We examine the problem of generating definite noun phrases that are appropriate referring expressions; that is, noun phrases that (a) successfully identify the intended referent to the hearer whilst (b) not conveying to him or her any false conversational implicatures (Grice, 1975). We review several possible computational interpretations of the conversational implicature maxims, with different computational costs, and argue that the simplest may be the best, because it seems to be closest to what human speakers do. We describe our recommended (...) algorithm in detail, along with a specification of the resources a host system must provide in order to make use of the algorithm, and an implementation used in the natural language generation component of the IDAS system. (shrink)

This paper focuses on the topic of evaluation of clinical ethics consultation. The concept of evaluation seems to contain an internal tension: On the one hand, evaluation is seen as distorting the conceptual and normative content of the case under scrutiny and, on the other, the evaluative act is the most important use of judgment and an inescapable part of everyday life. As such, we maintain that evaluation is essential.

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants (...) could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them. (shrink)

In a clinic-wide approach to establish liberal policies, a closed psychiatric ward was planned to be opened. The leaders of the multi-professional team of this ward requested continuous ethics support during the first few months after the transition from their previously closed ward into an open one. During the process of accompanying the team through this ethically sensitive period of institutional change, several variations of ethics consultation were developed: the ‘context-adjusted’ clinical ethics support. Some ethics consultations focused on a retrospective (...) evaluation of a patient case, in other ethics consultations consolidation of a previous case discussion was worked out, and/or reflections on fundamental ethical issues were included. Based on our experiences and the feedback of the team, we consider this context-adjusted clinical ethics support as feasible and effective. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

The coronavirus disease 2019 pandemic has brought about unprecedented uncertainty and challenges to the worldwide economy and people’s everyday life. Anecdotal and scientific evidence has documented the existence of a positive relationship between the experience of crisis and creativity. Though this appears to be ubiquitous, the crisis-creativity-well-being relationship has not been sufficiently examined across countries and using a working adult sample. The current study drew on a sample consisting of 1,420 employees from China, Germany, and the United States to examine (...) whether creativity can function as an effective means to cope with crisis and to achieve both flourishing and social well-being. Multivariate analyses showed that perceived impact of COVID-19 was positively related to creative process engagement, which was positively related to employees’ self-reported creative growth. Creative growth was associated with a higher level of flourishing well-being. This sequential mediation model was significant across the three samples. Creativity also mediated the relationship between perceived impact of COVID-19 and social well-being, but this connection was only found for the Chinese sample. Further data analyses revealed that individualism moderated this serial mediation model in that the positive coping effect of creativity on both flourishing and social well-being was stronger for individuals who hold more collectivistic views. Results of the study have implications for crisis management, personal development, and positive functioning of individuals and society. (shrink)

ZusammenfassungDas Verhältnis zwischen Ethikkonsultation und der bspw. in psychiatrischen Arbeitsfeldern und im Palliativbereich etablierten psychologischen Supervision ist bisher wenig untersucht. Dieser Vergleich und die Abgrenzung von Ethikkonsultation stellen eine Forschungslücke dar. Anhand von zwei Fallvignetten aus der Praxis von EK und PS werden unter Kontrastierung mit dem jeweils anderen Ansatz Unterschiede und Gemeinsamkeiten im methodischen und praktischen Vorgehen sowie Kriterien der Unterscheidung analysiert. Als Ergebnis wird eine systematische Gegenüberstellung präsentiert, die folgende Merkmale umfasst: 1. Ziele jedes Ansatzes, 2. Einberufung, 3. (...) Gegenstand, 4. Fokus, 5. Methode/Prozess, 6. Rolle des Beraters, 7. Ergebnisse, 8. Dokumentation, 9. Bearbeiten von Emotionen, 10. Bearbeiten ethischer Fragestellungen. Trotz Überschneidungen der beiden Arbeitsformen erscheinen EK und PS nicht wechselseitig austauschbar; eine Vermischung wird nicht empfohlen. Als Fazit werden Hinweise zur Indikationsstellung von EK oder PS gegeben; dabei spielen auch die Motivation der Teilnehmenden und die zeitnahe Verfügbarkeit der Beratungsangebote eine Rolle. (shrink)

