Due to the intense selection pressure against inbreeding, humans are expected to possess psychological adaptations that regulate mate choice and avoid inbreeding. From a gene’s-eye perspective, there is little difference in the evolutionary costs between situations where an individual him/herself is participating in inbreeding and inbreeding among other close relatives. The difference is merely quantitative, as fitness can be compromised via both routes. The question is whether humans are sensitive to the direct as well as indirect costs of inbreeding. Using (...) responses from a large population-based sample (27,364 responses from 2,353 participants), we found that human motivations to avoid inbreeding closely track the theoretical costs of inbreeding as predicted by inclusive-fitness theory. Participants were asked to select in a forced choice paradigm, which of two acts of inbreeding with actual family members they would want to avoid most. We found that the estimated fitness costs explained 83.6% of participant choices. Importantly, fitness costs explained choices also when the self was not involved. We conclude that humans intuit the indirect fitness costs of mating decisions made by close family members and that psychological inbreeding avoidance mechanisms extend beyond self-regulation. (shrink)

During the 1930s, while both movements were fleeing from persecution by the Nazis, the Vienna Circle and the Frankfurt School planned to collaborate. The plan failed, and in its stead Horkheimer published a critique of the Vienna Circle in “The Latest Attack on Metaphysics” (written in collaboration with Adorno, though he is not credited as an author). This paper will analyse Horkheimer’s (and Adorno’s) article, and the ensuing dialogue with Neurath. The Frankfurt School’s critical stance towards the Vienna Circle can (...) be traced back to Adorno’s earlier objections to the ‘positivist’ myth of the given. In response to Carnap’s attack on Heidegger, Horkheimer (and Adorno) criticized both metaphysics and its ‘scientistic’ overcoming. Their critique employs a number of overgeneralisations about ‘logical positivism’. Neurath’s unpublished reply proposes corrections to the Frankfurt School’s portrayal of ‘positivism’, pointing towards a partly conciliatory direction within the framework of Unified Science. The attempted collaboration between the Vienna Circle and the Frankfurt School ended when Horkheimer refused to publish Neurath's reply to his article in the Zeitschrift für Sozialforschung. Horkheimer subsequently made anti-positivism a central concern for critical theory, setting the tone of subsequent polemics in the Positivismusstreit of the 1960s. (shrink)

Confronted with mounting pressure to ensure accountability vis-à-vis customers, citizens and beneficiaries, organizational leaders need to decide how to choose and implement so-called accountability standards. Yet while looking for an appropriate standard, they often base their decisions on cost-benefit calculations, thus neglecting other important spheres of influence pertaining to more broadly defined stakeholder interests. We argue in this paper that, as a part of the strategic decision for a certain standard, management needs to identify and act according to the needs (...) of all stakeholders. We contend that the creation of a dialogical understanding among affected stakeholders cannot be a mere outcome of applying certain accountability standards, but rather must be a necessary precondition for their use. This requires a stakeholder dialogue prior to making a choice. We outline such a discursive decision framework for accountability standards based on the Habermasian concept of communicative action and, in the final section, apply our conceptual framework to one of the most prominent accountability tools (AA 1000). (shrink)

You were one of the noblest, the most genuine people, who have ever walked this earth. And though both friend and foe know this, I don't think it unwarranted to verbally bear witness to it before your grave. For we know the world, we know Spinoza's fate. For the world could lay shadows around Nietzsche's memory as well. And therefore I conclude with the words: Peace to your ashes! Holy be thy name to all those to come!1The only historical person (...) Peter Gast puts in relation to his much-revered master in these closing words of the funeral oration he delivered in front of Friedrich Nietzsche's open grave in Röcken on August 28, 1900, is Baruch de Spinoza.2 His intentions are clear: Nietzsche is to avoid the fate of .. (shrink)

This paper extends scholarship on multi-stakeholder initiatives (MSIs) in the context of corporate social responsibility in three ways. First, I outline a framework to analyze the strength of couplings between actors participating in MSIs. Characterizing an MSI as consisting of numerous local networks that are embedded in a wider global network, I argue that tighter couplings (within local networks) and looser couplings (between local networks) coexist. Second, I suggest that this coexistence of couplings enables MSIs to generate policy outcomes which (...) address the conditions of a transnational regulatory context. I argue that MSIs’ way of organizing enables them to cope with three challenges: the stability, flexibility, and legitimacy of governance. Reflecting on these challenges, the article identifies a number of problems related to MSIs’ role in transnational governance. Third, I discuss the UN Global Compact as an illustrative case and examine problems and opportunities related to its stability, flexibility, and legitimacy. (shrink)

