Next SectionThe personal identity problem expresses the worry that due to disrupted psychological continuity, one person’s advance directive could be used to determine the care of a different person. Even ethicists, who strongly question the possibility of the scenario depicted by the proponents of the personal identity problem, often consider it to be a very potent objection to the use of advance directives. Aiming to question this assumption, I, in this paper, discuss the personal identity problem’s relevance to the moral (...) force of advance directives. By putting the personal identity argument in relation to two different normative frameworks, I aim to show that whether or not the personal identity problem is relevant to the moral force of advance directives, and further, in what way it is relevant, depends entirely on what normative reasons we have for respecting advance directives in the first place. (shrink)

The global shortage of organs for transplantation and the development of new and better medical technologies for organ preservation have resulted in a renewed interest in non-heart-beating donation (NHBD). This article discusses ethical questions related to controlled and uncontrolled NHBD. It argues that certain preparative measures, such as giving anticoagulants, should be acceptable before patients are dead, but when they have passed a point where further curative treatment is futile, they are in the process of dying and they are unconscious. (...) Furthermore, the article discusses consequences of technological developments based on improvement of a chest compression apparatus used today to make mechanical heart resuscitation. Such technological development can be used to transform cases of non-controlled NHBD to controlled NHBD. In our view, this is a step forward since the ethical difficulties related to controlled NHBD are easier to solve than those related to non-controlled NHBD. However, such technological developments also evoke other ethical questions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reifying Relevance in Mild Cognitive Impairment:An Appeal for Care and CautionJanice E. Graham (bio) and Karen Ritchie (bio)KeywordsAlzheimer’s disease, construction, dementia, market forces, mild cognitive impairmentWe thank the reviewers for their thoughtful comments that probe shadowy areas in our argument, and we welcome this opportunity to elucidate our position. First, we are not repudiating the natural and social facts of pathologic brain degeneration and the physical and cognitive impairments (...) that manifest in people affected by dementia disorders. We are, however, questioning the epistemology, politics, and persistence by some to harden the construct of mild cognitive impairment (MCI) prematurely as a "natural" precursor to dementia. We suggested insufficiencies in viewing MCI as prodromal to Alzheimer's disease (AD; Graham and Ritchie 2006, 36), and pointed to evidence for the prognostic irrelevance of some MCI subcategories (35). The commentators have read our manuscript as suggesting that AD and MCI are different kinds, and that a diagnosis of AD is more "real" than that of MCI. But AD is also fraught with classification issues, as we describe in the section of our paper that deals with consensus committees, published practice guidelines, and the determination of treatment efficacy. Like MCI, AD is a heterogeneous condition, but unlike MCI, AD is a constructed practical kind that does some "work" beyond essentialist (neural degeneration, brain atrophy) claims. Its criteria identify people with well-defined dementia symptoms and multiple cognitive and functional impairments who are in need of, and benefit from, support. Even with these criteria, however, there have been great attempts to achieve definitional accuracy in dementia diagnoses. Practical refinements to the differential diagnosis of dementia based on solid research evidence have made way for more specific recognitions of vascular dementias, dementia of the Lewy body type, and other subtypes beyond AD. So AD too has been subject to more careful, more cautious operationalization in recent years, with research supporting multiple factors and the comorbidity of several types (kinds) of dementia in any one individual.Our paper takes up concerns that are not resolved for dementia and suggests that the nascent category of MCI is still so insufficiently defined as to be ambiguous, and as such, is in danger of identifying individuals with what will be, and has [End Page 57] already been, linked to a debilitating and deeply stigmatizing and fatal disorder (AD). We are not contesting the reality that some people begin to display early signs of cognitive loss, nor are we suggesting that symptoms be ignored; as researchers, we stand behind the careful tracking of symptoms and signs in patients and research participants as an essential clinical and research practice. In a era where the public has been made wary of the potentially fatal effects of new treatments whose more careful scrutiny in specific populations would have saved lives (e.g., Fontanarosa, Rennie, and DeAngelis 2004; Psaty and Furberg 2005), and made all the more popular by what Kramer coined "diagnostic bracket creep" (1993, 15), we are questioning the drivers and value of a premature diagnostic classification whose definitional accuracy is neither sufficient nor effective for specific identification of individuals.That matters of fact are constructed does not take away from their natural fact. Some people have subjective reports or show objective evidence of cognitive decline while having preserved activities of daily living—the construction of this evidence indicates they are not normal and they are not demented. Based on such evidence, where then does the balance of probability for MCI lie? A multidisciplinary international group of experts gathered in Stockholm in 2003 to discuss MCI concepts (Winblad et al. 2004). They acknowledged that the heterogeneous etiology of MCI contributes to "some confusion concerning the specific boundaries of the condition", stating that this "not normal, not demented" condition is nonetheless "useful both clinically and as a research entity" (p. 241). Importantly, they concluded that MCI needs "better definition" (p. 246). It was at this stage that we first wrote our manuscript, and in the subsequent two years we have eagerly awaited new studies, and the recognition of flexible, practical subtypes to evolve.We state "that MCI cannot be considered to be a separate clinical entity" (Graham and... (shrink)

