Although the main responsibility for informed consent of medical procedures rests with doctors, nurses’ roles are also important, especially as patient advocates. Nurses’ preparation for this role in settings with a hierarchical and communal culture has received little attention. We explored the views of hospital managers and nurses regarding the roles of nurses in informed consent and factors influencing these roles. We conducted a qualitative study in a private, multispecialty hospital in Indonesia. Semi-structured interviews were conducted with seven managers. Two (...) rounds of focus group discussions with nurses (n = 27) were conducted. Constant comparative approach was used in the analysis. Nurses can act as manager, witness, information giver, and advocate in the informed consent process. These roles are influenced by nurses’ preparedness, hospital culture and policy, patients’ understanding, family involvement, and cost-related issues. In preparation for these tasks, nurses should acquire communication skills, clinical knowledge, and legal and ethical knowledge. (shrink)

In the asymptotic safety paradigm, a quantum field theory reaches a regime with quantum scale invariance in the ultraviolet, which is described by an interacting fixed point of the Renormalization Group. Compelling hints for the viability of asymptotic safety in quantum gravity exist, mainly obtained from applications of the functional Renormalization Group. The impact of asymptotically safe quantum fluctuations of gravity at and beyond the Planck scale could at the same time induce an ultraviolet completion for the Standard Model of (...) particle physics with high predictive power. (shrink)

Putting laypeople in an active role as direct expert contributors in the design of service robots becomes more and more prominent in the research fields of human–robot interaction and social robotics. Currently, though, HRI is caught in a dilemma of how to create meaningful service robots for human social environments, combining expectations shaped by popular media with technology readiness. We recapitulate traditional stakeholder involvement, including two cases in which new intelligent robots were conceptualized and realized for close interaction with humans. (...) Thereby, we show how the robot narrative together with aspects of power balancing stakeholders, such as hardware constraints and missing perspectives beyond primary users, and the adaptivity of robots through machine learning that creates unpredictability, pose specific challenges for participatory design processes in HRI. We conclude with thoughts on a way forward for the HRI community in developing a culture of participation that considers humans when conceptualizing, building, and using robots. (shrink)

Incentivising has shown to improve participation in clinical trials. However, ethical concerns suggest that incentives may be coercive, obscure trial risks and encourage individuals to enrol in cli...

Consolation is needed when a human being suffers (i.e. feels alienated from him-or herself, from other people, from the world or from his or her ultimate source of meaning). The aim of this study was to illuminate the meaning of consolation. Tape-recorded narrative interviews were carried out with 18 professionals from various spheres. The transcribed interviews were interpreted hermeneutically. A model of consolation is outlined in a drawing. It states that the mediator and the receiver of consolation must become ready (...) for consolation before it can take place. To be ready means to be present and available. Availability means expressing suffering and listening respectively, and thereby opening up for communion and consoling dialogue. Communion brings about contact with the sacred dimension that human beings share and thus with goodness, light, joy, beauty and life. Consolation involves a shift of perspective and an experience of meaning in spite of suffering. (shrink)

Due to the socio-demographic change in most developed western countries, elderly populations have been continuously increasing. Therefore, preventive and assistive systems that allow elderly people to independently live in their own homes as long as possible will become an economical if not ethical necessity. These respective technologies are being developed under the term "Ambient Assistive Technologies". The EU-funded AAT-project Ambient Lighting Assistance for an Ageing Population has established the long-term goal to create an adaptive system capable of improving the residential (...) lighting conditions of single living elderly persons also aiming at supporting the preservation of their independence. Results of an earlier survey revealed that the elderly perceived their current lighting situation as satisfactory, whereas interviewers assessed in-house lighting as too dark and risk-laden. The overall results of ALADIN showed a significant increase in well-being from the baseline final testing with the new adaptive lighting system. Positive results for wellbeing and life quality suggest that the outcome effects may be attributed to the introduction of technology as well as to social contacts arising from participating in the study. The technological guidance of the study supervisors, in particular, may have produced a strong social reactivity effect that was first observed in the famous Hawthorne experiments in the 1930s. As older adults seem to benefit both from meaningful social contacts as well as assistive technologies, the question arises how assistive technology can be socially embedded to be able to maximize positive health effects. Therefore ethical guidelines for development and use of new assistive technologies for handicapped/older persons have to be developed and should be discussed with regard to their applicability in the context of AAT. (shrink)

