Background Concepts of health have been widely discussed in the philosophy and ethics of medicine. Parallel to these theoretical debates, numerous empirical research projects have focused on subjective concepts of health and shown their significance for individuals and society at various levels. Only a few studies have so far investigated the concepts of health of non-professionals and professionals involved in long-term home care and discussed these empirical perspectives regarding moral responsibilities. Objectives To identify the subjective concepts of the health of (...) non-professionals (care recipients, informal caregivers) and professionals (registered nurses) involved in long-term home care and to discuss them against the background of existing normative guidelines addressing non-professionals and professionals’ responsibilities and rights concerning health. Research design A qualitative design was chosen to explore subjective concepts of health. Data were collected by semi-structured interviews; content analysis was applied according to Mayring. Participants and research context Twenty-eight interviews were conducted with non-professionals and professionals in long-term home care arrangements in Northern Germany. Ethical considerations Ethics approval was obtained from the Institutional Review Board at the University Medicine Greifswald (BB123/16). Findings Non-professionals and professionals consider health as a capability that enables them to participate in social activities and live their own lives according to their preferences. The former regard health particularly as a feeling and an attitude, the latter as the absence of disease with a focus on mental and emotional well-being. Both groups highlight the unsurpassable value of health and the personal responsibility for it. Discussion Normative guidelines applicable to practice in long-term home care discuss responsibilities and rights unevenly and raise several problems regarding non-professionals and professionals’ subjective concepts of health. Conclusion Individuals’ concepts of health are relevant for the subsequent interpretation of rights and responsibilities and should, thus, be reflected upon to address health-related needs effectively. (shrink)

Quantitative research has called attention to the burden associated with informal caregiving in home nursing arrangements. Less emphasis has been placed, however, on care recipients’ subjective feelings of being a burden and on caregivers’ willingness to carry the burden in home care. This article uses empirical material from semi‐structured interviews conducted with older people affected by multiple chronic conditions and in need of long‐term home care, and with informal and professional caregivers, as two groups of relevant others. The high burden (...) of home‐care arrangements is unanimously stressed by all three groups involved in the triangle of care. An empirical‐ethical investigation of what can be legitimately expected from family members and informal caregivers, informed by Frith's symbiotic empirical ethics approach, was undertaken. Key tenets from the special goods theory and nursing professionalism are used as analytical tools. The study concludes that the current situation may hinder professional development and can reinforce feelings of being a burden to relevant others. (shrink)

Language's intentional nature has been highlighted as a crucial feature distinguishing it from other communication systems. Specifically, language is often thought to depend on highly structured intentional action and mutual mindreading by a communicator and recipient. Whilst similar abilities in animals can shed light on the evolution of intentionality, they remain challenging to detect unambiguously. We revisit animal intentional communication and suggest that progress in identifying analogous capacities has been complicated by (i) the assumption that intentional (that is, voluntary) production (...) of communicative acts requires mental-state attribution, and (ii) variation in approaches investigating communication across sensory modalities. To move forward, we argue that a framework fusing research across modalities and species is required. We structure intentional communication into a series of requirements, each of which can be operationalised, investigated empirically, and must be met for purposive, intentionally communicative acts to be demonstrated. Our unified approach helps elucidate the distribution of animal intentional communication and subsequently serves to clarify what is meant by attributions of intentional communication in animals and humans. (shrink)

Language’s intentional nature has been highlighted as a crucial feature distinguishing it from other communication systems. Specifically, language is often thought to depend on highly structured intentional action and mutual mindreading by a communicator and recipient. Whilst similar abilities in animals can shed light on the evolution of intentionality, they remain challenging to detect unambiguously. We revisit animal intentional communication and suggest that progress in identifying analogous capacities has been complicated by (i) the assumption that intentional (that is, voluntary) production (...) of communicative acts requires mental-state attribution, and (ii) variation in approaches investigating communication across sensory modalities. To move forward, we argue that a framework fusing research across modalities and species is required. We structure intentional communication into a series of requirements, each of which can be operationalised, investigated empirically, and must be met for purposive, intentionally communicative acts to be demonstrated. Our unified approach helps elucidate the distribution of animal intentional communication and subsequently serves to clarify what is meant by attributions of intentional communication in animals and humans. (shrink)

