ZusammenfassungBedingt durch den demographischen Wandel wird der Anteil an alten Patienten in Kliniken und Arztpraxen zunehmen. Damit müssen sich Ärzte verstärkt auf die spezifischen Anforderungen der Behandlung von alten Patienten einstellen. Diese sind wesentlich durch die Faktoren Alter, Multimorbidität und Demenz geprägt. Die Abhandlung analysiert die hiermit gegebenen sozial- und personalethischen Implikationen für Ausbildung und Arbeitsalltag der Ärzte sowie für das Gesundheitssystem.

An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of (...) 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services. (shrink)

The author traces the ways in which various patients and collective associations of patients come to regard themselves as the users of future stem cell technologies. The author uses Althusser’s notion of interpellation, whereby an identity is the result of the situated encounter of a subject and an authority, to analyze the ways in which patient associations’ current involvement with basic research is related to the enactment of science as a series of technology development projects. The author argues that this (...) ‘‘project-ness’’ forms a certain privileged logic that interpellates patients and their associations in specific ways. Through the listings of illnesses circulated in the mass media, which are hoped to be treatable or curable with stem cell therapies, patients come to recognize themselves as the projected users of stem cell technologies. The author fleshes out the process of this userfication and the various responses made by patients and their associations when hailed by the entrepreneurial projects of stem cell research. (shrink)

In the summer of 2017, wildflower seeds were spread on a large, empty open space close to a motorway flyover just outside Copenhagen, Denmark. This was an effort to use non-mechanical methods to prepare the soil for an ‘urban forest’ to be established on the site, since the flowers’ roots would penetrate the ground and enable the planned new trees to settle. As a result, the site was transformed into a gorgeous meadow, and all summer long Copenhageners were invited to (...) come and pick the flowers. In this article, I critically examine different aspects of this project – including the role of design, the perception of nature–culture relationships, climate change, and flower-picking as an event – in relation to my personal experience of visiting this meadow both on-site and on social media. The different temporalities that clash at the site give rise to conflicting interpretations, and I suggest that the meadow can be seen as a living plant archive of the Anthropocene, both physically and digitally. In doing so, I introduce and critique key conceptual pairs, including archive/death and bloom/decay, suggested by Lee Edelman’s queer cross-reading of Jacques Derrida’s ‘Archive Fever’ and Shakespeare’s Hamlet. I thereby contrast flower motifs pertaining to the cycles of blooming, decay, and nature’s (failed) eternal return in the meadow with the expansive futurity of the digitally mediated archive. (shrink)

Background Ethical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges. This paper explores how prehospital emergency personnel manage ethical challenges. The study is part of a larger action research project to develop and test an approach to clinical ethics support that is sensitive to the context of emergency medicine. Methods We (...) explored ethical challenges and management strategies in three focus groups, with 15 participants in total, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. Focus groups were audio-recorded and transcribed verbatim. The approach to data analysis was systematic text condensation approach. Results We stratified the management of ethical challenges into actions before, during, and after incidents. Before incidents, participants stressed the importance of mutual understandings, shared worldviews, and a supportive approach to managing emotions. During an incident, the participants employed moral perception, moral judgments, and moral actions. After an incident, the participants described sharing ethical challenges only to a limited extent as sharing was emotionally challenging, and not actively supported by workplace culture, or organisational procedures. The participants primarily managed ethical challenges informally, often using humour to cope. Conclusion Our analysis supports and clarifies that confidence, trust, and safety in relation to colleagues, management, and the wider organisation are essential for prehospital emergency personnel to share ethical challenges and preventing moral distress turning into burnout. (shrink)

This exciting collection offers a range of perspectives from some of the most prominent feminist voices of our time, including Rosi Braidotti, Judith Butler, Claire Colebrook, Elizabeth Grosz, and Jack Halberstam. Employing experimental modes of thinking and writing, the contributors remain faithful to the feminist tradition of subversion and resistance, while refusing to submit to its political tradition of a loving sisterhood or dutiful daughterhood. Through productive disagreement and cognitive dissonance, the essays presented here reflect the specific circumstances of our (...) present, and attempt to dream and envision possible alternatives for the future. The volume thus invites us to think of the becoming of feminism itself, and the possibilities of future feminisms-to-come. (shrink)

