During the last hundred years medical language has been influenced by scientific and technological progress. As a result uncertainty in medical communication is increasing. This may have serious consequences not only for health care delivery but also for medical science. Disease classification, assessment of the validity of epidemiological investigations and comparison of the results of various investigations are examples of what will become less secure. The purpose of the article is to emphasise a main source of uncertainty — the problem (...) of interpreting definitions. Two issues of interpretation are explored. One concerns the logical status of a statement and the other the function of a statement. It is concluded that the security of medical language can be increased through the elucidation of the logical status and functions of statements making up medical concepts. (shrink)

Urban fragt nach der Literaturkenntnis Edith Steins in ihrem Lesen, Interpretieren, Ubersetzen, Theoretisieren, Dichten und Zitieren und arbeitet Praferenzen, Identifikationen und Schwerpunkte heraus. Die erstmals so zusammengefuhrten und mit ausfuhrlichen Textzeugnissen versehenen Daten und Fakten zeigen, wie ihre Denkwelt und karmelitisch-klosterliche Existenzweise dadurch gepragt wurden. Zugleich wird so ihre spezifische Anthropologie erkennbar. Im zweiten Teil wird nach der Wirkung und bleibenden Aktualitat dieser Anthropologie gefragt. Die Erfahrungen von Kreuz und Leid, Schrecken und Grausamkeit beruhren nicht nur tiefgreifend die Gottes- (...) und Lebenserfahrung der Karmelitin Edith Stein, sondern auch literarische Bewaltigungen und Konzeptionen von Le Fort und Camus bis Goytisolo und jungst Jonathan Littell. (shrink)

Personalized medicine plays an important role in the development of current medicine. Among the numerous statements regarding the future of personalized medicine, some can be found that accord medicine a new scientific status. Medicine will be transformed from an art to a science due to personalized medicine. This prognosis is supported by references to models of historical developments. The article examines what is meant by this prognosis, what consequences it entails, and how feasible it is. It refers to the long (...) tradition of epistemological thinking in medicine and the use of historical models for the development of medicine. The possible answers to the question “art or science” are systematized with respect to the core question about the relationship between knowledge and action. The prediction for medicine to develop from an ‘empirical healing art’ to a ‘rational, molecular science’ is nonsensical from an epistemological point of view. The historical models employed to substantiate the development of personalized medicine are questionable. (shrink)

The article presents the judgment of the German Federal Constitutional Court from 26 February 2020 on assisted suicide. The statements regarding human dignity, human rights and the relationship between citizens and the state are examined. Furthermore, the consequences resulting from this interpretation of human dignity for states that are pluralistic and based on human rights will be laid out. The court’s judgment limits the power of parliaments and poses a challenge to many laws in states that see themselves as pluralistic, (...) human rights-based states. There are no data in this work. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In this dissertation, I critically examine the philosophy of transcendental empiricism. Transcendental empiricism is, among other things, a philosophy of mental content. It attempts to dissolve an epistemological dilemma of mental content by splitting the difference between two diametrically opposed accounts of content. John McDowell's minimal empiricism and Richard Gaskin's minimalist empiricism are two versions of transcendental empiricism. Transcendental empiricism itself originates with McDowell's work. This dissertation is divided into five parts. First, in the Introduction, I state the Wittgensteinian metaphilosophical (...) orientation of transcendental empiricism. This metaphilosophical approach provides a plateau upon which much of the rest of this work may be examined. Second, I offer a detailed description of McDowell’s minimal empiricism. Third, I critique Gaskin's critique and modification of McDowell's minimal empiricism. I argue that (1) Gaskin's critiques are faulty and that (2) Gaskin's minimalist empiricism is very dubious. Fourth, I scrutinize the alleged credentials of McDowell's minimal empiricism. I argue that McDowell's version of linguistic idealism is problematic. I then comment on a recent dialogue between transcendental empiricism and Hubert Dreyfus's phenomenology. The dialogue culminates with Dreyfus's accusation of the “Myth of the Mental.” I argue that this accusation is correct in which case McDowell's direct realism is problematic. I conclude that minimal empiricism does not dissolve the dilemma of mental content. Finally, I argue that Tyler Burge successfully undermines the doctrine of disjunctivism, but disjunctivism is crucial for transcendental empiricism. Ultimately, however, I aim to show that transcendental empiricism is an attractive alternative to philosophies of mental content. (shrink)