In this study, we consider the ways different degrees of dissent are established in interaction, especially in interactions among children. One important aspect in the development of the ability to argue is the framing of interactions as rather cooperative or agonistic. Different framings seem to allow for different forms of argumentative activity. The focus in this paper is on the mediation of degrees of dissensus in argumentation in child-child communication. It is established, we argue, through verbal as well as non-verbal (...) means, and the agonistic and cooperativity can be indicators for the space argumentation has in child-child interaction. (shrink)

The main thesis of this paper is that a large part of human behavior cannot be understood in terms of natural kinds but by appealing to normative kinds. In the first section we explain the distinction between natural kinds and normative kinds. In the second section we focus on the notion of “human behavior”, proposing a distinction between type A and type B behaviors and pointing out that psychology deals with type B behaviors, which are also included as diagnostic criteria (...) for mental disorders. In the third section we analyze the strategies used in biomedical research to find specific etiologies (“essences”) in order to explain such disorders. We argue that their results are inconsistent and that the lack of biomarkers that are clinically useful to refine the diagnoses is due to the fact that, unlike certain neuropathologies, there are no physiological essences behind such disorders. On the other hand, we argue that, as we are dealing with type B behaviors, we must interpret mental disorders as normative kinds. Keywords: human behavior, natural kinds, normative kinds. (shrink)

Assuming GCH, we prove that for every successor cardinal μ > ω1, there is a superatomic Boolean algebra B such that |B| = 2μ and |Aut B| = μ. Under ◊ω1, the same holds for μ = ω1. This answers Monk's Question 80 in [Mo].

The IAB’s selection of the Qatar-based Research Center for Islamic Legislation & Ethics (CILE) for hosting the 2024 World Congress of Bioethics does not leave the international bioethics community...

Garland, Morain, and Sugarman (2023) can be congratulated for their comprehensive and sharp analysis of physicians’ ethical duties with respect to pragmatic clinical trials (PCTs). PCTs embed resea...

McCullough et al have taken up an important issue that is highly interesting from a theoretical as well as from a practical standpoint in drawing attention to (in)civility as a matter of professional ethics: As a ‘low intensity deviant behaviour’1 p3 incivility seems to widely escape the scope of professional norms as well as legal regulation and jurisdiction. At the same time, empirical evidence suggests that incivility occurs frequently in healthcare and might have an enormous negative impact on the quality (...) of patient care. Against this background medical ethics should no longer hesitate conducting profound conceptual and empirical research on (in)civility as an ethical issue. The authors’ analysis sheds light on the different dimensions of practical rationality as involved clinical reasoning and behaviour. Whereas I agree with their idea of civility being a ‘professional virtue with cognitive, behavioural and social components’1 p2 I cannot fully support their claim of the cognitive component lasting on a ‘commitment to excellence in scientific and clinical reasoning’ (ibid.). Instead I would like to argue that professionalism comprises both, civility as …. (shrink)

Background The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals’ lifeworlds and need to be considered in implant care and in the course of technical developments. Methods This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical (...) research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. Results Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. Conclusions Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in “lived experiences” may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design. (shrink)

