In this paper, we explore and discuss the use of the concept of being affected in biomedical decision making processes in Germany. The corresponding German term ‘Betroffenheit’ characterizes on the one hand a relation between a state of affairs and a person and on the other an emotional reaction that involves feelings like concern and empathy with the suffering of others. An example for the increasing relevance of being affected is the postulation of the participation of people with disabilities and (...) chronic or acute diseases in the discourse, as partly realized in the German National Ethics Council or the Federal Joint Committee. Nevertheless, not only on the political level, the resistance against the participation of affected people is still strong; the academic debate seems to be cross-grained, too. Against this background, we explore the meaning and argumentative role of the concept of being affected as it is used by affected and lay people themselves. Our analysis is based on four focus group discussions in which lay people, patients and relatives of patients discuss their attitudes towards biomedical interventions such as organ transplantation and genetic testing. This setting allows for a comparison of how affected and non-affected people are concerned and deliberate about medical opportunities, but also of how they position themselves as being affected or non-affected with respect to (scientific) knowledge and morality. On this basis, we discuss the normative relevance of being affected for the justification of political participation. (shrink)

BackgroundThe diagnosis and treatment of cancer are associated with psychological distress that often leads to a significant reduction in emotional and physical well-being and quality of life. Early detection of psychological distress is therefore important. This study aims to assess the psychological distress of inpatient cancer patients using routine clinical data. Furthermore, variables and problems most strongly associated with psychological distress should be identified.Materials and MethodsN = 1,869 inpatients were investigated using the National Comprehensive Cancer Network Distress Thermometer and problem (...) checklist to assess distress as well as multiple possible problem areas. Visceral oncological cancer was the most common tumor diagnosis, followed by skin cancer and urological cancer.Results65.9% of the sample experienced high levels of distress. Female sex, stage 4 of disease, and visceral and head and neck cancer emerged as risk factors for high distress. A younger age was significantly correlated with higher distress. The most frequently self-reported problems were fears, worry, and fatigue. Patients with all 3 of these problems had 24 times higher risk [odds ratio = 23.9] for high levels of distress than patients without these problems. Women reported significantly more practical, emotional, and physical problems than men. Younger and middle-aged patients reported increased levels of practical, family, and emotional problems compared with older patients.DiscussionAlmost two-thirds of the sample reported high levels of distress. The most frequently reported problem areas were emotional and physical problems. These results can help to identify patients with high risk for psychological distress and, therefore, be used to optimize psychosocial and psycho-oncological care for patients with cancer. (shrink)

Die individuellen und gesellschaftlichen Folgen des demographischen Wandels rücken moralische Fragen, die den angemessenen Umgang mit älteren Menschen und die sinnvolle Gestaltung des Lebens im Alter betreffen, verstärkt in den Mittelpunkt öffentlicher Aufmerksamkeit sowie medizin- bzw. pflegeethischer und gesundheitspolitischer Auseinandersetzungen. Allerdings wird das Altern als Prozess und das höhere Alter als Lebensphase in vielen dieser medizin- bzw. pflegeethischen und gesundheitspolitischen Debatten zumeist lediglich unter dem spezifischen Gesichtspunkt der jeweils erörterten Praktiken, Fragestellungen und Problemlagen thematisiert. Eine Betrachtung, die diese verschiedenen konkreten (...) Praxis- und Diskussionskontexte übergreift, das in ihnen jeweils vorausgesetzte Verständnis des Alter(n)s als solches thematisiert und in seiner Bedeutung für die ethische Fachdiskussion grundsätzlich reflektiert, findet dagegen kaum statt. Die Arbeitsgruppe „Altern und Ethik“ in der Akademie für Ethik in der Medizin soll zur Entwicklung einer solchen grundlegenderen und umfassenderen Betrachtungsweise beitragen. Der vorliegende Beitrag gibt einen ersten orientierenden Überblick über die zentralen Themenschwerpunkte, Problemstellungen und Kontroversen in den aktuellen medizin- bzw. pflegeethischen und gesundheitspolitischen Diskursen um das Alter(n) und markiert offene Fragen und Forschungsdesiderate. Wie sich dabei zeigt, kann eine eingehendere Auseinandersetzung mit dem Alter(n) nicht nur den einschlägigen alter(n)sbezogenen Fachdebatten zu fundierteren Perspektiven verhelfen, sondern auch der ethischen Diskussion insgesamt wichtige Impulse im Hinblick auf ihre anthropologischen Grundlagen und ihren normativen Bezugsrahmen vermitteln. (shrink)