PREFACE. THE Author of this very practical treatise on Scotch Loch - Fishing desires clearly that it may be of use to all who had it. He does not pretend to have written anything new, but to have attempted to put what he has to say in as readable a form as possible. Everything in the way of the history and habits of fish has been studiously avoided, and technicalities have been used as sparingly as possible. The writing of this (...) book has afforded him pleasure in his leisure moments, and that pleasure would be much increased if he knew that the perusal of it would create any bond of sympathy between himself and the angling community in general. This section is interleaved with blank shects for the readers notes. The Author need hardly say that any suggestions addressed to the case of the publishers, will meet with consideration in a future edition. We do not pretend to write or enlarge upon a new subject. Much has been said and written-and well said and written too on the art of fishing but loch-fishing has been rather looked upon as a second-rate performance, and to dispel this idea is one of the objects for which this present treatise has been written. Far be it from us to say anything against fishing, lawfully practised in any form but many pent up in our large towns will bear us out when me say that, on the whole, a days loch-fishing is the most convenient. One great matter is, that the loch-fisher is depend- ent on nothing but enough wind to curl the water, -and on a large loch it is very seldom that a dead calm prevails all day, -and can make his arrangements for a day, weeks beforehand whereas the stream- fisher is dependent for a good take on the state of the water and however pleasant and easy it may be for one living near the banks of a good trout stream or river, it is quite another matter to arrange for a days river-fishing, if one is looking forward to a holiday at a date some weeks ahead. Providence may favour the expectant angler with a good day, and the water in order but experience has taught most of us that the good days are in the minority, and that, as is the case with our rapid running streams, -such as many of our northern streams are, -the water is either too large or too small, unless, as previously remarked, you live near at hand, and can catch it at its best. A common belief in regard to loch-fishing is, that the tyro and the experienced angler have nearly the same chance in fishing, -the one from the stern and the other from the bow of the same boat. Of all the absurd beliefs as to loch-fishing, this is one of the most absurd. Try it. Give the tyro either end of the boat he likes give him a cast of ally flies he may fancy, or even a cast similar to those which a crack may be using and if he catches one for every three the other has, he may consider himself very lucky. Of course there are lochs where the fish are not abundant, and a beginner may come across as many as an older fisher but we speak of lochs where there are fish to be caught, and where each has a fair chance. Again, it is said that the boatman has as much to do with catching trout in a loch as the angler. Well, we dont deny that. In an untried loch it is necessary to have the guidance of a good boatman but the same argument holds good as to stream-fishing... (shrink)

Zusammenfassung Die Forschungs- und Regulierungsebene bei datenintensiver Forschung in der Medizin liegen auseinander. Ein heterogenes Feld aus regulierenden Institutionen mit regional ungleichen Regelungen, sowohl hinsichtlich der Dichte als auch der Restriktivität von Regelungen, steht einer globalen Entwicklung der Technologien entgegen. Trotz oder gerade wegen mangelnder global-gültiger Regulierungen können auch unverbindliche oder nur bedingt verbindliche normative Vorgaben der Orientierung dienen. Doch wie soll eine solche normative Regulierung angesichts datenintensiver Forschung in der Medizin ausgestaltet werden und woran soll sie sich orientieren? Die (...) Frage, wie konkret und detailliert man eine solche Forschung regulieren sollte, lässt sich nur im Einzelfall für bestimmte Situationen und Institutionen beantworten. Ob dabei neue Normen oder Gewichtungen von Normen vorgenommen werden sollen, oder ob die Normen und deren Gewichtung weiterhin bestehen bleiben sollen, lässt sich nur mit Verweis auf starke normative Argumente beantworten. An zwingenden Argumenten für neue Normen angesichts der datenintensiven medizinischen Forschung mangelt es bisher. Dennoch ist eine Umsetzungsarbeit von Normen, egal ob neue oder alte, und deren Anwendung auf eine neue Methode oder Technologie allemal zu erbringen. Es bedarf daher – wie schon bisher – beider: sowohl etablierter und transparent kommunizierter Normen als auch des unabhängigen Urteils zur Anwendung dieser Normen. Angesichts der besonderen Eignung für diese Aufgabe sollten auch weiterhin Ethik-Kommissionen als prozedurale Instanz bei der Bewilligung von datenintensiver Forschung in der Medizin gefordert und befähigt werden, die als unabhängige Institution ein Urteil im Einzelfall anhand vorgegebener Normen fällen. Nichtsdestotrotz können sich die veränderten Praktiken datenintensiver Forschungsprojekte auch in neuen Anforderungen an Ethik-Kommissionen niederschlagen, denen mit Reformen der Arbeitsweise begegnet werden sollte. (shrink)