Ever decreasing numbers of applicants arrive in language departments at UK universities. In the face of this decline, and against the backdrop of higher education languages departments being reduced across the UK, it is important to investigate the supply chain of languages undergraduates in the pre-entry sector. This article reports on a collaborative action research project between Language Networks for Excellence, University of Wolverhampton, and King Edward VI College, Stourbridge. The objective was to investigate how the HE sector can effectively (...) influence and support linguists and post-16 establishments in enhancing progression to studying languages at university and how the post-16 sector can ensure they meet language students’ needs in progression to HE. The research presents a number of conclusions and recommendations, not least that, whilst support from HE for 17—18-year-old school students and their institutions is welcome and contributes to students’ confidence and skills, there may be merit in targeting students much further down the supply chain, encouraging progression to HE through tailored linguistic and motivational support strategies. (shrink)

Fred. L. Polak explored the mechanisms of social change in terms of “future—visions” held by a community. The future, says Polak, participates actively in the present, providing part of the context within which today's decisions are made. Barbara McClintock acquired her insights in maize genetics by developing “a feeling for the organism.” New insights, she maintains, emerge through a mutual relationship between researcher and subject. Though scholars in different fields, both acknowledge the power of images in the creative process. There (...) is a difference in the extent to which each scientist perceives this power to be available to create new ideas. (shrink)

To reduce global greenhouse gas emissions in order to limit global warming to 1.5°C, individuals and households play a key role. Behavior change interventions to promote pro-environmental behavior in individuals are needed to reduce emissions globally. This systematic literature review aims to assess the a) evidence-based effectiveness of such interventions and b) the content of very successful interventions without limiting the results to specific emitting sectors or countries. Based on the “PICOS” mnemonic and PRISMA statement, a search strategy was developed, (...) and eligibility criteria were defined. Three databases were searched to retrieve and review potential literature. As a result, 54 publications from 2010 to 2021 were included in the analysis. The results show that most interventions only have small positive effects or none at all. A total of 15 very successful interventions focused on the sectors of mobility, energy, and waste and incorporated improved structures, education, feedback, enablement or made the sustainable option the default. Six evidence-based recommendations for content, timing, and setting are deducted and given for interventions on enhancing pro-environmental behavior. In summary, although the various interventions and intervention types to promote PEB differ in their effectiveness, very successful interventions have common elements. Future research should focus on high-/low-impact and high-/low-cost behavior to develop interventions that aim at high-impact but low-cost behavior changes, or avoid low-impact but high-cost behavior. (shrink)

Abordagem do protagonismo social, analisando sua relação com a informação, concluindo pela compreensão deste como objetivo do trabalho informacional, situando a mediação da informação como sua ação central. Parte da apresentação das origens conceituais em torno do protagonismo, buscando, à medida que debate as referências acerca do tema, demonstrar a relação do desenvolvimento do protagonismo social com o trabalho informacional, assim como sua posição de meta da atividade da mediação da informação, executada nas suas cinco dimensões e na condição de (...) elemento central desse trabalho. As assertivas apresentadas são resultado do estudo crítico da bibliografia da área da Ciência da Informação que aborda o protagonismo e a mediação da informação, assim como de estudos de filósofos e pensadores que abordam os aspectos sociais e políticos da comunicação e da formação de sujeitos socialmente ativos, permitindo a identificação das relações entre protagonismo e mediação da informação, como também que a mediação consciente favorece o primeiro, concluindo que o apoio ao seu desenvolvimento representa a principal responsabilidade social do trabalho com a informação. (shrink)

"One might say that 'chance' is anything but blind in forking-path narratives."Fictional worlds attract the attention of debaters in particular when they are supposed to activate the viewers' reflections in a special way. Thus, movies that are most likely to irritate the audience and seem to animate people to reflect on their own personality and life are of major interest. In the following, I want to discuss a certain type of movie that meets these criteria: forking-path or multiple-draft narratives. On (...) the one hand they rely on well-known narrative schemata, and on the other hand they comprise something that is actually impossible: alternative futures. One central thesis raised by spokespersons of the .. (shrink)

Nous avons cherché à identifier un aspect du refoulement du cosmopolitismel'des Lumières, complémentaire de la fabrique des identités nationales enl'Europe au XIXe siècle et dans l'entre-deux-guerres. L'idée de civilisation communel'serait maintenue par la capacité réciproque de traduction des langues nationales, dul'fait de leurs origines communes indo-européennes. L'utopie de la langue remplaceraitl'le parcours matériel des Lumières. C'est l'échec de la construction du mythe indianistel'européen et non pas son succès qui explique le dévoiement idéologique des relationsl'entre langue et nation. La promotion manquée (...) de la langue tsigane dans le mondel'académique illustre bien cet échec. Après la Première Guerre mondiale, la transformationl'du principe des nationalités en ethnopolitique fit disparaître jusqu'au souvenirl'de cette ambition commune. (shrink)

This book approaches ethical and legal issues in medicine from the patient's viewpoint and argues that many patients do not want the full burden of decision making that contemporary bioethics has thrust upon them.