This article addresses a number of phenomena in the field of digital communication - disinformation, infodemics and conspiracy mania - that promote indifference regarding the distinction between truth and lies, fact and fiction, opinion and knowledge. They have thus decisively altered users' patterns of rationality and common sense and contributed to the rise of anti-democratic and anti-scientific positions. To address this complex problem, a systemic approach is provided that considers these phenomena to be factors that disturb the ethical-epistemic equilibrium between (...) uncertainty, trust and responsibility. After identifying a set of dynamics generated by these disruptive factors, three aspects are explored in depth: the polarisation and lack of a deliberative culture, the necessary correction of the social image of scientific practice, and the impact of the post-truth discourse. The article concludes with reflections on redefining the three key concepts of uncertainty, trust and responsibility in light of the demands of the digital sphere. (shrink)

Although the main responsibility for informed consent of medical procedures rests with doctors, nurses’ roles are also important, especially as patient advocates. Nurses’ preparation for this role in settings with a hierarchical and communal culture has received little attention. We explored the views of hospital managers and nurses regarding the roles of nurses in informed consent and factors influencing these roles. We conducted a qualitative study in a private, multispecialty hospital in Indonesia. Semi-structured interviews were conducted with seven managers. Two (...) rounds of focus group discussions with nurses (n = 27) were conducted. Constant comparative approach was used in the analysis. Nurses can act as manager, witness, information giver, and advocate in the informed consent process. These roles are influenced by nurses’ preparedness, hospital culture and policy, patients’ understanding, family involvement, and cost-related issues. In preparation for these tasks, nurses should acquire communication skills, clinical knowledge, and legal and ethical knowledge. (shrink)

Existing empirical research often do not explain which concepts about genetics underlie the assumption that genetic information is deemed important for donor-conceived offspring. This study focused on how donor-conceived individuals following anonymous sperm donation give meaning to and make sense of genes and genetics. Analysis is based on focus groups and interviews with adult donor-conceived offspring. Findings suggest that genes are part of their specific context of being donor-conceived but also play a role in daily life. Genes make sense on (...) an individual level and a relational level, both on parent-child as sibling-level. On an individual level they were perceived as (1) a biological starting package, (2) their own unique combination and (3) as a reference point. On a relational level, genes were seen as (1) “person-al”, (2) connecting and (3) locating individuals. This information is essential for those supporting/counseling donor conceived offspring and families as well as for policy-members. (shrink)

National greenhouse-gas accounting should reflect how countries’ policies and behaviours affect global emissions. Actions that contribute to reduced global emissions should be credited, and actions that increase them should be penalized. This is essential if accounting is to serve as accurate guidance for climate policy. Yet this principle is not satisfied by the two most common accounting methods. Production-based accounting used under the Kyoto Protocol does not account for carbon leakage — the phenomenon of countries reducing their domestic emissions by (...) shifting carbon-intensive production abroad1. Consumption-based accounting2,3 does not credit countries for cleaning up their export industries, and it also punishes some types of trade that could contribute to more carbon efficient production worldwide. We propose an improvement to consumption-based carbon accounting that takes technology differences in export sectors into account and thereby tends to more correctly reflect how national policy changes affect total global emissions. We also present empirical results showing how this new measure redraws the global emissions map. (shrink)

In Paul Ricœur's thought, suffering is primarily addressed from an existential and phenomenological perspective, as illustrated in the text of the lecture "Suffering is not Pain," delivered to an audience of psychiatrists. In this thematic issue, we present the very first English translation of this text. The contributions of the various authors explore Ricœur's definition of suffering as well as the dialogue he establishes between the philosophical and clinical approaches. By tracing the genealogy of suffering in Ricœur's systematic work, this (...) introduction highlights the conceptual shifts resulting from methodological changes, notably the transition from eidetic phenomenology to a hermeneutic phenomenology with ontological implications, along with the plurality of his motivations and interests (psychoanalytic, theological). Suffering, as the negativity of existence, while exposed to the risk of a solipsistic affect, nonetheless unfolds a unique semiology, in an openness to the other, which Ricœur inquires in "Suffering is not Pain.". (shrink)

