Hans-Martin Sass, Honorary Professor of Philosophy. Founder and board member of the Centre for Medical Ethics, Bochum, Germany. Honorary Senior Research Fellow at Kennedy Institute of Ethics at Georgetown University, Washington, DC. Honorary Professor of the Bioethics Research Centre, Beijing. He has written more than 60 books and pamphlets, more than 250 articles in professional journals. Editor of the Ethik in der Praxis/ Practical ethics, Muenster: Lit. Founder and co-editor of the brochures “Medizinethische Materialien”, Bochum: ZME. He has lectured in (...) Argentina, Austria, Belgium, Bulgaria, Brazil, Canada, Croatia, the Chech Republic, India, Iran, Israel, Italy, Japan, France, the Netherlands, the Philippines, Poland, Portugal, Russia, Spain, Switzerland and Taiwan. The interview devoted to exposition of the concept of bioethics in America and Germany, as well as the professor`s attitude to the idea of the integrative concept of bioethics. The concept of integrative bioethics has been developed in different countries, a component of this concept is the idea of the need for discussion on bioethics in various sectors of society. Equally important in this concept are the definitions of bioethics and the bioethical imperative proposed by Fritz Jahr in 1926. The scientist`s article, which was discovered in 1997, contains a new format of bioethical ideas, as well as a valuable opportunity to enhance understanding the term of bioethics as an integrative science. Interview has been conducted by Hanna Hubenko as a part of the joint international course «Integrative Bioethics». At the meeting it was discussed the experience of cooperation and plans for the future. Cooperation and feedback between scientists remains an unconditional prerogative, also in a pandemic situation. (shrink)

The phenomenological approach to schizophrenia has undergone something of a renaissance in Anglophone psychiatry in recent years. There has been a proliferation of works that focus on the nature of subjectivity in schizophrenia and related disorders, and that take inspiration from the work of such German and French philosophers as Husserl, Heidegger, and Merleau-Ponty, and such classical psychiatrists as Minkowski, Blankenburg, and Binswanger (Rulf 2003; Sass 2001a, 2001b). This trend includes predominantly theoretical articles, which typically incorporate clinical material as well (...) as reviews of empirical and experimental findings in psychopathology. Some very recent examples (since 2000) are studies of .. (shrink)

Disease-specific stem cell therapies, created from induced pluripotent stem cell lines containing the genetic defects responsible for a particular disease, have the potential to revolutionize the treatment of refractory chronic diseases. Given their capacity to differentiate into any human cell type, these cell lines might be reprogrammed to correct a disease-causing genetic defect in any tissue or organ, in addition to offering a more clinically realistic model for testing new drugs and studying disease mechanisms. Clinical translation of these therapies provides (...) an opportunity to design a more systematic, accessible and patient-influenced model for the delivery of medically innovative treatments to chronically ill patients. (shrink)

In an effort to meet growing stakeholder demands for transparency, accountability, and responsibility, many large organizations globally have voluntarily adopted the Global Reporting Initiative guidelines. Moreover, triggered by recent management transgressions, the ancient virtue of practical wisdom has gained increased attention from management scholars, who argue that the Aristotelian concept, with its interdisciplinary nature, has the capacity of turning management back into a holistic, contextual, and virtue-orientated practice. Especially the fact that practical wisdom is firmly based on normative values, coupled (...) with the emphasis on experience and practice, makes it well suited as a leitmotif for sustainable and responsible management. This conceptual paper builds on the link between practical wisdom and sustainability. I argue that the GRI may be regarded as an example of procedural practical wisdom in the context of sustainability reporting, specifically in terms of its emphasis on the holistic and situational dimensions, articulated through the concepts of materiality analysis and stakeholder dialogue. Practical implications, limitations, and avenues for further research are discussed. (shrink)

Mooreanism conjoins at least two claims: that (i) normative properties are grounded in natural properties, and that (ii) normative properties aren’t defined by natural properties; normative properties are instead sui generis. Call (i) the _grounding claim_ and (ii) the _non-definitional claim_. I argue that Mooreanism faces a problem when formulated in the terms of contemporary postmodal metaphysics. Namely, under recent theories of grounding and real definition, the grounding and the non-definitional claims may be inconsistent with each other. This is a (...) problem, because Mooreanism is an important option for the normative non-naturalist. If Mooreanism were inconsistent, then only stronger forms of non-naturalism—including those positing no grounding relations between the natural and the normative—would be available. After rejecting a variety of other proposals for addressing the problem, I argue the problem can be resolved through a recently drawn distinction in the metaphysics of ground between constitutive and non-constitutive grounding. In addition to precisifying Mooreanism, I argue that the distinction between constitutive and non-constitutive grounding reveals space for further varieties of both non-naturalism and naturalism. (shrink)