ZusammenfassungIn der Erfahrung, Kommunikation und Bewältigung von Krankheit spielen Metaphern eine wichtige Rolle: Als Denkkonzepte spiegeln sie zugrundeliegende Haltungen gegenüber den durch sie beschriebenen Vorgängen wider. Susan Sontag hat mit ihrem Essay „Illness as Metaphor“ nachhaltig die moralisch kritischen Implikationen einer unreflektierten Metaphernverwendung im Umgang mit Erkrankung aufgezeigt, indem sie deren stigmatisierende und hierin zusätzlich belastende Wirkung für Erkrankte reflektiert.In der gegenwärtigen Situation der Covid-19-Pandemie trifft ein bisher unbekanntes Virus mit der Macht und Dynamik der Globalisierung auf die hierauf nicht (...) vorbereiteten spätmodernen Gegenwartsgesellschaften, die nun nach Erklärung und Sinnzuschreibung suchen. Auch hier fungieren Metaphern als Denkkonzepte und Vehikel von Interpretation. Im Rückgriff auf die Perspektive Susan Sontags und ihren Appell für einen entmystifizierten Umgang mit Krankheit geht dieser Beitrag folgenden Fragen nach: Welche Bilder werden in der Berichterstattung über CoV‑2 vermittelt? Welche Einstellung gegenüber Gesundheit und Krankheit wird mit den Metaphern transportiert, und welche Lebenshaltung liegt dieser zugrunde? Welche Einsichten für einen gesunden Umgang mit Covid-19 und Krankheit generell ergeben sich, wenn man die Pandemie aus ihren Metaphern und zugrundliegenden Denkkonzepten herausschält? (shrink)

Automated decision-making (ADM) systems can be worn in and on the body for various purposes, such as for tracking and managing chronic conditions. One case in point is do-it-yourself open-source artificial pancreas systems, through which users engage in what is referred to as “looping”; combining continuous glucose monitors and insulin pumps placed on the body with digital communication technologies to develop an ADM system for personal diabetes management. The idea behind these personalized systems is to delegate decision-making regarding insulin to (...) an algorithm that can make autonomous decisions. Based on interviews and photo diaries with Danish “loopers”, this paper highlights two interrelated narratives of how users have to care for the loop by _maintaining_ a stable communication circuit between body and ADM system, and by _modifying_ the loop through analysis and reflection. It shows how the human takes turns with the ADM system through practical doings and anticipation to safeguard continuous management of chronic disease. (shrink)

Book reviewed in this article: Rights Talk: The Impoverishment of Political Discourse. By Mary Ann Glendon.

During the last two years several committees discussed the question of enlarging patients' autonomy in living wills. The problern is to tind a way to grant patients' wishes without violating the state's duty to preserve human life. One basic question in the debate is the meaning of human dignity. Deducing from the Christian image of man the author describes chances and Iimits of living wills and presents a way of handling them. In her opinion living wills represent a chance for (...) a succeeding, trusting physician-patient- relationship in the age of high-tech medicine. (shrink)

I argue that property dualists cannot hold that minds are physical substances. The focus of my discussion is a property dualism that takes qualia to be sui generis features of reality.

Personal health technologies such as apps and wearables that generate health and behavior data close to the individual patient are envisioned to enable personalized healthcare - and self-care. And yet, they are consumer devices. Proponents of these devices presuppose that measuring will be helpful, and that data will be meaningful. However, a growing body of research suggests that self-tracking data does not necessarily make sense to users. Drawing together data studies and digital health research, we aim to further research on (...) data ambivalence, a term we use to refer to the ambiguities and uncertainties people experience when interpreting their own data, as well as the critical obligation towards cultivating ethically sound uses and responses to such data in context. We develop the relationship between data, interpretation, and context as a central theoretical and practical problem in the datafication of healthcare. We then show how interpretation and context matter for data ambivalence through an empirical study of heart patients with an implanted advanced pacemaker who were offered a Fitbit wristband for self-tracking as part of a research project. We argue that the hope, anxiety, and doubt connected to the promise and accuracy of data are tempered by the context and purpose of self-tracking, and by individual circumstances. Finally, we link the findings on context-sensitivity in data interpretation to questions about response-ability in cloud-based care infrastructures. We discuss the ethical dilemmas associated with the use of commercial wellness-technologies in healthcare, and with researching such emerging practices. (shrink)