ZusammenfassungIm Zuge des „empirical turn“ der Medizin- und Bioethik ist von verschiedenen Autoren in den vergangenen Jahren die Idee einer „evidenzbasierten Ethik“ diskutiert worden. Die Analogie zwischen evidenzbasierter Medizin und „evidenzbasierter Ethik“ soll in diesem Beitrag kritisch diskutiert und dabei gezeigt werden, dass der Ausdruck „evidenzbasierte Ethik“ irreführend ist. Zentraler Ausgangspunkt der Kritik ist die unterschiedliche Bedeutung, die empirische Informationen für das medizinisch-klinische Urteil zum einen und das ethische Urteil in der Medizin zum anderen haben. Im medizinisch-klinischen Urteil können mit (...) Hilfe empirischer Informationen hypothetische Handlungsnormen generiert werden, welche auf den der Medizin inhärenten Zwecksetzungen basieren. Bei Fragen der Ethik in der Medizin hingegen sind die Handlungsziele selbst Gegenstand des Urteils; diese aber können allein aus empirischem Wissen heraus nicht zureichend bestimmt werden. Die Diskussion um die Möglichkeit einer „evidenzbasierten Ethik“ eröffnet weiterhin aufschlussreiche Perspektiven in Bezug auf empirische Forschung und den Umgang mit empirischen Informationen in der Angewandten Ethik und das Aufgabenfeld der Medizinethik. (shrink)

O artigo apresenta resultados iniciais de uma investigação sobre o modo como os jovens pesquisadores do Conicet utilizam e vivenciam o tempo em suas práticas cotidianas. O ponto de partida é que a inserção de lógicas competitivas de avaliação e acreditação tem como efeito o aumento dos níveis de produtividade necessários para alcançar e sustentar postos de trabalho, o que em termos temporais se traduz numa racionalização da equação tempo/resultados e em diferentes formas, ambas objetivas e subjetivo, da pressão do (...) tempo. Como o fenômeno não foi estudado anteriormente na Argentina, a pesquisa tem caráter exploratório e se limita ao grupo potencialmente mais exposto a essa dinâmica, o dos jovens em início de carreira. O principal resultado é que esses jovens precisam enfrentar e resolver quatro grandes tensões temporárias: aquela que contrasta o trabalho com outros aspectos da vida; aquela que contrasta as demandas de longo prazo da graduação com as da agenda diária ou de curto prazo; aquela que surge das exigências de diferentes aspectos do trabalho; aquele que opõe o interesse de fazer bem à necessidade de fazer rapidamente. Após apresentar sua abordagem teórico-metodológica, o artigo expõe as diferentes formas como essas tensões são vivenciadas e gerenciadas. (shrink)

Pavarini et al. should be congratulated to their highly valuable contribution shedding light on methodological innovation for bioethics in the digital era. I see a great potential in their a...

We explored the home learning environments of 173 Mexican preschool children (aged 3–6 years) in relation to their numeracy performance. Parents indicated the frequency of their formal home numeracy and literacy activities, and their academic expectations for children’s numeracy and literacy performance. Children completed measures of early numeracy skills. Mexican parent–child dyads from families with either high- or low-socioeconomic status (SES) participated. Low-SES parents (n= 99) reported higher numeracy expectations than high-SES parents (n= 74), but similar frequency of home numeracy (...) activities. In contrast, high-SES parents reported higher frequency of literacy activities. Path analyses showed that operational (i.e., advanced) numeracy activities were positively related to children’s numeracy skills in the high- but not in the low-SES group. These findings improve the understanding of the role of the home environment in different contexts and provide some insights into the sources of the variable patterns of relations between home learning activities and children’s numeracy outcomes. They also suggest that SES is a critical factor to consider in research on children’s home numeracy experiences. (shrink)

Comment expliquer que les savoirs de sciences humaines et sociales soient à ce point contestés voire ignorés dans les lieux où ils pourraient pourtant éclairer la réflexion et l'action? Comment expliquer la défiance et l'incompréhension qu'ils suscitent parfois? Les savoirs de sciences humaines et sociales ont la particularité de circuler dans des espaces variés et de devoir composer avec une critique prompte à remettre en cause leur validité et leur légitimité. Leur acceptabilité sociale ne se joue pas dans la seule (...) communauté savante mais bien dans les multiples réinterprétations et traductions auxquelles ils donnent lieu. Les études réunies dans ce volume analysent sept controverses ayant pour enjeu le sort réservé à des savoirs issus de la réflexion philosophique, sociologique, psychologique ou se revendiquant d'une économie hétérodoxe. Elles montrent que les résistances qu'ils rencontrent sont la marque paradoxale de leur vigueur et de leur capacité à bousculer les évidences partagées. Contributeurs : Elisabeth Chatel, Sandra Laugier, Frédéric Lebaron, Alexandra Oeser, Etienne Penissat, Sophie Richardot, Sabine Rozier. (shrink)