This study explored the influence of personal values on destructive leader behavior. Student participants completed a managerial assessment center that presented them with ambiguous leadership decisions and problems. Destructive behavior was defined as harming organizational members or striving for short-term gains over long-term organizational goals. Results revealed that individuals with self-enhancement values were more destructive than individuals with self-transcendence values were, with the core values of power (self-enhancement) and universalism (self-transcendence) being most influential. Results also showed that individuals defined and (...) structured leadership problems in a manner that reflected their value systems, which in turn affected the problem solutions they generated. (shrink)

ZusammenfassungDie qualitative Interviewstudie analysiert informelle Wissensstrukturen von Pflegenden und Ärzten hinsichtlich der beiden Einflussfaktoren „Alter“ und „Kosten“ auf Therapieentscheide am Lebensende als Grundlage ethischer Meinungsbildung. Als Auswertungsmaterial dienen spontane Aussagen zu „Alter“ und „Kosten“, die nicht im Kontext von Fragestellungen zu Ageism oder Rationierung erhoben wurden. Diese Aussagen wurden einer Inhaltsanalyse unterzogen, und zwar anhand von qualitativen und quantitativen Analyseschritten.Die Studie zeigt, dass der Faktor „Alter“ wesentlich häufiger als Einflussfaktor auf Therapieentscheide am Lebensende genannt wird als der Faktor „Kosten“. Zudem (...) gibt es Hinweise auf mögliche Ungleichbehandlung sowie auf Überversorgung von Patienten am Lebensende. Die Befunde stützen die Annahme, dass Therapieentscheidungen eher auf informellen, nicht-institutionalisierten Prozessen beruhen. Eine stärker explizite Strukturierung des Prozesses zur Therapieentscheidung könnte die Risiken von Ungleichbehandlung und Überversorgung reduzieren und dadurch zu ethisch besser vertretbaren Ergebnisse führen. (shrink)

The usual completeness theorem for first-order logic is extended in order to allow for a natural incorporation of real analysis. Essentially, this is achieved by building in the set of real numbers into the structures for the language, and by adjusting other semantical notions accordingly. We use many-sorted languages so that the resulting formal systems are general enough for axiomatic treatments of empirical theories without recourse to elements of set theory which are difficult to interprete empirically. Thus we provide a (...) way of applying model theory to empirical theories without tricky detours. Our frame is applied to axiomatizations of three empirical theories: classical mechanics, phenomenological thermodynamics, and exchange economics. (shrink)

In todays’ super-diverse societies, communication and interaction in clinical encounters are increasingly shaped by linguistic, cultural, social and ethnic complexities. It is crucial to better understand the difficulties patients with migration background and healthcare professionals experience in their shared clinical encounters and to explore ethical aspects involved. We accompanied 32 migrant patients during their medical encounters at two outpatient clinics using an ethnographic approach. Overall, data of 34 interviews with patients and physicians on how they perceived their encounter and which (...) difficulties they experienced are presented. We contrasted the perspectives on the difficult aspects and explore ethical questions surrounding the involved issues. Patients and physicians describe similar problem areas, but they have diverging perspectives on them. Two main themes were identified by both patients and physicians: >patients’ behaviour in relation to doctors’ advice relationship issues<. A deeper understanding of the difficulties and challenges that can arise in cross-cultural settings could be provided by bringing together healthcare professionals’ and patients’ perspectives on how a cross- cultural clinical encounter is perceived. Ethical aspects surrounding some of the difficulties could be highlighted and should get more attention in clinical practice and research. (shrink)

As individual subjects, creativity and personality have been the focus of much research and many publications. This Cambridge Handbook is the first to bring together these two topics and explores how personality and behavior affects creativity. Contributors from around the globe present cutting-edge research about how personality traits and motives make creative behavior more likely. Many aspects of personality and behavior are examined in the chapters, including genius, emotions, psychopathology, entrepreneurship, and multiculturalism, to analyse the impact of these on creativity. (...) The Cambridge Handbook of Creativity and Personality Research will be the definitive resource for researchers, students and academics who study psychology, personality, and creativity. (shrink)

