ABSTRACT “Complexity” is ubiquitous in contemporary political commentary, where it is invoked to justify innovative governance programs. However, the term lacks analytic clarity. One way to make sense of it is to construct a genealogy of the notion of “wicked problems,” a concept that highlights the intractability of complex problems and problematizes the technocratic management of complexity. The term wicked problems originated in science planning in postwar Germany and urban planning in the United States. In both cases, planners rejected a (...) naïve optimism about the potential of technical expertise in favor of recognizing that many problems transcend the knowledge possessed by experts. This appreciation of complexity led to attempts, still ongoing, to accommodate both participatory and expert-based decision making in the face of wicked problems, producing a form of technical democracy in which problem solving requires the orchestration of conflict. (shrink)

This article supports calls for an increased integration of patients into taxonomic decision making in psychiatry by arguing that their exclusion constitutes a special kind of epistemic injustice: preemptive testimonial injustice, which precludes the opportunity for testimony due to a wrongly presumed irrelevance or lack of expertise. Here, this presumption is misguided for two reasons: the role of values in psychiatric classification and the potential function of first-person knowledge as a corrective means against implicitly value-laden, inaccurate, or incomplete diagnostic criteria (...) sets. This kind of epistemic injustice leads to preventable epistemic losses in psychiatric classification, diagnosis, and treatment. (shrink)

This article follows the history of the idea of adventure in the Soviet Union, which started as a dream of the great communist adventure but two decades into the revolution turned into the nightmare of the Great Terror. Adventure was implicated in the violent realities of Stalinism through tropes of the adventure genre, such as the loneliness of the adventurer in a precarious world impenetrable by reason. Understanding this situation requires a focus on philosophies of both adventure and terror. For (...) instance, Hegel’s philosophy of adventure will help us to reveal features of the lived experience in times of terror, whilst Mikhail Ryklin’s philosophy of terror sheds light on the significance of the adventure genre in the Soviet 1930s. This double focus allows articulation of a primary feature of violence that is often overlooked, namely, the fundamental reciprocity that structures it. In the Soviet context, we find historically neglected but critically important reflections on the relation between violence and adventure in the life and works of Lev Kopelev. We also find a unique deliberation on the dialectics of violence (and counter-violence) in Evgeni Shvarc’s adventure tale The Dragon (1943) which can be fruitfully read in dialogue with Arendt’s vital distinction between violence and power. Reconsidering these sources is an important task for today given that Russian politics has once again, 30 years after perestroika, regressed into mass violence. (shrink)

Looking at contemporary Japanese images of the self and how Japanese scholars have conceptualised the notion of the subjectivity three remarkable concepts of “the self” can be identified and distinguished from another: the Inner Self, the Political Self, the Social Self. In my paper I will discuss these concepts by high lightening their hybridity, plurality and their emphasis on the identity as an effect of self-realization. I shall argue that the investigation in the Japaneseunderstanding of the self is particularly fruitful (...) for a global understanding of subjectivity, because Japanese selfhood does not represent the “otherness” of the western thought but is actually crisscrossed by western and eastern ideas. What can be marked as the Inner Self combines ideas of the Buddhist “Non-Self” (anatman) and the European Idealistic Ego (Ich). Embedded in practises of meditation the Inner Self in the Japanese understanding is realized through the activity of finding and loosing oneself. The Political Self can be perceived as an amalgamation of the Asian art of the regime of the group and the western thought of Liberalism and personal identity. Somewhat discovered in Japan as a possibility of the self in the 19th century the Political Self comes into existence througheducational practise. Furthermore the Social Self brings together Chinese Confucian ethics and ancient Japanese Shintoism. Understood as a particle in the flow of social relations the Social Self is realized in Japan within the rituals of everyday live and physical hence tactical education in the childhood of a person. The Japanese concepts of the self exemplify on the level of their formal configuration the qualities of what can be called a plural anthropology. (shrink)

Die Arbeit entwickelt erstmals eine von hermeneutischen Grundannahmen geleitete systematische Theorie des Films und reflektiert deren methodische Konsequenzen für die Analyse und Interpretation von Filmen. Auf der Grundlage einer zeichen- und sprechakttheoretischen Bestimmung filmischer Kommunikation werden die wichtigsten Strukturen filmischen Erzählens (Kameraführung, Montage, Erzählsituationen, verbale und nonverbale Figurenrede, Perspektivenstrukturen, uneigentliche Bilderrede) einer theoretischen und methodenpraktischen Reflexion unterzogen.

