Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

​This book gathers research and writings that reflect on traditional and current global issues related to art and aesthetics, gender perspectives, body theories, knowledge and learning. It illustrates these core dimensions, which are bringing together philosophy, tradition and cultural studies and laying the groundwork for comparative research and dialogues between aesthetics, Chinese philosophies, Western feminist studies and cross-cultural thought. Pursuing an interdisciplinary approach, the book also integrates philosophical enquiries with cultural anthropology and contextual studies. As implied in the title, the (...) main methodologies are cross-cultural and comparative studies, which touch on performances in art and aesthetics, social existence and education, and show that philosophical enquiries, aesthetical representation and gender politics are simultaneously historical, living and contextual. The book gathers a wealth of cross-cultural reflections on philosophical aesthetics, gender existence and cultural traditions. The critical thinking within will benefit undergraduates, postgraduates and researchers in the area of comparative philosophies. It blends academic rigor with personal reflection, which is a critical practice in feminist philosophy itself. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (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)

Книга предназначена для исследователей, специалистов, преподавателей, аспирантов, студентов, а также всех тех, кто интересуется вопросами становления постнеклассической науки.

Humphreys & Forde concentrate on the living/nonliving dissociation. However, further dissociations have been reported, including selective loss or preservation in recognizing body parts and numbers. This commentary outlines the relevance of the number category for understanding the organising principles of semantic memory.

In diesem Aufsatz wird untersucht, wie sinnvoll und berechtigt die Rede von neuen Formen der Menschenwürdeverletzung durch die Nutzung von KI-Systemen ist. Nach der Skizze eines Kernverständnisses von Menschenwürdeverletzung werden vier Anwendungsgebiete von KI-Systemen exemplarisch erörtert. Es wird dafür argumentiert, dass Menschenwürdeverletzungen zwar weder mit extensiver Werbung und Überredungsstrategien noch mit der Nutzung von Daten über Menschen an sich verbunden sind, dass sie aber tatsächlich da drohen, wo Menschen nicht selbst darüber entscheiden können, welche ihrer Daten wofür verwendet werden und (...) wo ein KI-System selbstständig, ohne weiteres Zutun eines Menschen, über wichtige Belange von Menschen wie Leben und Tod entscheidet. (shrink)

Johann Gottfried Herder initiated the modern disciplines of philosophical anthropology and cultural history, including the study of popular culture. He is also remembered as a sharp critic of colonialism and imperialism. But what types of social, economic and political arrangements did Herder envision for modern European societies? Herder and Enlightenment Politics provides a radically new interpretation of Herder's political thought, situating his ideas in Enlightenment debates on modern patriotism, commerce and peace. By reconstructing Herder's engagement with Rousseau, Montesquieu, Abbt, Ferguson, (...) Möser, Kant and many other contemporary authors, Eva Piirimäe shows that Herder was deeply interested in the potential for cultural, moral and political reform in Russia, Germany and Europe. Herder probed the foundations of modern liberty, community and peace, developing a distinctive understanding of human self-determination, natural sociability and modern patriotism as well as advocating a vision of Europe as a commercially and culturally interconnected community of peoples. (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)

Taking my cue from Judith Schalanskys 2018 work Verzeichnis einiger Verluste, I discuss the striking presence of lists and list-like, enumerative structures in contemporary literature. As a poetic principle, the use of lists and enumerations becomes a means of defamiliarizing the mundane and familiar, and at the same time also shows a preoccupation with existential issues.

Although consolation is one of the classic religious subjects it plays no role in the current debate about religious emotions. One reason for this neglect could be that this debate is mostly based on classical emotions such as joy and fear, love and hope, and that consolation is not understood as an emotion. This paper tries to show that consolation in fact can and should be seen as an emotion. After naming and refuting some reasons that speak against taking consolation (...) to be an emotion, I will explain how consolation can be positively conceptualized as an emotion within a recent theory of emotions. It will be decisive to see that the experience of consolation can be understood not only hedonistically-qualitatively, but also intentionally. This structural conception allows for a differentiated description of various types of consolation as an emotion, also, in the tradition of William James, of a secular as well as a religious form of consolation. (shrink)

Background Personal Health Monitoring (PHM) has the potential to enhance soldier health outcomes. To promote morally responsible development, implementation, and use of PHM in the armed forces, it is important to be aware of the inherent ethical dimension of PHM. In order to improve the understanding of the ethical dimension, a scoping review of the existing academic literature on the ethical dimension of PHM was conducted. Methods Four bibliographical databases (Ovid/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, and Elsevier/SCOPUS) were (...) searched for relevant literature from their inception to June 1, 2023. Studies were included if they sufficiently addressed the ethical dimension of PHM and were related to or claimed relevance for the military. After selection and extraction, the data was analysed using a qualitative thematic approach. Results A total of 9,071 references were screened. After eligibility screening, 19 articles were included for this review. The review identifies and describes three categories reflecting the ethical dimension of PHM in the military: (1) utilitarian considerations, (2) value-based considerations, and (3) regulatory responsibilities. The four main values that have been identified as being of concern are those of privacy, security, trust, and autonomy. Conclusions This review demonstrates that PHM in the armed forces is primarily approached from a utilitarian perspective, with a focus on its benefits, without explicit critical deliberation on PHM’s potential moral downsides. Also, the review highlights a significant research gap with a specific lack of empirical studies focussing specifically on the ethical dimension of PHM. Awareness of the inherent ethical dimension of PHM in the military, including value conflicts and how to balance them, can help to contribute to a morally responsible development, implementation, and use of PHM in the armed forces. (shrink)

