Background Recent publications reveal shortcomings in evidence review and summarization methods for patient decision aids. In the large-scale "Share to Care (S2C)" Shared Decision Making (SDM) project at the University Hospital Kiel, Germany, one of 4 SDM interventions was to develop up to 80 decision aids for patients. Best available evidence on the treatments' impact on patient-relevant outcomes was systematically appraised to feed this information into the decision aids. Aims of this paper were to (1) describe how PtDAs are developed (...) and how S2C evidence reviews for each PtDA are conducted, (2) appraise the quality of the best available evidence identified and (3) identify challenges associated with identified evidence. Methods The quality of the identified evidence was assessed based on GRADE quality criteria and categorized into high-, moderate-, low-, very low-quality evidence. Evidence appraisal was conducted across all outcomes assessed in an evidence review and for specific groups of outcomes, namely mortality, morbidity, quality of life, and treatment harms. Challenges in evidence interpretation and summarization resulting from the characteristics of decision aids and the type and quality of evidence are identified and discussed. Conclusions Evidence reviews in this project were carefully conducted and summarized. However, the evidence identified for our decision aids was indeed a "scattered landscape" and often poor quality. Facing a high prevalence of low-quality, non-directly comparative evidence for treatment alternatives doesn't mean it is not necessary to choose an evidence-based approach to inform patients. While there is an urgent need for high quality comparative trials, best available evidence nevertheless has to be appraised and transparently communicated to patients. (shrink)

An effectiveness assessment on ASCT in locally advanced and metastatic breast cancer identified serious ethical issues associated with this intervention. Our objective was to systematically review these aspects by means of a literature analysis. We chose the reflexive Socratic approach as the review method using Hofmann's question list, conducted a comprehensive literature search in biomedical, psychological and ethics bibliographic databases and screened the resulting hits in a 2-step selection process. Relevant arguments were assembled from the included articles, and were assessed (...) and assigned to the question list. Hofmann's questions were addressed by synthesizing these arguments. Of the identified 879 documents 102 included arguments related to one or more questions from Hofmann's question list. The most important ethical issues were the implementation of ASCT in clinical practice on the basis of phase-II trials in the 1990s and the publication of falsified data in the first randomized controlled trials (Bezwoda fraud), which caused significant negative effects on recruiting patients for further clinical trials and the doctor-patient relationship. Recent meta-analyses report a marginal effect in prolonging disease-free survival, accompanied by severe harms, including death. ASCT in breast cancer remains a stigmatized technology. Reported health-related-quality-of-life data are often at high risk of bias in favor of the survivors. Furthermore little attention has been paid to those patients who were dying. The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 42.1 (2004) 115-116 [Access article in PDF] Robert J. Dostal, editor. The Cambridge Companion to Gadamer. New York: Cambridge University Press, 2002. Pp. xiii + 317. Cloth, $65.00. Paper, $23.00. This twelve-essay collection should introduce Gadamer to new readers while engaging those familiar with his work. Essays treat central elements of Gadamer's hermeneutical philosophy: his concept of understanding; tradition and authority; the ontology (...) of language; and the centrality of dialogue. A varied group of scholars trace Gadamer's major philosophical influences and situate him in debates with rival critics of modernity.The book opens with Robert Dostal's biographical sketch, from Gadamer's Marburg years, fascination with Heidegger's interpretation of Aristotle, and the Leipzig rectorship, through his productive Heidelberg period, reception of Truth and Method, and later engagement with issues like globalization and health. Dostal rejects claims of Nazi collusion, and characterizes as superficial critiques of Gadamer's writings at this time on Plato and Herder. Dostal might have gone further: Gadamer's writings develop a politics of recognition among equal, different and autonomous subjects, and his central notions of conversation and I-Thou dialogue are deeply anti-authoritarian.For a general audience, Charles Taylor best communicates the humane relevance of Gadamer's thought, astutely captured as the challenge of trying to understand others without absorbing them into our interpretive frameworks but by letting them challenge those frameworks. New readers might also benefit from accounts of Gadamer's notion of understanding (Jean Grondin) and its ethical dimensions (Georgia Warnke).For readers more familiar with Gadamer, Brice Wachterhauser illustrates the critical dimensions of Gadamer's views of tradition and authority, drawing on John McDowell's work, illuminating the intentional character of belief justification. Falling into neither skepticism nor objectivism, Wachterhauser shows that Gadamer's claim, "Being that can be understood is language," is inextricably tied to epistemic realism: while our beliefs are formed through interpretations, they remain answerable to the world. "Our world has an 'inherent' intelligibility that is... 'independent' of the languages, traditions and standpoints through which the world is mediated" (73). Otherwise, the world could not challenge us—Wachterhauser's reading thus has the virtue of accounting for the experience of the tug of, e.g., nature or a text against willful or incorrect claims to know it.Quite different is an essay by J. M. Baker, who explores Gadamer's view that the relevance of poetry for philosophy is its speculative content. Contrasting Hegel's claim that poetry no longer reveals truth and is superceded by the prose of philosophy, Baker illustrates Gadamer's view with readings of Mallarmé and Rilke. Mallarmé, says Baker, "elaborated a language that at once brings things otherwise inaccessible into presence yet defeats any attempt to name that presence," his "pure poetry" repudiating reference yet suggesting a kind of revelation. Poetry expresses the "invisible," by which is meant not the opposite of the material, but "... things [that] have in their same material exteriority an invisibility that has first of all to be articulated" (158). This articulation, for Gadamer, is the first task of a post-Hegelian aesthetic.Richard Bernstein outlines the intersections of hermeneutics, critical theory, and deconstruction, using each to reveal the others' aporia. For Habermas, phronesis does not go far enough in understanding modernity's pathologies, showing the need for democratic political theory. For Gadamer, efforts to build a universal political theory lack an appreciation of human finitude. Derrida's skepticism about slippage and misprisions of language challenges Gadamer's account of the "fusion of horizons," which emphasizes [End Page 115] dialogical achievement in understanding. Yet Derrida's deconstruction depends (to have effect through language) on a concern for coherence, as his view of the "undecidability" of ethical decisions shares the risk to identity of Gadamer's commitment to the "openness of experience."In a provocative essay, Robert Pippin analyzes Gadamer's complex relation to Hegel. Gadamer shares a view of Hegel as mired in a philosophy of consciousness, i.e., the "problem of reflection." Tracing the trajectory of this problem from Locke... (shrink)

