In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are tailored (...) to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. (shrink)

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

Moral deliberation has been receiving more attention in nursing ethics. Several ethical conversation models have been developed. This article explores the feasibility of the so-called CARE (Considerations, Actions, Reasons, Experiences) model as a framework for moral deliberation in psychiatric nursing practice. This model was used in combination with narrative and dialogical approaches to foster discourse between various stakeholders about coercion in a closed admission clinic in a mental hospital in the Netherlands. The findings demonstrate that the CARE model provides a (...) substantial framework for structuring moral deliberations. Narratives and dialogue are useful tools for broadening issues in conversations, to engage various stakeholders (including patients), and to gain shared understandings. (shrink)

It is not uncommon that nurses are unable to meet the normative expectations of chronically ill patients. The purpose of this article is to describe and illustrate Walker’s expressive-collaborative view of morality to interpret the normative expectations of two women with multiple sclerosis. Both women present themselves as autonomous persons who make their own choices, but who also have to rely on others for many aspects of their lives, for example, to find a new balance between work and social contacts (...) or to find work. We show that their narratives of identity, relationship and value differ from the narratives that others use to understand and identify them. Since identities, relationships and values give rise to normative expectations, in both cases there is a conflict between what the women expect of their caregivers and vice-versa. The narratives also show that two similar persons with multiple sclerosis may need very different care. This implies that nurses caring for such persons should listen carefully to their stories and reflect on their own perceptions of self. (shrink)

While parents have long received guidance on how to raise children, a relatively new element of this involves explicit references to infant brain development, drawing on brain scans and neuroscientific knowledge. Sometimes called ‘brain-based parenting’, this has been criticised from within sociological and policy circles alike. However, the engagement of parents themselves with neuroscientific concepts is far less researched. Drawing on 22 interviews with parents/carers of children (mostly aged 0–7) living in Scotland, this article examines how they account for their (...) (non-)use of concepts and understandings relating to neuroscience. Three normative tropes were salient: information about children’s processing speed, evidence about deprived Romanian orphans in the 1990s, and ideas relating to whether or not children should ‘self-settle’ when falling asleep. We interrogate how parents reflexively weigh and judge such understandings and ideas. In some cases, neuroscientific knowledge was enrolled by parents in ways that supported biologically reductionist models of childhood agency. This reductionism commonly had generative effects, enjoining new care practices and producing particular parent and infant subjectivities. Notably, parents do not uncritically adopt or accept (sometimes reductionist) neurobiological and/or psychological knowledge; rather, they reflect on whether and when it is applicable to and relevant for raising their children. Thus, our respondents draw on everyday epistemologies of parenting to negotiate brain-based understandings of infant development and behaviour, and invest meaning in these in ways that cannot be fully anticipated (or appreciated) within straightforward celebrations or critiques of the content of parenting programmes drawing on neuropsychological ideas. (shrink)

John Bell showed that a big class of local hidden-variable models stands in conflict with quantum mechanics and experiment. Recently, there were suggestions that empirically adequate hidden-variable models might exist which presuppose a weaker notion of local causality. We will show that a Bell-type inequality can be derived also from these weaker assumptions.

Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and (...) from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge (embodied, experiential, visual, and cognitive-scientific). In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves. (shrink)

In their contribution, Wiggins and Wilbanks (2019) discuss the rise of citizen science and elaborate on several ethical issues that go beyond standard approaches in research ethics. They rightly sa...

This article analyses Averroes/Ibn Rushd´s (d. 1198) views on motherhood in his commentary on Plato´s Republic. The starting point for this inquiry is Averroes´ comparison of the women in his society to plants. Averroes argues that performing the duties of motherhood, i.e. being children´s primary caregiver, does not constitute nor involve any form of human virtue. Averroes´ low esteem for activities of motherhood has hitherto been ignored. This paper argues that the comparison of women to plants does not hinge on (...) societal criticism solely but on at least two additional factors: Aristotle on plants in De Anima and on this low appreciation for tasks of parenthood. Furthermore, this paper aims to show that the latter is incompatible with Aristotle´s views in his ethics and biology, which emphasize, respectively, the friendship that characterizes the parent-child relationship and the intelligence and virtue needed to raise the next generation. (shrink)

In Western societies, participation is promoted as fundamental right of citizens and a prerequisite for better health and quality of life. Over the last 10 years, individual parti-cipation in treat...

In this book Otfried Hoffe provides a comprehensive introduction to the life and work of Aristotle, covering well-known Aristotelian topics such as ethics, ...