Contextualizing Ricœur’s lecture “Suffering is Not Pain” alongside his other peripheral works on the matter uncovers a “practical philosophy,” that could provide new perspectives for clinicians faced with suffering. The analysis unfolds in four stages. First, it examines Ricœur’s interest in dialoguing with psychiatry to nourish his philosophical work. Second, it highlights Ricœur’s contributions as a third party to help psychiatrists overcome some major issues at that time. Third, it contextualizes the topic of suffering within the prevailing medical views at (...) that time, and their corresponding issues in clinical practice. Finally, it delineates three principles for an applied ethics of suffering; namely, the need to dissociate suffering from any moral justification, approaching the therapeutic relationship as an alliance, and a minimal recognition that patients endure despite the damages suffering inflict on the self-other axis, to preserve their dignity. (shrink)

Im Zuge einer Änderung des Arzneimittelgesetzes im November 2016 hat der Deutsche Bundestag beschlossen, dass gruppennützige Arzneimittelforschung mit nicht-einwilligungsfähigen Erwachsenen unter bestimmten Bedingungen erlaubt sein soll. Das entsprechende Gesetz wird voraussichtlich im Jahr 2020 in Kraft treten. Das ethische Problem dieser Forschung besteht darin, dass Personen, die nicht in der Lage sind, ihre Einwilligung in die Forschung zu erteilen, nicht vom medizinischen Fortschritt ausgeschlossen werden sollen. Der Gesetzgeber hat versucht, diesen Konflikt zu lösen, indem er die Zulässigkeit der gruppennützigen Forschung (...) mit nicht-einwilligungsfähigen Erwachsenen an die Voraussetzung geknüpft hat, dass Studienteilnehmer ihre Einwilligung zuvor in einer Probandenverfügung erteilen. Der Beitrag hat das Ziel, die neue Regelung zur gruppennützigen Forschung mit nicht-einwilligungsfähigen Erwachsenen aus ethischer Sicht zu bewerten. Die Frage, ob die Gesetzesänderung weitere Forschung ermöglichen wird, hängt wesentlich davon ab, ob man mit Blick auf Studien, die sowohl eigennützige als auch gruppennützige Maßnahmen umfassen, eine Gesamtbetrachtung oder eine Einzelbetrachtung dieser Studien vorzieht. In unserem Beitrag argumentieren wir für eine Einzelbetrachtung. Es wird weiterhin die Auffassung vertreten, dass die im Gesetzgebungsverfahren vorgeschlagene Probandenverfügung die Selbstbestimmung der Patienten fördern kann, wenn sie mit Blick auf die mit der Teilnahme verbundenen Eingriffe ein Mindestmaß an Bestimmtheit erreicht.Zusammenfassend wird die Auffassung vertreten, dass gruppennützige Forschung mit nicht-einwilligungsfähigen Erwachsenen trotz der genannten Bedenken unter bestimmten Bedingungen ethisch zulässig sein kann. In der Gesamtabwägung erscheint dabei die eindeutige Definition und strenge Beachtung der Bedingungen der EU-Verordnung 536/2014 mit Blick auf einen ethisch gerechtfertigten Einbezug von nicht-einwilligungsfähigen Erwachsenen in gruppennützige Forschung als besonders bedeutsam. (shrink)

BackgroundThe public’s attitudes to conscientious objection are likely to influence political decisions about CO and trust towards healthcare systems and providers. Few studies examine the pub...

In Arequipa, Peru’s second largest city, engineers work hard to control water flows and provide different sectors with clean and sufficient water. In 2011, only 10 percent of the totality of water used daily by Arequipa’s then close to 1 million people—in households, tourism, industry, and mining—was treated before it was returned to the river where it continues its flow downstream towards cultivated fields and, finally, into the Pacific Ocean. It takes specialized knowledge and manifold technologies to manage water and (...) sustain life in Arequipa, and engineers are central actors for making water flow. Examining the ecology of water management, this article asks to what extent we can talk of a way of knowing and enacting water that is particular to engineers. Through engineering practices, a technical domain emerges as separate from and superior to political and social domains. This production of categories can be understood as practices of purification. However, a purely technical grip on water is never possible. Unruly elements, like weather, contamination, urban dwellers, and competing interests, interfere and make processes of intervention unstable. Water is never completely cleaned, and, equally, the continuous processes of purification of categories and domains take place while other processes work to blur their boundaries. (shrink)

