Context: Philosophical and - more recently - empirical approaches to the study of mind have recognized the research of lived experience as crucial for the understanding of their subject matter. Such research is faced with self-referentiality: every attempt at examining the experience seems to change the experience in question. This so-called “excavation fallacy” has been taken by many to undermine the possibility of first-person inquiry as a form of scientific practice. Problem: What is the epistemic character and value of reflectively (...) acquired phenomenological data? Can the study of experience, despite the excavation fallacy, rely on the act of reflection on lived experience and make sense and use of its results? Method: Through a philosophical discourse, informed by empirical first-person inquiry, we explore the experiential structure of the act of reflection and the formation of the corresponding belief about past experience. Results: We present a provisional first-person model of the experiential dynamics of retrospective reflection, in which the reflective act is characterized as enaction of belief about past experience that co-determines - rather than distorts - its results. From a constructivist perspective on the inevitable interdependence between the act of observing and the observed, the excavation “fallacy” is recognized as an intrinsic characteristic of reflection. Reflection is described as an iterative, self-referential process, guided by a context- and subject-specific horizon of expectations. Implications: Knowing the characteristics of the formation of beliefs about experience is essential for understanding first-person data and for the possibility of their acquisition and use in scientific practice, particularly in the context of second-person approaches to the study of experience. Constructivist content: We relate the proposed understanding of reflection to constructivist epistemology and argue that constructivism provides an epistemological foundation for the empirical study of experience more suitable than the traditional epistemological objectivism of cognitive science. We suggest that the constructive nature of the process of reflection calls for a collaboration between the fields of constructivism, phenomenology, and first-person research, and points towards the potential for their mutual enrichment. (shrink)

The article critically responds to "A Planetary Health Pledge for Health Professionals in the Anthropocene" which was published by Wabnitz et al. in The Lancet in November 2020. It focuses on the different roles and responsibilities of a physician. The pledge is criticised because it neglects the different roles, gives no answers in case of conflicting goals, and contains numerous inconsistencies. The relationship between the Planetary Health Pledge and the Declaration of Geneva is examined. It is argued that the Planetary (...) Health Pledge should have supplemented the Declaration of Geneva instead of changing it. (shrink)

The article tries to clarify the relation between history of medicine and medical ethics. Therefore it distinguishes between the double meaning of the german word Geschichte , which means both: development of events and story . For the first option no systematic relation between history and ethics can be reconstructed. In the second sense historical knowledge can be a readable and worth reading text for the ethical debate. Therefore the methodological professionality of the historian is required.

Moral Repair examines the ethics and moral psychology of responses to wrongdoing. Explaining the emotional bonds and normative expectations that keep human beings responsive to moral standards and responsible to each other, Margaret Urban Walker uses realistic examples of both personal betrayal and political violence to analyze how moral bonds are damaged by serious wrongs and what must be done to repair the damage. Focusing on victims of wrong, their right to validation, and their sense of justice, Walker presents a (...) unified and detailed philosophical account of hope, trust, resentment, forgiveness, and making amends - the emotions and practices that sustain moral relations. Moral Repair joins a multidisciplinary literature concerned with transitional and restorative justice, reparations, and restoring individual dignity and mutual trust in the wake of serious wrongs. (shrink)

The article presents the judgment of the German Federal Constitutional Court from 26 February 2020 on assisted suicide. The statements regarding human dignity, human rights and the relationship between citizens and the state are examined. Furthermore, the consequences resulting from this interpretation of human dignity for states that are pluralistic and based on human rights will be laid out. The court’s judgment limits the power of parliaments and poses a challenge to many laws in states that see themselves as pluralistic, (...) human rights-based states. There are no data in this work. (shrink)

