In quantum mechanics, the wavefunction predicts probabilities of possible measurement outcomes, but not which individual outcome is realised in each run of an experiment. This suggests that it describes an ensemble of states with different values of a hidden variable. Here, we analyse this idea with reference to currently known theorems and experiments. We argue that the ψ-ontic/epistemic distinction fails to properly identify ensemble interpretations and propose a more useful definition. We then show that all local ψ-ensemble interpretations which reproduce (...) quantum mechanics violate Statistical Independence. Theories with this property are commonly referred to as superdeterministic or retrocausal. Finally, we explain how this interpretation helps make sense of some otherwise puzzling phenomena in quantum mechanics, such as the delayed choice experiment, the Elitzur-Vaidman bomb detector, and the Extended Wigner's Friends Scenario. (shrink)

Bell’s theorem is often said to imply that quantum mechanics violates local causality, and that local causality cannot be restored with a hidden-variables theory. This however is only correct if the hidden-variables theory fulfils an assumption called Statistical Independence. Violations of Statistical Independence are commonly interpreted as correlations between the measurement settings and the hidden variables. Such correlations have been discarded as “fine-tuning” or a “conspiracy”. We here point out that the common interpretation is at best physically ambiguous and at (...) worst incorrect. The problem with the common interpretation is that Statistical Independence might be violated because of a non-trivial measure in state space, a possibility we propose to call “supermeasured”. We use Invariant Set Theory as an example of a supermeasured theory that violates the Statistical Independence assumption in Bell’s theorem without requiring correlations between hidden variables and measurement settings. (shrink)

Die Frage der »guten Behandlung im Alter« gehört zu den Schlüsselthemen unserer Gesellschaft. Wie können wir gute Pflege für ältere Menschen, eine adäquate medizinische Versorgung im Alter und ganz allgemein Generationengerechtigkeit erreichen? Wie kann Inklusion auch für Menschen mit Demenz oder stigmatisierenden psychischen Erkrankungen erreicht werden? Dieser Band versammelt Expert*innen aus Philosophie, Soziologie, Medizin, Ethik, Psychogerontologie und Pflegewissenschaft sowie weiteren Feldern, die Möglichkeiten gelingender Therapie für Ältere - und damit auch Grundfragen von Menschenrechten und Ethik auf allen gesellschaftlichen Ebenen - (...) diskutieren. (shrink)

We study L∞κ-freeness in the variety of Boolean algebras. It is shown that some of the theorems on L∞κ-free algebras which are known to hold in varieties such as groups, abelian groups etc. are also true for Boolean algebras. But we also investigate properties such as the ccc of L∞κ-free Boolean algebras which have no counterpart in the varieties above.

To organise future behaviour, it is important to remember both the central and contextual aspects of a situation. We examined the impact of contextual threat or safety, learned through verbal instructions, on face identity recognition. In two studies (N = 140), 72 face–context compounds were presented each once within an encoding session, and an unexpected item/source recognition task was performed afterwards (including 24 new faces). Hierarchical multinomial processing tree modelling served to estimate individual parameters of item (face identity) and source (...) memory (threat or safety context) as well as guessing behaviour. Results show that language was highly effective in establishing threatening and safe context conditions. In Study 1, a fleeting picture stream (1 s per picture) led to poor item and source recognition. Prolonged presentation times (Study 2 with 6 s per picture) improved face memory but no contextual modulation was observed. Thus, incidental face learning was surprisingly poor and rapidly changing contextual settings might have interfered with the accurate encoding of face identity information and item–source binding. (shrink)

Background Artificial intelligence (AI) has revolutionized various healthcare domains, where AI algorithms sometimes even outperform human specialists. However, the field of clinical ethics has remained largely untouched by AI advances. This study explores the attitudes of anesthesiologists and internists towards the use of AI-driven preference prediction tools to support ethical decision-making for incapacitated patients. Methods A questionnaire was developed and pretested among medical students. The questionnaire was distributed to 200 German anesthesiologists and 200 German internists, thereby focusing on physicians who (...) often encounter patients lacking decision-making capacity. The questionnaire covered attitudes toward AI-driven preference prediction, availability and utilization of Clinical Ethics Support Services (CESS), and experiences with ethically challenging situations. Descriptive statistics and bivariate analysis was performed. Qualitative responses were analyzed using content analysis in a mixed inductive-deductive approach. Results Participants were predominantly male (69.3%), with ages ranging from 27 to 77. Most worked in nonacademic hospitals (82%). Physicians generally showed hesitance toward AI-driven preference prediction, citing concerns about the loss of individuality and humanity, lack of explicability in AI results, and doubts about AI’s ability to encompass the ethical deliberation process. In contrast, physicians had a more positive opinion of CESS. Availability of CESS varied, with 81.8% of participants reporting access. Among those without access, 91.8% expressed a desire for CESS. Physicians' reluctance toward AI-driven preference prediction aligns with concerns about transparency, individuality, and human-machine interaction. While AI could enhance the accuracy of predictions and reduce surrogate burden, concerns about potential biases, de-humanisation, and lack of explicability persist. Conclusions German physicians frequently encountering incapacitated patients exhibit hesitance toward AI-driven preference prediction but hold a higher esteem for CESS. Addressing concerns about individuality, explicability, and human-machine roles may facilitate the acceptance of AI in clinical ethics. Further research into patient and surrogate perspectives is needed to ensure AI aligns with patient preferences and values in complex medical decisions. (shrink)