Hoy en día vivimos aún con el estereotipo de las dos culturas, con la idea de una cierta incomunicabilidad entre ciencias y humanidades, en términos más generales: entre la esfera de la ciencia y la de la cultura. Este artículo presenta una visión filosófica de la relación entre cultura y ciencia más allá de la tópica dicotomía, sosteniendo en cambio un enfoque en el que se concibe la ciencia como fenómeno cultural. Un recorrido histórico-sistemático por algunos hitos de la filosofía (...) de la cultura y la filosofía de la ciencia muestra cómo las dos se compenetran entre sí y se influyen mutuamente. Poner el foco en las convergencias entre ambas permite identificar una serie de preocupaciones y retos compartidos que conciernen al campo de la epistemología en su conjunto: afrontar la complejidad de la condición epistémica y la vulnerabilidad cognitiva del ser humano; hacer frente a las posiciones más extremas tanto del relativismo como del fundamentalismo; y desarrollar un concepto de responsabilidad epistémica en los distintos ámbitos de conocimiento para contrarrestar la cultura de desconfianza y la percepción de nuestra época como era de la posverdad. (shrink)

Question the scientific method -- Different modes of experimentation -- Tirelessly tinkering with unruly conditions -- Practising experiments in a world of environmental concerns.

This paper studies the effects of social comparison on risk taking behavior. In our theoretical framework, decision makers evaluate the consequences of their choices relative to both their own and their peers’ conditions. We test experimentally whether the position in the social ranking affects risk attitudes. Subjects interact in a simulated workplace environment where they perform a work task, receive possibly different wages, and then undertake a risky decision that may produce an extra gain. We find that social comparison matters (...) for risk attitudes. Subjects are more risk averse in the presence of small social gain than social loss. In addition, risk aversion is decreasing in the size of the social gain. (shrink)

La ética del cuidado es la propuesta teórica feminista más conocida en bioética. Mediante una revisión y análisis bibliográfico abordaré la ética del cuidado e interseccionalidad, como marco para discurso bioético aplicado a las estructuras en la atención de salud y para la toma de decisiones. La ética del cuidado y la interseccionalidad otorgan elementos pocas veces considerados en el análisis bioético, como es el contexto, la subjetividad, la experiencia vivida, las relaciones de cuidado y la responsabilidad con sí misma (...) y los otros. Estos elementos deben permear a la bioética en salud y en el actuar del ser humano con su entorno. (shrink)

A new analytical framework for understanding literary videogames, the literary-ludic spectrum, illustrated by close readings of selected works. In this book, Astrid Ensslin examines literary videogames—hybrid digital artifacts that have elements of both games and literature, combining the ludic and the literary. These works can be considered verbal art in the broadest sense (in that language plays a significant part in their aesthetic appeal); they draw on game mechanics; and they are digital-born, dependent on a digital medium (unlike, for (...) example, conventional books read on e-readers). They employ narrative, dramatic, and poetic techniques in order to explore the affordances and limitations of ludic structures and processes, and they are designed to make players reflect on conventional game characteristics. Ensslin approaches these hybrid works as a new form of experimental literary art that requires novel ways of playing and reading. She proposes a systematic method for analyzing literary-ludic (L-L) texts that takes into account the analytic concerns of both literary stylistics and ludology. After establishing the theoretical underpinnings of her proposal, Ensslin introduces the L-L spectrum as an analytical framework for literary games. Based on the phenomenological distinction between deep and hyper attention, the L-L spectrum charts a work's relative emphases on reading and gameplay. Ensslin applies this analytical toolkit to close readings of selected works, moving from the predominantly literary to the primarily ludic, from online hypermedia fiction to Flash fiction to interactive fiction to poetry games to a highly designed literary “auteur” game. Finally, she considers her innovative analytical methodology in the context of contemporary ludology, media studies, and literary discourse analysis. (shrink)

Im Alltag wie in ethischen Fachdiskussionen verweisen wir häufig auf moralische Intuitionen. Doch welche Art mentaler Zustand sind moralische Intuitionen eigentlich? Wie 'generieren' sie moralische Wertungen? Unter Rückgriff auf zeitgenössische Theorien aus der Philosophie des Geistes argumentiert die Autorin, dass moralische Intuitionen zu konkreten Fällen eine Form der Emotion sind. Sie spezifiziert, in Anlehnung an Millikans biosemantisches Intentionalitätskonzept und Prinz? Emotionstheorie, was diese moralisch wertenden Emotionen auszeichnet und welche mentalen Prozesse ihrem Auftreten zugrunde liegen. Burgbachers Modell gibt eine zeitgemässe, empirisch (...) orientierte Antwort auf die stark diskutierte Vorfrage der Ethik und Metaethik nach der Natur moralischer Intuitionen. Es bietet eine solide Basis für die Diskussion des epistemischen und handlungsbezogenen Status moralischer Intuitionen. (shrink)