Studies into the ethical aspects of consumption tend to focus on a limited class of actions that are explicitly understood as “ethical consumption”. The SARS-CoV-2 pandemic provided a context in which other ethical issues and questions of whom we should care for first, and how, suddenly and dramatically gained salience. This article draws on the care literature to explore the reconfiguration of consumption decisions and dilemmas during this period. Building on twenty-eight in-depth interviews, it considers the temporal and spatial dimensions (...) of care and consumption and examines various ethical and ideological considerations that arose, particularly regarding the allocation of care in the face of competing demands. Subsequently, the article problematises mainstream accounts of ethical consumption, arguing for considering a plurality of ethics present within decisions about consumption. It concludes with a call to incorporate a more capacious understanding of care in broader discussions of ethics in consumption. (shrink)

Looking Beneath the Surface explores Arab-Islamic and Western perspectives on medical ethical issues: genetic research and treatment, abortion, organ donation, and palliative sedation and euthanasia. The contributions in this volume discuss the state of the art, the role of laws, counseling, and spiritual counseling in the decision-making process. The different approaches to the ethical issues, ways of moral reasoning, become clear in these contributions, especially the role of tradition for Islam and the importance of autonomy for the West. Beneath the (...) differences, however, the reader will also discover common values, such as the role of dignity and the value of life, and similar practices. Some of the main differences are sociocultural in nature, rather than religious as such. Well-known experts in the fields of medicine and ethics have contributed to this volume from different religious and secular backgrounds. The book offers a carefully written introduction and final chapter on intercultural comparisons. Looking Beneath the Surface is more than a collection of writings on issues in medical ethics: it helps the reader to compare different paradigms of accountability and moral reasoning. (shrink)

In literature, indices of overall walking ability that are based on ground reaction forces have been proposed because of their ease of administration with patients. In this study, we analyzed the correlation between the indices of dynamic loading and propulsion ability of 40 chronic hemiparetic post-stroke patients with equinus foot deviation and a set of clinical assessments of ankle joint deviations and walking ability. Ankle passive and active range of motion and triceps surae spasticity were considered, along with walking speed (...) and three complementary scales of walking ability focusing respectively on the need for assistance on functional mobility, including balance and transfers, and the limitation in social participation. The correlation between the ground reaction force-based indices and both clinical and functional variables was carried out using the non-parametric Spearman correlation coefficient. Both indices were correlated to 8 of the 10 investigated variables, thus supporting their use. In particular, the dynamic propulsive ability was correlated with all functional scales, and has the advantage of being a continuous variable. Among clinical assessments, limited ankle ROM affected walking ability the most, while spasticity did not. Since the acquisition of ground reaction forces does not require any patient prepping, the derived indices can be used during the rehabilitation period to quickly detect small improvements that, over time, might lead to the broad changes detectable by clinical scales, as well as to immediately highlight the lack of these improvements, thus suggesting adjustments to the ongoing rehabilitation approach. (shrink)

Consensus around what constitutes researcher conflicts of interest (COIs) and awareness of their influence on our research are two critical steps in ensuring the integrity of our science. In this research, data were collected from individual scholars via 2 surveys 5 years apart and from journals and associations to examine the level of social consensus and moral awareness among scholars, journals, and associations regarding researcher COIs. Although we observed increases in level of social consensus and moral awareness between 2012 and (...) 2017, results still revealed limited agreement about what relationships constitute a COI and limited awareness about the presence of and the ethical issues surrounding COIs. Although all journals and associations we examined supported COI disclosure, most did not provide researchers with detailed COI-related information, guidance, or disclosure tools. Limited social consensus and moral awareness regarding COIs is problematic because it inhibits the recognition, disclosure, and management of COIs and limits ethical decision making. We need to continue and enhance discussions about COIs and aim to create consensus and awareness where we do not have it with the goal of reducing potential scientific misconduct related to COIs. (shrink)

The increasing availability of large‐scale, complex data has made research into how human genomes determine physiology in health and disease, as well as its application to drug development and medicine, an attractive field for artificial intelligence (AI) approaches. Looking at recent developments, we explore how such approaches interconnect and may conflict with needs for and notions of causal knowledge in molecular genetics and genomic medicine. We provide reasons to suggest that—while capable of generating predictive knowledge at unprecedented pace and scale—if (...) and how these approaches will be integrated with prevailing causal concepts will not only determine the future of scientific understanding and self‐conceptions in these fields. But these questions will also be key to develop differentiated policies, such as for education and regulation, in order to harness societal benefits of AI for genomic research and medicine. (shrink)

We analyze log-data generated by an experiment with Mathtutor, an intelligent tutoring system for fractions. The experiment compares the educational effectiveness of instruction with single and multiple graphical representations. We extract the error-making and hint-seeking behaviors of each student to characterize their learning strategy. Using an expectation-maximization approach, we cluster the students by their strategic profile. We find that a) experimental condition and learning outcome are clearly associated b) experimental condition and learning strategy are not, and c) almost all of (...) the association between experimental condition and learning outcome is found among students implementing just one of the learning strategies we identify. This class of students is characterized by relatively high rates of error as well as a marked reluctance to seek help. They also show the greatest educational gains from instruction with multiple rather than single representations. The behaviors that characterize this group illuminate the mechanism underlying the effectiveness of multiple representations and suggest strategies for tailoring instruction to individual students. Our methodology can be implemented in an on-line tutoring system to dynamically tailor individualized instruction. (shrink)