Mit der Vielzahl von Daten aus genetischen Untersuchungsverfahren wächst das Problem von „Zufallsbefunden“, d. h. von zufällig erhobenen Nebenbefunden, die mit der ursprünglichen Fragestellung nicht in Verbindung stehen und dennoch eine Bedeutung für Gesundheit und Reproduktionsverhalten der untersuchten Person selbst oder ihrer Anverwandten haben. In Ermangelung nationaler oder internationaler Richtlinien greifen die Autoren die aktuelle Diskussion um den Umgang mit genetischen Zufallsbefunden in Behandlungs- und Forschungskontext auf. Dabei nehmen sie auf die für Deutschland relevanten rechtlichen und ethischen Rahmenbedingungen Bezug. Nach (...) Gendiagnostikgesetz (GenDG) muss in Deutschland im Rahmen eines Behandlungsvertrages auf die Möglichkeit von Zufallsbefunden hingewiesen werden. Es ist Bestandteil der Aufklärung und Einwilligung, inwieweit Zufallsbefunde mitgeteilt werden, wobei das Recht auf Nichtwissen und der Schutz nicht-einwilligungsfähiger Personen berücksichtigt werden müssen. Im Forschungskontext greift das GenDG nicht, aber auch hier sollte über mögliche Zufallsbefunde aufgeklärt werden, wenngleich eine Rückmeldung nicht zwingend, aber bei Befunden mit hohem klinischen Nutzen ethisch geboten sein kann. Folgende Aspekte sind im Umgang mit Zufallsbefunden zu berücksichtigen: 1) Art und Umfang der Aufklärung und Einwilligung bei einer unüberschaubaren Zahl von möglichen Befunden. 2) Einordnung der klinischen Bedeutung einer genetischen Veränderung im Sinne von gesichertem, wahrscheinlichem, möglichem oder fraglichem/unbekanntem klinischen Nutzen. 3) Prozessierung des Informationsrückflusses für Gegenwart und Zukunft. 4) Ressourcenplanung im Hinblick auf die klinische Validierung, die Erläuterung von Befunden und den Transfer in die klinische Praxis. Im Umgang mit genetischen Zufallsbefunden besteht erheblicher empirisch-ethischer Forschungs- und politischer Regelungsbedarf. Zeitgleich ist es unabdingbar, die Wahrnehmung und das Verständnis der untersuchten Personen sowie die Grundhaltung gegenüber Zufallsbefunden im Rahmen von Studien zu beleuchten und entsprechende Bildungs- und Kommunikationswerkzeuge zu entwickeln. (shrink)

Physicians frequently encounter situations in which their professional practice is intermingled with moral affordances stemming from other domains of the physician’s lifeworld, such as family and friends, or from general morality pertaining to all humans. This article offers a typology of moral conflicts ‘at the margins of professionalism’ as well as a new theoretical framework for dealing with them. We start out by arguing that established theories of professional ethics do not offer sufficient guidance in situations where professional ethics overlaps (...) with moral duties of other origins. Therefore, we introduce the moral theory developed by Christine M. Korsgaard, that centres around the concept of practical identity. We show how Korsgaard’s account offers a framework for interpreting different types of moral conflicts ‘at the margins of professionalism’ to provide either orientation for solving the conflict or an explanation for the emotional and moral burden involved in moral dilemmas. (shrink)