Phenomenological psychiatry has suffered from a failure to translate its insights into terms specific enough to be applied to psychiatric diagnosis or to be used in contemporary research programs. This difficulty can be understood in light of the well-known tradeoff between reliability and validity. We argue, however, that with sufficient ingenuity, phenomenological concepts can be adapted and applied in a research context. Elsewhere, we have described a phenomenologically oriented conception of schizophrenia as a self- or ipseity-disorder with two main facets: (...) decline in the sense of existing as a subject of awareness (diminished self-affection) and heightened awareness of aspects of experience that would normally remain tacit or presupposed (hyperreflexivity). This approach is consistent with Minkowski, Blankenburg, and Kimura and offers one possible synthesis of their views. Here we describe two areas of empirical research that are congruent with, or actually inspired by, a phenomenological approach emphasizing such disorders of consciousness and self-experience: (1) Phenomenologically oriented, interview studies show that, whereas negative-symptom patients generally deny any diminishment of affect and thinking, they do describe qualitative alterations of experience suggestive of hyperreflexivity and diminished self-affection. (2) Another line of research suggests that the early detection of schizophrenic symptoms may be enhanced by adopting a phenomenological approach. (shrink)

Much discussion of the ethics of algorithms has focused on harms to autonomy—especially harms stemming from manipulation. Nonetheless, although manipulation can often be harmful, we suggest that in certain contexts it may not impair autonomy. To fully assess the impact of algorithm design on autonomy, we argue for a need to move beyond a focus on manipulation towards a multidimensional account of autonomy itself. Drawing on the autonomy literature and recent data ethics, we propose a novel account which takes autonomy (...) to supervene on three distinct but related elements: agency, authenticity and individual control over decision-making. By distinguishing autonomy from control, the account can explain the variable effects of manipulation on user autonomy within algorithm-driven systems. In particular, it can explain why improving user control may improve autonomy in some contexts, while in other contexts—such as in some kinds of newsfeeds—certain algorithm designs that instead _reduce_ user control may nevertheless improve autonomy. As a result, the account can accommodate the sometimes convoluted interplay between control, autonomy, manipulation, and commercial versus prosocial design goals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of delusion has (...) been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 125-132 [Access article in PDF] Incomprehensibility and Understanding:On the Interpretation of Severe Mental Illness Louis A. Sass Keywords hermeneutics, psychopathology, paradox, Wittgenstein, solipsism, delusion, principle of charity, phenomenological psychopathology. I would like to begin by thanking Rupert Read for the care he has put into reading my work, and into thinking through its implications in the context of the "new-Wittgensteinian" interpretation of the (...) thought of Ludwig Wittgenstein. This interpretation derives from an influential reading of this philosopher's early book, the Tractatus Logico-Philosophicus (1961), that is not explicitly discussed in Read's article, yet that lies behind much of his argument. Read does allude to this reading of the Tractatus when he refers to the concept of "logically alien thought" (see Conant [1992]), and by citing, in his endnotes, the Diamond, Conant, and Cerbone articles that appear in Crary and Read's edited collection, The New Wittgenstein (2000). In an earlier paper that also addresses my work, "On approaching schizophrenia through Wittgenstein," Read (2001) explicitly discusses the relevance of the new-Wittgensteinian interpretation of the Tractatus.According to this new-Wittgensteinian interpretation of the Tractatus, Wittgenstein took absolutely seriously his own realization (explicitly stated at the end of the Tractatus) that his book was internally self-contradictory, and he therefore realized that all or nearly all the sentences of the Tractatus must be totally devoid of any meaning or semantic reference. According to this austere view, the vast bulk of the Tractatus only pretends to be making meaningful statements about the nature of logic and semantics; its real purpose is to give the reader the illusion of meaning, and this it does in order to lead the reader to the eventual realization that there can in fact be no meaningful statements or thoughts at the level of self-referential abstraction at which the Tractatus pretends to be operating. Further, when Wittgenstein (1961) writes (in the famous last line of the book), "Whereof one cannot speak, thereof one must be silent" (p. 189), this statement should, supposedly, not be taken as any kind of mystical pointing toward some ineffable realm or truth, but, rather, as an austere recognition that there just are no ineffable truths—that, so to speak, there just is no mystical there there. [End Page 125]Rupert Read sees an analogy between, on the one hand, the (supposedly mistaken) readers of Wittgenstein's Tractatus who think that Wittgenstein is exploiting self-contradiction to allude to some higher, ineffable truth (i.e., something that can be pointed at even if it cannot be said), and, on the other hand, my own elucidation of Schreber's contradictions (see especially Chapter 2 of Paradoxes of Delusion [1994]) to argue that Schreber can be said to be having particular kinds of experiences, which I refer to as solipsistic or quasi-solipsistic in nature. Just as Wittgenstein's self-contradictions can (supposedly) point nowhere other than to their own failure to mean, so Schreber's self-contradictory and other nonstandard statements cannot (according to Read) be used to illuminate in any meaningful way the form of experience that supposedly lies behind them—as I, for example, have tried to do by offering a phenomenological account of Schreber and schizophrenia. Patients like Schreber and Renée cannot really be understood, just as we cannot really understand logically alien thought—which, in fact, is not really thought at all; in both cases, there is only the illusion of meaning, only the mirage of an alternative mode of thinking or of living. This, at least, is Read's new-Wittgensteinian claim.Few readers of Philosophy, Psychiatry, & Psychology will, I suspect, be familiar with these discussions centering on Wittgenstein's Tractatus, which were introduced largely by the philosophers Cora Diamond and James Conant (see Crary and Read [2000]). (I myself have found their writings fascinating and inspiring in many ways, despite my ultimate disagreement on fundamental issues.) 1 Most readers of Philosophy, Psychiatry, & Psychology will have no way of assessing the validity of this austere reading of the Tractatus... (shrink)

