La discussione generale sulla filosofia della scienza contemporanea è complicata dal numero e dall’eterogeneità delle scienze, mentre lo studio di temi specifici porta inevitabilmente a dissertazioni specialistiche che mancano nel dare ragione della trama di senso sottostante. Questo Piccolo trattato di epistemologia intende occupare uno spazio vuoto, proponendo alcuni temi chiave per la comprensione dei meccanismi alla base della conoscenza scientifica: i rapporti tra filosofia e scienze, siano esse naturali o umane; la complessa relazione tra fatti e valori; la distinzione (...) tra scoperta e giustificazione; la necessità di un discorso etico sulla ricerca, che chiami in causa categorie come fiducia, empatia, altruismo ed egoismo. Con un approccio chiaro e rigoroso, il volume intende rivolgersi a quell’ampia fascia di pubblico interessata alle tematiche centrali dell’epistemologia, della filosofia e delle scienze. (shrink)

In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.

Genetic counselling is an important aspect of prenatal care in many developed countries. This tendency has also begun to emerge in Br.

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of (...) a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process. (shrink)

Riassunto: In questo contributo analizzeremo il criterio del danno, presente nella definizione generale di disturbo mentale del DSM. La questione ha rilevanza sia da un punto di vista filosofico, perché il danno è una componente normativa e valoriale, non oggettiva, sia da un punto di vista clinico, perché chi ha difeso il criterio del danno ha spesso sostenuto che in sua assenza avremmo troppi falsi positivi. Infine, ha importanza dal punto di vista socio-sanitario in relazione al rapporto tra la psichiatria (...) e la medicina non psichiatrica, nello specifico tra il DSM e l’ICD. Sosterremo che ci sono buone ragioni per non mantenere il danno come criterio necessario nella definizione generale del disturbo mentale. Dopo una breve introduzione, forniremo una panoramica storica sul ruolo del criterio del danno nelle varie edizioni del DSM. Successivamente si illustrerà la principale obiezione contro l’inclusione del criterio del danno nella definizione generale di disturbo mentale, ossia il problema dei falsi negativi, per poi presentare e discutere ulteriori ragioni – medico-pratiche e concettuali – che depongono a sfavore dell’attribuzione di un forte peso al criterio del danno. In sede conclusiva ribadiamo come la decisione presa dalla task force del DSM-5 di escludere il criterio del danno dalla definizione generale di disturbo mentale debba essere sostenuta. Parole chiave: Danno; Disabilità; Disagio; Disturbo mentale; DSM “Harm” as Criterion for the Definition of Mental Disease in DSM. Some Epistemological Reflections: In this paper, we analyse the harm requirement in the general definition of mental disorder in the Diagnostic and Statistical Manual for Mental Disorders. This issue has both philosophical and clinical relevance: on the one hand the harm requirement is a normative, value-laden, non-objective component in the definition of mental disorder; on the other hand, the harm requirement has often been defended on the grounds that it prevents an increase in false positives. The issue is also important in assessing the relationship between psychiatry and somatic medicine, more precisely, between the DSM and the International Classification of Diseases. We argue that there are good reasons not to maintain the harm requirement in the general definition of mental disorder. After a brief introduction, we overview the history of the harm requirement across the various editions of the DSM. Then, we examine the main objection to the inclusion of the harm requirement in the general definition of mental disorder, that is, the problem of false negatives, and also present several other points – both practical and conceptual – that help demonstrate why the harm requirement is inadequate as a definiens of mental disorder. To conclude, we stress that the decision of the DSM-5 task force not to regard the harm requirement as a necessary component of mental disorder should be endorsed. Keywords: Harm; Disability, Distress; Mental Disorder; DSM. (shrink)

