While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

La 4e de couv. indique : "Prenant ici toute l’initiative, Elisabeth Weber a choisi, en les présentant, vingt entretiens parmi tous ceux auxquels Jacques Derrida a participé depuis près de vingt ans. Elle s’est donné pour cela un certain nombre de critères, et d’abord celui de la diversité : celle des sujets (la question des femmes, la poésie, la drogue, le sida, l’enseignement, en particulier celui de la philosophie, et, croisant tous ces thèmes, la politique et les médias), celle (...) des tons (analytique ou joueur, militant ou « autobiographique »), celle des destinataires (en France, en Europe, Outre-Altantique).". (shrink)

Negative compatibility effects in the masked-prime paradigm are usually obtained when primes are masked effectively. With ineffective masks—and primes above the perceptual threshold—positive compatibility effects occur. We investigated whether this pattern reflects a causal relationship between conscious awareness and low-level motor control, or whether it reflects the fact that both are affected in the same way by changes in physical stimulus attributes. In a 5-session perceptual learning task, participants learned to consciously identify masked primes. However, they showed unaltered NCEs that (...) were not different from those produced by participants in a control group without equivalent perceptual learning. A control experiment demonstrated that no NCEs occur when prime identification is made possible by ineffective masking. The results suggest that perceptual awareness and low-level motor control are affected by the same factors, but are fundamentally independent of each other. (shrink)

BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities (...) in the Norwegian municipalities and the ethical topics addressed.ResultsOne hundred and thirty-seven municipal contact persons answered the first survey, whereas 217 ethics facilitators from 48 municipalities responded to the second. The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions whilst seldom reaching others. Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The “ethics reflection group” was the most common venue for ethics deliberation.ConclusionsThe Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large scale implementation of CES structures for the municipal health and care services is complex, yet feasible. (shrink)

This paper critically engages with how life not worth living (LNWL) and cognate concepts are used in the field of beginning-of-life bioethics as the basis of arguments for morally requiring the application of preimplantation genetic diagnosis (PGD) and/or germline genome editing (GGE). It is argued that an objective conceptualization of LNWL is largely too unreliable in beginning-of-life cases for deriving decisive normative reasons that would constitute a moral duty on the part of intending parents. Subjective frameworks are found to be (...) more suitable to determine LNWL, but they are not accessible in beginning-of-life cases because there is no subject yet. Conceptual and sociopolitical problems are additionally pointed out regarding the common usage of clear case exemplars. The paper concludes that a moral requirement for the usage of PGD and GGE cannot be derived from the conceptual base of LNWL, as strong reasons that can be reliably determined are required to limit reproductive freedom on moral grounds. Educated predictions on prospective well-being might still be useful regarding the determination of moral permissibility of PGD and/or GGE. It is suggested that due to the high significance of subjective experience in the normativity of beginning-of-life bioethics, the discipline is called to more actively realize the inclusion of people with disabilities. This regards for instance research design, citation practices, and language choices to increase the accessibility of societal debates on the reproductive ethics of genetic technologies. (shrink)

Elisabeth Young-Bruehl illuminates the psychological and intellectual demands writing biography makes on the biographer and explores the complex and frequently conflicted relationship between feminism and psychoanalysis. She considers what remains valuable in Sigmund Freud's work, and what areas - theory of character, for instance - must be rethought to be useful for current psychoanalytic work, for feminist studies, and for social theory. Psychoanalytic theory used for biography, she argues, can yield insights for psychoanalysis itself, particularly in the understanding of (...) creativity. (shrink)

Background: Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses. Aim: The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour. Research design, participants and research context: A phenomenological (...) and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital. Ethical consideration: Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained. Findings: The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’. Conclusion: Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness. (shrink)

A crítica da cultura como reflexo do mundo que realmente existe é o ponto de partida para a apreensão do caráter social dos sentidos estéticos, manifestamente sobre a criação artística, o conhecimento estético e a produção material sob o capitalismo. Partindo de tal pressuposto, o presente artigo se debruçará sobre a problemática geral da estética e do seu papel formador na cultura.