This article presents an introductory overview of the interpretations of schizophrenia offered by three phenomenological psychiatrists: Eugene Minkowski (1885-1972), Wolfgang Blankenburg (b. 1928), and Kimura Bin (b. 1931). Minkowski views schizophrenia as characterized by a diminished sense of dynamic and vital connection to the world ("loss of vital contact"), often accompanied by a hypertrophy of intellectual and static tendencies ("morbid rationalism," "morbid geometrism"). Blankenburg emphasizes the patient's loss of the normal sense of obviousness or "natural self-evidence"—a loss of the usual (...) common-sense background that enables normal persons to cope easily with the social and practical world. Kimura focuses on certain distortions of self-experience: a distinctive splitting of the subjective self, alienated awareness of one's own ongoing consciousness, and profound uncertainty about the "I-ness" of the self. In addition to a summary, this article offers a comparison and critique of these three approaches. The three approaches are also considered in light of a more recent, phenomenological formulation of schizophrenia as a disorder of self-experience (an ipseity disturbance) involving hyperreflexivity and diminished self-affection (i.e., heightened awareness of aspects of experience that would normally remain tacit or presupposed and decline in the feeling of existing as a subject of awareness). (shrink)

This essay argues for the necessity of a phenomenological perspective on mind and mental disorder while also emphasizing the inherent difficulty of adopting such an orientation. Here I adopt a via negativa approach—by considering three forms of error that the phenomenologists Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty recognize as needing to be guarded against, lest they subvert the project of attaining an adequate understanding of consciousness or subjectivity: namely (1) prejudices deriving from theory and common sense, (2) distorting effects (...) of reflection, and (3) what Heidegger termed the forgetting of the ontological difference. Phenomenology insists on the importance of studying subjective life while also acknowledging the epistemological paradoxes inherent to this domain—a domain whose very self-evidence is inseparable from mystery, whose visibility conceals a deeper invisibility. I consider these issues in light of phenomenology’s relevance for certain issues in psychopathology and literary representation. (shrink)

Preview: If we define “philosophy” simply as “love of knowledge,” then it is obviously a requirement for any serious scientific, scholarly, or professional pursuit – in whatever field. Philosophy’s relevance is also wide-ranging or even universal when we define it as the most basic or general discipline: the one that poses foundational questions regarding the nature and legitimacy of knowledge itself. Philosophy does seem, however, to have special pertinence for the human sciences, and perhaps especially for the mental-health-related disciplines and (...) professions of psychiatry and clinical psychology. Physics and the biological sciences run up against such problematic issues as the nature of causality, the impact of the observer on the observed, or the essence of life; yet these disciplines seem able to progress quite nicely on their own, with little demand for philosophers or for philosophizing of an explicit sort. Fields like psychiatry and clinical psychology appear, by contrast, to have a more profound need for such input; and indeed, without self-critical philosophical thinking, they often seem to run the risk of degenerating into one or another form of what philosopher of science Imre Lakatos called a “degenerating research program” – whether this take the form of reductionism, rigidification, or mere banality. (shrink)

Madness and Modernism provides a phenomenological study of schizophrenic disorders, criticizing some standard conceptions of these disorders. Sass argues that many aspects of this group of disorders can actually involve more sophisticated (albeit dysfunctional) forms of mind and experience.

A particularly influential thesis about epistemic axiology is veritism: that true belief is the only basic, or fully non-derivative, epistemic value. One recent argument against veritism claims that the naturalness or joint-carvingness of beliefs is also a basic epistemic value. The basic epistemic value of naturalness is held to explain intuitions that true, natural beliefs have greater epistemic value than similar but unnatural beliefs. I argue that epistemic significance, rather than naturalness, can best explain any variations in the value of (...) natural versus unnatural beliefs. Against claims that significance itself undermines veritism, I defend an account of significance that explains why the epistemic value of significance derives entirely from the value of truth. The account also shows how significance can be grounded in multiple features, while still deriving all its value from that of truth. As a result, the epistemic value of natural beliefs offers little reason to abandon veritism, in the absence of stronger arguments favoring the basic epistemic value of naturalness. (shrink)

The term and concept of bioethics (Bio-Ethik) originally were developed by Fritz Jahr, a Protestant Pastor in Halle an der Saale in 1927, long before in the 1970ties bioethics in the modern sense was recreated in the US and since has spread globally. Jahr’s bioethical imperative, influenced by Christian and humanist traditions from Assisi to Schopenhauer and by Buddhist philosophy holds its own position against Kant’s anthropological imperative and against dogmatic Buddhist reasoning: ‘Respect each living being as an end in (...) itself and treat it, if possible, as such’. Jahr interprets the 5th Commandment ‘Thou shalt not kill’ offensively and liberally as ‘common morality’ which includes the obligation of caring for one’s own health, public health and health education within the wider framework of a universal bioethical Sittengesetz. Pastor Fritz Jahr, who had no immediate influence during his times, built a strong first Protestant foundation for contemporary theological and ethical concepts in medical ethics, bioethics, and environmental ethics. (shrink)

Brentano is often considered the originator of the fitting-attitudes analysis of value, on which to be valuable is to be that which it’s fitting to value. But there has been comparatively little attention paid to Brentano’s argument for this analysis. That argument advances the stronger claim that fittingness is part of the analysis of normativity. Since the argument rests on an analogy between truth and fittingness, its impact may seem limited by the idiosyncratic features of Brentano’s later notion of truth. (...) I argue, however, that the Brentanian argument is defensible even if fittingness is analogized to a more typical realist account of truth. The result is what I call the worldly Brentanian account of normativity. I defend this account as a form of naturalistic realism. I then show how the account can fare better than prominent alternatives against two kinds of error-theoretic arguments. (shrink)