Over the last three quarters of a century, international guidelines and regulations have undergone significant changes in how children are problematised as participants in biomedical research. While early guidelines enacted children as vulnerable subjects with diminished autonomy and in need of special protection, beginning in the early 2000s, international regulatory frameworks defined the paediatric population as vulnerable due to unaddressed public health needs. More recently, ethical recommendations have promoted the active engagement of minors as research partners. In this paper, I (...) adopt a post-structuralist approach to policy analysis to examine deep-seated assumptions and presuppositions underlying the changes in the problematisation of children as biomedical research participants over time. While biomedical research ethics focuses on the autonomy and vulnerability of minors, ethical guidelines are situated in specific sociocultural contexts, shaped, among other things, by contingent public health needs and changing conceptions of the value of research and science for society. In the process, I demonstrate the challenge of moving away from an approach that in taking adults as the model overshadows the complexity of children’s lived experiences as well as their personal, cultural, and social lives. The lack of acknowledgement of this complexity makes children vulnerable to epistemic injustice, which is particularly crucial to address in public involvement initiatives. (shrink)

This volume breaks new grounds by bringing together a great variety of innovative contributions on triangulation, epistemology, and mind. The notion of triangulation, developed by Donald Davidson during the last two decades of his life, has changed our understanding of the relationship between subjective, intersubjective, and objective, and shed new light on concepts such as externalism, internalism, communication, interpretation, and language. At the same time, however, it has been strongly criticized for several aspects. The papers collected in this volume written (...) by established contributors aim to provide new insights into the contemporary debate on triangulation. The upshot is not only a deeper understanding of Davidson s ideas but also a new appreciation of some central problems of epistemology and the philosophy of mind with regard to adjoining disciplines such as, for instance, cognitive sciences and the philosophy of language.". (shrink)

Most of the epidemiological models of the Covid-19 pandemic contain the reproduction number as a parameter. In this article we focus on some shortcomings regarding its role in driving health policies and political decisions. First, we summarize what R is and what it is used for. Second, we introduce a three-question matrix for the evaluation of any construct or parameter within a model. We then review the main literature about R to highlight some of its shortcomings and apply to them (...) our three-question matrix. Finally, we argue that these shortcomings are important for an epistemic and political evaluation of R. (shrink)

The purpose of this paper is to clarify the nature of research methods in the history of economic thought. In reviewing the "techniques" which are involved in the discipline, four broader categories are identified: a) textual exegesis; b) "rational reconstructions"; c) "contextual analysis"; and d) "historical narrative". After examining these different styles of doing history of economic thought, the paper addresses the question of its appraisal, namely what is good history of economic thought. Moreover, it is argued that there is (...) a distinction to be made between doing economics and doing history of economic thought. The latter requires the greatest possible respect for contexts and texts, both published and unpublished; the former entails constructing a theoretical framework that is in some respects freer, not bound by derivation, from the authors. Finally, the paper draws upon Econlit records to assess what has been done in the subject in the last two decades in order to frame some considerations on how the past may impinge on the future. (shrink)

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of (...) professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice. (shrink)

The general definition of mental disorder stated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders seems to identify a mental disorder with a harmful dysfunction. However, the presence of distress or disability, which may be bracketed as the presence of harm, is taken to be merely usual, and thus not a necessary requirement: a mental disorder can be diagnosed as such even if there is no harm at all. In this paper, we focus on the (...) harm requirement. First, we clarify what it means to say that the harm requirement is not necessary for defining the general concept of mental disorder. In this respect, we briefly examine the two components of harm, distress and disability, and then trace a distinction between mental disorder tokens and mental disorder types. Second, we argue that the decision not to regard the harm requirement as a necessary criterion for mental disorder is tenable for a number of practical and theoretical reasons, some pertaining to conceptual issues surrounding the two components of harm and others pertaining to the problem of false negatives and the status of psychiatry vis-à-vis somatic medicine. However, we believe that the harm requirement can be maintained among the specific diagnostic criteria of certain individual mental disorders. More precisely, we argue that insofar as the harm requirement is needed among the specific diagnostic criteria of certain individual mental disorders, it should be unpacked and clarified. (shrink)