Die Frage, ob sie eine Kunst oder eine Wissenschaft sei, begleitet die Medizin seit der Antike. Die vorliegende Arbeit untersucht die Frage insbesondere im Hinblick auf den Einfluss Kants, Fichtes und Schellings auf das Selbstverstandnis der Medizin. Sie zeichnet die geschichtlichen Linien nach, die zum Verstandnis der gegenwartigen Situation fuhren und liefert wichtige Argumente zu einem zeitgemassen Selbstverstandnis der Medizin, das fur die wissenschaftstheoretische und ethische Diskussion in der Medizin von heute unverzichtbar ist. Since antiquity, the question has been whether (...) medicine is an art or a science. This work explores the question, in particular in view of Kants, Fichtes and Schellings influence on the self-conception of medicine. It traces the historical timelines which help to understand the current situation and provides important arguments for a timely self-conception of medicine which is indispensable for the discussion of scientific theory and ethics in todays medicine. (shrink)

I critically examine possible advantages of the introduction of a “naturalistic” setting to empirical phenomenological inquiry. As an alternative, I suggest taking the sum of factors ….

La désinstitutionnalisation des services de santé mentale a créé un espace pour la création de solutions nouvelles et communautaires dans les pays occidentaux. Toutefois, le domaine semble encore manquer de dispositifs idéologiques et pratiques cohérentes. Cet article a pour objectif d’examiner les caractéristiques des services de logement conçus pour soutenir les individus atteints d’un handicap psychique en Suède, et s’appuie sur les expériences des prestataires de services locaux. L’accent est mis sur le cadre organisationnel des services, l’orientation principale et le (...) contenu conceptuel. L’article se fonde sur une étude de cas sur de multiples individus et portant sur dix municipalités suédoises. Les données consistent principalement en des entretiens avec des informateurs clés de l’organisation de services sociaux. Les conclusions soulignent l’émergence d’une nouvelle génération d’utilisateurs de services ayant des besoins complexes et qui remettent en question à la fois l’organisation et la nature des services offerts. Les foyers collectifs et l’aide au logement mobile ont été considérés comme les piliers de l’offre de services. Toutefois, un certain nombre de solutions locales pragmatiques ont également été identifiées, ainsi que des initiatives ayant pour objectif de réduire l’étendue des structures de type institutionnel. (shrink)

An edited version of a talk between Urban and Toynbee on Radio Free Europe. The book concerns the nature of history as well as discussing Marxism and Christianity, the third world, and the effects of technology.

Wenn wir über aktuelle Tendenzen sprechen, wo fängt dieses Gespräch an und wo hört es auf? Müssen wir bestimmte Themen ausschliessen oder sollten wir andere noch miteinbeziehen? Wann befinden wir uns bei einem solchen Gespräch innerhalb einer kanonisierten Debatte, wann befinden wir uns im Bereich des Spekulativen? Das Verhandeln solcher Gegensätze ist allgegenwärtig. In besonderer Weise wird es der Kunst zugeschrieben. Sie erlaube, so heisst es häufig, das Ausloten von Grenzen. Doch ist das wirklich so? Sind künstlerisches Handeln und die (...) vermuteten Grenzen wirklich immer so eindeutig? Und definiert ein solches Ausloten, sei es in der Kunst oder Wissenschaft, wirklich das, was Gegenwart ausmacht? Oder ist es nicht doch so, dass sich erst mit der Zeit bestimmte Verlaufslinien abzeichnen? Die Autoren dieses Buches diskutieren Tendenzen. Sie gehen in die Vergangenheit und verweisen auf die Zukunft. Sie stellen Bezüge und Abgrenzungen her mit Beiträgen aus der Kunst- und Medientheorie. Dieses Buch ist Dr. habil. Arthur Engelbert gewidmet, der seit über drei Jahrzehnten im Bereich der zeitgenössischen Kunst- und Medientheorie arbeitet und wirkt. (shrink)