My basic question in this paper is pretty straightforward: which resources does the Christian tradition have to overcome envy? If one reads the story of Christ’s passion as an “envy drama” and Christ’s cross as the unjust result of his enemies’ sinful envy (see Mk 15:10), one might offer a more elaborate version of the initial question: what do the crucifixion and resurrection mean when reconsidered as overcoming – or, as I shall say: suspending – envy as cardinal sin? Section (...) one lays out conceptual issues, while section two repudiates two attempts of defending a particular form of envy. Section three is dedicated to different soteriological and Christological models in asking how they can deal with sin (and envy). It reacts to the problems implied by these accounts, particularly the subjectivist one, by suggesting a praxeological answer to the question of this paper. (shrink)

Zusammenfassung Dies ist eine Antwort auf George Pattisons magistrale Triologie über eine „Philosophy of Christian Life“ – mit Schwerpunkt auf dem zweiten Teil: „A Rhetorics of the Words“. Der Beitrag bietet eine Analyse des zentralen Begriffes, nämlich des „Rufs“ oder der „Berufung“. Dies führt zu drei grundlegenden Fragen nach dem fehlenden Gemeinschaftscharakter der Berufung in Pattisons Darstellung; seiner einseitigen Neigung zum Pessimismus in seiner Kulturkritik; und, der nur marginalen Rolle, die andere Artikulationen als der Ruf innerhalb eines „frommen Lebens“ und (...) seiner ambivalenten Autorität spielen. (shrink)

The present study analyzes the relations between Mauss and Sartre. It investigates, primarily, the connections between the obligation of reciprocating a gift and the consequences of this symbolic act, to elaborate a morality deemed as a total fact. Freedom stands out, in this context, as a fundamental value.

A hipótese do presente estudo é a seguinte: a obra de Dilthey representa a verdadeira fundamenta-ção da metodologia própria ao estudo das ciências humanas. Em particular, a constituição de uma antropologia radicada no método compreensivo. Esse método é a principal estrutura sobre a qual podem ser erigidas as ciências humanas. Não se pretende vincular estreitamente toda a história do pensamento contemporâneo aos pressupostos da filosofia de Dilthey. A intenção é tecer um fio condutor suficientemente resistente a ponto de tornar-se a (...) fundamentação da filosofia que se quer metodologicamente independente das ciências naturais. (shrink)

We develop an account of societal democratization that synthesizes cultural sociology and deliberative democracy. Cultural sociologists emphasize the symbolic inclusion of marginalized groups into the civil sphere. Deliberative democrats stress growth in the deliberative capacity of society. We argue that democratization entails the co-evolution of culture and reason. The basis of co-evolution is the performative construction of an inclusive demos, which requires a deliberative background but is also a source of the moral emotions that motivate deliberation. Since moral emotions can (...) also sweep people up and make them do reckless things, they must in turn be redeemable in inclusive deliberation. This synthesis sharpens a normative position for the evaluation of episodes of inclusion, extends current accounts of the place of emotion in cultural sociology and deliberative democracy, and provides a frame for comparative analyses of democratization. We illustrate with an examination of the exclusion and inclusion of Indigenous Australians. (shrink)

God’s being is becoming – the title is the thesis. The first section of this paper will be dedicated to the problem of radical historicity in sketching three dogmatic approaches dealing with the relation between God and history. After critically introducing the concept of relational – in contrast to intrinsic – properties in the second section I will apply a revised version of this concept theologically in integrating it into the architecture of Trinitarian thinking. Accordingly, and on that basis, the (...) last section can address the ambivalent as well as precarious question in which sense God’s ultimate being is in real coming. (shrink)

This article considers the differences between Edmund Husserl and Martin Heidegger in light of Pascal’s distinction between the esprit de géometrie and the esprit de finesse. According to Pascal, the essential “principles” dominating our perceptual lives cannot be clearly and confidently demonstrated in a manner akin to logic and mathematics, but must be discerned in a more spontaneous or intuitive manner.It is unsurprising that Husserl, originally a student of mathematics, might seem closer to the esprit de géometrie, whereas Heidegger, trained (...) in theology and drawn to poets and poetic thinkers, is closer to the esprit de finesse. This difference is clear from the styles of writing of these two seminal figures. I consider how this stylistic difference is also linked with the substance of their respective philosophies, and with the approaches they recommend for exploring subjective life. A related difference concerns how each theorist responds to what Husserl called the “paradox of human subjectivity” and what Michel Foucault later termed the “empirico-transcendental doublet”: the fact that, in doing phenomenology, human consciousness exists as both the subject and the object of our knowing. Husserl mostly emphasized the advantages, epistemological and existential, that this potential reflexivity can afford. Heidegger was more interested in the obstacles or traps it sets—both for accurate self-knowledge and for authentic living. These issues are discussed in relation to the “natural attitude” and “everydayness,” and to the linguistic grounding of human existence and knowledge—especially as these issues emerge in Foucault’s Les mots et les choses and Eugen Fink’s Sixth Cartesian Meditation. (shrink)

The term >Bioethik Bioethical Imperative: Respect every living being in general as an end in itself and treat it, if possible, as such! reinvented Bioethics: The Science of Survival Kennedy Institute of Bioethics three-located birth bioethics medical ethics bioethics< as a comprehensive term, which includes social, cultural, environmental, medical and other fields of applied ethics.