BackgroundPublic involvement activities are promoted as measures for ensuring good governance in challenging fields, such as biomedical research and innovation. Proponents of public involvement activities include individual researchers as well as non-governmental and governmental organizations. However, the concept of ‘public’ in public involvement deserves more attention by researchers because it is not purely theoretical: it has important practical functions in the guidance, evaluation and translation of public involvement activities.DiscussionThis article focuses on collective agency as one property a public as a (...) small group of participants in a public involvement activity could exhibit. It introduces a prominent theoretical approach to collective agents as one specific kind of social entities and demonstrates how this approach can be applied to current practice in public involvement activities. A brief discussion of different types of representation as they are used in the existing literature on this topic is also included because representation and collective agency can be closely related to each other. Suggestions and ideas that are derived from this reasoning include the proposal to use a ‘validity check’ for the generation of collective agents as a regular element of certain types of public involvement activities, the consequences of combining collective agency and representativeness as a further property a public could exhibit, and standards for reporting the content of public involvement activities in scientific publications.SummaryThis article discusses the importance of the concept of ‘public’ in public involvement activities, with a focus on biomedical research and innovation. It introduces various practically relevant ideas that are based on a theoretical analysis of collective agency as an important property a public can possess. (shrink)

We are extremely grateful for the insightful and thought-provoking commentaries on our feature article.1 We have distilled four themes emerging from the commentaries, and we would also like to address one misunderstanding of our argument that has appeared. In our article, we explicitly acknowledge that major decisions relevant for climate protection take place at the mesolevels and macrolevels of healthcare, a point raised again in some of the commentaries.2–4 Climate protection is a societal issue, and we thank these authors for (...) the concrete proposals of potential models to guide action. Yet, to us, it still makes sense to reflect simultaneously on the responsibilities that physicians have themselves. Without wanting to put the main responsibility on them, we argue it is important to start thinking about the scope of action that physicians actually have (or not have). As we have argued the need for climate action comes ever more into focus of society, we wanted to explore whether the professional ethics of the medical professionals needs to be amended. Our argument is that this is the case, based on the reasons that climate change has a big health impact while simultaneously the health system has a strong climate impact. Based on the World Medical Association (WMA) Declaration of Geneva the focus on the individual patient is clear, but this and other important codices do also include a public health perspective. The (model) Professional Code for Physicians in Germany, for example, states in its first article that ‘Physicians serve the health of …. (shrink)

The anonymous treatise De sex inconvenientibus is a good example of the calculatores’ approach when dealing with motion. It is organized around four main questions relating to the determination of rapidity in four kinds of changes, i.e. in the generation of substantial forms, in alteration, in increase, and in local motion. In some arguments the author points out the paradoxes to which the two ways of determining the rapidity of a motion can lead: rapidity is determined by the effect produced (...) (the degree of quality generated, the space covered, etc.) or it results from the ratio between the moving power and the resistance of the mobile or patient. While this twofold approach to determining rapidity appears in the majority of calculator texts, the two points of view – the analysis according to its effects and the analysis according to its causes – have rarely been confronted. (shrink)

Recent philosophical work on children and childhood has revealed many new questions concerning minors’ rights. This special issue of Moral Philosophy and Politics offers new contributions to the topics of paternalism, the nature of the right to parent and children’s voting. It also contains articles about the so far less explored questions of adolescents’ parental rights, minors’ rights against the harms of parental imprisonment, and their right to veto their own parents’ decision to relocate.

This paper reviews the main pricing policies in Latin American countries, discussing their shortcomings. It also gives an overview of the most common pricing and reimbursement policies in Europe and describes in detail three well-established approaches — international price referencing, value-based pricing, including setting up of health technology assessment, and generic and biosimilar policies — building on country examples.

Giorgia Pozzi’s feature article1 on the risks of testimonial injustice when using automated prediction drug monitoring programmes (PDMPs) turns the spotlight on a pressing and well-known clinical problem: physicians’ challenges to predict patient behaviour, so that treatment decisions can be made based on this information, despite any fallibility. Currently, as one possible way to improve prognostic assessments of patient behaviour, Machine Learning-driven clinical decision support systems (ML-CDSS) are being developed and deployed. To make her point, Pozzi discusses ML-CDSSs that are (...) supposed to deliver physicians an accurate estimation of the likelihood of narcotic, sedative and stimulant opioid misuse by a given patient (like, e.g., ‘NarxCare’). Regarding cases of deviating assessment between human evaluators and automated systems, the medico-ethical discussion has so far mainly focused on disagreement between clinicians and Machine Learning (ML) algorithms,2 for example in ‘second opinions’ that have been reconstructed as disagreements between physician testimony and ML-CDSS testimony.3 Examples such as those of PDMPs, by contrast, draw attention to situations in which patient testimony potentially contradicts ML-CDSS testimony. Pozzi examines decision-making situations in which ML-CDSS testimony factually overrides the testimony of the person affected. Thus, in the presented case of patient Kathryn, the testimony of her own physical and mental condition was insufficient to overturn the unfavourable outcome for …. (shrink)