Ethics consultation is the most engaged aspect of clinical ethics, a field focused on ethical issues, questions, and conflicts arising in the course of patient care and delivery of healthcare services. Despite the skepticism of some academic bioethicists and criticism expressed by social commentators, clinical ethics, which began in North America, has expanded to Europe and many other parts of the world with the proliferation of healthcare institution ethics and ethics consultation support services. Along with the development and implementation of (...) ethics policies and guidelines for patient care through work on hospital ethics committees, clinical ethicists are increasingly involved in the ethics of healthcare organizational structures and processes and the day to day provision of ethics consultative services to health professionals, patients, and families. (shrink)

Die sechzehn Beitrage stellen in vielen Schwerpunkten die rasante Entwicklung dar, die die Eurolinguistik seit der ersten Tagung 1997 genommen hat. Den Hintergrund bilden der Europa-Begriff und die Vorgeschichte der Eurolinguistik im 20.

This paper examines interpersonally sensitive exchanges in two calls for information to the call centre of a public transport company. In order to provide relevant information and facilitate sequence progressivity, the agents need to go through specific steps. Although this is typical of institutional settings, customers may not necessarily be aware of them. The excerpts examined in this paper show how the customers’ lack of knowledge of the institutional steps the agents have to go through to attend to their requests (...) and customers’ claims to product knowledge, coupled with the agents’ labour intensive work at the call centre, provide fertile ground for the agents’ verbal outbursts which are oriented to as interpersonally sensitive by the customers in so far as they are interpreted as inappropriate and potentially impolite. The analysis draws on the notion of face and incorporates a variety of concepts from pragmatics and Conversation Analysis. (shrink)

This book contains the results of two European/American preparatory workshops for the First World Conference on Ethics Codes in Medicine and Biotechnology (October 1997, Freiburg, Germany) supported by the leading national institutions in the field. It aims to stimulate research about codes, the effects of codification and other forms of implementing ethics. It breaks new ground with interdisciplinary and international discourse on the subject, emphasising the need for a complete collection of codes for systematic research and evaluation and filling the (...) gap in literature on the subject to date. (shrink)

Caring for patients with anorexia nervosa (AN) is associated with high levels of moral distress among healthcare professionals. The main moral conflict has been posited to be between applying coercion to prevent serious complications such as premature death and accepting treatment refusals. However, empirical evidence on this topic is scarce. We identified all 19 documentations of ethics consultations (ECs) in the context of AN from one clinical ethics support service in Switzerland. These documentations were coded with a sequential deductive-inductive approach (...) and the code system was interpreted in a case-based manner. Here, we present findings on patient characteristics and ethical concerns. The ECs typically concerned an intensely pretreated, extremely underweight AN patient endangering herself by refusing the proposed treatment. In addition to the justifiability of coercion, frequent ethical concerns were whether further coerced treatment aimed at weight gain would be ineffective or even harmful, evidencing uncertainty about beneficence and non-maleficence and a conflict between these principles. Discussed options included harm reduction (e.g. psychotherapy without weight gain requirements) and palliation (e.g. initiating end-of-life care), the appropriateness of which were ethical concerns in themselves. Overall, nine different types of conflicts between or uncertainties regarding ethical principles were identified with a median of eight per case. Ethical concerns in caring for persons with AN are diverse and complex. To deal with uncertainty about and conflict between respect for autonomy, beneficence and non-maleficence, healthcare professionals consider non-curative approaches. However, currently, uncertainty around general justifiability, eligibility criteria, and concrete protocols hinders their adoption. (shrink)

This collection of essays examines the ways in which disputes and controversies about the application of scientific knowledge are resolved. Four concrete examples of public controversy are considered in detail: the efficacy of Laetrile, the classification of homosexuality as a disease, the setting of safety standards in the workplace, and the utility of nuclear energy as a source of power. The essays in this volume show that debates about these cases are not confined to matters of empirical fact. Rather, as (...) is seen with most scientific and technical controversies, they focus on and are structured by complex ethical, economic, and political interests. Drs. Engelhardt and Caplan have brought together a distinguished group of scholars from the sciences and humanities, who sketch a theory of scientific controversy and attempt to provide recommendations about the ways in which both scientists and the public ought to seek more informed resolutions of highly contentious issues in science and technology. Scientific Controversies is offered as a contribution to the better understanding of the roles of both science and nonscientific interests in disputes and controversies pertaining to science and technology. (shrink)

