Zusammenfassung Die Forschungs- und Regulierungsebene bei datenintensiver Forschung in der Medizin liegen auseinander. Ein heterogenes Feld aus regulierenden Institutionen mit regional ungleichen Regelungen, sowohl hinsichtlich der Dichte als auch der Restriktivität von Regelungen, steht einer globalen Entwicklung der Technologien entgegen. Trotz oder gerade wegen mangelnder global-gültiger Regulierungen können auch unverbindliche oder nur bedingt verbindliche normative Vorgaben der Orientierung dienen. Doch wie soll eine solche normative Regulierung angesichts datenintensiver Forschung in der Medizin ausgestaltet werden und woran soll sie sich orientieren? Die (...) Frage, wie konkret und detailliert man eine solche Forschung regulieren sollte, lässt sich nur im Einzelfall für bestimmte Situationen und Institutionen beantworten. Ob dabei neue Normen oder Gewichtungen von Normen vorgenommen werden sollen, oder ob die Normen und deren Gewichtung weiterhin bestehen bleiben sollen, lässt sich nur mit Verweis auf starke normative Argumente beantworten. An zwingenden Argumenten für neue Normen angesichts der datenintensiven medizinischen Forschung mangelt es bisher. Dennoch ist eine Umsetzungsarbeit von Normen, egal ob neue oder alte, und deren Anwendung auf eine neue Methode oder Technologie allemal zu erbringen. Es bedarf daher – wie schon bisher – beider: sowohl etablierter und transparent kommunizierter Normen als auch des unabhängigen Urteils zur Anwendung dieser Normen. Angesichts der besonderen Eignung für diese Aufgabe sollten auch weiterhin Ethik-Kommissionen als prozedurale Instanz bei der Bewilligung von datenintensiver Forschung in der Medizin gefordert und befähigt werden, die als unabhängige Institution ein Urteil im Einzelfall anhand vorgegebener Normen fällen. Nichtsdestotrotz können sich die veränderten Praktiken datenintensiver Forschungsprojekte auch in neuen Anforderungen an Ethik-Kommissionen niederschlagen, denen mit Reformen der Arbeitsweise begegnet werden sollte. (shrink)

Wenn wir über aktuelle Tendenzen sprechen, wo fängt dieses Gespräch an und wo hört es auf? Müssen wir bestimmte Themen ausschliessen oder sollten wir andere noch miteinbeziehen? Wann befinden wir uns bei einem solchen Gespräch innerhalb einer kanonisierten Debatte, wann befinden wir uns im Bereich des Spekulativen? Das Verhandeln solcher Gegensätze ist allgegenwärtig. In besonderer Weise wird es der Kunst zugeschrieben. Sie erlaube, so heisst es häufig, das Ausloten von Grenzen. Doch ist das wirklich so? Sind künstlerisches Handeln und die (...) vermuteten Grenzen wirklich immer so eindeutig? Und definiert ein solches Ausloten, sei es in der Kunst oder Wissenschaft, wirklich das, was Gegenwart ausmacht? Oder ist es nicht doch so, dass sich erst mit der Zeit bestimmte Verlaufslinien abzeichnen? Die Autoren dieses Buches diskutieren Tendenzen. Sie gehen in die Vergangenheit und verweisen auf die Zukunft. Sie stellen Bezüge und Abgrenzungen her mit Beiträgen aus der Kunst- und Medientheorie. Dieses Buch ist Dr. habil. Arthur Engelbert gewidmet, der seit über drei Jahrzehnten im Bereich der zeitgenössischen Kunst- und Medientheorie arbeitet und wirkt. (shrink)

Das Buch versammelt grundlegende Studien zu Edith Stein und ihren Lektüren von Homer, mittelalterlicher Literatur, Lessing, Schleiermacher, Hauptmann und dem Expressionismus. Es geht den Lektüreeinflüssen in Tradition, Spiritualität und Begegnungen nach und untersucht dazu aktuelle Fragen um Glaube, Wissen und eine neue Phänomenologie. Ein literarisch intensiver und aus der rekonstruierten Bibliothek quellenerschlossener Bildungsgang wirkte auf die Frömmigkeitsentwicklung der späteren Karmelitin und befruchtete massgeblich ihre Denkwelt und mystisch eigene Position.