This paper considers the ethical risks and opportunities presented by generalist medical artificial intelligence (GMAI), a kind of dynamic, multimodal AI proposed by Moor et al. (2023) for use in health care. The research objective is to apply widely accepted principles of biomedical ethics to analyze the possible consequences of GMAI, while emphasizing the distinctions between GMAI and current-generation, task-specific medical AI. The principles of autonomy and health equity in particular provide useful guidance for the ethical risks and opportunities of (...) novel AI systems in health care. The ethics of two applications of GMAI are examined: enabling decision aids that inform and educate patients about certain treatments and conditions, and expanding AI-driven diagnosis and treatment recommendation. Emphasis is placed on the potential of GMAI to improve shared decision-making between patients and providers, which supports patient autonomy. Another focus is on health equity, or the reduction of health and access disparities facing underserved populations. Although GMAI presents opportunities to improve patient autonomy, health literacy, and health equity, premature or inadequately regulated adoption of GMAI has the potential to compromise both health equity and patient autonomy. On the other hand, there are significant risks to health equity and autonomy that may arise from not adopting GMAI that has been thoroughly validated and tested. A careful balancing of these risks and benefits will be required to secure the best ethical outcome, if GMAI is ever employed at scale. (shrink)

In his 1786 essay, What does it mean to orient oneself in thinking?, Kant characterizes the business of reasoning by referring to the use of the spatial orientations ‘right’ and ‘left’; he, then, extents his analysis to mathematical and logical ways of orientation. The following paper will start off by analyzing the Kantian standard account of orientation to, eventually, amend that account by deepening and correcting it in three respects: the indexical character of orientation that is due to the particular (...) standpoint of the subject who is oriented by a particular cluster of available reference points; the twofold comparative procedure of orientation in which a situation is assessed by virtue of a practically justified and indexically structured net of orientation; and the receptive modes of orientation, mirroring the ‘existential’ fact that the subject is already oriented to a situation by established institutions. The paper ends in briefly considering the pitfalls and benefits of being disoriented. (shrink)

G.A. Cohen’s value conservatism entails that we ought to preserve some existing sources of value in lieu of more valuable replacements, thereby repudiating maximizing consequentialism. Cohen motivates value conservatism through illustrative cases. The consequentialist, however, can explain many Cohen-style cases by taking extrinsic properties, such as historical significance, to be sources of final value. Nevertheless, it may be intuitive that there’s stronger reason to preserve than to promote certain sources of value, especially historically significant things. This motivates an argument that (...) the weights of our reasons to preserve such things are especially strong relative to the amounts of value they bear. The value conservative can then explain these intuitions in non-consequentialist terms. There may be reason to preserve historically significant things as a matter of recognition respect for a cultural and historical heritage, or because it is virtuous to cultivate the right kind of connection with such a heritage. (shrink)

The biological impact of electromagnetic radiation on humans and other living beings still is controversial and inconclusive. In 1935 Albert Einstein called such an impact ‘fake news’, probably using the prestige of the Nobel Price as a powerful placebo. How should he and we deal with issues of electrosmog, placebo effects, and fake news today?

ZUSAMMENFASSUNGTraditionell wird Demea als das schwächste Glied in Humes berühmten Dialogues concerning Natural Religion angesehen; die Bühne ist ganz dominiert vom optimistischen Theismus, der durch Cleanthes vertreten wird, und den dagegen gerichteten skeptischen Manövern vonseiten Philos. Entgegen diesem traditionellen Bild wird der ›orthodoxe‹ Demea nun verteidigt mit der These: Demea hat – von Hume selbst ungewollt und unbemerkt – das Interessanteste zum religiösen Glauben beizutragen; in ihm deutet sich eine Position jenseits der metaphysischen Phantasien des Theismus einerseits und Philos Destruktionen, (...) die in eine moralische Minimalversion des Glaubens zu münden scheinen, andererseits an. Es wird deutlich, dass diese Verteidigung keine primär exegetischen Ziele verfolgt, sondern auf eine in Humes Figurenkabinett nur treffend personifizierte Konstellation reagiert, die uns sehen lässt, an welchem Punkt theologisch und religionsphilosophisch auch heute zu arbeiten wäre. Dazu wird nach einer begrifflichen Kritik an Cleanthes und Philo anhand von drei konkreten Beispielen herausgearbeitet, wie ein Bild religiösen Glaubens aussehen könnte, das jenseits der metaphysischen Hoffnungen, die Gott zu einer Person erklären, und der reduktionistischen Zugeständnisse, die in ›Gott‹ lediglich den Ausdruck einer moralischen Einstellung zu erkennen meinen, liegt. Demea steht somit für ein postmetaphysisches Bild religiösen Glaubens – und wir sind eingeladen, zu den »friends of Demea« zu gehören.SUMMARYTraditionally, Demea is considered to be the weakest part in Hume's famous Dialogues concerning Natural Religion; the stage is completely dominated by Cleanthes' optimistic theism and by Philo's sceptical moves already critical of the former. Contrary to this traditional approach, however, the ›orthodox‹ Demea will be defended here in maintaining: Demea contributes – neither consciously intended nor recognized by Hume – the most interesting observations concerning religious belief; in him a position is at least alluded lying beyond the metaphysical fantasies of theism on the one hand and Philo's destructions which seem to amount to a moral minimal version on the other hand. It will be clear that this defense is not exegetically orientated; rather, it reacts to a constellation just personalized by Hume's ›casting‹ letting us see at which topics we shall continue to work theologically as well as philosophically today. Accordingly and following a conceptual critique of Cleanthes and Philo it will be elaborated by three concrete examples how a picture of religious belief could look like located beyond metaphysical hopes turning God to a person and reductivist concessions regarding ›God‹ as a mere expression of a moral attitude. Demea, however, represents a postmetaphysical picture of religious belief – and we are invited to belong to the »friends of Demea«. (shrink)