In this article, we discuss the importance of emotions for ethical reflection on technological developments, as well as the role that art can play in this. We review literature that argues that emotions can and should play an important role in the assessment and acceptance of technological risk and in designing morally responsible technologies. We then investigate how technologically engagedartcan contribute to critical, emotional-moral reflection on technological risks. The role of art that engages with technology is unexplored territory and gives (...) rise to many fascinating philosophical questions that have not yet been sufficiently addressed in the literature. (shrink)

No Brasil os estudos pedagógicos limitam-se a áreas que não desenvolvem o raciocínio lógico racional da criança; preferimos reproduzir as ideologias e regras normativas do sistema. Acreditar que os sujeitos têm que estudar a fim de obter apenas um emprego considerado “bom” é insuficiente para a construção de cidadãos realmente críticos, que não caiam no conformismo, mas questionem os objetos que estudamos, sabendo lutar contra ideologias e a manipulação de valores, com a formação de conceitos, e tendo um pensamento criativo, (...) crítico e curioso. (shrink)

In this paper we propose a narrative hypothesis on the nature of language and a proto-discursive hypothesis on the origin of our communicative abilities. Our proposal is based on two assumptions. The first assumption, concerning the properties of language, is tied to the idea that global discourse coherence governs the origin of our communicative abilities as well the functioning of these abilities. The second assumption, concerning processing devices, is connected to the idea that the systems of spatial and temporal navigation (...) are implicated in discourse coherence processing. Analysis of the relationship between these two assumptions allows us to integrate the model of language based on clues proposed by Sperber and Wilson with Relevance Theory with the discursive foundation of human communication. In this respect, our proposal can be considered as a tentative extension of Relevance Theory. (shrink)

Hospize verstehen sich als Orte einer ganzheitlichen Sterbebegleitung, welche nicht allein die Behandlung körperlicher und psychischer Symptome, sondern auch die soziale und spirituelle Betreuung der Sterbenden beinhaltet. Eine zentrale Bedeutung innerhalb dieser umfassenden Begleitung am Lebensende hat die Idee der Selbstbestimmung. Dem Hospizgast soll ermöglicht werden, im Sinne einer größtmöglichen Autonomie über die eigenen Belange bis zuletzt selbst entscheiden zu können. Diese zentrale Zielsetzung der Hospizarbeit wurde in der Literatur bisher überwiegend in theoretisch-programmatischer Weise thematisiert, es liegen jedoch kaum Untersuchungen (...) zu der Frage vor, wie die Idee der „Selbstbestimmung bis zuletzt“ im Alltag der Hospize praktisch umgesetzt wird. Über die besonderen Umstände der Pflege in stationären Hospizen hinaus ist der hier zugrunde gelegte Begriff von Autonomie auch von grundsätzlichem medizinethischen Interesse. Das ganzheitlich-palliative Konzept von Behandlung und Pflege, welches bereits im Hospiz als Institution fest verankert ist, legt nahe, dass die Idee der Selbstbestimmung in diesem Umfeld anders konzeptualisiert wird als im Bereich der „klassischen“, zumeist kurativ orientierten Medizin. Die qualitative Interviewstudie mit haupt- und ehrenamtlichen Mitarbeiterinnen und Mitarbeitern konnte zeigen, dass in stationären Hospizen ein Konzept von Selbstbestimmung vertreten wird, welches über rein medizinische Entscheidungen weit hinausgeht. Zugleich konnte aber auch herausgearbeitet werden, wo nach Ansicht der Mitarbeiterinnen und Mitarbeiter mögliche Grenzen der Selbstbestimmung des Gastes im Hospiz liegen. (shrink)