Much evidence has accumulated in favor of such a dual view of reasoning. There is however some vagueness in the way the two systems are characterized. Instead of a principled distinction, we are presented with a bundle of contrasting features - slow/fast, automatic/controlled, explicit/implicit, associationist/rule based, modular/central - that, depending on the specific dual process theory, are attributed more or less exclusively to one of the two systems. As Evans states in a recent review, “it would then be helpful to (...) have some clear basis for this distinction”; he also suggests that “we might be better off talking about type 1 and type 2 processes” rather than systems. We share the intuitions that drove the development of dual system theories. Our goal here is to propose in the same spirit a principled distinction between two types of inferences: ‘intuitive inference’ and ‘reflective inference’. We ground this distinction in a massively modular view of the human mind where metarepresentational modules play an important role in explaining the peculiarities of human psychological evolution. We defend the hypothesis that the main function of reflective inference is to produce and evaluate arguments occurring in interpersonal communication. This function, we claim, helps explain important aspects of reasoning. We review some of the existing evidence and argue that it gives support to this approach. (shrink)

This collection of essays, Global Bioethics: The Collapse of Consensus, deals with the issue of the repeated failure of attempts to derive a universal set of ...

This paper presents a unified framework that explains and extends the already successful applications of the Leibniz operator, the Suszko operator, and the Tarski operator in recent developments in abstract algebraic logic. To this end, we refine Czelakowski’s notion of an S-compatibility operator, and introduce the notion of coherent family of S-compatibility operators, for a sentential logic S. The notion of coherence is a restricted property of commutativity with inverse images by surjective homomorphisms, which is satisfied by both the Leibniz (...) and the Suszko operators. We generalize several constructions and results already existing for the mentioned operators; in particular, the well-known classes of algebras associated with a logic through each of them, and the notions of full generalized model of a logic and a special kind of S-filters. We obtain a General Correspondence Theorem, extending the well-known one from the theory of protoalgebraic logics to arbitrary logics and to more general operators, and strengthening its formulation. We apply the general results to the Leibniz and the Suszko operators, and obtain several characterizations of the main classes of logics in the Leibniz hierarchy by the form of their full generalized models, by old and new properties of the Leibniz operator, and by the behaviour of the Suszko operator. Some of these characterizations complete or extend known ones, for some classes in the hierarchy, thus offering an integrated approach to the Leibniz hierarchy that uncovers some new, nice symmetries. (shrink)

We elaborate on the approach to syllogistic reasoning based on “case identification” (Stenning & Oberlander, 1995; Stenning & Yule, 1997). It is shown that this can be viewed as the formalisation of a method of proof that dates back to Aristotle, namely proof by exposition ( ecthesis ), and that there are traces of this method in the strategies described by a number of psychologists, from St rring (1908) to the present day. We hypothesised that by rendering individual cases explicit (...) in the premises, the chance that reasoners would engage in a proof by exposition would be enhanced, and thus performance improved. To do so, we used syllogisms with singular premises (e.g., this X is Y ). This resulted in a uniform increase in performance as compared to performance on the associated standard syllogisms. These results cannot be explained by the main theories of syllogistic reasoning in their current state. (shrink)

Recent discussions of civil disobedience show the world of scholarship and public affairs in disarray. Not only is there considerable disagreement over how civil disobedience is to be justified, there is hardly less disagreement over what civil disobedience is. Can it be violent, or must it be nonviolent, in intention and in outcome? Can civil disorder be a special case of mass civil disobedience? Must civil disobedience proceed within the framework of the existing politico-legal system or may it be revolutionary (...) in intention? Could it be anarchistic? Should the authorities endeavor to prosecute and punish the civil disobedient as though he were a common criminal? Is disobedience which results in no punishment of the disobedient not civil disobedience after all? Because of disagreements over the answers to these questions, the description of an act as an act of civil disobedience is likely to be ambiguous and controversial not only for the general public and the government but even in some cases for the protesters themselves. Confusion rooted in honest misunderstanding is compounded by bad faith, by basic disagreements over the ideal and the actual relations between the individual and the state, and by obscurity in the facts surrounding the intentions of the protesters and the consequences of their acts. (shrink)