First publication of a letter of Albert Einstein to Hans Vaihinger, dated May, 1919, concerning Vaihinger's concept of "Fiktionen", the role of Geometry in Poincaré's system, and the importance of "real culture" in the intellectual's style of life. The letter is introduced and annotated.

Term and concept of bioethics originally were developed by Fritz Jahr, a Protestant Pastor in Halle an der Saale in 1927, long before the period, when bioethics in the modern sense was recreated in the US in 1970s and since that time has spread globally. Jahr’s bioethical imperative, influenced by Christian and humanist traditions from Assisi to Schopenhauer and by Buddhist philosophy holds its own position against Kant’s anthropological imperative and against dogmatic Buddhist reasoning: ‘Respect each living being as an (...) end in itself and treat it, if possible, as such’. Jahr interprets the 5th Commandment ‘Thou shall not kill’ offensively and liberally as ‘common morality’ which includes the obligation of caring for one’s own health, public health and health education within the wider framework of a universal bioethical Sittengesetz. In the article-translation the actual contemporary thoughts about the bioethical imperative, which serves not only the object of interdisciplinary study, but also the practical approach to acquiring responsibility and environmental image of thinking, are found. Didactic considerations of Yahr go beyond the paternalistic upbringing, they point to the content and methodological purpose of teaching ethics to ethical discourse. According to Yahr, ethics does not regulate philosophical, theological or political knowledge, does not act as a dictatorship of a way of behavior. Ethics is the conduct of discussions, the culture of discussion and communication. Following the philosophy of Yahr, Professor Hans-Martin Zass formulated the geo-ethical imperative: "Respect the Mother Earth and all natural life as it is, for which the responsible person is an end in itself, and get around as much as possible in this way!". In respect for all living things, there is a relationship between man and animals, plants, nature, including the health systems, educational-informational and research organizations. Pastor Fritz Jahr, who had no immediate influence during his times, built a strong first Protestant foundation for contemporary theological and ethical concepts in medical ethics, bioethics, and environmental ethics. (shrink)

In this exploratory study, we look at the professed values that people have, and their performance in a negotiation. We found relations between Schwartz values and conflict handling behaviors, and distributive, integrative, and compatible negotiation outcomes in a controlled environment using Actor-Partner Interdependence Model (APIM) analysis.

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global (...) reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. (shrink)

In the United States, at least 6% of all hospital beds are in the intensive care unit or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ (...) some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1. (shrink)

This paper outlines several of the challenges that are inherent in any attempt to communicate subjective experience to others, particularly in the context of a clinical interview. It presents the phenomenological interview as a way of effectively responding to these challenges, which may be especially important when attempting to understand the profound experiential transformations that take place in schizophrenia. Features of language experience in schizophrenia—including changes in interpersonal orientation, a sense of the arbitrariness of language, and a desire for faithful (...) communication of experience —are described, together with discussion of their relevance for the interview context. Furthermore, the interview presents a unique context in which both intersubjective and interpersonal aspects of experience will be described as well as evoked. It is proposed that phenomenological interviewers should not only be familiar with these and other experiences that can occur in schizophrenia, but also capable of applying the techniques of phenomenological and hermeneutic methods in order to understand the descriptions of interviewees with sensitivity and accuracy. (shrink)

Die Archäologien gelten als junge Wissenschaften, da sie erst vom 19. Jahrhundert an zu universitären Fächern wurden. Die Ur- und Frühgeschichte beruft sich auf die Skandinavier Thomsen und Montelius, die Klassische Archäologie auf Winckelmann. Ältere, als antiquarisch und vorwissenschaftlich bezeichnete Arbeiten schließt man aus der Fachtradition aus. Eine vergleichende europäische Wissenschaftsgeschichte archäologischen Forschens vor dem 19. Jahrhundert ist deshalb ein Desiderat. Die Autorin füllt diese Lücke, indem sie in ihrem zweibändigen Werk Arbeiten mit archäologischem Inhalt aus verschiedenen europäischen Ländern auf (...) ihre grundlegenden Konzepte, Fragestellungen und Methoden hin untersucht. In Studien zu einzelnen Arbeitsschritten geht sie u. a. der Frage nach, inwieweit und unter welchen sozialen und politischen Bedingungen vor der akademischen Fachbildung methodische und konzeptuelle Arbeitsnormen entstanden und sich durchsetzen konnten. Sie kann zeigen, dass archäologische Quellen seit der Antike als wissenschaftliche Beweise dienten, Untersuchungsmethoden zielgerichtet entwickelt wurden und heutige fachliche und nationale Ausprägungen tiefe historische Wurzeln haben. Der zweite Band ist der Zeit von 1630 bis 1852 gewidmet. Sasse erfasst damit die Anfänge der Institutionalisierung, die von der Entwicklung der Grabungsmethodik sowie der Erfindung des heute noch grundlegenden Dreiperiodensystems geprägt sind. Skandinavien, das deutsche Sprachgebiet, England und Frankreich stehen im Fokus. Deutlich wird, dass einige Ergebnisse seit 1660 wesentlich zur europäischen Säkularisierung beitrugen. Erst die Methoden zur Beobachtung und Bearbeitung von Fundkomplexen und die Definition kultureller Kontexte seit 1750 jedoch schufen die Voraussetzung zur Formulierung tragfähiger Fachparadigmen. (shrink)