Pour chaque volume de la collection Lectures de..., l'éditeur a fait appel aux universitaires les plus éminents dans le souci d'offrir au public francophone un ensemble d'études, hors de tout parti pris, sur les principaux philosophes de l'Antiquité à nos jours. Longtemps tenu pour un auteur ésotérique, Wittgenstein est aujourd'hui une référence centrale dans la vie intellectuelle, et il ne s'agit plus d'un simple effet de mode. Son oeuvre est présente dans le paysage international, non seulement en philosophie, mais aussi (...) en sciences humaines et sociales : la sociologie, l'anthropologie, la philosophie du droit et de l'économie s'en inspirent. Elle a largement débordé le monde anglophone, où elle façonne une partie de la réflexion depuis plus d'un demi-siècle. Pourtant, l'appréhension philosophique de cette oeuvre est loin d'être univoque, puisque l'on a assisté, depuis la mort de Wittgenstein en 1951, à une série de lectures divergentes de ses textes, dont les plus prégnantes méritent d'être ici expliquées. Les points de vue sur Wittgenstein se sont par ailleurs multipliés : d'abord lu dans les années 1950-1960 comme philosophe avant tout logicien, en fonction du Tractatus et dans le sillage de ses maîtres Frege et Russell, comme mystique ou comme philosophe du langage, au vu de sa "seconde" philosophie, il apparaît ensuite comme l'auteur d'une oeuvre complexe et multidimensionnelle touchant à des questions de philosophie générale (expérience, signification, réalité, etc.). Le présent ouvrage se donne pour tâche de cartographier ce réseau complexe qu'est la philosophie de Wittgenstein, d'abord en présentant les grands textes et les thèmes majeurs qui ont jalonné son parcours philosophique, puis en introduisant aux différentes lectures qui en ont été proposées dans la tradition interprétative. (shrink)

A myriad of sensations inform and direct us when we engage with the environment. To understand their influence on the development of our habitus it is important to focus on unifying processes in sensing. This approach allows us to include phenomena that elude a rather narrow view that focuses on each of the five discrete senses in isolation. One of the central questions addressed in this volume is whether there is something like a sensual habitus, and if there is, how (...) it can be defined. This is especially done by exploring the formation and habituation of the senses in and by a culturally shaped habitat. Two key concepts, Synaesthesia and Kinaesthetics, are addressed as essential components for an understanding of the interface of habitat and the rich and multisensory experience of a perceiving subject. At a Berlin-based conference Synaesthesia and Kinaesthetics, scholars from various disciplines gathered to discuss these issues. In bringing together the outcome of these discussions, this book gives new insights into the key phenomena of sensory integration and synaesthetic experiences, it enriches the perspectives on sensually embedded interaction and its habituation, and it expands this interdisciplinary inquiry to questions about the cultures of sensory habitus. (shrink)

This qualitative study investigated the personal and professional stances of 40 health and social care professionals confronted with assisted suicide of older persons living in nursing homes or supported by social welfare or home care and support services in French-speaking Switzerland. Requests of assisted suicide triggered questions with regard to the professional mission, the quality of accompaniment, values, and ethical principles. Four types of stances emerged from the analysis performed according to the principles of the grounded theory: favorable in principle, (...) professional compromise, personal compromise, and opposed in principle. Each stance results from the combination of several dimensions: personal or professional concordance or compatibility with assisted suicide; implication in, and impact of, the process; appreciation of the process; and satisfaction with the resources at disposal. The differentiated stances adopted by professionals depend largely on their way of interpreting their mission, deontology, and the relationship to the older person. (shrink)