Die Frage, ob sie eine Kunst oder eine Wissenschaft sei, begleitet die Medizin seit der Antike. Die vorliegende Arbeit untersucht die Frage insbesondere im Hinblick auf den Einfluss Kants, Fichtes und Schellings auf das Selbstverstandnis der Medizin. Sie zeichnet die geschichtlichen Linien nach, die zum Verstandnis der gegenwartigen Situation fuhren und liefert wichtige Argumente zu einem zeitgemassen Selbstverstandnis der Medizin, das fur die wissenschaftstheoretische und ethische Diskussion in der Medizin von heute unverzichtbar ist. Since antiquity, the question has been whether (...) medicine is an art or a science. This work explores the question, in particular in view of Kants, Fichtes and Schellings influence on the self-conception of medicine. It traces the historical timelines which help to understand the current situation and provides important arguments for a timely self-conception of medicine which is indispensable for the discussion of scientific theory and ethics in todays medicine. (shrink)

To what extent can postmodern developments be observed in modern medicine and which theories of postmodern philosophy can we draw on with regard to medicine's theoretical problem? This article explores these questions with special emphasis on the epistemological status of medicine, the concept of disease, and the anthropological model. It is examined whether medicine's inherent duty to act can be questioned in the light of the plurality that characterizes postmodernity. It is concluded that, according to postmodern philosophy, medicine should be (...) characterized by a justified variety of paradigms. Cooperation within the variety must continue to be guaranteed, always in favor of the constitutive moral duty of medicine. (shrink)

In reference to historical developments, this article introduces the topic of this special issue of Theoretical Medicine and Bioethics, that is, the relationship(s) between theory and practice. The authors emphasize the need for scientific research in this neglected area for the sake of both clinical practice and medical education.

According to Michael Tomasello’s evolutionary anthropological approach, joint attention is one of the essential keys to understanding the difference between human and animal. The present paper discusses a recent phenomenological account of the anthropological difference inspired by Tomasello’s conception. A criticism of this account is put forward, while an alternative view is also introduced that stresses the impact of differential rearing experiences on the socio-cognitive development of human and non-human animals.

Background: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy. Aim: To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care. Research design: The study has a (...) qualitative, inductive design. Participants and research context: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. Ethical considerations: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. Findings: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together. Discussion: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy. Conclusion: If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient. (shrink)

Recent decades have seen a development of a variety of approaches for examining lived experience in the context of cognitive science. However, the field of first-person research has yet to develop a pragmatic epistemological framework that would enable researchers to compare and integrate – as well as understand the epistemic status of – different methods and their findings. In this article, we present the foundation of such a framework, grounded in an epistemological investigation of gestures involved in acquiring data on (...) experience. We examine the acts of turning towards one’s experiential field and attending to experience within the process of reflection. We describe what we call the _horizon of attending to experience_ by analogy to the “experimental arrangement” in quantum observation: this horizon, we argue, co-defines experiential phenomena that end up being observed and reported; at the same time, it itself forms an element of experience and is therefore amenable to phenomenological investigation. Drawing on the constructivist notion of enaction, we show that acknowledging the inherently constructive nature of attending to experience and accepting one’s lack of epistemic access to the “original”, observation-independent pre-reflective experience is not a dead end for first-person research when situated in a constructivist (but not relativist) understanding of the reflective act and its results. Expanding the notion of the horizon to encompass all epistemic acts involved in producing phenomenological data and final results of a first-person study (i.e., _horizon of the method_), we suggest some lines of inquiry that would allow researchers to identify and articulate horizons of particular methods, opening a way towards integrating past and future findings of different complementary first-person approaches into a comprehensive map of lived experience. (shrink)

Personalized medicine plays an important role in the development of current medicine. Among the numerous statements regarding the future of personalized medicine, some can be found that accord medicine a new scientific status. Medicine will be transformed from an art to a science due to personalized medicine. This prognosis is supported by references to models of historical developments. The article examines what is meant by this prognosis, what consequences it entails, and how feasible it is. It refers to the long (...) tradition of epistemological thinking in medicine and the use of historical models for the development of medicine. The possible answers to the question “art or science” are systematized with respect to the core question about the relationship between knowledge and action. The prediction for medicine to develop from an ‘empirical healing art’ to a ‘rational, molecular science’ is nonsensical from an epistemological point of view. The historical models employed to substantiate the development of personalized medicine are questionable. (shrink)