Moral Repair examines the ethics and moral psychology of responses to wrongdoing. Explaining the emotional bonds and normative expectations that keep human beings responsive to moral standards and responsible to each other, Margaret Urban Walker uses realistic examples of both personal betrayal and political violence to analyze how moral bonds are damaged by serious wrongs and what must be done to repair the damage. Focusing on victims of wrong, their right to validation, and their sense of justice, Walker presents (...) a unified and detailed philosophical account of hope, trust, resentment, forgiveness, and making amends - the emotions and practices that sustain moral relations. Moral Repair joins a multidisciplinary literature concerned with transitional and restorative justice, reparations, and restoring individual dignity and mutual trust in the wake of serious wrongs. (shrink)

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)

BackgroundIndividuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues. The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial -design and methods. The main hypothesis is that participants receiving PIPCI will increase their (...) psychological flexibility compared to participants in the active control group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health compared to participants in the active control group and the waiting list control group.Materials and MethodsThis three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group, an active control group or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers and health care costs. Assessments will be performed at pre- and post-intervention, as well as at a 6-month follow-up.DiscussionThe development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia.Clinical Trial RegistrationClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924. (shrink)

Background: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy. Aim: To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care. Research design: The study has a (...) qualitative, inductive design. Participants and research context: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. Ethical considerations: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. Findings: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together. Discussion: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy. Conclusion: If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient. (shrink)

This book is an attempt at a restatement of the traditional view of the relation of God to man. In opposition to humanism which proposes a religion of pure humanity, and to the theology of crisis which, so to speak, teaches a religion of pure Deity, it maintains a view of religion and theology which holds that the notions of humanity and Deity can not be separated without making them unintelligible. This view makes religion not merely a matter of faith (...) and emotion but of reason as well. The development of this thesis involves looking again at the relation of dogmatic to rational theology and reinterpreting the latter. An examination of the historic proofs for the existence of God and an axiological interpretation of the entire theistic argument constitute the heart of the book. In pursuance of this programme the book includes a study of such topics as language, myth, symbolism, logic, intuition and creed. Finally, after taking up the problems of religious knowledge, it discusses religion and science in contemporary thought, and the relation of religion to the humanities. (shrink)

Theranostics or theragnostics are new terms which start to appear occasionally in publications from 2001 onwards, with a marked increase in references from 2011. In the last few years more than 1100 articles using this term were published each year. In 2011 the journal Theranostics was founded. This paper addresses the question of whether this new term is appropriate. The etymology of the term is analysed. A literature search for definitions of “theranostics” is carried out and the definitions examined as (...) to whether they give grounds for justifying the use of a new term. The differences between diagnostics and therapy are explored. A broad and a narrow definition are found. According to the broad definition theranostics provides a closer relationship between diagnostics and therapy. According to the narrow definition diagnostics and therapy become a single intervention. On closer examination it turns out that in the narrow definition the diagnostics capacities are limited to monitoring. Neither the broad nor the narrow definition actually demonstrate a new concept in medicine. Rather, they describe the well-known practice of medical decision making. In this respect, the new term cannot be justified. The level of diagnostics is new but not the relationship between diagnostics and therapy. The term theranostics is misleading as it obscures the existing differences between diagnostics and therapy and wrongly insinuates that steps between diagnostics and therapy could be omitted. (shrink)

According to Michael Tomasello’s evolutionary anthropological approach, joint attention is one of the essential keys to understanding the difference between human and animal. The present paper discusses a recent phenomenological account of the anthropological difference inspired by Tomasello’s conception. A criticism of this account is put forward, while an alternative view is also introduced that stresses the impact of differential rearing experiences on the socio-cognitive development of human and non-human animals.

In the evaluation of genomic high-throughput technologies, the idea of “utility” plays an important role. The “clinical utility” of genomic data refers to the improvement of healthcare outcomes, its “personal utility” to benefits that go beyond healthcare purposes. Both concepts are contested. Moreover, there are only few empirical insights regarding their interpretation by those professionally involved or personally affected. Our paper presents results from qualitative research (20 semi-structured interviews) regarding professionals’ and personally affected people’s views on the utility of genomic (...) information. We find that the discussion of clinical utility is the domain of professionals who primarily consider aspects of test validity and clinical outcomes. By contrast, personal utility plays a prominent role in affected persons’ discussions. Four different aspects are addressed: (a) life and family planning, (b) relief and justification, (c) self-knowledge and self-determination, and (d) entertainment. These differences have important implications for informed consent and counseling in the context of genomic high-throughput technologies. (shrink)