Hintikka, J. Knowing how, knowing that, and knowing what: observations on their relation in Plato and other Greek philosophers.--Hedenius, I. The concept of punishment.--Marc-Wogau, K. On the concept of dialectial development in Marxism.--Ekelöf, P. O. Definitions and concept formation in the law.--Hermerén, G. The existence of aesthetic qualities.--Regnéll, H. Explanation in analytical philosophy.--Furberg, M. On questions and pseudo-problems.--Moritz, M. Imperative implication and conditional imperatives.--Sosa, E. Standard conditions.--Danielsson, S. On the strength of commitments.--Aqvist, L. The emotive theory of ethics in (...) the light of recent developments in formal semantics and pragmatics.--Von Wright, G. H. Truth as modality. A contribution to the logic of sense and nonsense.--Hansson, B. and Gärdenfors, P. A guide to intentional semantics.--Kanger, S. Entailment.--Edman, M. Adding independent pieces of evidence.--Lindström, P. A characterization of elementary logic.--Woodruff, P. W. On constructive nonsense logic.--Segerberg, K. Halldén's theorem on Post completeness.--Philosophical works by Sören Halldén. (shrink)

Marx und die "bürgerliche" Nationalökonomie, von G. Aspelin.--Några textkritiska problem i Berkeleyforskningen, av B. Belfrage.--Några kommentarer till C.L. Stevensons teori om etisk oenighet, av L. Befgström.--Viljeteorins premisser, av J. Evers.--Axel Hägerströms analys av värdeupplevelsen, av L. Fröström.--On archetypical performatives, by M. Furberg.--The better something is, the worse its absence, by S. Halldén.--Ett slags representationsteorem för deontisk logik, av B. Hansson.--Om Platons "Euthyphron," av I. Hedenius.--Tolkningssatsernas logik, av G. Hermerén.--Är verkligheten motsägande? Ett dialektiskt argument, av K. Marc-Wogau.--Moral, amoral og indifferens, (...) av H. Ofstad.--Begreppet "property" hos John Locke, av K. Olivecrona.--En skademodell, av U. Persson.--Objektivitet som kunskaps teoretiskt begepp och som värderingsideal, av H. Regnéll.--Satsen "Flickan F är vacker," av E. Ryding.--Lathund för lagläsare, av T. Strömberg. (shrink)

Berg, J. Buñuels dagdröm.--Bergström, L. Pessimismens konsekvenser.--Furberg, M. Möjliga teser hos Johannes Climacus.--Halldén, S. Teckenrelationen och språkreglernas juridik.--Hedenius, I. Ett argument mot den rättsfilosofiska domstolsrealismen.--Mates, B. Om Platons argument "den tredje människan."--Marc-Wogau, K. Kant om lögnen.--Næss, A. Om filosofiske projekter som forener empirisk semantikk og metafysisk spekulasjon.--Ofstad, H. Får nazister lettere magesår enn humanister?--Prawitz, D. Om moraliska och logiska satsers sanning.--Stenius, E. Om Descartes' psykofysiska modell.--Tranøy, K. E. Filosofenes etiske ansvar.--Wright, G. H. von. En filosof ser på filosofien.