At present, the debate on global justice, a debate which is at the core of global ethics, is largely being conducted by European and American scholars from different disciplines without taking into account views and concepts from other regions of the world, particularly, from the Global South. The lack of a truly intercultural, interreligious, and international exchange of ideas provokes doubts whether the concepts of global justice introduced so far are able to transcend regional and cultural horizons. The article introduces (...) concepts of justice from African scholars, whose voices have remained marginal until now, like the Kenyan philosopher Henry Odera Oruka, the Ethiopian philosopher Teodros Kiros, and the debate on ubuntu, one of the most controversial concepts in southern Africa today. These concepts focus on issues that are seldom considered in the debate on global justice, such as the importance of bodily needs as a prerequisite for human beings to act as moral beings and the importance of human rel.. (shrink)

This article gives an overview of the influence of the work of Michel Foucault on the philosophy of Agamben. Discussed are Foucault’s influence on the Homo Sacer cycle, on (the development) of Agamben’s notion of power (and on his closely related notion of freedom and art of life), as well as on Agamben’s philosophy of language and methodology. While most commentaries focus on Agamben’s interpretation of Foucault’s concept of biopower, his work also contains many interesting references to Foucault on freedom (...) and possibilities—and I think that it is here that Foucault’s influence on Agamben is most deeply felt. This article focuses on the shifts Agamben takes while looking for the Entwicklungsfähigkeit in the work of Foucault. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

Volume 26, Issue 1, March 2023, Page 86-90.

TheoryDigital technologies have become an integral part of everyday life that children are exposed to. Therefore, it is important for children to acquire an understanding of these technologies early on by teaching them computational thinking as a part of STEM. However, primary school teachers are often reluctant to teach CT. Expectancy-value theory suggests that motivational components play an important role in teaching and learning. Thus, one hindrance to teachers’ willingness to teach CT might be their low expectancies of success and (...) high emotional costs, e.g., anxiety towards CT. Thus, introducing preservice teachers to CT during their university years might be a promising way to support their expectancies and values, while simultaneously alleviating their emotional costs. Prior CT competences might contribute to these outcomes.AimsWe investigated whether a specifically designed seminar on CT affected preservice teachers’ expectancies and values towards programming.Method: A total of 311 German primary school and special education preservice teachers took part in the study. The primary school preservice teachers received a seminar on CT and programming with low-threshold programming tasks, while the special education teachers served as a baseline group. The seminar was specifically designed to enhance expectancies and values and decrease emotional costs, following implications of research on expectancy-value theory.ResultsThe preservice teachers who visited the seminar gained higher expectancies and values towards CT and programming compared to the baseline group. Moreover, their emotional costs decreased. CT was positively related to change in expectancies and values and negatively related to emotional costs.DiscussionInterventions with low-threshold programming tasks can support primary school preservice teachers in finding trust in their abilities and values towards CT. Moreover, their anxiety towards CT and programming can be alleviated. Thus, first steps in preparing preservice teachers to teach CT in their future classrooms can be taken in university. (shrink)

Feminist scholars have identified pervasive gender discrimination in science as an institution, as well as gender bias in the very content of many scientific theories. An ameliorative project at heart, feminist philosophy of science has inquired into the social and epistemological roots and consequences of these problems and into their potential solutions. Most feminist philosophers agree on a need for diversity in scientific communities to counter the detrimental effects of gender bias. Diversity could thus serve as a unifying concept for (...) a potential consensus of the field. Yet there are substantial differences in the kinds and roles of diversity envisaged. This element argues that we need diversity, both in terms of social locations and of values, to overcome former biases and blind spots. Diversity as such, however, is insufficient. To reap its epistemic benefits, diversity also needs to be institutionalised in a way that counters various forms of epistemic injustice. (shrink)

ABSTRACTThis is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task, an Emotional Visual Search Task, and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: (...) evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying... (shrink)

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)