BackgroundRecurrent Major Depressive Disorder is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion (...) would associate with lower ruminative tendencies and higher vmHRV in a sample of adults with recurrent MDD.MethodsWe included a sample of 63 patients between 20 and 71 years old with a history of three or more depressive episodes. They filled out the Self-Compassion Scale, Beck Depression Inventory, and Rumination Rating Scale. ECG was acquired while resting and the square root of the mean squared differences of successive RR interval values was calculated as measure of vmHRV.ResultsAs hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses.ConclusionThe results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response. Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies. (shrink)

L’ouvrage d’Elizabeth MacKnight, Aristocratic Families in Republican France, offre une contribution novatrice à l’étude des rôles privés et publics des femmes aux xixe et xxe siècles et à leur importance sociopolitique en analysant les interactions domestiques, la vie émotionnelle, les centres d’intérêt politique et l’influence culturelle des familles nobles sous la Troisième République. Alors que la plupart des travaux historiques sur les femmes françaises de la période 1870-1940 se sont att...

The topic of Hannah Arendt's Jewish identity can be approached from many directions. This chapter considers Arendt in the context of the vision of world history articulated by her teacher and mentor Karl Jaspers, in which her people, the Jews of Palestine, were considered as one of the “Axial Age” peoples. It argues that it is Arendt's Jewish identity—not just the identity she asserted in defending herself as a Jew when attacked as one, but more deeply her connection to the (...) Axial Age prophetic tradition—that made her the cosmopolitan she was, while Jaspers's cosmopolitanism was more learned than inherited and reinforced by group experience. (shrink)

Rauprich O, Marckmann G, Vollmann J: Gleichheit und Gerechtigkeit in der modernen Medizin Content Type Journal Article Pages 71-75 DOI 10.1007/s10202-007-0032-0 Authors Elisabeth Weisser-Lohmann, Institut für Philosophie FernUniversität Hagen 58084 Hagen Germany Journal Poiesis & Praxis: International Journal of Technology Assessment and Ethics of Science Online ISSN 1615-6617 Print ISSN 1615-6609 Journal Volume Volume 5 Journal Issue Volume 5, Number 1.

Jeder wissenschaftlichen Theorie und jedem alltäglichen Weltbild liegen "ontologische Festlegungen" zugrunde, also Annahmen betreffend die Existenz bestimmter Gegenstände. Manchmal widersprechen implizite Existenzannahmen expliziten Überzeugungen und sind in diesem Sinne unerwünscht. Unerwünschte ontologische Festlegungen werfen unter anderem die folgenden Fragen auf: Nach welchen Kriterien kann entschieden werden, worauf jemand ontologisch festgelegt ist? Gibt es so etwas wie ein "ontologisch neutrales" Sprechen? Gibt es verschiedene "Weisen des Seins"? Wie können unerwünschte Festlegungen (etwa auf abstrakte, fiktive oder vergangene Gegenstände) vermieden werden? Welche Rolle (...) spielen dabei Paraphrasierungen, nicht-gegenständliche Deutungen der Quantifikation oder existenzfreie Logiken? Aus dem Inhalt: I. Ontologische Festlegung – 1. Was ist ontologische Festlegung? – 2. Ontologische Festlegung und Wirklichkeit – 3. Carnaps ontologischer Pragmatismus – 4. Prinzipien der ontologischen Festlegung. II. Gibt es ontologisch neutrale Äußerungen? – 1. Die Paraphrasierungsstrategie – 2. "Kontextuelle Semantik" – 3. Ist die Objektsprache ontologisch neutral? – 4. Seinsweisen. III. Ontologie und Logik – 1. Natürliche und reglementierte Sprachen – 2. Ontologisch neutrale versus gegenständliche Quantifikation – 3. Existenzfreie Logiken – 4. Ist Existenz ein Prädikat? IV. Probleme der ontologischen Festlegung – 1. Fiktive Gegenstände – 2. Das Problem der nichtexistierenden intentionalen Gegenstände – 3. Das Problem der vergangenen und zukünftigen Gegenstände – 4. Das Problem der möglichen und unmöglichen Gegenstände. (shrink)

Given the high prevalence and dramatic impact of being bullied at school, it is crucial to get more insight into how teachers can reduce bullying. So far, few instruments have measured elementary teachers’ responses to bullying. This study investigated the validity of the student-reported Teachers’ Responses to Bullying Questionnaire. The factor structure and measurement invariance were tested across two educational contexts among fourth and fifth grade students from Italy and Belgium. Furthermore, associations between student-perceived teachers’ responses and students’ bullying behavior (...) were examined. Confirmatory Factor Analysis supported the predicted five-factor structure, distinguishing Non-Intervention, Disciplinary Methods, Group Discussion, Mediation, and Victim Support. A partial factor means invariance model was found, allowing for valid comparisons between the Italian and Belgian educational contexts. Significant associations were found between self-reported, but not peer-nominated, bullying behavior and most student-perceived teachers’ responses. (shrink)

Proefschrift Katholieke Universiteit Nijmegen. Onderzoek naar de metaforische functie van de vrouw en het vrouwelijke in het werk van Nietzsche, gerelateerd aan Nietzsche's concept van het dionysische. Dit concept van het dionysische wordt uitgewerkt als thematisering van het verlangen.

