ZusammenfassungÖkonomische Rahmenbedingungen der klinischen Tätigkeit bringen die Ärzteschaft häufig in Konflikte zwischen ihrem Berufsethos und den wirtschaftlichen Zielen der Klinik. Nicht selten werden diese Konflikte zwischen der Ärzteschaft und dem nicht-klinischen Krankenhausmanagement ausgetragen. Obwohl sowohl medizinische als auch ökonomische Ziele relevant sind, um eine ineffiziente Verteilung finanzieller Ressourcen im Gesundheitswesen zu vermeiden, gibt es großes Konfliktpotenzial. Insbesondere die klinische Ärzteschaft steht in der Verantwortung, einen adäquaten Umgang mit den ökonomisch-ethischen Konfliktpotentialen zu erlernen. Denn von ihnen wird erwartet, das ärztliche Ethos (...) zu bewahren, wirtschaftliche Forderungen nicht unkritisch zu übernehmen sowie eine qualitativ hochwertige Patientenversorgung zu gewährleisten. Inwiefern der Umgang mit den Konflikten und deren Auswirkungen auf die Zusammenarbeit zwischen Ärzteschaft und Krankenhausmanagement in der medizinischen Lehre eine Rolle spielt bzw. spielen sollte, wird in der vorliegenden Forschungsarbeit mittels der Analyse der medizinischen Curricula, nationaler und internationaler Publikationen, eines Modellprojektes sowie Experteninterviews untersucht. Anhand dieser Untersuchungen konnte herausgearbeitet werden, dass jene Inhalte vor allem in den Querschnittsbereichen 2 „Geschichte, Theorie und Ethik der Medizin“ und 3 „Gesundheitsökonomie, Gesundheitssystem, Öffentliches Gesundheitswesen“ des Medizinstudiums gelehrt werden. Da diese Lehre von den Hochschulen frei gestaltbar ist, besteht diesbezüglich jedoch eine hohe Heterogenität. Insbesondere die Ergebnisse der Interviews bestätigen die Relevanz einer Integration dieser Inhalte ins Medizinstudium und die Chance, dadurch den Umgang der Ärzteschaft mit den ethischen Konfliktsituationen zu Gunsten der Patientenversorgung zu verbessern. Zudem besteht die Möglichkeit, die Inhalte in interprofessioneller Form zu lehren und dadurch das gegenseitige Verständnis und die Zusammenarbeit der klinischen Ärzteschaft mit dem Krankenhausmanagement zu stärken. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

This essay introduces Semyon Lyudvigovich Frank as a philosopher who deservedly may be called a revolutionary thinker: he introduced a remarkable social ontology that foregrounds service. His oeuvre presents service as the supreme principle of personal and hence social life. The singular personality is seen as being there to creatively serve itself: his view of man focuses on the human soul as being there to bring forth creative action—to serve those who will come after, the community, society, and the Christian (...) Churches. Service, then, is the source for freedom as a derivative principle. Consequently, and in opposition to the fundamental idea of the “Charter of Human Rights,” freedom in Frank has no absolute value, but only a functional one. It is justified by the ontological principle of service. All governmental organization is, ideally, the organization of freedom, the planned, systematic formation of free, spontaneous cooperation. Spontaneous cooperation makes up part of his concept of sobornost’, the empirical substrate of social culture. Frank would have agreed with Karl Popper’s notion of the “open society,” yet he would have certainly added that accessibility and transparency, be they spiritual or social, emanate from the principle of the universality of service. The true ontological meaning and the true source of democracy is, in his eyes, not the rule of all, but the service of all. (shrink)

The present book is the result of a conference supported by the Karl-und-Gertrud-Abel-Stiftung which was dedicated to the reception of the Presocratics in the western world from the 12th to the 19th century. The chapters of the book are based on papers given at the conference. For publication, they have been revised and some of them have been amplified to a considerable extent.

The present book is the result of a conference supported by the Karl-und-Gertrud-Abel-Stiftung which was dedicated to the reception of the Presocratics in the western world from the 12th to the 19th century. The chapters of the book are based on papers given at the conference. For publication, they have been revised and some of them have been amplified to a considerable extent.

Gilead et al. raise some fascinating issues about representational substrates and structures in the predictive brain. This commentary drills down on a core theme in their arguments; namely, the structure of models that generate predictions. In particular, it highlights their factorial nature – both in terms of deep hierarchies over levels of abstraction and, crucially, time – and how this underwrites agency.