In recent years, children and young people (CYP) have been increasingly included in patient and public involvement (PPI) in health research and innovation. Such initiatives intend to give a voice to CYP in such matters. Given that it is debated whether PPI in health care fosters the values of participation, public discussion and decision making put forward by deliberative democracy, this article examines three sets of challenges concerning the involvement of CYP by focusing on age biases. After describing some existing (...) initiatives, the paper critically examines why CYP are involved, how the CYP group is constituted and then investigates the moral status of CYP in biomedical settings. It shows that the rationale for involving CYP in PPI is mainly top-down and adult-centric, thereby questioning the authentic participation in decision making. It also suggests that to ensure democratic inclusion, the CYP group should be constituted by considering both age and politics. Lastly, the article indicates that, despite the increasing recognition of child-specific rights, the sociocultural norms and power dynamics in pediatrics undermine their moral status and challenge political equality. These three sets of considerations offer a preliminary theoretical contribution toward improving democratic legitimacy and representation of CYP in health research and innovation. (shrink)

Esses escritos compartilham experiências de entrada em campo etnográfico com pesquisas com crianças ciganas do acampamento Mathias, no município de Quissamã, estado do Rio de Janeiro. O estudo, ainda em andamento, se justifica pela urgência em respeitar o povo cigano e compreender suas demandas. Pretendemos também, como nossa pesquisa e através de nossa fotoetnografia miúda, ampliar espaços nos chamados Estudos das Infância. Urge que os grupos ciganos sejam vistos pelos seus valores, seus modos de vida e suas narrativas, incluindo as (...) narrativas das crianças. (shrink)

Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease and for who may be accorded the social privileges and personal responsibilities associated with being sick. In this article, we consider an ideal diagnostic test for coronavirus disease 2019 infection with respect to four groups of people—positive and asymptomatic; positive and symptomatic; negative; and (...) untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency. (shrink)

Este artículo explora mi devenir como indagadora narrativa en la educación superior. Se trata de una aproximación íntima a las formas teóricas y metodológicas en las cuales, dentro de mi grupo de investigación en la Facultad de Humanidades de la Universidad Nacional de Mar del Plata, Argentina, hemos recogido relatos sus docentes y estudiantes para estudiar entre otros temas, representaciones sobre el currículo, buenas prácticas de enseñanza, docentes memorables, identidades y experiencias de docentes en ciernes. En el transcurso de este (...) devenir indagador reconocemos, en este orden, estaciones de cruces con diversas metodologías tan narrativas como íntimas: investigación de narrativas; investigación con narrativas; investigación biográfico-narrativa; indagación narrativa; indagación poética; autoetnografía; indagación narrativa visual. Examinamos los vínculos metodológicos y teóricos entre qué investigamos y relatamos, cómo lo hacemos y lo re-presentamos y quiénes devenimos entre los contenidos teóricos y las formas metodológicas. Mediante este trabajo, aspiramos a continuar los diálogos con el variado universo narrativo en el ámbito de la educación universitaria. (shrink)

Introduction to the book symposium “THE BIOPSYCHOSOCIAL MODEL OF HEALTH AND DISEASE: NEW PHILOSOPHICAL AND SCIENTIFIC DEVELOPMENTS BY DEREK BOLTON AND GRANT GILLETT”.

En la gran discusión pública en torno a la pandemia de la COVID-19 fueposible identificar cuatro líneas argumentales que contenían un análisis delevento pandémico, una valoración y una predicción o propuesta futuro. Laprimera fue la de la negación o el engaño bajo el paradigma del Estado deexcepción permanente. La segunda cifró el peligro en la posible inacción delos Estados y en la consiguiente violación de la dignidad humana. La terceraconsideró la pandemia un acelerador de la crisis de los sistemas democráticosy (...) del triunfo del capitalismo tecnológico. Finalmente, la cuarta líneaargumental anunció el advenimiento de un momento único de catarsis colectiva.El objeto de este artículo es repensar con la perspectiva del tiempo losmarcos interpretativos que iluminaron un debate que todavía hoy no puededarse por cerrado. (shrink)

