BackgroundThe UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer’s disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, (...) which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the ‘spatial intervention study’ of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. MethodsPeople with a suspected or confirmed diagnosis of dementia in Alzheimer’s disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed.DiscussionThe results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice.Trial registration: DRKS00030799. (shrink)

BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

The point of departure of any ethical theory is the anthropological fact that normally developed humans must lead their own lives themselves. This means that their conduct is neither programmed nor determined by instincts. Human beings must on every occasion engage the circumstances of a practical situation by their own choice and decision. Even when they find themselves delivered over to the stimuli and powers of particular circumstances in a completely passive manner, this does not occur in the way that (...) it does for a robot, but rather, on the basis of a background of an essential possibility that they can conduct themselves otherwise than they are now behaving. Where there is the possibility of a choice, then the question inevitably arises regarding the principle of the choice. On what do we base our decision to choose one possibility rather than another? We can let fate decide, we can consult astrological charts, we can appeal to an authority, or we can try to find out what we truly want, what are our deepest desires and what choice agrees best with these desires. Finally, we can also inquire into what decision is the objectively correct and rational one, i.e. which decision is good independent of our subjective preferences. This latter case, of course, presupposes a standard of the objectively good and rational, in regard to which we can be responsible for and evaluate our decisions as well as our ensuing actions. (shrink)

Following the publication of the Contributions to Philosophy, Mindfulness and the History of Being, the question of the significance of Heidegger’s later work has been widely discussed. However, th...

Martin Heidegger's Nietzsche's Second Untimely Meditation presents crucial elements for understanding Heidegger's thinking from 1936 to 1940. Heidegger offers a radically different reading of a text that he had read decades earlier, showing how his relationship with Nietzche's has changed, as well as how his understandings of the differences between animals and humans, temporality and history, and the Western philosophical tradition developed. With his new reading, Heidegger delineates three Nietzschean modes of history, which should be understood as grounded in the (...) structure of temporality or historicity and also offers a metaphysical determination of life and the essence of humankind. Ullrich Hasse and Mark Sinclair offer a clear and accessible translation despite the fragmentary and disjointed quality of the original lecture notes that comprise this text. (shrink)

In 2013, Kurt Ullrich set out to chronicle the magic of the Iowa State Fair in words and photographs. Join him as August days and nights blow warm and easy over the fairgrounds, brushing lightly against fellow travelers on this earth, both human and not. He captures precious moments of extreme joy and unbridled delight in these beautiful black-and-white images, celebrating the brash rural energy of the fair, from Big Wheel races to people-watching goats, fair queen contestants to arm (...) wrestlers, Percherons to ponies. Prize pigs, prize sheep, prize apples, and the famous butter cow all have their moment in the limelight. Iowa s very best ear of corn and old friends reminiscing outside their RVs draw the photographer s fond eye, as do brightly lit beer stands and the brilliant arc of the Ferris wheel against the night sky. ". (shrink)

Avant-propos du traducteur Cet article est la deuxième (et dernière) partie de la traduction du chapitre d’ouvrage de Ullrich Melle ayant pour titre « Husserls deskriptive Erforschung der Gefühlserlebnisse », publié en 2012. Le premier volet de ce travail a paru dans le précédent numéro d’Alter, accompagné d’une introduction précisant l’intérêt majeur de ce texte pour l’étude de la phénoménologie husserlienne de l’affectivité et justifiant les traductions de quelques termes centraux. Nous y...

Cet article est la traduction de la première partied’un chapitre d’ouvrage écrit par Ullrich Melle, ayant pour titre original « Husserls deskriptive Erforschung der Gefühlserlebnisse » et paru en 2012. La traduction de cet article nous a paru particulièrement pertinente en raison du contexte actuel effervescent autour du problème de l’affectivité chez Husserl, matérialisé bien sûr par la parution tant attendue des Studien zur Struktur des Bewußtseins, notamment de leur second volume intitulé...

Als Religionsphilosoph ist Georg Simmel weniger bekannt denn als Kulturphilosoph und Soziologe, doch wird aus seinem Werk der Entwurf einer eigenständigen Religionsphilosophie erhebbar. Weder inhaltlich verfasster Glaube, noch philosophische Religionskritik erfassen demnach die Religion; erst jenseits ihrer kann sie werden, was sie ist: reines, ursprunghaftes Leben. Ausgehend von einer umfänglicheren Sichtung der Sekundärliteratur entfaltet Ullrich die innere Logik der Religionsphilosophie Simmels und diskutiert sie in ihrem Verhältnis zum Christentum.