Participation of older people in designing and improving the care and services provided in residential care settings is limited. Traditional forms of democratic representation, such as client councils, and consumer models are management-driven. An alternative way of involving older people in the decisions over their lives, grounded in notions of care ethics and deliberative democracy, was explored by action research. In line with this tradition older people engage in collective action to enhance the control over their lives and those of (...) others. In this article the theoretical background of altruistic action is presented and illustrated by a case example of a group of older women who changed the food policies within their residential home. Altruistic action is the joint and coordinated action by a group of clients based on their agenda. Such action is given in by a shared dissatisfaction and search for connections. Altruistic action may enhance the sense of self, belonging and ownership, and create a transformative movement enhancing the wellbeing and community life in residential settings. (shrink)

A teoria da justiça política, segundo Hóffe, fundamentada na justiça comutativa, sustenta que a fundamentação das reivindicações normativas da sociedade na comunidade discursiva, como o fazem Apel e Habermas em sua ética do discurso, é apenas uma fundamentação derivada, pois a comunidade discursiva necessariamente pressupõe direitos humanos. Por sua vez, a ética do discurso argumenta que os direitos humanos só podem ser legitimados através do discurso. Este artigo mostra que o pressuposto normativo tanto para a comunidade discursiva quanto para o (...) princípio da justiça comutativa é que todos os seres humanos são autorizados a uma partilha do mundo. Somente através desta premissa de uma justiça distributiva pode haver parceiros capazes de exercer reciprocidade e participantes do discurso que também tenham algo sobre o que tenham de decidir juntos. (shrink)

Dans « Unsettling the Coloniality of Being/Power/Truth/Freedom », Sylvia Wynter soutient que l’auto-cognition humaine de l’Europe occidentale a pris une forme adaptative pour servir ce qu’elle appelle « Man 1 » (le sujet libre, rationnel et politique) et « Man 2 » (le sujet bioéconomique). Selon Wynter, il serait nécessaire de faire advenir une forme d’auto-cognition humaine non adaptative et universelle, n’excluant pas la majorité de l’humanité, et qu’elle appelle homo narrans. Je soutiens que la distinction établie par Wynter entre (...) l’adaptatif et le non-adaptatif est cruciale, tout comme la nécessité de considérer les conséquences oppressives, pour le contact interculturel, de l’adaptatif. Je montre que ses arguments résonnent de manière significative avec les idées centrales de la vie éthique et de l’esprit absolu chez Hegel, et je fais référence à ces idées clés pour renforcer ses objectifs critiques, tout en suggérant de réviser son analyse de la manière dont ces modes de connaissance opèrent dans la culture humaine. Je soutiens que les pratiques de l’ homo narrans, en tant que pratiques de l’esprit absolu, sont toujours immanentes à la spécificité concrète des domaines que nous expérimentons comme notre chez-soi, et qui encourage l’adaptation dans la connaissance. Je soutiens de plus que nous mettons en œuvre des pratiques de transcendance précisément en prêtant attention à leur caractère corruptible et en favorisant le développement des contextes concrets dans lesquels elles s’inscrivent. Enfin, je me tourne vers la conception de l’ homo narrans en analysant la manière dont Hegel rend compte de la tragédie antique et moderne, et en montrant comment l’activité expressive est une capacité à raconter de nouvelles histoires qui reconfigurent les relations de l’humain avec le monde et avec lui-même, et ainsi les transforment continuellement. (shrink)

Media reporting of science has consequences for public debates on the ethics of research. Accordingly, it is crucial to understand how the sciences of the brain and the mind are covered in the media, and how coverage is received and negotiated. The authors report here their sociological findings from a case study of media coverage and associated reader comments of an article from Annals of Neurology. The media attention attracted by the article was high for cognitive science; further, as associates/members (...) of the Centre where it was produced, the authors of the research reported here had rare insight into how the scientists responsible for the Annals of Neurology article interacted with the media. The data corpus included 37 news items and 228 readers’ comments, examined via qualitative thematic analysis. Media coverage of the article was largely accurate, without merely copying the press release. Analysis of reader comments showed these to be an important resource for considering issues of import to neuroethics scholars, as well as to scientists themselves. In particular, the findings demonstrate how personal experiences were vital in shaping readers’ accounts of their agreements with the scientific article. Furthermore, the data show how scientific research can catalyse political discussions in ways likely unanticipated by scientists. The analysis indicates the importance of dialogue between journalists, laboratory scientists and social scientists in order to support the communication of the messages researchers intend. (shrink)

In the Apophthegmata Erasmus presents a great number of famous sayings of famous people from Classical Antiquity, which he culled from Plutarch and paraphrased or loosely translated into Latin.