In lieu of an abstract, here is a brief excerpt of the content:Conflicts—and Consensus—about Conflicts of Interest in MedicineMatthew K. Wynia and Bette–Jane Crigger*This fascinating collection of essays about individual experiences of conflict of interest leaves little doubt that physicians remain divided about the importance, impact and meaning of conflicts of interest in their work. These essays offer differing views about what conflicts of interest look and feel like “on the ground” and about whether specific conflicts of interest are bad, (...) just a fact of life, or maybe even good.Conflict, Conflict EverywhereThese essays situate conflict of interest in a variety of contexts: the treatment recommendations a physician makes for an individual patient; the relationship between teaching physician and medical student or practicing physician and health care organization; the interaction between academic researchers and industry collaborators or professional bodies and industry supporters. In this, the narratives taken together reflect the scope of concern about conflict of interest in medicine familiar in the literature. In his classic 1993 essay, Dennis Thompson noted that concerns about conflict of interest encompass issues of physician self–referral, risk sharing between physicians and health care institutions, gifts from industry, hospital purchasing practices, as well as sponsored research and research with patients (Thompson 1993). To that list have subsequently been added relationships with industry in medical education at all levels, physicians’ service as consultants to industry or members of industry speakers bureau, and development of clinical practice guidelines (Lo & Fields 2009).That almost none of these essays draw attention to some widely publicized situations of conflict of interest—for example, gifts to physicians or the provision of drug samples—should, we think, be seen more as an artifact of the authors’ varied individual experiences than as a failure by the authors to engage key concerns in the ongoing professional and public debate. It could also be that the authors, asked to submit personal stories, assumed that yet another essay about the ‘traditional’ issues in the conflicts of interest literature would be seen as redundant, routine or even boring. Or, there is the tantalizing possibility that the absence of some of the more familiar conflicts from these narratives is the early fruit of efforts to address these traditional issues through policies governing interactions between physicians and industry promulgated by academic medical centers and health systems, medical specialty societies, and industry.One significant area of concern that has emerged in recent years is conflict of interest in the development of clinical practice guidelines. E.g., Choudry et al. 2002; Sniderrman & Furberg 2009; Guyatt et al. 2010. Although none of the essays in this [End Page 101] collection address it head on, Perlmutter touches on several key issues. His depiction of how an FDA committee process limited the input he was able to provide as an expert, undermined his potential to contribute to the professional dialogue, and raised concerns about the objectivity of the drug approval process echoes concerns about objectivity, the role of expert opinion, and the presence on guideline development panels of individuals with financial interests in the recommendations to be developed that have been explored at some length in the literature, most recently by the Institute of Medicine in reports on evidentiary standards (Eden et al 2011) and principles for guideline development (Graham et al. 2011).Conflict of Interest or Dual Agency?Several essays set out physicians’ experience in navigating situations of diverging expectations. Bierut, for example, reflects on the disjunction between the goals and products of academic researchers and commercial sponsors. She saw herself advancing basic knowledge and was forced to grapple with the reality of sponsors’ goals to advance commercial ends as well. Nagldinne and Mikulec each recall struggles to reconcile their obligation to exercise professional judgment on behalf of patients with the demands of health care organizations focussed also on the bottom line. Cruz–Flores attests to the challenge of making recommendations for care when one is both a practicing clinician and a clinical investigator engaged in research that might offer benefit to a patient for whom there are limited options.Thompson defined conflicts of interest as “a set of conditions in which professional judgment concerning a primary interest (such as a patient’s welfare or the validity of... (shrink)

Theoria , the international Swedish philosophy journal, was founded in 1935. Its contributors in the first 75 years include the major Swedish philosophers from this period and in addition a long list of international philosophers, including A. J. Ayer, C. D. Broad, Ernst Cassirer, Hector Neri Castañeda, Arthur C. Danto, Donald Davidson, Nelson Goodman, R. M. Hare, Carl G. Hempel, Jaakko Hintikka, Saul Kripke, Henry E. Kyburg, Keith Lehrer, Isaac Levi, David Lewis, Gerald MacCallum, Richard Montague, Otto Neurath, Arthur N. (...) Prior, W. V. Quine, Nicholas Rescher, Ernest Sosa, Robert C. Stalnaker, P. F. Strawson, Patrick Suppes, Johan van Benthem, Georg Henrik von Wright and many others. Hempel's confirmation paradoxes, Ross's deontic paradox, Montague's universal grammar and Lindström's theorem are among the contributions to philosophy that were first published in Theoria. (shrink)