Alles dreht sich um Werte. Sie werden von Politikern herbeizitiert, gerne bekennt man sich zu ihnen? in der Konsumwelt, in der politischen Aktionskunst, beim Wohnen, beim Essen und im Fitnesskult. Wolfgang Ullrich nimmt die Karriere der Werte in verschiedenen Bereichen unter die Lupe. Seine These: Sich zu Werten zu bekennen ist so beliebt, weil es dem Selbstbewusstsein schmeichelt. Man darf sich dann moralisch gut und sogar kreativ fühlen. Ullrich untersucht, wie Werte im Einzelnen in Szene gesetzt werden. Aber (...) er fragt auch, wie sich gesellschaftspolitische Debatten unter diesen Vorzeichen entwickeln. (shrink)

Is consolidation needed to account for retroactive interference in free recall? Interfering mental activity during the retention interval of a memory task impairs performance, in particular if the interference occurs in temporal proximity to the encoding of the to-be-remembered information. There are at least two rival theoretical accounts of this temporal gradient of retroactive interference. The cognitive neuroscience literature has suggested neural consolidation is a pivotal factor determining item recall. According to this account, interfering activity interrupts consolidation processes that would (...) otherwise stabilize the memory representations of TBR items post-encoding. Temporal distinctiveness theory, by contrast, proposes that the retrievability of items depends on their isolation in psychological time. According to this theory, information processed after the encoding of TBR material will reduce the temporal distinctiveness of the TBR information. To test between these accounts, implementations of consolidation were added to the SIMPLE model of memory and learning. We report data from two experiments utilizing a two-list free recall paradigm. Modeling results imply that SIMPLE was able to model the data and did not benefit from the addition of consolidation. It is concluded that the temporal gradient of retroactive interference cannot be taken as evidence for memory consolidation. (shrink)

I am grateful to the National Endowment for the Humanities for a year-long fellowship that enabled me to write major portions of this book; ...

Michel de Montaigne, the great Renaissance skeptic and pioneer of the essay form, is known for his innovative method of philosophical inquiry which mixes the anecdotal and the personal with serious critiques of human knowledge, politics and the law. He is the first European writer to be intensely interested in the representations of his own intimate life, including not just his reflections and emotions but also the state of his body. His rejection of fanaticism and cruelty and his admiration for (...) the civilizations of the New World mark him out as a predecessor of modern notions of tolerance and acceptance of otherness. In this volume an international team of contributors explores the range of his philosophy and also examines the social and intellectual contexts in which his thought was expressed. (shrink)

ABSTRACT This paper reports on an empirical performance analysis of four modal theorem provers on benchmark suites of randomly generated formulae. The theorem provers tested are the Davis-Putnam-based procedure KSAT, the tableaux-based system KRZIS, the sequent-based Logics Workbench, and a translation approach combined with the first-order theorem prover SPASS. Our benchmark suites are sets of multi-modal formulae in a certain normal form randomly generated according to the scheme of Giunchiglia and Sebastiani [GS 96a, GS 96b]. We investigate the quality of (...) the random modal formulae and show that the scheme has some shortcomings, which may lead to mistaken conclusions. We propose improvements to the evaluation method and show that the translation approach provides a viable alternative to the other approaches. (shrink)

Recently there has arisen a new wave of optimism in the discussions about the environment. According to Gregg Easterbrook, one of the most prominent of the environmental optimists, we are presently witnessing fundamental and far-reaching changes for the better: “the Western world today is on the verge of the greatest ecological renewal that humankind has known; perhaps the greatest that the Earth has known” .The optimism of these new environmental optimists is not simply strategic, a mere psychological stimulant to maintain (...) the struggle against environmental destruction. They believe there are good reasons for being optimistic: they claim that a sober and scientific analysis of the environmental problematic shows that the prospects for the Earth and for our own kind are actually much better than the eco-alarmists would have us think. Nature is not on the brink of collapse. The real existing problems can be controlled and solved, at least if we are prepared to adopt a less dogmatic, more rational, pragmatic and flexible approach. The environmental movement, and environmental protesters are locked into ideas, analyses and attitudes that are no longer in touch, or never were in touch, with reality. So the time is ripe, according to the American environmental optimist Ronald Bailey, for a second wave of environmental activism. It is time for “a modern, smart environmentalism” .In what follows, I shall look at environmental optimism primarily as it is presented in Gregg Easterbrook’s voluminous book. His book contains a comprehensive and well-documented argument in favour of a new approach and a new attitude toward the whole environmental problematic. Of particular interest is his attempt to ground environmental optimism in an image of nature that has clearly been influenced by dynamic or evolutionary ecology — a new paradigm in ecology. Easterbrook considers himself a ‘liberal’, which might be translated as a ‘social democrat’ in the European political spectrum. He is not at all opposed to the environmental movement, environmental protest or environmental politics. Indeed, he regards the environmental movement as one of the most positive social developments of the 20th century. The politics of the environment and environmental protection legislation are, in his opinion, among the greatest success stories of the post-war social-democratic welfare state. “Americans and Europeans today live in a world where effective environmental influence is assured at nearly every level of government and business. This is a wonderful development for society”. (shrink)