Increasing interest in applying the theory and practice of deliberative democracy to new and varied political contexts leads us to ask whether or not deliberation is a universal political practice. While deliberation does manifest a universal competence, its character varies substantially across time and space, a variation partially explicable in cultural terms. We deploy an intersubjective conception of culture in order to explore these differences. Culture meets deliberation where publicly accessible meanings, symbols, and norms shape the way political actors engage (...) one another in discourse. Fuller understanding of political deliberation requires comparative and historical studies of particular contexts. We look at one case from Egypt in some depth and provide shorter illustrations from Botswana, Europe, India, Japan, Madagascar, the United States, Yemen, and elsewhere. Cross-cultural learning can enrich the theory of deliberative democracy, and give democratic theory a more universal reach. (shrink)

If not for the interest in the more professional aspects of Nietzsche’s rooting in the history of academic philosophy in Germany, this book would not have been written. Following Vaihinger’s remark that Nietzsche had studied Lange’s History of Materialism, and that he might have been influenced by chapter four of the second volume entitled “The Standpoint of the Ideal,” Salaquarda studied the relationship between Lange and Nietzsche more in detail. Stack follows Salaquarda, but credits Lange with an even greater influence (...) on Nietzsche’s post-Kantian concept of Ideal. Stack’s scholarly book gives us good insights into the lesser known topography of German philosophical history, which, due to an unfortunate fashionable concentration on recognizing only selected mountains from Kant to Hegel to Nietzsche, disregards the lower hills and the valleys. The rich yield of Stack’s book, therefore, lies in his exploration of a certain part of the terra incognita of nineteenth-century academic philosophy. (shrink)

To understand reality in terms of what is possible has methodological implications which a contemplative philosophy makes explicit. The goal is no longer to determine how things are or must be but rather to provide an overview of how they could be and the diversity with which they already appear. The function of philosophy is not the discovery of a single answer but rather a careful description of the diversity and the heterogeneity of possible answers in different contexts and practices. (...) This approach, inspired by Wittgenstein, was applied to the philosophy of religion by Dewi Z. Phillips in particular. This volume explores his contemplative philosophy of religion in an intense and lively discussion, showing how the description of religious faith and the access to its practice and language change unexpectedly and provocatively in this way of thinking. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (shrink)

Understanding alterations of selfhood (termed self-disorders or self-disturbances) that are considered typical of the schizophrenia-spectrum is a central focus of phenomenological research. The currently most influential way of phenomenologically conceiving self-disorders in schizophrenia is as disorders of the so-called most basic or “minimal self”. In this paper, we first highlight some challenges for the minimal self-view of self-disorders, focusing on (1) problems arising from the supposedly “essential” or “universal” nature of minimal self with respect to phenomenal awareness and (2) the (...) critical implications of alterations of self-experience in schizophrenia that involve heightened or exaggerated sense of self. In the second part, we tentatively explore how a (non-egological) transparency-view of consciousness may offer an alternative way of understanding the experiential abnormalities involved in self-disorders in schizophrenia. We discuss how such a transparency-view (1) may account for loss-of-self experiences; (2) is compatible with the key notion of “hyper-reflexivity”; and (3) can help explain instances of self-disorder involving increased sense of self. In conclusion, we consider some possible advantages of this alternative view for research on self-disorders and clinical approaches. (shrink)

: In 1927, Fritz Jahr, a Protestant pastor, philosopher, and educator in Halle an der Saale, published an article entitled "Bio-Ethics: A Review of the Ethical Relationships of Humans to Animals and Plants" and proposed a "Bioethical Imperative," extending Kant's moral imperative to all forms of life. Reviewing new physiological knowledge of his times and moral challenges associated with the development of secular and pluralistic societies, Jahr redefines moral obligations towards human and nonhuman forms of life, outlining the concept of (...) bioethics as an academic discipline, principle, and virtue. Although he had no immediate long-lasting influence during politically and morally turbulent times, his argument that new science and technology requires new ethical and philosophical reflection and resolve may contribute toward clarification of terminology and of normative and practical visions of bioethics, including understanding of the geoethical dimensions of bioethics. (shrink)

This paper discusses ethical and theological issues of Sterbehilfe, assistance in the process of dying versus assistance to die, in particular the challenges of comfort care and palliative for the dying. Advance Directives are evaluated as instruments to establish patients preferences, to guide caregivers and physicians, and to honor patient~s values, visions and beliefs. It is recommended that churches and pastors take a lead in addressing these issues and help patients and their families in preparing for and executing Advance Directives, (...) churches also should take a Iead in developing model forms. The appendix contains a sample of an integrated Patientenverfügrung, Advance Medical Directive including a durable power of attomey and a value-based wish-and-directive list, taking the German legal framework into account and based on monotheistic systems of regious orientation. (shrink)

New dimensions in different ethical scenarios following genetic information require new medical-ethical Action Guides for physician-patient interaction. This paper discusses the ambiguity in moral choice between a “right not to know” and “a duty to know”, regarding parental decisionmaking pro or contra selective abortion following prenatal screening for autosomal dominant polycystic kidney disease (Potter III) and related public policy issues.