This paper proposes a new classification algorithm for the partitioning of a conceptual space. All the algorithms which have been used until now have mostly been based on the theory of Voronoi diagrams. This paper proposes an approach based on potential theory, with the criteria for measuring similarities between objects in the conceptual space being based on the Newtonian potential function. The notion of a fuzzy prototype, which generalizes the previous definition of a prototype, is introduced. Furthermore, the necessary conditions (...) that a natural concept must meet are discussed. Instead of convexity, as proposed by Gärdenfors, the notion of geodesically convex sets is used. Thus, if a concept corresponds to a set which is geodesically convex, it is a natural concept. This definition applies, for example, if the conceptual space is an Euclidean space. As a by-product of the construction of the algorithm, an extension of the conceptual space to d-dimensional Riemannian manifolds is obtained. (shrink)

In his early interpretation and representation of the oral teachings of the Hasidic masters, Martin Buber engaged in issues pertinent to the critique of language (Sprachkritik,) of the fin-de-siècle. Associated pre-eminently with Fritz Mauthner and his circle, the critique of language (Sprachkritik) questioned the epistemological status of language, wedded as it is to the divisive Erfahrungswelt. By drawing attention to ecstatic speech, which paradoxically gives expression to the experience (Erlebnis) of the ineffable unity of existence, Buber adumbrates a solution to (...) the cognitive limitations of language. Refracted through Lebensphilosophie, he distinguishes between language as bound to Erfahrung and speech as nurtured by Erlebnis. Whereas language is propelled by conceptual and propositional forms of cognition, speech, principally sustained by metaphors evoked by an experience of the noumenal. Through an examination of his interpretive translation of a well-known Hasidic parable, this article explores how he amplifies this distinction by means of a semantic transformation of the key mystical metaphor of 'ahizat ' enayim (lit. seizing the eyes). Discerning the hermeneutical layers of Buber's rendition of the parable, we argue that his own ambiguous propositional casting of the metaphor entraps him into the very problem he sought to overcome. /// O presente artigo tem como ponto de partida o facto de que na interpretação e representação que dos mestres do Hasidismo fez logo na primeira fase da sua actividade como intelectual, Martin Buber assumiu como próprias questões especialmente pertinentes para uma crítica da linguagem (Sprachkritik) típica da época fin-de-siècle. Associada de modo particular a Fritz Mauthner e ao seu círculo, a Sprachkritik interrogava-se sobretudo acerca do estatuto epistemológico da linguagem, conectada como ela estava com uma Erfahrungswelt que era, desde logo, fonte de divisão. Nesse sentido, a autora do artigo defende que ao chamar a atenção para o discurso ecstático, o qual de modo paradoxal dá expressão à experiência (Erlebnis,) da unidade inefável da existência, Martin Buber pretende fazer vir ao de cima uma solução para o problema das limitações cognitivas da linguagem. Com efeito, mediante recurso à Lebensphilosophie, Buber distingue entre linguagem enquanto ligada à Erfahrung e discurso enquanto que propriamente alimentado pela Erlebnis. Ou seja, Buber reconhece que a linguagem esta animada por formas conceptuais e proposicionais de cognição, ao passo que o discurso aparece sobretudo sustentado por metáforas evocadas por uma experiência do noumenal Em suma, ao focar a sua atenção numa análise da tradução interpretativa que Buber faz de uma bem conhecida parábola Hasídica, o presente artigo explora de que modo o pensador judeu amplifica esta distinção mediante uma transformação semântica da principal metáfora mística do 'ahizaí 'enayim, ou seja, literalmente, da confiscação dos olhos. Tudo isso de modo a discernir os estratos hermenêuticos da interpretação buberiana da parábola, acabando a autora por mostrar de que modo Martin Buber ao dar uma forma propo-sicional ambígua à metáfora acabou por se encerrar no exacto problema que, desde logo, tinha procurado ultrapassar. (shrink)

This is a revised edition of Walker's well-known book in feminist ethics first published in 1997. Walker's book proposes a view of morality and an approach to ethical theory which uses the critical insights of feminism and race theory to rethink the epistemological and moral position of the ethical theorist, and how moral theory is inescapably shaped by culture and history. The main gist of her book is that morality is embodied in "practices of responsibility" that express our identities, values, (...) and connections to others in socially patterned ways. Thus ethical theory needs to be empirically informed and politically critical to avoid reiterating forms of socially entrenched bias. Responsible ethical theory should reveal and question the moral significance of social differences. The book engages with, and challenges, the work of contemporary analytic philosophers in ethics. Moral Understandings has been influential in reaching a global audience in ethics and feminist philosophy, as well as in tangential fields like nursing ethics; research ethics; disability ethics; environmental ethics, and social and political theory. This revised edition contains a new preface, a substantive postscript to Chapter 1 about "the subject of moral philosophy"; the addition of a new chapter on the importance of emotion in practices of responsibility; and the addition of an afterword, which responds to critics of the book. (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)

ZusammenfassungDer Artikel untersucht die Frage, ob es sinnvoll ist, Doping im Sport unter ärztlicher Kontrolle freizugeben. Dazu werden die Auswirkungen einer Freigabe untersucht, die stets nur eine begrenzte Freigabe wäre, allein wegen der Risiken. Die unangenehmen Begleiterscheinungen der Dopingkontrollen würden nicht entfallen. Die Auswirkungen einer Freigabe von Doping im Wettkampfsport wären entweder unsinnig oder aber mit Nachteilen behaftet. Es ist nicht notwendig, die Frage zu klären, was die „Idee des Sportes“ ausmacht und ob sie verändert werden darf. Allein unter praktischen (...) Aspekten zeigt sich, dass dem Sport mit einer Freigabe des Dopings keine Vorteile, aber viele Nachteile erwachsen. (shrink)