ABSTRACTSince its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and (...) from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge . In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves. (shrink)

In Western countries a considerable number of older people move to a residential home when their health declines. Institutionalization often results in increased dependence, inactivity and loss of identity or self-worth (dignity). This raises the moral question as to how older, institutionalized people can remain autonomous as far as continuing to live in line with their own values is concerned. Following Walker's meta-ethical framework on the assignment of responsibilities, we suggest that instead of directing all older people towards more autonomy (...) in terms of independence, professional caregivers should listen to the life narrative of older people and attempt to find out how their personal identity, relations and values in life can be continued in the new setting. If mutual normative expectations between caregivers and older people are not carefully negotiated, it creates tension. This tension is illustrated by the narrative of Mr Powell, a retired successful public servant now living in a residential home. The narrative describes his current life, his need for help, his independent frame of mind, and his encounters with institutional and professional policies. Mr Powell sees himself as a man who has always cared for himself and others, and who still feels that he has to fulfil certain duties in life. Mr Powell's story shows that he is not always understood well by caregivers who respond from a one-sided view of autonomy as independence. This leads to misunderstanding and an underestimation of his need to be noticed and involved in the residential community. (shrink)

In nursing ethics the role of narratives and dialogue has become more prominent in recent years. The purpose of this article is to illuminate a relational-narrative approach to ethics in the context of palliative nursing. The case study presented concerns a difficult relationship between oncology nurses and a husband whose wife was hospitalized with cancer. The husband’s narrative is an expression of depression, social isolation and the loss of hope. He found no meaning in the process of dying and death. (...) The oncology nurses were not able to recognize his emotional and existential problems. A narrative perspective inspired by relational ethics indicates that participants may develop a relational narrative that seeks good for all involved in a situation. In palliative nursing this entails open communication about the fragility of life and approaching death. In relational narratives, answers to these ethical dilemmas are co-authored, contingent and contextual. (shrink)

Institute of Theoretical Physics, Exact Sciences Sidlerstrasse 5, University of Bern, CH-3012 Bern Switzerland portmann{at}itp.unibe.ch' + u + '@' + d + ''//--> awuethr{at}itp.unibe.ch' + u + '@' + d + ''//--> John Bell showed that a big class of local hidden-variable models stands in conflict with quantum mechanics and experiment. Recently, there were suggestions that empirically adequate hidden-variable models might exist which presuppose a weaker notion of local causality. We will show that a Bell-type inequality can be derived also (...) from these weaker assumptions. Introduction The EPR-Bohm experiment Local causality Bell's inequality from separate common causes 4.1 A weak screening-off principle 4.2 Perfect correlation and ‘determinism’ 4.3 A minimal theory for spins 4.4 No conspiracy Discussion. (shrink)

This article deals with the question of how ethicists respond to practical moral problems emerging in health care practices. Do they remain distanced, taking on the role of an expert, or do they become engaged with nurses and other participants in practice and jointly develop contextualized insights about good care? A basic assumption of dialogical ethics entails that the definition of good care and what it means to be a good nurse is a collaborative product of ongoing dialogues among various (...) stakeholders engaged in the practice. This article discusses the value of a dialogical approach to ethics by drawing on the work of various nursing scholars. We present a case example concerning the quality of freedom restrictions for intellectually disabled people. Issues for discussion include the role and required competences of the ethicist and dealing with asymmetrical relationships between stakeholders. (shrink)