The umbrella-term ‘executive functions’ includes various domain-general, goal-directed cognitive abilities responsible for behavioral self-regulation. The influential unity and diversity model of EF posits the existence of three correlated yet separable executive domains: inhibition, shifting and updating. These domains may be influenced by factors such as socioeconomic status and culture, possibly due to the way EF tasks are devised and to biased choice of stimuli, focusing on first-world testees. Here, we propose a FREE test battery that includes two open-access tasks for (...) each of the three abovementioned executive domains to allow latent variables to be obtained. The tasks were selected from those that have been shown to be representative of each domain, that are not copyrighted and do not require special hardware/software to be administered. These tasks were adapted for use in populations with varying SES/schooling levels by simplifying tasks/instructions and using easily recognized stimuli such as pictures. Items are answered verbally and tasks are self-paced to minimize interference from individual differences in psychomotor and perceptual speed, to better isolate executive from other cognitive abilities. We tested these tasks on 146 early adolescents of both sexes and varying SES, because this is the age group in which the executive domains of interest become distinguishable and in order to confirm that SES effects were minimized. Performance was determined by Rate Correct Scores, which consider speed-accuracy trade-offs. Scores were sensitive to the expected improvement in performance with age and rarely/inconsistently affected by sex and SES, as expected, with no floor or ceiling effects, or skewed distribution, thus suggesting their adequacy for diverse populations in these respects. Using structural equation modeling, evidence based on internal structure was obtained by replicating the three correlated-factor solution proposed by the authors of the model. We conclude that the FREE test battery, which is open access and described in detail, holds promise as a tool for research that can be adapted for a wide range of populations, as well as altered and/or complemented in coming studies. (shrink)

There is much debate on how social values should influence scientific research. However, the question of practical applicability of philosophers’ normative proposals has received less attention. Here, we test the attainability of Matthew J. Brown’s (2020) Moral Imagination ideal (MI ideal), which aims to help scientists to make warranted value-judgements through reflecting on goals, options, values, and stakeholders of research. Here, the tools of the MI ideal are applied to a climate modelling setting, where researchers are developing aerosol-cloud interaction (ACI) (...) parametrizations in an Earth System Model with the broader goal of improving climate sensitivity estimation. After the identification of minor obstacles to applying the MI ideal, we propose two ways to increase its applicability. First, its tools should be accompanied with more concrete guidance for identifying how social values enter more technical decisions in scientific research. Second, since research projects can have multiple goals, examining the alignment between broader societal aims of research and more technical goals should be part of the tools of the MI ideal. (shrink)

Gender inequalities in education – in terms of systematic variations in access to educational institutions, in competencies, school marks, and educational certificates along the axis of gender – have tremendously changed over the course of the 20 th century. Although this does not apply to all stages and areas of the educational career, it is particularly obvious looking at upper secondary education. Before the major boost of educational expansion in the 1960s, women’s participation in upper secondary general education, and their (...) chances to successfully finish this educational pathway, have been lower than men’s. However, towards the end of the 20 th century, women were outperforming men in many European countries and beyond. The international contributions to this book attempt to shed light on the mechanisms behind gender inequalities and the changes made to reduce this inequality. Topics explored by the contributors include gender in science education in the UK; women’s education in Luxembourg in the 19 th and 20 th century; the ‘gender gap’ debates and their rhetoric in the UK and Finland; sociological perspectives on the gender-equality discourse in Finland; changing gender differences in West Germany in the 20 th century; the interplay of subjective well-being and educational attainment in Switzerland; and a psychological perspective on gender identities, gender-related perceptions, students’ motivation, intelligence, personality, and the interaction between student and teacher gender. This book was originally published as a special issue of _Educational Research. _. (shrink)

This volume represents the state of the art in research on the controversial Muslim legal scholar, theologian and man of letters Ibn azm of Cordoba (d. 456/1064), who is widely regarded as one of the most brilliant minds of Islamic Spain.

The auditory system is able to recognize auditory objects and is thought to form predictive models of them even though the acoustic information arriving at our ears is often imperfect, intermixed, or distorted. We investigated implicit regularity extraction for acoustically intact versus disrupted six-tone sound patterns via event-related potentials. In an exact-repetition condition, identical patterns were repeated; in two distorted-repetition conditions, one randomly chosen segment in each sound pattern was replaced either by white noise or by a wrong pitch. In (...) a roving-standard paradigm, sound patterns were repeated 1–12 times in a row before a new pattern occurred. The participants were not informed about the roving rule and had to detect rarely occurring loudness changes. Behavioral detectability of pattern changes was assessed in a subsequent behavioral task. Pattern changes elicited mismatch negativity and P3a, and were behaviorally detected above the chance level in all conditions, suggesting that the auditory system extracts regularities despite distortions in the acoustic input. However, MMN and P3a amplitude were decreased by distortions. At the level of MMN, both types of distortions caused similar impairments, suggesting that auditory regularity extraction is largely determined by the stimulus statistics of matching information. At the level of P3a, wrong-pitch distortions caused larger decreases than white-noise distortions. Wrong-pitch distortions likely prevented the engagement of restoration mechanisms and the segregation of disrupted from true pattern segments, causing stronger informational interference with the relevant pattern information. (shrink)