Background Retraction is a mechanism for alerting readers to unreliable material and other problems in the published scientific and scholarly record. Retracted publications generally remain visible and searchable, but the intention of retraction is to mark them as “removed” from the citable record of scholarship. However, in practice, some retracted articles continue to be treated by researchers and the public as valid content as they are often unaware of the retraction. Research over the past decade has identified a number of (...) factors contributing to the unintentional spread of retracted research. The goal of the Reducing the Inadvertent Spread of Retracted Science: Shaping a Research and Implementation Agenda (RISRS) project was to develop an actionable agenda for reducing the inadvertent spread of retracted science. This included identifying how retraction status could be more thoroughly disseminated, and determining what actions are feasible and relevant for particular stakeholders who play a role in the distribution of knowledge. -/- Methods These recommendations were developed as part of a year-long process that included a scoping review of empirical literature and successive rounds of stakeholder consultation, culminating in a three-part online workshop that brought together a diverse body of 65 stakeholders in October–November 2020 to engage in collaborative problem solving and dialogue. Stakeholders held roles such as publishers, editors, researchers, librarians, standards developers, funding program officers, and technologists and worked for institutions such as universities, governmental agencies, funding organizations, publishing houses, libraries, standards organizations, and technology providers. Workshop discussions were seeded by materials derived from stakeholder interviews (N = 47) and short original discussion pieces contributed by stakeholders. The online workshop resulted in a set of recommendations to address the complexities of retracted research throughout the scholarly communications ecosystem. -/- Results The RISRS recommendations are: (1) Develop a systematic cross-industry approach to ensure the public availability of consistent, standardized, interoperable, and timely information about retractions; (2) Recommend a taxonomy of retraction categories/classifications and corresponding retraction metadata that can be adopted by all stakeholders; (3) Develop best practices for coordinating the retraction process to enable timely, fair, unbiased outcomes; and (4) Educate stakeholders about pre- and post-publication stewardship, including retraction and correction of the scholarly record. -/- Conclusions Our stakeholder engagement study led to 4 recommendations to address inadvertent citation of retracted research, and formation of a working group to develop the Communication of Retractions, Removals, and Expressions of Concern (CORREC) Recommended Practice. Further work will be needed to determine how well retractions are currently documented, how retraction of code and datasets impacts related publications, and to identify if retraction metadata (fails to) propagate. Outcomes of all this work should lead to ensuring retracted papers are never cited without awareness of the retraction, and that, in public fora outside of science, retracted papers are not treated as valid scientific outputs. (shrink)

The essay is framed by conflict between Christianity and Darwinian science over the history of the world and the nature of human personhood. Evolutionary science narrates a long prehuman geological and biological history filled with vast amounts, kinds, and distributions of apparently random brutal and pointless suffering. It also strongly suggests that the first modern humans were morally primitive. This science seems to discredit Christianity's common meta-narrative of the Fall, understood as a story of Paradise Lost. The author contends that (...) this Augustinian story and its character of Adam as endowed with superhuman gifts, and yet as so fragile as to fall, as claimed, is implausible, at any rate, even apart from science. He proposes that Christians consider adopting a Supralapsarian metaphysics of divine purpose supported by the intuitions of Irenaeus, who depicted the first human beings as comparable to innocent, but morally undeveloped children. In this approach the existence of evils is part of the divine plan to "defeat" them in and through the Incarnation, Atonement, and Resurrection of Christ. Putting an "Irenaean Adam" in place of the "Augustinian" counterpart may not remove conflict with science completely, but at least reduces it, and leads to a Christian narrative that is more plausible, in the light of science. (shrink)

(2001). Fruits, Apples, and Category Mistakes: On Sport, Games, and Play. Journal of the Philosophy of Sport: Vol. 28, No. 2, pp. 151-159. doi: 10.1080/00948705.2001.9714610.