This article presents an interpretation of Merleau-Ponty's notion of pre-reflective intentionality, explicating the similarities and differences between his and Husserl's understandings of intentionality. The main difference is located in Merleau-Ponty's critique of Husserl's noesis-noema structure. Merleau-Ponty seems to claim that there can be intentional acts which are not of or about anything specific. He defines intentionality by its ``directedness'', which is described as a bodily, concrete spatial motility. Merleau-Ponty's understanding of intentionality is part of his attempt to rewrite the relation (...) between the universal and the particular. He claims that meaning is intrinsic to the phenomenal field and impossible to analyse by a distinction between form and matter. Still, Merleau-Ponty's notion of meaning and philosophy is strictly opposed to any naturalized philosophy. This becomes explicated at the end of the article, where his attempt to embody intentionality is compared to Daniel Dennett's corresponding approach. (shrink)

This article is dedicated to Euclid’s Elements, to translations of this work into Czech, and to the translators who have taken on the task of translation. It contains a short overview of the results achieved during a three-year project supported by the Czech Grant Agency.We explored how Euclid’s Elements were spread around the Czech lands.We will try to describe the circumstances that lay behind attempts to translate the Elements into the Czech language.

In this paper I explore the prospects of a Neo-Aristotelian position—according to which the difference between the human species and non-human animals is a difference in ‘form’—in the context of the question of how the human form of life is related to the idea of education. Two interpretations of this idea have been suggested by contemporary Neo-Aristotelian philosophy that offer contrasting accounts of the role played by education. According to the first, the idea of a formal difference goes with a (...) notion of potentiality, according to which the distinctiveness of the human is mainly a product of education, and hence a matter of second nature. According to the second, the idea of the human is the idea of a formally distinctive kind of first nature that explains the very possibility of education. I maintain that both interpretations do justice to an important aspect of human life yet fail fully to grasp the significance of the notion of ‘form’ that they employ. I argue that to embrace the insight that the difference of the human is a difference in ‘form’, we must think of the human as a form of life whose very concept contains the concept of education. The concept of education, I argue, is a logical concept, contained in the concept of life that it describes. (shrink)

There are several approaches implementing reasoning based on conditional knowledge bases, one of the most popular being System Z (Pearl, Proceedings of the 3rd conference on theoretical aspects of reasoning about knowledge, TARK ’90, Morgan Kaufmann Publishers Inc., San Francisco, CA, USA, pp. 121–135, 1990). We look at ranking functions (Spohn, The Laws of Belief: Ranking Theory and Its Philosophical Applications, Oxford University Press, Oxford, 2012) in general, conditional structures and c-representations (Kern-Isberner, Conditionals in Nonmonotonic Reasoning and Belief Revision: (...) Considering Conditionals as Agents, vol. 2087 of LNCS, Springer, Berlin, 2001) in order to examine the reasoning strength of the different approaches by learning which of the known calculi of nonmonotonic reasoning (System P and R) and Direct Inference are applicable to these inference relations. Furthermore we use the recently proposed Enforcement-postulate (Kern-Isberner and Krümpelmann, Proceedings of the 22nd international joint conference on artificial intelligence, vol. 2, IJCAI’11, AAAI Press, pp. 937–942, 2011) to show dependencies between these approaches. (shrink)

The target article proposes a model to explain the emergence of sex differences in attachment in middle childhood and their implications for reproductive strategies. While biological factors are prominent in the model, little is said about the social context of middle childhood and its contributions. There is also a need to clarify the fundamental nature of attachment in middle childhood.

What should I do? What can I hope for? The essays are weighted towards the practical philosophy, which Kant himself described as the keystone of his complete philosophical system.

Whereas some of the critics of Hermann Cohen's strictly rational foundation of religious consciousness promoted a turn to subjectivism, others endorsed an ethicotheology while seeking to revise the "Religion of Reason." Among the latter was the Ukrainian-born social philosopher David Koigen (1877-1933), author of Der moralische Gott. Eine Abhandlung über die Beziehungen zwischen Kultur und Religion/The Moral God: An essay on the relations between culture and religion (Berlin: Jüdischer Verlag, 1922). This article examines Koigen's reevaluation of Jewish monotheism as a (...) culture-forming religion (Kulturreligion) grounded in a religious ethos which integrates the rational will, ethics and emotion. (shrink)

"How can human beings, who are liable to error, possess knowledge, since the grounds on which we believe do not rule out that we are wrong? Andrea Kern argues that we can disarm this skeptical doubt by conceiving knowledge as an act of a rational capacity. In this book, she develops a metaphysics of the mind as existing through knowledge of itself."--Provided by publisher.

