includes the long-term morbidity (...) caused by wars. They need to be more politically active in conflict resolution and prevention at local, community, national and international levels. The purpose of this article is to address these issues from an ethical perspective and to suggest implications for nursing education and practice. (shrink)

Interactions between corporations and nonprofits are on the rise, frequently driven by a corporate interest in establishing credentials for corporate social responsibility (CSR). In this article, we show how increasing demands for accountability directed at both businesses and NGOs can have the unintended effect of compromising the autonomy of nonprofits and fostering their co-optation. Greater scrutiny of NGO spending driven by self-appointed watchdogs of the nonprofit sector and a prevalence of strategic notions of CSR advanced by corporate actors weaken the (...) ability of civil society actors to change the business practices of their partners in the commercial sector. To counter this trend, we argue that corporations should embrace a political notion of CSR and should actively encourage NGOs to strengthen “downward accountability” mechanisms, even if this creates more tensions in corporate–NGO partnerships. Rather than seeing NGOs as tools in a competition for a comparative advantage in the market place, corporations should actively support NGO independence and critical capacity. (shrink)

Zwischen der Veröffentlichung der "Phänomenologie der Wahrnehmung" im Jahr 1945 und dem Tod Merleau-Pontys im Jahr 1961 liegen gerade einmal 16 Jahre. In dieser Zeitspanne nimmt Merleau-Ponty das Projekt einer Ausweitung und Grundlegung seiner Überlegungen auf, indem er zum einen das Phänomen der Expressivität in den unterschiedlichsten kulturellen Dimensionen erkundet, um vom Ausdrucksverhalten her eine Kulturphilosophie eigenen Typs zu entwickeln, und um zum anderen ein ontologisches Fundament der ästhetischen Stellung des Menschen in der Welt freizulegen. Diese Projekte konnte Merleau-Ponty aufgrund (...) seines frühen Todes nicht vollständig verwirklichen und zusammenführen. Seine letzte große Veröffentlichung, die unter dem Titel "Zeichen (Signes)" die wichtigsten Beiträge aus jener Zeit versammelt und die nun erstmals vollständig in deutscher Übersetzung vorliegt, läßt den Rahmen dieses Unterfangens erkennen und skizziert die Konturen der Überlegungen Merleau-Pontys in den 50er Jahren. Aufgenommen wurden von ihm Aufsätze und Essays, die der Sprachphilosophie, der Ästhetik, der Wissenschaftstheorie der Sozialwissenschaften sowie der Phänomenologie und Philosophiegeschichte gewidmet sind. Zusätzlich fügt er politische Artikel und Stellungnahmen zur kulturellen Situation Frankreichs sowie Interviews hinzu, die belegen, in welche Zeit hinein und aus welcher Situation heraus sich sein Denken realisiert. (shrink)

BackgroundLight to moderate physical activity, which includes walking, is associated with positive effects on physical and mental health. However, concerning mental health, social and physical environmental factors are likely to play an important role in this association. This study investigates person-place interactions between environmental characteristics and momentary affective states during walking episodes. A within-subject design is implemented, in which affective states and environmental characteristics are assessed while participants are walking outside.MethodsOn smartphones, coupled with a motion sensor, e-diaries were triggered as (...) soon as people walked 100 m outside. E-diaries assessed momentary affective states, and social interaction between 6 am and 10 pm over nine days. The percentage of greenness was determined afterward from recorded GPS and GIS data. Demographics were collected in advance via an online questionnaire. Multilevel models were calculated with R for 46 individuals.ResultsAffective state dimension energetic arousal showed a significant association with social interaction and greenness, i.e., participants rated energetic arousal lower when walking alone, and if there was less greenness vs. when interacting shortly with someone while walking, and being in situations with more greenness. Furthermore, associations with social interaction and greenness were found for dimension calmness: walking together with someone was associated with higher calmness, and the higher the proportion of surrounding greenness during a walk, the higher calmness was rated, i.e., participants were calmer. Significant associations with valence were not present.ConclusionThe findings indicate that the affective states varied significantly due to different social and physical environmental factors. In the future, the importance of environmental factors should be further investigated, e.g., by assessing environmental factors right in situations contrary to a subsequent imputation. Within-subject designs, and in particular triggered assessments with the addition of GPS, can aid in developing interventions for health-promoting urban environments. (shrink)

Resolution of the entropy‐evolution problem was a significant issue for Pierre Teilhard de Chardin throughout his scientific career. Although never truly satisfied with his solution, he proposed that all energy must be psychic and contain two components. Tangential energy is related to physical energy. Radial energy in some way accounts for increasing complexity and consciousness in evolution. Analysis of developments in thermodynamics, statistical mechanics, and information theory show that Gibbs free energy contains both calorimetric and noetic components, thus validating Teilhard's (...) intuition. (shrink)

This volume advances discussions between critics and defenders of the force-content distinction and opens new ways of thinking about force and speech acts in relation to the unity problem. -/- The force-content dichotomy has shaped the philosophy of language and mind since the time of Frege and Russell. Isn’t it obvious that, for example, the clauses of a conditional are not asserted and must therefore be propositions and propositions the forceless contents of forceful acts? But, others have recently asked in (...) response, how can a proposition be a truth value bearer if it is not unified through the forceful act of a subject that takes a position regarding how things are? Can we not instead think of propositions as being inherently forceful, but of force as being cancelled in certain contexts? And what do indicators of assertoric, but also of directive and interrogative force mean? (shrink)

The resolution of ambiguities is one of the central problems for Machine Translation. In this paper we propose a knowledge-based approach to disambiguation which uses Description Logics (dl) as representation formalism. We present the process of anaphora resolution implemented in the Machine Translation systemfast and show how thedl systemback is used to support disambiguation.The disambiguation strategy uses factors representing syntactic, semantic, and conceptual constraints with different weights to choose the most adequate antecedent candidate. We show how these factors can be (...) declaratively represented as defaults inback. Disambiguation is then achieved by determining the interpretation that yields a qualitatively minimal number of exceptions to the defaults, and can thus be formalized as exception minimization. (shrink)

Background While most countries that allow abortion on women’s request also grant physicians a right to conscientious objection (CO), this has proven to constitute a potential barrier to abortion access. Conscientious objection is regarded as an understudied phenomenon the effects of which have not yet been examined in Germany. Based on expert interviews, this study aims to exemplarily reconstruct the processes of abortion in a mid-sized city in Germany, and to identify potential effects of conscientious objection. Methods Five semi-structured interviews (...) with experts from all instances involved have been conducted in April 2020. The experts gave an insight into the medical care structures with regard to abortion procedures, the application and manifestations of conscientious objection in medical practice, and its impact on the care of pregnant women. A content analysis of the transcribed interviews was performed. Results Both the procedural processes and the effects of conscientious objection are reported to differ significantly between early abortions performed before the 12th week of pregnancy and late abortions performed at the second and third trimester. Conscientious objection shows structural consequences as it is experienced to further reduce the number of possible providers, especially for early abortions. On the individual level of the doctor-patient relationship, the experts confirmed the neutrality and patient-orientation of the vast majority of doctors. Still, it is especially late abortions that seem to be vulnerable to barriers imposed by conscientious objection in individual medical encounters. Conclusion Our findings indicate that conscientious objection possibly imposes barriers to both early and late abortion provision and especially in the last procedural steps, which from an ethical point of view is especially problematic. To oblige hospitals to partake in abortion provision in Germany has the potential to prevent negative impacts of conscientious objection on women’s rights on an individual as well as on a structural level. (shrink)