ObjectiveThe scarcity of research on associations between inflammatory markers and symptoms of depression and anxiety during adolescence has yielded inconsistent results. Further, not all studies have controlled for potential confounders. We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample.MethodsData was derived from 373 girls and 294 boys aged 15–18 years at baseline, in the Fit Futures Study, a large-scale 2-year follow-up study on adolescent health. Baseline data was gathered (...) from 2010 to 2011 and follow-up data from 2012 to 2013. Psychological distress was measured with Hopkins Symptom Checklist. Serum levels of the following inflammatory markers were measured: C-reactive protein, Interleukin 6, Transforming growth factor alpha, Tumor necrosis factor alpha variant 1, and variant 2. Independent associations between baseline inflammatory markers and HSCL-10 at follow-up were explored by linear regressions, in sex-stratified analyses.ResultsIn girls, analyses showed positive associations between all inflammatory markers and HSCL-10, except for TRANCE. However, all associations were non-significant in crude as well as in adjusted analyses. In boys, CRP and TGF-α showed significant associations with HSCL-10, that remained significant after adjustment. Additionally, moderators were found. In boys, CRP was associated with HSCL-10 in those with high body fat and those being physical inactive, and the association between TWEAK and HSCL-10 was dependent upon sleep duration.ConclusionThere were significant prospective associations between CRP, TFG-α, and HSCL-10 in boys aged 15–18 years at baseline. (shrink)

Lisa Furberg har argumenterat för att altruistiskt surrogatmödraskap kan anses moraliskt problematiskt utifrån en perfektionistisk teori om det goda livet. I följande svar riktar jag ett antal invändningar mot Furbergs resonemang.

De uma perspectiva comportamentalista radical, o eu é um repertório verbal complexo, que, como tal, tem uma gênese social. O reconhecimento da origem social do “eu” abre caminho para uma análise política, incluindo uma discussão do pa- pel das relações de poder na constituição do eu. Entretanto, uma concepção radicalmente social do “eu”, como a proposta pelo comportamentalismo, suscita um problema político: se o eu é integralmente produto do ambiente social, de onde viria uma eventual “vontade” de romper com esse (...) sistema? Parece que para reconhecer a possibilidade de ação política transformadora seria preciso preservar uma noção descontextualizada de “eu”. Considerando essa dificuldade, o objetivo deste artigo é propor uma interpretação política da constituição do “eu” no âmbito do comportamentalismo radical, mantendo no horizonte a possibilidade de uma ação política transformadora. Para tanto, destacamos como “eus” oprimidos são tornados submissos, mas também como de certas contingências podem emergir “eus” subversivos, que se opõem a um sistema social opressivo. Esse “eu” subversivo é caracterizado por um repertório de autoconhecimento mais amplo, que inclui a discriminação do papel das relações de poder e do controle promovido por instituições. Concluímos, com isso, que um “eu” socialmente constituído pode ser politicamente ativo. (shrink)

Durkheim écrit ce livre avec un but double : d'abord il voulait expliquer ce qui crée une société, ce qui la tient ensemble ; ensuite il voulait éclaircir l'influence qu'a la société sur la pensée logique. Pour Durkheim, la religion est la clé utilisée pour déverrouiller ces deux problématiques.Dans ce livre, Durkheim argumente que les représentations religieuses sont en fait des représentations collectives : l'essence du religieux ne peut être que le sacré. Il est une caractéristique qui se trouve universellement (...) dans toutes les religions. Le sacré, être collectif et impersonnel, représente ainsi la société elle-même. Ensuite il argumente que la société a un impact majeur dans la genèse de la pensée logique. C'est la société qui fournit à l'individu les catégories (le temps, l'espace, le nombre etc.) et les concepts nécessaires pour la pensée logique. (shrink)