A dominant view of guilt and shame is that they have opposing action tendencies: guilt- prone people are more likely to avoid or overcome dysfunctional patterns of behaviour, making amends for past misdoings, whereas shame-prone people are more likely to persist in dysfunctional patterns of behaviour, avoiding responsibility for past misdoings and/or lashing out in defensive aggression. Some have suggested that addiction treatment should make use of these insights, tailoring therapy according to people’s degree of guilt-proneness versus shame-proneness. In this (...) paper, we challenge this dominant view, reviewing empirical findings from others as well as our own to question (1) whether shame and guilt can be so easily disentangled in the experience of people with addiction, and (2) whether shame and guilt have the opposing action tendencies standardly attributed to them. We recommend a shift in theoretical perspective that explains our main finding that both emotions can be either destructive or constructive for recovery, depending on how these emotions are managed. We argue such management depends in turn on a person’s quality of self-blame (retributive or ‘scaffolding’), impacting upon their attitude towards their own agency as someone with fixed and unchanging dispositions (shame and guilt destructive for recovery) or as someone capable of changing themselves (shame and guilt productive for recovery). With an eye to therapeutic intervention, we then explore how this shift in attitude towards the self can be accomplished. Specifically, we discuss empathy-driven affective and narratively-driven cognitive components of a process that allow individuals to move away from the register of retributive self-blame into a register of scaffolding ‘reproach’, thereby enabling them to manage their experiences of both shame and guilt in a more generative way. (shrink)

While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the consequences (...) of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

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Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem (...) to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction. (shrink)

Psychiatric classification is highly controversial, as could be witnessed again with the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM). These controversies comprise multiple kinds of critiques by a variety of actors. It is unlikely that all these issues will be overcome by one perfect solution in the future. Rather, it is precisely the DSM’s “one-size-fits-all-approach” that lies at the root of many of the current problems. To restore the scientific and public credibility of psychiatric classification, (...) a multi-dimensional pluralist response is thus needed: (1) theoretical pluralism, meaning a promotion of different research projects and heuristic strategies, (2) taxonomic pluralism, which allows for different classifications used in research versus clinical practice, and (3) participatory pluralism, which concerns the diversity of perspectives and stakeholders in DSM-revisions. (shrink)

People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, (...) where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed. (shrink)

Gilbert et al. argue that the concerns about the influence of Deep Brain Stimulation on – as they lump together – personality, identity, agency, autonomy, authenticity and the self are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence (...) for that. Rather they show the challenges of doing research in a field that is stretched out over multiple disciplines. In that sense their paper is an important starting point for a discussion on methodology and offers valuable lessons for a future research agenda. (shrink)

The value-freedom of scientific knowledge is commonly hold to be a necessary condition for objectivity. Helen Longino’s contextual empiricism aims to overcome this connection. She questions the suitability of the normative ideal of value-freedom and develops an alternative conception of objectivity, which integrates social and epistemic aspects of scientific enquiry. The function of this notion of ‘social objectivity’ is to make value-laden assumptions assessable through a process of criticism, even if there cannot be any guarantee of their elimination. This assessability (...) requires common standards of evaluation, which are threatened by Longino’s rejection of the distinction between cognitive and non-cognitive values guiding theory choice. I will argue that in order to resolve this inherent tension, social objectivity has to be understood as based on a procedural epistemology and, differing from Longino’s own approach, must include the normative requirement to strive for consensus instead of allowing for epistemological pluralism. (shrink)

The nomadic Kazaks inhabiting Xinjiang Province, China, retain many aspects of their pre‐Islamic way of life, including the use of methods of traditional healing usually classified under the rubric of "shamanism." These practices are closely related to those in Kazakstan, Mongolia, and other parts of the former Soviet Union.The present study addresses aspects of traditional healing in use among the Xinjiang Kazaks in recent times, and presents a native taxonomy of these practices obtained during recent fieldwork in Xingjiang. Special attention (...) is paid to the use of words, sound, and movement in healing contexts by elders and specialized individuals. (shrink)

[Vol. 1.] Text volume -- [Vol. 2.] Illustrated volume.