The provenance of “naturalized epistemology,” so called, is too recent for the hand of Quine not to be still heavily upon it. But like its older relative, “naturalism,” it is an idea rich enough to be coveted, and protean enough to be claimed, by diverse comers with different things in mind. While Quine's version of naturalized epistemology of science inevitably furnishes the backdrop for current discussion of naturalizing moral epistemology, it is important to pause over what “naturalized epistemology” can and (...) should mean in ethics. To what extent is Quine's example of an epistemologyofscience that helps itselfto sciencethe model for understanding knowledge of and in morality? Does it require a view of moral knowledge as reducible to, or in a fundamental way furnished by, science? Or a view of moral theory as sciencelike in some way? I argue that the appropriate analogy is instead a holistic and reflexive epistemology of morality that helps itself to moral judgments and standards seen as answerable to the experience of the kinds of shared lives they make possible and necessary. This approach neither privileges nor rejects wholesale what scientific inquiries might have to say. (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)

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 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.

In Germany — as probably worldwide — in vitro fertilization has provoked disapproval, fears, and dread, but it also raises hope and gives feelings of pride and satisfaction in a new scientific achievement. Critics look for convincing argu- ments that could ban IVF completely or at least restrict it considerably. Some of the most important arguments are outlined below.The main aspect of IVF that was new to society was that conception could take place outside the female body. Although this fact (...) has made a deep impression on us, no ethical relevance has been attributed to it. One must look further for arguments against IVF. (shrink)

There can be little doubt, I think, that the quality and texture of recent scientific and philosophical thought mark a greater break with the past than any innovations such as were introduced by a Gallileo or a Newton, a Descartes or a Kant. The switch over from the logicality and essential rationality of these men to the irrationalisms, the anti-intellectualisms, and the new logics of the moderns, is not at all on the same footing as that deepening of our concepts (...) of knowledge and reality which we associate with the masters of thought, more particularly with the critical philosophy of Kant. Strong and significant as these earlier changes were, they marked but the onward strides of an art of thinking which remained in its essence the same in spite of them. But the thinkers in the public eye to-day are exploring in unknown regions, and it may turn out that they have got beyond their depth. Whatever their fate, it seems undeniable that the experiments that they have made and are making constitute, at points at least, and for the time being, a veritable revolution. (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.

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)

Urban fragt nach der Literaturkenntnis Edith Steins in ihrem Lesen, Interpretieren, Ubersetzen, Theoretisieren, Dichten und Zitieren und arbeitet Praferenzen, Identifikationen und Schwerpunkte heraus. Die erstmals so zusammengefuhrten und mit ausfuhrlichen Textzeugnissen versehenen Daten und Fakten zeigen, wie ihre Denkwelt und karmelitisch-klosterliche Existenzweise dadurch gepragt wurden. Zugleich wird so ihre spezifische Anthropologie erkennbar. Im zweiten Teil wird nach der Wirkung und bleibenden Aktualitat dieser Anthropologie gefragt. Die Erfahrungen von Kreuz und Leid, Schrecken und Grausamkeit beruhren nicht nur tiefgreifend die Gottes- und (...) Lebenserfahrung der Karmelitin Edith Stein, sondern auch literarische Bewaltigungen und Konzeptionen von Le Fort und Camus bis Goytisolo und jungst Jonathan Littell. (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 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)

A new construction of a certain conceptual space is presented. Elements of this conceptual space correspond to concept elements of reality, which potentially comprise an infinite number of qualities. This construction of a conceptual space solves a problem stated by Dietz and his co-authors in 2013 in the context of Voronoi diagrams. The fractal construction of the conceptual space is that this problem simply does not pose itself. The concept of convexity is discussed in this new conceptual space. Moreover, the (...) meaning of convexity is discussed in full generality, for example when space is deprived of it, its substitutes for concept domains are considered. (shrink)

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.

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)

Der Beitrag untersucht die ethischen Konflikte, die einer Regelung der Arbeitszeit von Ärzten zugrunde liegen. Als oberstes ethisches Prinzip ist die Vermeidung von Schäden zu beachten, die durch Überarbeitung der Ärzte sowie durch übermäßige Aufteilung der Arbeit entstehen. Zudem sind andere ethische Prinzipien zu berücksichtigen, insbesondere die Schadensvermeidung und Nutzenmehrung für zukünftige Patienten sowie für die Ärzte. Der Beitrag begründet Präferenzen bei konfligierenden ethischen Prinzipien und untersucht überdies die strukturellen Schwierigkeiten, die unvermeidlich bei der Regelung einer komplexen Tätigkeit, wie der (...) ärztlichen, anfallen. (shrink)

ABSTRACT Definition of the problem: The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. Arguments and conclusion: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over‐work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments (...) for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians. (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.