É bem conhecida a oposição estabelecida por Kant entre experiência possível e dialética, na medida em que esta última é caracterizada como a “lógica da ilusão”. Ao mesmo tempo, o modo de pensar metafísico, que ocorre dialeticamente, em sentido kantiano, é uma tendência inevitável da razão, expressa na exigência formal de completude das categorias. Como o pensar, enquanto exercício livre da razão, é em si mesmo mais amplo do que a atividade de conhecer, própria do entendimento, o pensar contém o (...) conhecimento, embora este se qualifique pelas regras e pelos limites determinantes da objetividade. A pergunta que tentaremos formular é se essa relação continente-conteúdo não poderia configurar também uma dependência da experiência em relação ao raciocínio dialético, que estaria de algum modo indicada na função reguladora das idéias da razão. Nesse caso, a oposição formal entre conhecer e pensar seria inseparável da inclusão estrutural (dependência) da experiência no âmbito da razão. Na raiz do problema estaria talvez a tensão (dialética) entre a aspiração subjetiva de totalidade e as exigências objetivas de limitação e segmentação da experiência e a forma da experiência teria de ser finalmente concebida a partir de um fundo de inteligibilidade problemática. Dialectics and experienceThe separation of possible experience as objective knowledge and dialetics as a non-objective or non-theoretical knowledge is one of the most important aspects of kantian critical philosophy. But Kant also says that the activity of reason, as a pure thinking, has more amplitude than understanding knowledge. So we could say that theoric knowledge would depend on rational ( and non-theoretical) knowledge, as something contained in it. If we accept that, the consequence would be a relation of dependence between the form of objective knowledge and the background of a problematic – even doubtful – inteligible knowledge. (shrink)

gl. 1. Ėkofilosofii︠a︡ kak zhiznesokhrani︠a︡i︠u︡shchiĭ kulʹturnyĭ proekt -- gl. 2. Obrazy kulʹtury mira v istoriko-personologicheskom izmerenii -- gl. 3. Borʹba za mir v sovremennom mire : opyt, kont︠s︡ept︠s︡ii, modeli resheniĭ.

Em artigo inédito, Franklin Leopoldo e Silva desenvolve os sentidos da memória na produção da identidade, destacando as relações significativas do presente com o passado e o futuro na construção da história. Desse ponto, o autor acentua o papel das instituições nesse processo – um processo de exercício de poder, no qual se tem, na verdade, a institucionalização do poder – e, dentre elas, em particular a instituição universitária.

Carta escrita por Gilda de Mello e Souza, remetida ao colega Oswaldo Porchat, que se encontrava em Berkeley, quando a ditadura civil-militar brasileira, recrudescida desde a implantação, em agosto de 1968, do AI-5, representava uma verdadeira ameaça a estudantes e docentes da Universidade de São Paulo, especialmente se lhe fizessem qualquer tipo de oposição. Porchat trocou uma sequência de cartas com Gilda nessa época, nas quais relata sua desilusão com a Faculdade de Filosofia, e com os acontecimentos políticos no Brasil. (...) Ao mesmo tempo, confessa estar encantado com a descoberta de novos elementos da Lógica, e com a atmosfera mais amena dos Estados Unidos. Porchat sabe que Gilda enfrenta momentos difíceis, tendo de assumir a Presidência do curso em meio à tentativa do reitor Miguel Reale de submetê-lo a um interventor. Enfrentando a dúvida sobre se valeria a pena retornar ao Brasil naquele momento, Porchat escreve à amiga. A carta a seguir expressa, dentro do que era possível na época, quando as correspondências eram vigiadas, o parecer de Gilda sobre as indagações do amigo, sobre os rumos da ditadura, e sobre o que ela pensava de sua própria atitude de resistência naquele contexto. A carta original, assim como a sequência de correspondências da qual faz parte, está depositada no Fundo Gilda de Mello e Souza, no Instituto de Estudos Brasileiros (IEB/USP). Agradeço à família de Gilda, especialmente a Ana Luisa Escorel e a Laura Escorel, pela disponibilização desse documento para a presente publicação. (shrink)