Women’s empowerment is often an important goal of development interventions. This paper explores local perceptions of empowerment in the Upper East Region of Ghana and the pathways through which small-scale irrigation intervention targeted to men and women farmers contributes to women’s empowerment. Using qualitative data collected with 144 farmers and traders through 28 individual interviews and 16 focus group discussions, this paper innovates a framework to integrate the linkages between small-scale irrigation and three dimensions of women’s empowerment: resources, agency, and (...) achievements. The relationship between the components of empowerment and small-scale irrigation are placed within a larger context of social change underlying these relationships. This shows that many women face serious constraints to participating in and benefitting from small-scale irrigation, including difficulties accessing land and water and gender norms that limit women’s ability to control farm assets. Despite these constraints, many women do benefit from participating in irrigated farming activities leading to an increase in their agency and well-being achievements. For some women, these benefits are indirect—these women allocate their time to more preferred activities when the household gains access to modern irrigation technology. The result is a new approach to understanding women’s empowerment in relation to irrigation technology. (shrink)

The term ‘sustainability’ is vague and open to interpretation. In this paper we analyze how firms use the term in an effort to make the concept their own, and how it becomes a premise for further decisions, by applying a bottom-up approach focusing on the interpretation of ‘sustainability’ in the Norwegian salmon-farming industry. The study is based on a strategic selection of informants from the industry and the study design rests on: 1) identification of the main drivers of sustainability, and (...) 2) the application of five different discursive strategies to analyze how the firms maneuver to legitimize ‘sustainability’ in their conduct. We employ the Critical Discourse Analysis framework, which emphasizes how discourses provide different concepts of meaning. The sustainability concept is assessed based on how sustainability is brought into action by social actors in a legitimate way, and how this action results in sustainable practices. The empirical case of the study is the verbal justification of sustainability practices among representatives of the Norwegian salmon-farming industry. We aim to find out how these representatives translate the rather vague directives of the sustainability concept into legitimate choices that resonate with the firms’ contextual environment, hence, how the salmon farmers perceive, explore, interpret, explain, enact, and defend the diverse landscape of sustainability when implementing professional decisions. We found a trend of passive adaptation to external requirements, such as public regulations and regulative requirements from certification bodies. At the same time, there are progressive forces that attempt to improve the sustainability of the farming practices by involvement in research and innovation projects or cooperation with other firms, e.g. the contribution from offshore engineers in developing high seas farms. The strategies outlined and discussed cannot be seen as a typology to categorize the firms. More than one discursive strategy may be involved in one firm’s choice, and the strategies may work on different levels. (shrink)

In diesem Beitrag wird zunächst erläutert, worin das ontologische Problem fiktiver Gegenstände besteht. Dies geschieht, indem zwei Typen von Paradoxien vorgestellt werden. In Abschnitt 2 werden die wichtigsten antirealistischen Theorien fiktiver Gegenstände übersichtlich dargestellt, und es wird erläutert, auf welche Weise Vertreter dieser Theorien die eingangs entwickelten Paradoxien aufzulösen versuchen. In Abschnitt 3 werden Einwände gegen diese antirealistischen Theorien formuliert. In Abschnitt 4 werden die wichtigsten realistischen Theorien fiktiver Gegenstände übersichtlich dargestellt, und es wird gezeigt, wie man mit Hilfe dieser (...) Theorien die Paradoxien auflösen kann. In Abschnitt 5 werden Einwände gegen realistische Theorien fiktiver Gegenstände vorgebracht. Im sechsten und letzten Abschnitt wird für eine bestimmte realistische Theorie argumentiert; im Zuge dieser Argumentation werden Entgegnungen auf die in Abschnitt 5 dargestellten Einwände vorgebracht. (shrink)