Paul Ricœur and Jan Patočka are considered among the most important phenomenologists of the 20 th century. As with Ricœur, Patočka ’s philosophy is shaped by an enduring critical confrontation with Husserl’s phenomenology and Heidegger’s phenomenological analyses of Dasein. The present paper aims at analyzing Ricœur ’s and Patočka ’s convergences and mutual inspirations in their perspectives on the topic of history. More precisely, I will take up the question of the meaning of history in Ricœur and Patočka as profoundly (...) influenced by their readings of Husserl’s Krisis. Then, the attention will be turned to Ricœur ’s concept of historicity and Patočka ’s notion of care of the soul as concerns involved in the search for meaning in history as an open-ended mediation. In this context, I will discuss Ricœur ’s and Patočka ’s critical examination of Heidegger’s conception of thrownness and projection, that is, Dasein’s already-being-in-the-world and its disclosedness, as necessary concepts for understanding their own philosophical approaches to history. (shrink)

Thanks to their heterogeneity, the nine essays in this volume offer a clear testimony of Donald Davidson's authority, and they undoubtedly show how much his work - even if it has raised many doubts and criticisms - has been, and still is, highly influential and significant in contemporary analytical philosophy for a wide range of subjects. Moreover, the various articles not only critically and carefully analyse Davidson's theses and arguments (in particular those concerning language and knowledge), but they also illustrate (...) how such theories and ideas, despite their unavoidable difficulties, are still alive and potentially fruitful. Davidson's work is indeed an important and provocative starting point for discussing the future progress of philosophy. (shrink)

Ecce Homo certainly is an unconventional autobiography. Both its structure and its contents are in fact quite different from that traditionally adopted. First, in Ecce Homo life and literary production basically coincide; second, in that book Nietzsche deals with an “I” which is not the traditional “subject” of Western philosophy. In this paper I shall argue that in Ecce Homo Nietzsche tries to develop a new kind of subjectivity. In particular, Nietzsche rejects the idea of an unchanging, absolute, substance subject, (...) and sees it as a mobile construction, something that can be described only insofar as it “becomes what it is”, that is, as it consciously reacts to its unavoidable destiny. (shrink)

I testi biblici si guardano, rinviano l'uno all'altro, si citano si rispecchiano l'uno nell'altro, e il frutto di tale rispecchiamento precipita a formare nuovi strati testuali.

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 45 Heft: 1 Seiten: 222-222.

La primera parte de este artículo se refiere a las reglas que definen la autoridad legislativa suprema de un orden jurídico. En esta primera parte, además, el artículo se ocupa de algunas distinciones: entre normas y meta-normas, entre reglas legisladas y reglas consuetudinarias, y entre reglas constitutivas y reglas regulativas; todo ello con el objetivo de determinar a cuál de estas categorías pertenecen las reglas que definen la autoridad legislativa suprema de un orden jurídico. La conclusión es que las reglas (...) básicas que definen las autoridades legislativas supremas de cada orden jurídico existente, son necesariamente meta-normas constitutivas con naturaleza consuetudinaria. En la segunda parte de este artículo se toman en consideración los diferentes contenidos posibles de las reglas últimas que definen la autoridad legislativa. Sobre esta base, se distinguen cuatro modelos de sistema jurídico y autoridad legislativa: los que se corresponden con la autoridad absoluta y con la autoridad moral, y los que se corresponden con el estado de derecho y con el estado constitucional. En este sentido, se ofrecen algunas consideraciones: por un lado, para hacer referencia a la específica noción de autoridad que opera dentro del estado constitucional; y, por otro lado, para formular una puntual crítica a la distinción teórica entre autoridad constituyente y autoridad constituida. Según el análisis provisto en este artículo, cada autoridad es una autoridad constituida. En particular, las autoridades legislativas supremas son constituidas por normas constitutivas consuetudinarias que están fuera del alcance de las propias autoridades y que no dependen de la decisión o de la voluntad de ningún individuo en particular. | El original en inglés de este artículo fue publicado en Revus 29: 33-60. (shrink)