During the past few years, the IRBIT domain has emerged as an important add‐on of S‐adenosyl‐L‐homocystein hydrolase (AHCY), thereby creating the new family of AHCY‐like proteins. In this review, we discuss the currently available data on this new family of proteins. We describe the IRBIT domain as a unique part of these proteins and give an overview of its regulation via (de)phosphorylation and proteolysis. The second part of this review is focused on the potential functions of the AHCY‐like proteins. We (...) propose that the IRBIT domain serves as an anchor for targeting AHCY‐like proteins towards cytoplasmic targets. This leads to regulation of (i) intracellular Ca2+ via the inositol 1,4,5‐trisphosphate receptor (IP3R), (ii) intracellular pH via the Na+/HCO3− cotransporters (NBCs); whereas inactivation of the IRBIT domain induces (iii) nuclear translocation and regulation of AHCY activity. Dysfunction of AHCY‐like proteins will disturb these three important functions, with various biological implications. BioEssays 30:642–652, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Etude du phénomène du kitsch à travers les littératures et cultures d'Europe, d'Amérique du Nord et du Sud et du Japon.

Introduction: Congenital myasthenic syndromes refer to a heterogenic group of neuromuscular transmission disorders. CMS-subtypes are diverse regarding exercise intolerance and muscular weakness, varying from mild symptoms to life-limiting forms with neonatal onset. Long-term follow-up studies on disease progression and treatment-response in pediatric patients are rare.Patients and Methods: We analyzed retrospective clinical and medication data in a cohort of 32 CMS-patients including the application of a standardized, not yet validated test to examine muscular strength and endurance in 21 patients at the (...) last follow-up. Findings obtained in our cohort were compared with long-term follow-up studies of CMS-cohorts from the literature by considering the underlying molecular mechanisms. Outcomes of CMS-ST were compared to results of normal clinical assessment.Results: Thirty-two pediatric patients with defects in eight different CMS-genes were followed by a median time of 12.8 years. Fifty-nine percentage of patients manifested with first symptoms as neonates, 35% as infants. While 53% of patients presented a reduced walking distance, 34% were wheelchair-bound. Even under adequate therapy with pyridostigmine and 3,4-diaminopyridine, CHAT-mutations led to the progression of muscular weakness partly in combination with persistent respiratory and bulbar symptoms. RAPSN, CHRND, and CHRNB1 patients with neonatal manifestation, early respiratory problems, and bulbar symptoms showed a good and maintained treatment response. CHAT and CHRNE patients required higher PS dosages, whereas RAPSN patients needed a lower mean dosage at the last follow-up. The benefits of short-term medication and long-term progression of symptoms were highly dependent on the specific genetic defect. CMS-ST was carried out in 17/21 patients, determined affected muscle groups including bulbar and ocular symptoms, some of which were not reported by the patients.Conclusions: Our findings and comparison with the literature- suggest a better treatment-response and less severe progression of symptoms present in patients suffering from mutations in CMS-genes directly associated with receptor deficiency, while patients with defects leading to synaptopathy and presynaptic defects tend to have worse outcomes. Assessment of affected muscular groups and clinical symptoms by CMS-ST may be a useful tool for optimal therapeutic management of the patients, especially for future clinical studies. (shrink)

Research question The secondary research use of treatment data has the potential to expand medical knowledge and improve patient care. Hospitals play an important role in systematic secondary research use: they generate large amounts of treatment data and are supposed to establish the necessary structures for their use in research. This raises the ethical question: do hospitals have a moral duty to support secondary research use of treatment data by establishing and operating the necessary resources and infrastructure? Procedure Our aim (...) is to outline a conceptual framework to discuss the question and to propose a first normative position. Building on insights from business and organizational ethics, we develop a conceptual framework in which we view hospitals as moral actors. Our normative-ethical analysis is based on a reconstructive stakeholder approach, in which we identify the following general duties of hospitals: orientation towards patient wellbeing; cost efficiency; enabling employees to act in accordance with professional ethical standards; supporting public health and research. We examine whether these general duties provide reasons for a specific duty of hospitals to support secondary research use of treatment data. We discuss potential objections to such a duty arising from other, potentially conflicting general duties of hospitals (e.g., data protection), from practice (e.g., costs/resources), or related discourses (data ownership). Conclusion Certain general duties (orientation towards patient wellbeing, cost efficiency, support of public health) justify a duty of hospitals to support secondary research use of treatment data. The duty to enable employees to act in accordance with professional ethical standards is only an indirect reason; the duty to support research applies solely to university hospitals. Potential objections apply to a certain extent but can be mitigated through targeted measures. (shrink)

This research study investigates the implementation of the Conflict Management Socialization and Mapping of Conflict Prone Areas program by the National Unity and Political Affairs Agency (Bakesbangpol) in Kuningan Regency, Indonesia. Using qualitative methods, including interviews and a literature review, the study examines how Bakesbangpol Kuningan detects and manages potential conflicts to maintain regional stability. Findings reveal that the program effectively utilizes early detection initiatives and community engagement forums such as Focus Group Discussions (FGDs) and collaborates with various stakeholders, including (...) local authorities and community organizations. Creating a conflict-prone area map in 2017 is a vital tool for proactive conflict prevention and policy formulation. However, the study identifies areas for enhancement, including further staff training, robust administrative support systems development, and more decisive leadership in program execution. This research highlights the significance of systematic program implementation and collaborative efforts in managing social conflicts and ensuring sustained regional harmony. It contributes to the field by providing insights into effective conflict management strategies at the local level in Indonesia, particularly in diverse and potentially conflict-prone regions like Kuningan. (shrink)