‘DU bist Radio’ (DBR) is an award winning [DBR has been awarded with the “Catholic Media Award of the German Bishops Conference, Prädikat WERTvoll” (2011), the Suisse “Media Prize Aargau/Solothurn” (2010), the German “Alternative Media Award” (2009) and was nominated for the “Prix Europa” (2009)] monthly radio format that goes on air on three Swiss radio stations. The purpose of this program which was first broadcast in 2009 is the development of a new media format which—without applying any journalistic (or (...) other) filter and influence—conveys authenticity of expression amongst society’s most vulnerable fellow citizens such as patients, clients and the socially deprived. So-called marginal groups are encouraged to speak for themselves, as a possible paradigm case for encouraging the inclusion of patients’ and relatives’ “unfiltered” voices in general and in clinical ethics as well. Before handing over the microphone to the groups in focus, a team of journalists, educated in medical ethics, over a period of 4 days, teaches them on-site radio skills and craft. Once this task is completed and the actual production of the broadcast begins, the media crew does not exert any influence whatsoever on the content of the 1-h program. Thus, the final product is solely created and accounted for by the media-inexperienced participants, leading to unforeseen and often surprising results. It is discussed that the DBR approach of fostering authenticity of expression can serve as an enhancement to today’s respect and autonomy oriented field of medical ethics. (shrink)

L’étude scientifique du comportement animal s’est en partie développée en réaction à des excès « anthropomorphiques», où l’observateur projetait chez l’animal une forme de psychologie populaire. En conséquence, le langage théorique des représentations mentales a été largement proscrit de l’éthologie pendant une bonne partie du xxe siècle. Même si la méthodologie du behaviorisme – centrée sur l’observation et la mesure du comportement – constitue toujours la règle, l’avènement de la révolution cognitive, les études de terrain de longue durée sur des (...) populations animales dans leurs conditions naturelles, ainsi qu’un intérêt accru pour la cognition physique et sociale, ont replacé le cadre théorique des représentations mentales au premier plan. L’intérêt porté aux représentations mentales vient en partie de la capacité qu’ont certaines espèces à catégoriser, réaliser des inférences ou prendre des décisions flexibles qui vont au-delà du simple flux perceptif. Enfin, l’étude du rôle causal des modèles mentaux chez les animaux a été largement enrichie par des considérations écologiques et évolutives sur l’espèce animale en question. (shrink)

Se plantea la cuestión de los lazos entre la teoría ética y las ciencias empíricas del comportamiento. En particular a modo de estudios de caso se pasa revista a la relevancia de ciertos descubrimientos sobre el comportamiento en la formulación de teorías sobre la virtud, el carácter o la voluntad. Desde ahí se pretende esbozar un procedimiento general de cambio progresivo y parcial de términos teóricos, descriptivos y normativos, de la teoría ética por nuevos términos apoyados en el aumento de (...) nuestro conocimiento. (shrink)

The possibility of artificial intelligence is usually discussed by philosophers as a problem about artificial thought: can an artificial system think? The production of intelligence in an artificial system would, however, give rise to an intelligent artificial being: an artificial thinker. As such, there is another, less explored way of discussing the possibility of artificial intelligence: can there be an artificial thinker? This is the problem of artificial thinkers (Olson 2018). In this essay, I discuss this problem. To do so, (...) first, I present the problem of artificial thinkers and discuss how best to interpret it (section §1). Then, I discuss the three main views on the metaphysical nature of artificial thinkers: the hardware view, according to which artificial thinkers are intelligent artificial systems; the software view, according to which artificial thinkers are types or copies of programs for artificial intelligence; and finally, the CPU perspective, according to which artificial thinkers are intelligent spatial parts of artificial systems (section §2). All of these views have problems regarding their conception of the persistence conditions of artificial thinkers. Even so, I conclude, artificial thinkers are best conceived as functional artificial systems. (shrink)