The Hippocratic Oath and the Declaration of Geneva of the World Medical Association are compared in terms of content and origin. Their relevance for current medical practice is investigated. The status which is ascribed to these documents will be shown and the status which they can reasonably claim to have will be explored. Arguments in favor of the Hippocratic Oath that rely on historical stability or historical origin are being examined. It is demonstrated that they get caught up in paradoxes. (...) Should doctors swear the Hippocratic Oath or the Declaration of Geneva? The Hippocratic Oath is a remarkable historic document, which contains important elements still relevant for medical ethics today. Its interpretation as a timeless, still valid medical code is unfounded. The historical arguments, that should justify its validity, are untenable. The Declaration of Geneva, and not the Hippocratic Oath, can legitimately claim to come close to representing the most important principles of professional medical conduct in today’s globalised world. (shrink)

Theranostics or theragnostics are new terms which start to appear occasionally in publications from 2001 onwards, with a marked increase in references from 2011. In the last few years more than 1100 articles using this term were published each year. In 2011 the journal Theranostics was founded. This paper addresses the question of whether this new term is appropriate. The etymology of the term is analysed. A literature search for definitions of “theranostics” is carried out and the definitions examined as (...) to whether they give grounds for justifying the use of a new term. The differences between diagnostics and therapy are explored. A broad and a narrow definition are found. According to the broad definition theranostics provides a closer relationship between diagnostics and therapy. According to the narrow definition diagnostics and therapy become a single intervention. On closer examination it turns out that in the narrow definition the diagnostics capacities are limited to monitoring. Neither the broad nor the narrow definition actually demonstrate a new concept in medicine. Rather, they describe the well-known practice of medical decision making. In this respect, the new term cannot be justified. The level of diagnostics is new but not the relationship between diagnostics and therapy. The term theranostics is misleading as it obscures the existing differences between diagnostics and therapy and wrongly insinuates that steps between diagnostics and therapy could be omitted. (shrink)

Michel Bitbol offers a well-thought-out system of metaphysical coordinates. Despite the elegance and soundness of the proposed system, I nevertheless have concerns about the very need for a tailor-….

I critically examine possible advantages of the introduction of a “naturalistic” setting to empirical phenomenological inquiry. As an alternative, I suggest taking the sum of factors ….

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

The personalist ethics of Edith Stein and her feminist thought are intrinsically interrelated. This unique connection constitutes perhaps the main novelty of Stein’s ethical thought that makes her a forerunner of some recent developments in feminist ethics, particularly ethics of care. A few scholars have noticed the resemblance between Stein’s feminist personalism and care ethics, yet none of them have properly explored it. This paper offers an in-depth discussion of the overlaps and differences between Stein’s ethical insights and the core (...) ideas of care ethics. It argues that both Stein and care ethicists relocate a certain set of practices, values and attitudes from the periphery to the center of ethical reflection. This includes relationality, emotionality and care. The paper finally argues that it is plausible and fruitful to read Stein’s advocacy of ‘woman’s values and attitudes’ in a critical feminist way, rather than as an instance of essentialist difference feminism. (shrink)

The aim of this article is to add to the research surrounding nurses' work in hospitals. Throughout history, nurses have faced adverse working conditions, an aspect of their work that remains remarkably unchanged today. Prevailing historical ideologies and sociopolitical conditions influences the context of nurses' work in contemporary hospitals. This research revealed how ruling patriarchal power and nurses' altruistic ways normalize the conditions in hospitals as nurses' work. Moving discourses further add to the work of nurses in hospitals. For example, (...) cost containment strategies, overcapacity and short staffing have resulted in practices to accommodate these problems. While contemporary hospitals may look different, clearly, inside, little has changed since the early days; hospital issues have clearly become an ordinary part of nurses' work. This article discusses how the conditions in hospitals have become an ordinary part of nurses' work. The research in this article emphasizes how prevailing ideologies and institutional discourses make invisible and taken‐for‐granted, how this normalizing of nurses' work contributes to sustaining the hospital's power. (shrink)

The term metaphysics was formed at a time when physics and the physical categories constituted the whole of natural science and to describe the field of thought beyond physics. With the development of other fields of knowledge such as the biological and the historical, it has of necessity acquired a much broader meaning. It describes a field of speculative thought which lies beyond the categories of any of these sciences. In the present context the metaphysical is the meta-historical.