God's action in the world poses a challenge for the Christian scholar. At the scholarly level of one's discipline, invocations of divine Providence as an explanatory category are considered unacceptable. Yet the scholar-believer necessarily acknowledges that God is indeed active in His Creation. Generally, this tension is resolved via the assumption of methodological naturalism at the level of one's discipline and the embrace of theism at the level of one's faith. This can result in an incoherence between the commitments of (...) one's discipline and one's faith. Yet both theology and physics suggest that this tension may be relieved somewhat by acknowledging that the physical universe is no longer understood to be closed to the possibility of divine action. Consequently, Christian historians may want to reconsider the value of Providence as an explanatory category. (shrink)

Der Wissenschaftskonzeption der "kritischen Theorie" der zu verändernden Gesellschaft wird im wesentlichen zugestimmt. Sie wird verteidigt insbesondere gegen ein Selbstverständnis der Geistes- und Sozialwissenschaften, das sich im Namen der "Freiheit von Forschung und Lehre" auf einen Begriff "der" interesse- bzw. wertfreien Wissenschaft zurückzieht. Andererseits will der Autor die genannte Konzeption ergänzen bzw. präzisieren: Zwar stellt die Einheit von Theorie und Praxis ein Postulat philosophischer Reflexion dar, letztere erweist aber auf ihrer höchsten Stufe das politisch interessierte Engagement und das wissenschaftliche Interesse (...) an entdogmatisierender Reflexion jedes Engagements unter den Bedingungen menschlicher Endlichkeit als polar-entgegengesetzte, auseinandertretende Momente. (shrink)

[314] En examinant les malades mentaux, on a l’habitude de distinguer symptômes objectifs et symptômes subjectifs. Les symptômes objectifs sont tous les processus dont la manifestation est perceptible aux sens : les réflexes, les mouvements et le visage susceptibles d’être enregistrés et photographiés, les excitations motrices, les extériorisations langagières, les productions écrites, les actions, le mode de vie, etc. ; appartiennent en outre aux symptômes objectifs toutes les opérations mes...

How does Kant understand the representation of an empirical self? For Kant, the sources of the representation must be both a priori and a posteriori. Several scholars claim that the a priori part of the ‘self’ representation is supplied by the category of ‘substance,’ either a regular substance (Andrew Chignell), a minimal substance (Karl Ameriks) or a substance analog (Katharina Kraus). However, Kant opens the Paralogisms chapter by announcing that there is a thirteenth ‘transcendental’ concept or category: “We (...) now come to a concept that was not entered in the above general list of transcendental concepts, and that must yet be classed with them … This is the concept – or, if one prefers, the judgment – I think.” (A341/B399). I argue that it is the ‘I think’ that provides the a priori framework for the representation of the empirical self. (shrink)

Cell biologists, including those seeking molecular mechanistic explanations of cellular phenomena, frequently rely on experimental strategies focused on identifying the cellular context relevant to their investigations. We suggest that such practices can be understood as a guided decomposition strategy, where molecular explanations of phenomena are defined in relation to natural contextual (cell) boundaries. This “top-down” strategy contrasts with “bottom-up” reductionist approaches where well-defined molecular structures and activities are orphaned by their displacement from actual biological functions. We focus on the central (...) role of microscopic imaging in cell biology to uncover possible constraints on the system. We show how identified constraints are used heuristically to limit possible mechanistic explanations to those that are biologically meaningful. Historical examples of this process described here include discovery of the mechanism of oxidative phosphorylation in mitochondria, molecular explanation of the first steps in protein secretion, and identification of molecular motors. We suggest that these instances are examples of a form of downward causation or, more specifically, constraining relations, where higher-level structures and variables delimit and enable lower-level system states. The guided decomposition strategy in our historical cases illustrates the irreducibility of experimentally identified constraints in explaining biological activities of cells. Rather than viewing decomposition and recomposition as separate epistemic activities, we contend that they need to be iteratively integrated to account for the ontological complexity of multi-level systems. (shrink)

The meaning of the term logagogy is elucidated, and logagogic practices are outlined in the history of medicine. It is shown how the traditional medicine of India, Ayurveda, shows signs of logagogic practices(sattvavajaya), and that not only Ayurveda but also the famous Greek physician Galenus emphasize a philosophical approach to medicine. As Galenus’s logagogic practices have their roots in the tradition of practical philosophy in Greek antiquity, the most important Greek schools of thought that are relevant to logagogic approaches are (...) sketched. It is shown that the Stoics created a rationalistic system emphasizing the importance of the logos for human beings, and that Epicurus made advances in psychoeducation and cognitive reframing that are important for logagogic practices. These logagogic approaches of antiquity have been taken up by modern counseling in philosophical practices. The article closes with an outline of a clinical logagogy. (shrink)

The complete works of Marks and Engels on one CD.,This unique CD Rom includes full text search,facilities, thousands of index items, and is,compatible with Windows, Macs and Unix. An ideal,study tool for research or reference.