In 'Art as Festival', I put Heidegger and Gadamer into dialogue concerning their respective critiques of traditional aesthetics and their more positive views on the work of art. I use the festival theme to examine some of the philosophical issues in Heidegger's and Gadamer's approaches to the work of art. Specifically, I look at the way both figures conceive the work of art as an encounter which, like the festival, involves a transcendence of subjectivity in an encounter with an event (...) - in this case, the artwork - which the individual does not direct, but rather in which they participate. Putting the theme of festival into play also provides a useful critical lever, especially in the way that it raises important issues of community. More specifically, reflecting on the festival celebration raises questions of the nature of this community, of the relation of the community created in the festival event to the community of the everyday, and thus also of the relation of the aesthetic and the political. (shrink)

This article takes its shape from a recent conference at the School of Visual Arts in NYC on the theme, 'Tradition and the New: Educating the Artist for the Millennium'. Central to the way the conference was advertised and described was an implicit tendency to view tradition as wholly separate from the new. While the conference did not itself make a theoretical argument for the opposition of tradition and the new, Arthur Danto's recent elaboration of a thesis of the 'end (...) of art' does provide such a theoretical underpinning for the opposition that the conference seemed to presuppose. Danto's thesis of the end of art offers a compelling view of 'what' and 'where' art is today, but it also has troubling implications for how our relation to the past is configured and, in Danto's view of art's having come to an end, for what it means that we are now living in 'post-historical' times. That is, as a compelling contemporary reading of the history of art, Danto's thesis seems to be more implicated in the very modernist project that he, in other ways, seeks to move effectively beyond. This article, then, explores the problem of counterposing tradition and the new, specifically, in Danto's thesis, but also more generally. In the first part of the article, I present Danto's end of art thesis. Next, I will offer a counterweight to this tendency to separate tradition and the new by examining the concept of 'effective history', focussing here on the writing of Hans-Georg Gadamer. Gadamer's insights, which I will link to Nietzsche, provide a way of moving beyond some of the problematic implications of Danto's thesis, and also illuminate some of the ethical dimensions at stake. In concluding, I will look at some contemporary examples where the notion of effective history can be productively applied. Key Words: art theory • effective history • end of art • hermeneutics • modernism • tradition. (shrink)

The view that linguistic questions were not central to the philosophical tradition of German Idealism has recently begun to be challenged, but a number of central texts still remain largely unknown or untranslated. Surber’s book increases our understanding of the significant role of linguistics in the German Idealist tradition, while also challenging traditional conceptions of Fichte’s role within this tradition.

The God Within is a collection of ten essays, the product of Fackenheim’s long-standing concern with German Idealism in the period from Kant, Fichte, and Schleiermacher to Schelling, and an epilogue: “Holocaust and Weltanschauung: Philosophical Reflections on Why They Did It.”.

Die Frage, wie ein Anfang im Denken zu machen sei, oder wie der Anfang von Denken zu denken sei, war Gegenstand der philosophischen Reflexion des Klassischen Deutschen Idealismus. Die Autoren dieses Bandes thematisieren nun für philosophische Konzepte aus der Zeit vor und nach dem Klassischen Idealismus, wie in ihnen das Problem des Anfangs gedacht wird. Betrachtete Autoren sind: Marsilius Ficino, Johannes Scotus Eriugena, Giordano Bruno, Christoph Scheibler, Husserl, Meister Eckhard, Nishida und Davidson.

"All life upon the stage"; the Theatrum Mundi. In this volume, a seventeenth century metaphor is revisited and is seen as applying to all art in all times. In the "magic mirror of art" the human being discerns the hidden spheres of human life and commemorates and celebrates its glorious victories and mourns its ignominious defeats. Let us rediscover Art as a witness to the human predicament as well as a celebrant of humanity's most sublime moments. This is the invitation (...) of this collection of studies by A-T. Tymieniecka, Hanna Scolnicov, Muella Erkilic, Matt Landrus, Patricia Trutty-Coohill, Monika Bakke, David Brubaker, Tammy Knipp, Howard Pearce, Ellen J. Burns, G. Backhaus, Ethan J. Leib, Lawrence Kimmel, Ingrid Scheibler, Gottfried Scholz, L.F. Werth, A. Carillo, M. Statkiewicz, K. O'Rourke, B. Meyler, H. Meltzer, Jiuan Heng, W.V. Davies. Art as mirror of life, human life as participating in a stage play, corresponds to the fervent search human being of the causes, reasons, puzzles of our existence which elude us in the concrete life. This XVII c. conception of Theatrum Mundi opens as this volume shows a fascinating field of investigation for our times. (shrink)