The presentation of nature as part of natural history is usually connected with a natural cabinet or natural history museum. A closer look at travel and field work, however, shows that display of nature as a spatial concept and material conditions begins already in the first moment of collecting objects, specimens, and economis news about a region to be investigated. In the year 1720 the German physician Daniel Gottlieb Messerschmidt was sent to Siberia by the Tsar Peter I of Russia (...) to explore this hithero terra incognita. During his travels Messerschmidt established two main instruments for collecting data and things, which I shall describe as organizing, material principles for his field work: written lists and notes, and boxes and cases. An analysis of these material objects and their specific uses reveals the intellectual and practical traditions in which learned activities and strategies took place in the beginning of the eighteenth century. (shrink)

Diagnostic terms in psychiatry like ‘schizophrenia’ and ‘bipolar disorder’ are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of ‘schizophrenia.’ Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their actual usage (...) and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders. (shrink)

This article examines the relation between the critical theory of Moishe Postone and the philosophy of Theodor Adorno. While the former is clearly influenced by the latter, these influences mostly stay implicit. When explicit, he does not so easily put his own thought in line with Adorno’s and is highly critical of him. I will investigate the ways in which ideas from Adorno made their way into Postone’s work, but also where the latter diverts from them. As will be shown, (...) Postone’s critical theory runs into a problem when one examines the immanent ground of his critical norm, freedom. Adorno, on the contrary, does succeed in employing the same norm in his own immanent critique. I will conclude that the problem Postone encounters can be avoided by being more of an ‘Adornian’, and that his theory allows this. (shrink)

This paper explores some ideas of Wilfrid Sellars to raise two difficulties for a naturalistic approach to the mind. The first difficulty, which is methodological, is a corollary of Sellars’s distinction between two images of man-in-the-world, the manifest and the scientific image. For Sellars, taking science seriously requires that we think of it as constructing a unified image of man-in-the-world of its own. I argue that it is the rivalry between the manifest and the scientific image which gives rise to (...) the mind-body-problem. The challenge for a naturalistic solution to the mind-body-problem is that it is not legitimate to isolate single scientific results from their theoretical context in order to integrate them piecemeal into the manifest image. According to Sellars, a satisfactory solution to the mind-body-problem must attempt nothing less than a fusion of both images which somehow respects and preserves the unity of each. The second, substantial difficulty for a naturalistic approach to the mind is that of coming to terms with the normativity of the mental. Many interpreters take Sellars to hold that normativity sets the mental apart from the rest of nature. Against this I argue that according to Sellars the living is governed by norms of its own. It follows that normativity cannot serve as the mark of the mental. I argue that according to Sellars the distinguishing feature of the mental lies elsewhere, namely in the way in which normative force comes about. Unlike biological norms, the norms of thought owe their force to a common practice of mutual evaluation. However, the assumption that there are norms in animate nature should make it easier for naturalists to accept that the mental is characterized by norms of its own. (shrink)

People struggling with addiction are neither powerless over their addiction, nor are they fully in control. Lewis vigorously objects to the brain disease model of addiction, because it makes people lose belief in their self-efficacy, and hence hinders their recovery. Although he acknowledges that there is a compulsive state in addiction, he objects to the claim that this compulsion is carved in stone. Lewis argues that the BDMA underestimates the agency of addicted people, and hence hinder their recovery. Lewis’s work (...) offers us a very much to be welcomed neurobiology of recovery. It offers addicted people a hopeful and respectful narrative for their recovery that treats them as agents rather than as damaged brains. However, I argue that overestimating people’s agency can also result in people losing belief in their self-efficacy. Lewis’s strong focus on the agency of addicted people might not match their experiences of struggle, hence reinforcing their feelings of guilt when they fail to control their use. I propose to replace the notion of addiction as a disease with a notion of a disease-like stage in addiction. I call this stage the duress stage in addiction, in which the addictive behaviour is largely impervious to the agent’s values and to available techniques of self-control. However, the agent can overcome this stage by developing new techniques of self-control, by building on their self-concept and belief in self-efficacy, by changing their environments and habits, and by engaging in projects that are meaningful to the agent. (shrink)

Based on the ideas of two main representatives of the academic discourse on Ubuntu, Michael O. Eze and Mogobe B. Ramose, the paper shows how the concept of Ubuntu can contribute to transcending conventional concepts of cosmopolitanism. Referring to the concept of Ubuntu, Ramose and Eze criticize ‘Western’ concepts of cosmopolitanism because they always seem to start from binary oppositions (‘I’ and ‘other’), which must be reconciled. ‘Western’ cosmopolitanism continues to build on boundaries (nations, cultures, etc.) that constitute communities and (...) exclude the ‘other’. Here the boundary remains a place of exclusion. Therefore, it is necessary to conceptualize categories such as ‘boundary’ and the ‘Other’ in a different way. Ubuntu as a concept where the human being is essentially a relational being (one who exists in and through relationships) seems to offer an alternative in the sense of a ‘critical’ (Mignolo, 2002a) or ‘emancipatory’ cosmopolitanism. (Pieterse, 2006; Ngcoya, 2015). (shrink)