Background Only a few studies have been conducted to assess physicians’ knowledge of legal standards. Nevertheless, prior research has demonstrated a dearth of medical law knowledge. Our study explored physicians’ awareness of legal provisions concerning informed consent and confidentiality, which are essential components of the physician-patient relationship of trust. -/- Methods A cross-sectional study assessed attending physicians’ legal knowledge of informed consent and confidentiality regulations. The study was conducted in nine hospitals in Dolj County, Romania. Physicians were given a questionnaire (...) with ten scenarios and instructed to select the response that best reflected their practice. We assessed the responses of physicians who claimed their practice to be entirely legal. Their legal knowledge was evaluated by comparing their answers to applicable laws. We also calculated a score for the physicians who admitted to committing a legal breach. -/- Results Of the 305 respondents, 275 declared they never committed any law violation. However, their median correct answer score was 5.35 ± 1.66 out of 10. The specialty was the strongest predictor of legal knowledge, with emergency physicians rating the lowest and non-surgical physicians scoring the highest. Physicians who worked in both private and public sectors were better knowledgeable about legal issues than those who worked exclusively in the public sector. Results indicate that physicians are aware of the patient’s right to informed consent but lack comprehensive understanding. While most physicians correctly answered simple questions, only a tiny minority identified the correct solution when confronted with ethical dilemmas. The physicians who acknowledged breaching the law, on the other hand, had a slightly higher knowledge score at 5.45 ± 2.18. -/- Conclusion Legal compliance remains relatively low due to insufficient legal awareness. Physicians display limited awareness of legal requirements governing patient autonomy, confidentiality, and access to health data. Law should be taught in all medical schools, including undergraduate programs, to increase physicians’ legal knowledge and compliance. (shrink)

This article is primarily focused on two interconnected discussions presented by John Gardner in Law as a Leap of Faith. The first one is related to the thesis which, according to Gardner, all positivists agree on; the second one is referred to the positivist’s position regarding the connection between law and morality. In order to address these issues I rely on the distinction between two kinds of criteria: the conceptual criteria and the validity criteria. On this basis, and against what (...) Gardner asserts, I try to defend two main ideas. Firstly, that the thesis on which all positivists agree is not one about the validity criteria that norms must satisfy in order to belong to a legal system, but rather one concerning the conceptual criteria delimiting the concept of law. By the same token, I argue that, according to the positivist understanding of the concept of law, there is no necessary connection between law and morality. (shrink)

Pretende-se, neste artigo, desvendar as maneiras pelas quais múltiplas formas de opressão como o racismo, o sexismo e a opressão de classes se conectam e se retroalimentam constantemente formando um só sistema de dominação-exploração. Para que se efetive uma explicação destes conceitos e suas articulações, tenciona-se trabalhar autoras e autores como Heleieth Saffioti, Silvia Federici, Lélia Gonzalez e Karl Marx. Inferiorizações de imensos contingentes populacionais como mulheres e pessoas negras têm sido produzidas e reproduzidas constantemente dentro do modo de produção (...) capitalista com a finalidade de hierarquizar, dividir e mais explorar a classe trabalhadora. Estes elementos fazem com que não seja possível compreender uma opressão separadamente do todo, assim como não é possível falar de opressões atuais sem explicitar o significado do modo de produção capitalista. (shrink)

Reason and rationality represent crucial elements of the self-image of human beings and have unquestionably been among the most debated issues in Western philosophy, dating from ancient Greece, through the Middle Ages, and to the present day. Many words and thoughts have already been spent trying to define the nature and standards of reason and rationality, what they could or ought to be, and under what conditions something can be said to be rational. This volume focuses instead on the relationships (...) of reason and rationality to some relevant specific topics, i.e., science, knowledge, gender, politics, ethics, religion, aesthetics, language, logic, and metaphysics, trying to uncover and clarify both the connections and differences in their various characterisations and uses. (shrink)