Jean Jacques Rousseau definía como "segundo parto" a la transición que supone la adolescencia, al nacimiento de la nueva identidad tras la crisis. La adolescencia coge siempre desprevenido, comienza y con ella llega un tsunami de cambios y transiciones de cuerpo y mente. Por un lado la imaginación se desborda, la sensibilidad está a flor de piel, se vive con grandes dosis de vitalidad y alegría y con la certeza de que todo es posible; hasta cambiar el mundo. Sin embargo (...) se reconoce también al adolescente por los desarreglos emotivos a los que están expuestos, los sentimientos de angustia, los miedos exagerados al ridículo, la crisis de identidad y la fuerte falta de confianza en sí mismos. (shrink)

According to Sutton et al. a “clinical decision support system (CDSS) is intended to improve healthcare delivery by enhancing medical decisions with targeted clinical knowledge, patient information...

This document exposes the conflict from the Post-Rational cognitive perspective, understanding the conflict as a relational phenomenon, which emerges when the need of recognition is exposed to its contrary: the non-recognition. “To know oneself” means in fact, to recognize oneself through the mediation of the other. An individual develops himself by recognizing the “otherness” that constitutes him. The self that goes out toward the other and then returns as ipse/selfhood, having acquired self-awareness through the other. For this reason, recognition is (...) a fundamental element in the building of human subjectivity. Identity is a continuous process that lasts a lifetime. It contains a central nucleus that ensures continuity by which a person is able to recognize him/ herself. In this way individuals learn to define who they are through interactions with others, especially those whom are more significant. Being recognized by others and by the environment offer the individual a sense of unity and coherence about himself. Conflict arises when the other or the environment becomes a threat to the survival of the subjectivity; when the absence or lack of recognition leads to harm in a person. Relational experiences are able to engender and ensure recognition, while holding onto an indispensable acceptance of individual differences. They thus allow each one to bring forth their own unique identity. (shrink)

Se ha propuesto el uso de heurísticas como una herramienta para solucionar el problema de marco. Los objetivos de este trabajo son proveer una clarificación de la literatura filosófica sobre el tema e intentar resolver los debates pendientes considerando la evidencia empírica disponible. Luego de distinguir varios aspectos del problema de marco, analizaremos las disputas filosóficas sobre el tema. A continuación comentaremos la literatura sobre la evidencia empírica relevante proveniente de la psicología cognitiva. Argumentaremos que las heurísticas pueden ser útiles (...) para solucionar sólo un aspecto del problema de marco, aun con varias restricciones. (shrink)

Este artículo estudia un corto tratado de polémica en contra del judaísmo escrito por el conocido erudito otomano Aḥmad Muṣṭafā Ṭāšhkubrīzāde. El autor utiliza los mismos argumentos que conocemos de la polémica religiosa medieval, tales como que la Torah, abrogada por el Islam, contenía referencias al Profeta Muḥammad a pesar de que su texto fue corrompido por los judíos. Además de la Biblia, Ṭāšhkubrīzāde cita una serie de fuentes judías tardías que añaden una importante dimensión a este trabajo. Después de (...) una breve introducción en que se discute la posibilidad de la deuda del autor respecto a la obra de Ibn Abī ‘Abd al-Dayyān, un converso del judaísmo al Islam, se presenta una edición y traducción del texto. (shrink)

El presente artículo tiene como objetivo realizar una revisión sistemática que posibilite dar información a la comunidad científica sobre el estado de la cuestión de la implementación del enfoque de pensamiento visible dentro de los centros de enseñanzas artísticas. Si la pedagogía del instrumento utiliza dicho enfoque para conseguir que los estudiantes adquieran capacidad comprensiva, el estudio demuestra que hay un limitado número de publicaciones científicas específicas que aborden dicho objeto de estudio y que, por ende, existe un amplio campo (...) de investigación sobre dicha temática necesario para conseguir una mejora en el aprendizaje eficaz del instrumento. (shrink)