Gender-medicine has been very successful in discovering gaps in medical knowledge, disclosing biases in earlier research, and generating new results. It has superseded a more androcentric and sexist medicine. Yet, its development should not be understood in terms of a further approximation of value-freedom. Rather, it is a case of better value-laden science due to an enhanced pluralism in medicine and society. This interpretation is based on an account of the origins of gender-medicine in the feminist women’s health movement and (...) an analysis of the debate on inclusion of women in clinical trials. Consequently, the history of gender-medicine provides support for a procedural account of objectivity that stresses the importance of a diversity of perspectives. (shrink)

The aim of this chapter is to question the punitive approach towards substance dependent parents, especially substance dependent parents struggling with poverty, by outlining the complex ways in which poverty can shape reasoning, and hence capacities for self-control. I will outline two ways in which poverty can shape reasoning: a rational shift from a global to a local perspective, and a more invasive one: resignation. I will argue that when people with addictions become resigned, it is especially important to not (...) hold a punitive approach, but to treat them with compassion while simultaneously bootstrapping their sense of agency. I will argue that having children can be an important turning point for people struggling with addiction, and possibly resignation. In order to successfully turn their lives around, they must feel comfortable to seek professional support without fear for retribution or stigma. This paradigm shift in how we treat substance dependent parents will be an important contribution to breaking the circle of intergenerational transmission of resignation, poverty and substance abuse. (shrink)

Historians have usually connected the presentation of nature as a part of natural history with the natural cabinet or the natural history museum. A closer look at travel and field work, however, shows that display of nature as a spatial concept and set of material conditions begins already in the first moment of collecting objects, specimens and economic information about a region. In 1720 Tsar Peter I of Russia sent the German physician Daniel Gottlieb Messerschmidt to Siberia to explore this (...) hitherto terra incognita. During his travels Messerschmidt established two main instruments for collecting data and things, which I shall describe as organizing, material principles for his field work: written lists and notes, and boxes and cases. An analysis of these material objects and their specific uses reveals the intellectual and practical traditions in which learned activities and strategies took place at the beginning of the eighteenth century. (shrink)

Zusammenfassung In der Langzeitbetreuung von Menschen mit Demenz finden kommunikative Handlungen, die das Potenzial haben, Menschen mit Demenz zu täuschen, auf der Seite des Personals eine unterschiedliche Akzeptanz. Bushaltestellen, an denen kein Bus fährt, falsche Zugabteile, in denen ein Film die vorbeiziehende Landschaft simuliert, das Verstecken von Medikamenten in Nahrungsmitteln sind Interventionen, die Menschen in die Irre führen können, ohne ihnen tatsächlich falsche Informationen zu geben. Derartige kommunikative Praktiken wie Täuschungen, aber auch Lügen, definiert als absichtlich mitgeteilte irreführende Nachrichten, werfen (...) die Frage auf, wie sie ethisch begründet werden können. Anhand einer fiktiven Fallschilderung, in dem eine Pflegeheimbewohnerin mit Hilfe eines vorgetäuschten Telefonanrufs daran gehindert wird, das Heim zu verlassen, zeige ich, dass die Täuschung, als eine von drei möglichen Handlungsoptionen, aus der Fürsorgeperspektive positiv bewertet werden kann, da die Bewohnerin ohne Zwang am Verlassen des Heimes gehindert wird. Das Prinzip der Autonomie aber wird verletzt, da die Bewohnerin nicht frei zwischen der Täuschung und der Realität wählen kann. Hinsichtlich der Verpflichtung gegenüber Dritten ist die Täuschung problematisch, da orientierte Bewohner und Bewohnerinnen die Szene beobachten und befürchten könnten, sie würden ebenfalls getäuscht. Die Synthese der verschiedenen Argumente zeigt, dass ein Spaziergang in Verbindung mit einem validierenden Gespräch als weitere Handlungsoption die Prinzipien der Fürsorge und Autonomie in Einklang bringt, aber aufgrund des Zeitaufwands das Risiko einer ungerechten Verteilung der Pflegeressourcen birgt. (shrink)