L’article donne une vue d’ensemble sur la réception antique et moderne de la figure alexandrine de la philosophe païenne Hypatie, dont le martyre en 415 de notre ère symbolise l’obscurantisme religieux des premiers chrétiens. L’article étudie les mécanismes de la transmission antique des savoirs, laquelle fonde la longue tradition de l’histoire européenne des idées. Surtout, il interroge la valeur de la tradition produite autour des textes évoquant Hypatie : par exemple, les lettres que Synésios de Cyrène aurait adressées à celle (...) qu’il désigne comme sa Maîtresse. Celles-ci, loin de révéler la réalité historique d’un amour très platonicien entre un savant et une femme à l’intelligence perçue comme quasi-divine, semblent plutôt mettre en scène un couple philosophique fictif, qui, à l’instar de Diotime et Socrate, valorise finalement l’élu, seul entre les disciples capable de saisir l’essence de la parole philosophique. Après cette déconstruction du personnage de la philosophe néo-platonicienne, l’article interroge la production de l’Hypatie historique. Il analyse en particulier les débats autour de la paternité ou la co-paternité des œuvres d’Hypatie traitant de l’astronomie et des mathématiques avant de conclure sur l’importance de l’oralité dans la tradition philosophique antique, des Pythagoriciens aux cercles alexandrins de la fin du iiie siècle et du début du ive siècle de notre ère. (shrink)

Although emotions play a crucial role in understanding and encouraging sustainable behavior and decision-making, many open questions currently remain unanswered. In this review, we advance three broad areas of particular theoretical and applied importance that affective science and emotion researchers could benefit from engaging with: (1) “ sustainable emotions” or empirically testing the possibility of positive reinforcing feedback loops between anticipatory and experienced emotions following the adoption of sustainable behaviors, (2) “ non- Western emotions” or exploring the extent to which (...) people's understanding and experience of climate-relevant emotions differs across non-WEIRD populations, and (3) “ impactful emotions” or the need to carefully differentiate the conceptual and empirical role of emotions in encouraging the adoption of low-impact (e.g., recycling) versus high-impact (e.g., flying less) environmental behaviors. (shrink)

(1993). Why Olympic Athletes Should Avoid the Use and Seek the Elimination of Performance-Enhancing Substances and Practices From the Olympic Games. Journal of the Philosophy of Sport: Vol. 20, No. 1, pp. 64-81. doi: 10.1080/00948705.1993.9714504.

In this conceptual paper, we draw on social identity theory as a means to bridge individuals’ memberships in social groups with value creation in stakeholder networks defined by a socio-economic issue. To address recent calls for microfoundations of stakeholder theory, we introduce a reconceptualization of stakeholders as social groups to examine how value is defined and interpreted in intergroup processes embedded in an issue-based stakeholder network. We establish a theoretical model of value creation that links individuals’ identification with stakeholder groups (...) to intergroup trust, co-operation, and value creation. Specifically, we argue that the salience of preexisting social identities causes harmful tensions in stakeholder relationships that negatively impact value creation. We then propose that the development of a more inclusive stakeholder identity overcomes these negative intergroup consequences in multistakeholder settings. We discuss the impact on value creation of four stakeholder identity representations based on the salience of specific and superordinate stakeholder groups. The paper concludes with implications of our theoretical model for both research and practice related to value creation in issue-based stakeholder networks. (shrink)

Eye movements during false-belief tasks can reveal an individual's capacity to implicitly monitor others' mental states (theory of mind - ToM). It has been suggested, based on the results of a single-trial-experiment, that this ability is impaired in those with a high-functioning autism spectrum disorder (ASD), despite neurotypical-like performance on explicit ToM measures. However, given there are known attention differences and visual hypersensitivities in ASD it is important to establish whether such impairments are evident over time. In addition, investigating implicit (...) ToM using a repeated trial approach allows an assessment of whether learning processes can reduce the ASD impairment in this ability, as is the case with explicit ToM. Here we investigated the temporal profile of implicit ToM in individuals with ASD and a control group. Despite similar performance on explicit ToM measures, ASD-diagnosed individuals showed no evidence of implicit false-belief tracking even over a one-hour period and many trials, whereas control participants did. These findings demonstrate that the systems involved in implicit and explicit ToM are distinct and hint that impaired implicit false-belief tracking may play an important role in ASD. Further, they indicate that learning processes do not alleviate this impairment across the presentation of multiple trials. (shrink)

One of the most influential philosophical voices in the consciousness studies community is that of Daniel Dennett. Outside of consciousness studies, Dennett is well-known for his work on numerous topics, such as intentionality, artificial intelligence, free will, evolutionary theory, and the basis of religious experience. (Dennett, 1984, 1987, 1995c, 2005) In 1991, just as researchers and philosophers were beginning to turn more attention to the nature of consciousness, Dennett authored his Consciousness Explained. Consciousness Explained aimed to develop both a theory (...) of consciousness and a powerful critique of the then mainstream view of the nature of consciousness, which Dennett called,. (shrink)