This paper proposes an analytical framework for the analysis of organizational cognition that borrows from distributed and ecological cognition. In so doing, we take a case study featuring a decision on the topic of agreeing on a set point in the agenda of a meeting. It is through the analysis of a few minutes of video-recording used in the case that enables us to demonstrate the power of applying distributed and ecological cognition to organizing processes. Cognitive mechanism, resources, and processes (...) are identified within this combined framework. Mechanisms are described as “socio-material” (CM1)—where “people” and “artifacts” are the related cognitive resources—and as “conceptual” (CM2)—with “group” identity, “topic” understanding, meaning of “procedures,” and perception of “time” as resources. Processes are defined as “coupling,” “de-coupling,” and “un-coupled” depending on the type of relation in place. Finally, the paper presents an agent-based computational simulation to demonstrate the potentials of operationalizing this approach. (shrink)

How can a confederation of business and industry influence companies and make them more aware of ethical issues? This article examines the work of Norwegian Business and Industry , and the results it has achieved. The author is Assistant Director of NHO, P.b. 5250, Majorstua, 0303 Oslo, and she has been responsible for its business ethics programme for the past three years. This article comes to us through the agency of our Associate Editor for Norway, Dr Heidi von Weltzien Høivik, (...) of the Norwegian School of Management, who has recently been instrumental in founding a Norwegian Centre for Business Ethics. (shrink)

Fernando de Toro y Alfonso de Toro / "Alberto Kurapel. Teatro-Performance, Alteridad y Memoria"./ Editorial Cuarto Propio/2018/ 245 páginas/ ISBN 978-956-396-023-5.

Images from the nanoworld are not at all disorienting or bewildering, as one might expect from contemplating the strange and surprising features that arise where classical physics comes to an end and quantum effects begin to appear. Instead, we see the traces of explorers in a world that appears to be infinitely malleable. The paper shows that the capability to visualize processes and phenomena at the nanoscale is a matter not only of research technologies and the advancement of observational techniques, (...) but also a matter of developing a visual setting that exhibits knowledge and practice, surprise and control. The surface is such a stage and so is the landscape: they invite us to become immersed and move around like someone who goes for a walk. In order to appreciate this pictorial, as well as discursive, setting we turn to “strollology” as a method of reconstructing the world that is experienced in the manner of walking. With the notion of imagescape this method is applied to the modes of partaking in the nanoworld and its specific features. Rather than articulate theoretical or metaphysical presuppositions these nanoscapes serve to validate the very idea of nanotechnology. (shrink)

What are the essential features that a phenomenology of eros should take into account in order to do justice to the complexity of this reality? In order to put some light on this phenomenon, we have compared two contemporary French studies, that of Emmanuel Levinas in 'Totality and Infinity' and that of Sartre in 'Being and Nothingness'. We started by pointing at the new way in which subjectivity is experienced in eros. Sartre emphasizes the fact of feeling justified in one's (...) life, Levinas accentuates the feeling of being liberated from the burden of oneself . Both authors nevertheless agree on the fact that eros is fundamentally ambivalent . Unless Levinas, according to whom the ambiguities constitute the richness of the erotic relation, Sartre has shown that those ambiguities can always be experienced as a threat. They indeed threaten the typically human desire of the lover to control the other . Sartrian love is not only ambiguous, but has an essentially paradoxical character. Nevertheless, if the lover tries to free himself from this threatening feature, perversion is imminent. As such, love is threatened from within by perversion. Sartre uncovers an essential feature of eros, whereas Levinas can only consider perversion to be the consequence of an inauthentic desire of fusion . The essentially conflictual character of eros is illustrated by an analysis of the erotic gaze . In conclusion it can be stated that true love cannot be found in a relation without conflicts, but supposes lovers to handle the tension proper to the erotic relation without ever being sure of the result. (shrink)