Previous studies of verbal short-term memory indicate that STM for serial order may be linked to language development and developmental language disorder. To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence. We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the (...) HelSLI project in this cross-sectional study. The children were 4–6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD. (shrink)

According to orthodoxy, there are two basic moods of supposition: indicative and subjunctive. The most popular formalizations of the corresponding norms of suppositional judgement are given by Bayesian conditionalization and Lewisian imaging, respectively. It is well known that Bayesian conditionalization can be generalized (via Jeffrey conditionalization) to provide a model for the norms of partial indicative supposition. This raises the question of whether imaging can likewise be generalized to model the norms of ‘partial subjunctive supposition’. The present article casts doubt (...) on whether the most natural generalizations of imaging are able to provide a plausible account of the norms of partial subjunctive supposition. (shrink)

In this commentary I expand on the first of Noble’s illusions, the selection metaphor. Building on my work with Simona Ginsburg on the evolution of minimal consciousness, I argue that the existence of some complex sensory and motor patterns in the living world can be accounted for only through the evolution of conscious choice.

On 11 September 2019, the verdict was read in the first prosecution of a doctor for euthanasia since the Termination of Life on Request and Assisted Suicide (Review Procedures) Act of 2002 was installed in the Netherlands. The case concerned euthanasia on the basis of an advance euthanasia directive (AED) for a patient with severe dementia. In this paper we describe the review process for euthanasia cases in the Netherlands. Then we describe the case in detail, the judgement of the (...) Regional Review Committees for Termination of Life on Request and Euthanasia (RTE) and the judgement of the medical disciplinary court. Both the review committees and the disciplinary court came to the conclusion there were concerns with this case, which mainly hinged on the wording of the AED. They also addressed the lack of communication with the patient, the absence of oral confirmation of the wish to die and the fact that the euthanasia was performed without the patient being aware of this. However, the doctor was acquitted by the criminal court as the court found she had in fact met all due care criteria laid down in the act. We then describe what this judgement means for euthanasia in the Netherlands. It clarifies the power and reach of AEDs, it allows taking conversations with physicians and the testimony of the family into account when interpreting the AED. However, as a practical consequence the prosecution of this physician has led to fear among doctors about prosecution after euthanasia. (shrink)

BackgroundResearch using data from medical care promises to advance medical science and improve healthcare. Academia is not the only sector that expects such research to be of great benefit. The research-based health industry is also interested in so-called ‘real-world’ health data to develop new drugs, medical technologies or data-based health applications. While access to medical data is handled very differently in different countries, and some empirical data suggest people are uncomfortable with the idea of companies accessing health information, this paper (...) aims to advance the ethical debate about secondary use of medical data generated in the public healthcare sector by for-profit companies for medical research (ReuseForPro).MethodsWe first clarify some basic concepts and our ethical-normative approach, then discuss and ethically evaluate potential claims and interests of relevant stakeholders: patients as data subjects in the public healthcare system, for-profit companies, the public, and physicians and their healthcare institutions. Finally, we address the tensions between legitimate claims of different stakeholders in order to suggest conditions that might ensure ethically sound ReuseForPro.ResultsWe conclude that there are good reasons to grant for-profit companies access to medical data if they meet certain conditions: among others they need to respect patients’ informational rights and their actions need to be compatible with the public’s interest in health benefit from ReuseForPro. (shrink)

Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

In this chapter, I clarify the notions of mental content and of concept. I present competing views on these notions and indicate my own position. I introduce content in terms of correctness conditions and distinguish several kinds of propositions, as well as non-propositional scenario content, with which perceptual content might be identified. I relate this discussion to a wide-spread commitment in philosophy of perception to respect the subject’s perceptual perspective in ascriptions of perceptual content. Then I compare views of concepts (...) as Fregean senses, as mental representations, and as cognitive abilities and investigate how they relate to the central idea that concepts are possessed by subjects. I suggest that our talk of concept possession and exercise is anchored in subjects’ abilities for re-identification and for general thought and in their inferential abilities. I clarify how possession and exercise of these three conceptual abilities relate. (shrink)

The children of today live in a time when the images of themselves and their childhood, their needs, interests, and skills, are discussed, researched, challenged, and changed. Childhood, education and educational settings for young children are to a great extent governed by temporality. In this paper, temporality and temporal notions in education are explored and discussed. We especially illuminate two different ways of thinking about children in education and care for younger children in the West— the predominant biased notions of (...) the child as becoming or being. The child as becoming, is manifested primarily in classical developmental psychology while the notion of the child as being, has been highlighted mainly by sociological researchers in their critique of developmental psychology. This latter notion is also visible in a totally different manner in the philosophy of Rousseau, emphasizing the free and natural child. In addition, we explore an alternative way of thinking about temporality and children. Drawing upon the philosophy of Maurice Merleau-Ponty and Gilles Deleuze, we argue for a rethinking of temporality beyond linear views on time and biased notions of children as ‘either or’. A movement towards a perspective which not only combines notions, but where the whole is more than merely the sum of the parts, is proposed. This leads to an ambiguous, intertwined and ongoing connection between the temporal notions of have been, being and becoming, described by a novel concept—a chiasmic be(com)ing. We suggest that this alternative may be a fruitful way to overcome binary approaches and expand the discussion of temporality, and temporal notions of children, in education. Such an alternative could function as a counterweight to the predominant notions of education and teachers’ work. It may also be seen as a significant foundation for an ethical education since it is built upon ongoing and intertwined relationships, which appreciate openness and unpredictability. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

This chapter explores whether a version of causalism about reasons for action can be saved by giving up Davidsonian psychologism and endorsing objectivism, so that the reasons for which we act are the normative reasons that cause our corresponding actions. We address two problems for ‘objecto-causalism’, actions for merely apparent normative reasons and actions performed in response to future normative reasons—in neither of these cases can the reason for which the agent acts cause her action. To resolve these problems, we (...) move from objecto-causalism to ‘objecto-capacitism’, which appeals to agential competences manifest-ed in acting for a reason. We briefly apply this view of reasons for action to historical action explanations. (shrink)

The debate on abortion has tended to avoid the psychological significance of an unwanted pregnancy, dominated istead by the strong emotions the subject excites. Eva Pattis Zoja examines the thoughts that surround a woman's decision to end a pregnancy, and presents the challenging thesis that voluntary abortion can often be a violent and unconscious act of self-realisation. Treating a theme which is central to our existence, the author makes no attempt to argue for or against, or to deny the painful (...) nature of the subject which she tackles, but instead looks at the way in which a decision to abort can affect a woman's inner life. (shrink)

The global economy has an impact on female beauty today, regardless of the multicultural and historical factors in its formation and construction, resulting in monolithic crazes in women's fashion and appearance. but female beauty in china has been greatly contested with China's turbulent modern history, and this contestation deserves serious consideration, together with the politics by which the Chinese state apparatus has promoted and regulated female beauty. I argue that certain factors have been constant in contemporary discourses of female beauty. (...) Ideal bodies, in all their specifics, are defined by physical standards very few women can attain. These standards are accompanied by demeaning characterizations of women who fail to achieve them, and who are therefore destined to be discontent. It is now necessary for feminist theorists to examine the social and cultural roles of the body in terms of gender, power, the established patriarchy, and its oppression of women. (shrink)