A well-known difficulty of the interdisciplinary dialogue beyond the limits of particular disciplines is the lack of common ground regarding their metaphysical and methodological assumptions and commitments. This is particularly evident for the precarious relationship between science and religion. In a 2016 conference entitled “The Many Faces of Panentheism” held in Zurich, and now in this introduction as well as this section, we try to counteract this situation by choosing a focus theme located at the interface between nature and the (...) divine. Thus, key perspectives, arguments, and implications of panentheism are introduced not only from one selected point of view but in relation to others. This allows us to explore territory beyond the boundaries of disciplinary backgrounds and to address intellectual and practical consequences for current debates. (shrink)

This paper considers contradictory features of emotional or affective experience and expression in schizophrenia in light of the “Kretschmerian paradox”—the fact that schizophrenia-spectrum patients can simultaneously experience both exaggerated and diminished levels of affective response. An attempt is made to explain the paradox and explore its implications. Recent research on emotion in schizophrenia is reviewed, including subjective reports, psychophysiological measures of arousal or activation, and behavioural measures, focusing on flat-affect and negative-symptom patients. After discussing relevant concepts and vocabulary of emotion (...) (“affect”, “emotion”, “mood”, “feelings”, the “passions”), the need for a phenomenological approach focusing on subjective experience is proposed. Four modes of nonparanoid experience in schizophrenia are discussed: Bodily Alienation, Disengagement, Unworlding, and Subjectivisation. Each mode involves withdrawal from functional contexts—temporal, practical, and interpersonal—normally associated with emotional reactivity and expression; each may be accompanied by forms of non-emotional affectivity no less intense than the emotions they replace. Possible relationships between psychophysiological measures, expressive behaviour, and subjective emotional or affective response are considered. (shrink)

In this response to Wiggins and Schwartz, Ratcliffe, and Stanghellini, we first wish to express our gratitude to Philosophy, Psychiatry, and Psychology for providing us the space to clarify our views and to overcome certain misunderstandings. Ratcliffe notes that our critique is "harsh," whereas Wiggins and Schwartz lament the fact that the debate "has taken the form of sometimes acid formulations and rejoinders . . . that lack the tone of mutual appreciation" (2011, 31). We deplore the fact that this (...) exchange was at all necessary, and we share Wiggins and Schwartz's concerns. However, we need to recall here and emphasize that our article originated as a response. It originated as a response to an article that was .. (shrink)

Depersonalization/derealization disorder is classified as a dissociative disorder in the DSM5. It is noteworthy that the symptoms of depersonalization and derealization are commonly found in many other psychological disorders, including schizophrenia spectrum disorders, while phenomenological features of schizophrenia are commonly found in DPDR. The current study attempts to clarify these apparent similarities via highly detailed phenomenological interviews with four persons diagnosed with DPDR. The data revealed four interrelated facets: 1, Loss of resonance, 2, Detachment from experience, 3, Loss of self, (...) and 4, Commitment to reality. These facets point to a felt loss of immediate and familiar engagement in experience as a basic organizing Gestalt which permeates the various symptoms and signs of our participants with DPDR. Close consideration of this disruption allows their experiences to be more easily distinguished from those of schizophrenia-spectrum disorders. (shrink)

French thought in the twentieth century is typically described as marked by a major fault line, a rupture or grande coupure, that emerged in the 1960s, the heyday of the ‘crisis of the subject.’ Before this time French philosophy, together with associated fields, were focused on issues of subjectivity—first in the vein of Bergsonian vitalism but then shifting, with Sartre and Merleau-Ponty in the late 1930s and 1940s, to forms of phenomenology and existentialism inspired first by Husserl and then, even (...) more decisively, by Heidegger.1 But starting mid-century, developments in the ‘human sciences’ of linguistics, anthropology, and psychoanalysis began to offer a different.. (shrink)

What does it mean for ethics to say, as Wittgenstein did, that philosophy “leaves everything as it is”? -/- Though clearly absorbed with ethical questions throughout his life and work, Wittgenstein's remarks about the subject do not easily lend themselves to summation or theorizing. Although many moral philosophers cite the influence or inspiration of Wittgenstein, there is little agreement about precisely what it means to do ethics in the light of Wittgenstein. -/- Ethics after Wittgenstein brings together an international cohort (...) of leading scholars in the field to address this problem. The chapters advance a conception of philosophical ethics characterized by an attention to detail, meaning and importance which itself makes ethical demands on its practitioners. Working in conversation with literature and film, engaging deeply with anthropology and critical theory, and addressing contemporary problems from racialized sexual violence against women to the Islamic State, these contributors reclaim Wittgenstein's legacy as an indispensable resource for contemporary ethics. (shrink)