In this paper, we argue that, although neglected so far, there is a strong link between generics and testimonial injustice. Testimonial injustice is a form of epistemic injustice that “occurs when prejudice causes a hearer to give a deflated level of credibility to a speaker’s word”. Generics are sentences that express generalizations about a category or about its members without specifying what proportion of the category members possess the predicated property. We argue that generics are especially suited to cause testimonial (...) injustice for three reasons. First, generics elicit an “inferential asymmetry” :1452–1482, 2010). That is, generics are accepted even if only a few individuals possess the predicated property but are, nonetheless, taken to refer to almost all the members of the category. This peculiar combination makes generics particularly apt to cause testimonial injustice. High resistance to counter-evidence is a crucial feature of prejudice, the cause of testimonial injustice, and the more highly predictive a generalization the more it will be employed in concrete situations, leading to instances of testimonial injustice. Second, generics seem to play a key role in leading people to develop essentialist beliefs : 273–301, 2010; Rhodes et al. Proc Natl Acad Sci 109: 13526–13531, 2012). Subjects holding such beliefs treat categories as warranting strong generaliations over their members. Therefore, they will be more likely to rely on prejudice while dealing with the category members. Finally, generics are outstandingly common in everyday speech. Hence, their noxious effects are amplified by their diffusion and should not be underestimated. (shrink)

The aim of this paper is to reinforce anti-physicalism by extending the hard problem to a specific kind of intentional states. For reaching this target, I investigate the mental content of the new intentional states of Jackson’s Mary. I proceed in the following way: I start analyzing the knowledge argument, which highlights the hard problem tied to phenomenal consciousness. In a second step, I investigate a powerful physicalist reply to this argument: the phenomenal concept strategy. In a third step, I (...) propose a constitutional account of phenomenal concepts that captures the Mary scenario adequately, but implies anti-physicalist referents. In a last step, I point at the ramifications constitutional phenomenal concepts have on the constitution of Mary’s new intentional states. Therefore, by focusing the attention on phenomenal concepts, the so-called hard problem of consciousness will be carried over to the alleged easy problem of intentional states as well. (shrink)

"Lch _ke nur an, dass es gar nicMs Ungewohnliches sei, sowohl im gemeinen Gespriiche, als in den Schriften, durch Vergleichung der Gedanken, welche ein Vertasser aber seinen Gegenstand aussert, ihn sogar besser, u lIerstehen, als er sich selbst lIerstand, indem er seinen Begrilf nicht genugsam be stimmte utJd dadurch bisweilen seiner eigenen Absicht ent gegen redete oder auch dachte." Diesen Sat, aus Kanis "Kritik der, einen Vernunft" hat Husserl aut die Titelseite seines Exemplars lion Kants Hauptwerk geschrieben. Ober die Beziehungen (...) zwischen Husseds Phiinomenologie und der Kantischen und neukantianischen Philosophie ist schon Vieles ge schrieben worden. Dabei wurden die verschiedensten Auffassun gen geaussert; man kann sagen, dass hier die ganze Skala mogli cher Deutungen durchgangen wurde. Am einen Ende dieser Skala steht Hussed als Antipode Kants und jeglichen N eukantianismus, am andem Ende der N eukantianer Hussed; und dazwischen liegen nuanciertere Bilder. Offenbar sind die Beziehungen zwi schen Hussed einerseits und Kant und den Neukantianem an dererseits komplexer Natur; offenbar bestehen hier aber auch innere Beziehungen, seien sie nun positiver oder negativer Art. Es drangte Hussed selbst danach, sich iiber sein Verhaltnis zur Philosophie Kants klar auszusprechen_ Fiir sein letztes Werk, fiir die Krisis, hatte er eine Auseinandersetzung mit Kant geplant.l Bevor er aber diesen Plan ausfiihren konnte, erreichte ihn der Tod. (shrink)

Current debates on collective intentionality focus on the cognitive capacities, attitudes, and mental states that enable individuals to take part in joint actions. It is typically assumed that collective intentionality is a capacity which is added to other, pre-existing, capacities of an individual and is exercised in cooperative activities like carrying a table or painting a house together. We call this the additive account because it portrays collective intentionality as a capacity that an individual possesses in addition to her capacity (...) for individual intentionality. We offer an alternative view according to which the primary entity to which collective intentionality has to be ascribed is not the human individual, but a “form of life.” As a feature of a form of life, collective intentionality is something more than the specific capacity exercised by an individual when she cooperates with others. Collective intentionality transforms all the capacities of the bearers of this specific form of life. We thus call our proposal the transformative account of collective intentionality. (shrink)