Die größte politische Errungenschaft seit dem Zweiten Weltkrieg, die Europäische Union, sieht sich mit enormen Herausforderungen konfrontiert, die einen erneuten Europadiskurs erforderlich machen. Auf der einen Seite wollen immer mehr Länder der Union beitreten, neuerdings die Ukraine und Moldau. Weitere Länder wie Serbien und Montenegro führen seit bald zehn Jahren Beitrittsgespräche, ohne daß sich der Abschluss abzeichnete. Auf der anderen Seite wird die bestehende Union nicht nur von europafeindlichen Bewegungen bedroht, sondern verstoßen auch einige Länder gegen die europäischen Grundwerte, auf (...) die sie sich mit dem Beitritt zur Union verpflichtet hatten. Nicht zuletzt ist ein so bedeutendes europäisches Land wie das Vereinigte Königreich aus der Union ausgetreten und sind so wichtige Staaten wie Island, Norwegen und die Schweiz der Union erst gar nicht beigetreten. Diese Phänomene mahnen zur Bescheidenheit. Die Union muß einsehen, dass Europa in politischer, auch in wissenschaftlicher und kultureller Hinsicht in weit mehr als lediglich der Union besteht. Die teils gedankenlose, teils durchaus imperialistische Gleichsetzung unseres Kontinents mit der Union ist aufzugeben.Jedenfalls ist es an der Zeit, den Europadiskurs in der nicht bloß wirtschaftlichen, sondern auch gesellschaftlichen, politischen, insbesondere auch in der kulturellen Vielfalt und in jener Gründlichkeit zu erneuern, den die für uns existentiell überragende Sache, Europa, verdient. (shrink)

The topic of this paper concerns corporate responsibility and worker safety. In particular it focuses on the notions of willing and intending and how these relate to risk-taking in the workplace. I discuss the metaphysical status of the corporation, the distinction between willing and intending and the motivations of each, and Austin's distinction between accidents and mistakes in light of a single industrial accident which occurred at the Texaco Oil Refinery, Port Arthur, Texas, in October, 1982. My aim is to (...) argue that corporations do not alleviate themselves from moral responsibility in the workplace solely because they might not intend to produce harm in a given situation. (shrink)

Many feminist and other interpreters of the Phenomenology of Spirit have misconstrued the motive behind Hegel’s representation of ethical life and his assessment of Antigone’s agency in its downfall. Upon developing an alternative interpretation, based on Hegel’s challenge of ethical life’s purportedly immediate reading of the meaning of sexual difference, this paper assesses several prominent feminist interpretations in its light. Hegel’s critique of the unstable and unsustainable relationship between nature and law, or sexual difference and legal identification, is shown to (...) constitute a valuable resource for contemporary feminist and legal approaches to the politically volatile negotiation of nature and culture and the critique and elaboration of law. (shrink)

This paper aims to illuminate the ongoing significance of Locke’s political philosophy. It argues that the legitimacy of political authority lies, for Locke, in the extent to which it collaborates with individuals so as to allow them to be themselves more effectively, and in its answerability in principle to the consent such individuals should thereby give it. The first section discusses how the free will inevitably asserts its authority; the second shows the inevitability of the will’s incorporation of authority as (...) a kind of prosthesis, which in turn transforms the operation of the will; and the third treats the issue of consent, arguing that Locke is less interested in individual acts of consent than in the ways in which structures of authority reflect their answerability to consent by being shaped so as to honour the beings whose capacity to consent is definitive for them. (shrink)

Anyone interested in theories of moral or human practice will find in Aristotle’s Nicomachean Ethics one of the few basic models relevant through to today.

Perfect adaptation in a dynamical system is the phenomenon that one or more variables have an initial transient response to a persistent change in an external stimulus but revert to their original value as the system converges to equilibrium. With the help of the causal ordering algorithm, one can construct graphical representations of dynamical systems that represent the causal relations between the variables and the conditional independences in the equilibrium distribution. We apply these tools to formulate sufficient graphical conditions for (...) identifying perfect adaptation from a set of first-order differential equations. Furthermore, we give sufficient conditions to test for the presence of perfect adaptation in experimental equilibrium data. We apply this method to a simple model for a protein signalling pathway and test its predictions in both simulations and using real-world protein expression data. We demonstrate that perfect adaptation can lead to misleading orientation of edges in the output of causal discovery algorithms. (shrink)

Psychiatrisches Handeln sieht sich in besonderem Maße dem Risiko dogmatischer Einengung ausgesetzt. Schon dies stellt eine Parallele zu Fichte dar, dessen Wissenschaftslehre es ja auch wesentlich um die Kritik an unbegründeten erkenntnistheoretischen Vorurteilen, also an dogmatischen Fassungen von Theorien, ging. Seine - und auch schon vor ihm Kants - Transzendentalphilosophie wandte sich gegen das idealistische Dogma, nur der Geist als absolut freies Wirken sei von Bedeutung, und gegen das realistische Dogma, die Welt bestehe aus »real« außer uns und unabhängig von (...) uns existierenden Dingen, die wir zwar erkennend abbilden können und sollen, die wir aber dadurch nicht beeinflussen und schon gar nicht wesentlich mit konstituieren. Dieser Zusammenhang ist an anderer Stelle näher ausgeführt worden. (shrink)