Over the past century or so, questions concerning the word ‘meaning’ have been understandably prominent in the field of the philosophy of language. There is, however, a historical aspect to the debate that is of especial interest to literary critics – the fact that verbs and expressions of meaning have been applied to different kinds of things in a number of languages spanning the western literary tradition. I shall introduce the topic by focussing on the Latin expressionsibi uelleand on how (...) Roman authors exploited its ambiguities for the purposes of humour (§§ I and II). I shall then move on to a discussion of a later Latin phrase familiar from the pages of the Virgilian commentator Servius,hoc uult dicere, and argue that the assumptions we have about expressions of meaning may lead us to adopt a particular interpretation of it (§§ III and IV). In the final part of the paper (§§ V, VI and VII) I shall proceed to a discussion of why it is important for modern literary critics to pay attention to how they use verbs such as ‘to mean’: I argue that the different functions of the verb facilitate a personification of the text that allows us to equivocate about the role of the author. (shrink)

:Brain–computer interfaces are driven essentially by algorithms; however, the ethical role of such algorithms has so far been neglected in the ethical assessment of BCIs. The goal of this article is therefore twofold: First, it aims to offer insights into whether the problems related to the ethics of BCIs can be better grasped with the help of already existing work on the ethics of algorithms. As a second goal, the article explores what kinds of solutions are available in that body (...) of scholarship, and how these solutions relate to some of the ethical questions around BCIs. In short, the article asks what lessons can be learned about the ethics of BCIs from looking at the ethics of algorithms. To achieve these goals, the article proceeds as follows. First, a brief introduction into the algorithmic background of BCIs is given. Second, the debate about epistemic concerns and the ethics of algorithms is sketched. Finally, this debate is transferred to the ethics of BCIs. (shrink)

I argue that many of the priority rankings that have been proposed by effective altruists seem to be in tension with apparently reasonable assumptions about the rational pursuit of our aims in the face of uncertainty. The particular issue on which I focus arises from recognition of the overwhelming importance and inscrutability of the indirect effects of our actions, conjoined with the plausibility of a permissive decision principle governing cases of deep uncertainty, known as the maximality rule. I conclude that (...) we lack a compelling decision theory that is consistent with a longtermist perspective and does not downplay the depth of our uncertainty, while also supporting orthodox effective altruist conclusions about cause prioritization. (shrink)

This article provides a semantic analysis of Protagonist Projection, the phenomenon by which things are described from a point of view different from that of the speaker. Against what has been argued by some, the account vindicates the intuitive idea that Protagonist Projection does not give rise to counterexamples to factivity, and similar plausible principles. A pragmatics is sketched that explains the attitude attributions generated by Protagonist Projection. Further, the phenomenon is compared to Free Indirect Discourse, and the proposed account (...) is seen to preserve the relation between them. (shrink)

Upon discovering that certain beliefs we hold are contingent on arbitrary features of our background, we often feel uneasy. I defend the proposal that if such cases ofcontingency anxietyinvolve defeaters, this is because of the epistemic significance of disagreement. I note two hurdles to our accepting thisDisagreement Hypothesis. Firstly, some cases of contingency anxiety apparently involve no disagreement. Secondly, the proposal may seem to make our awareness of the influence of arbitrary background factors irrelevant in determining whether to revise our (...) beliefs. I show that each of these problems can be successfully accommodated by theDisagreement Hypothesis. (shrink)

This study explores the underlying drivers of US public pension funds’ tendency to tilt their portfolios towards companies with stronger corporate social responsibility. Studying the equity holdings of large, internally managed US state pension funds, we find evidence that the political leaning of their beneficiaries and political pressures by state politicians affect funds’ investment decisions. State pension funds from states with Democratic-leaning beneficiaries tilt their portfolios more strongly towards companies that perform well on CSR issues, and this tendency is intensified (...) when the state government is dominated by Democratic state politicians. Moreover, we find that funds which tilt their portfolios towards companies with superior CSR scores generate a slightly higher return compared with their counterparts. Overall, our findings indicate that funds align their investment choices with the financial and non-financial interests of their beneficiaries when deciding whether to incorporate CSR into their equity allocations. (shrink)

This paper investigates different modes of organizing for corporate social responsibility (CSR). Based on insights from organization theory, we theorize two ways to organize for CSR. “Complete” organization for CSR happens within businesses and depends on the availability of certain organizational elements (e.g., membership, hierarchy, rules, monitoring, and sanctioning). By contrast, “partial” organization for CSR happens when organizers do not have direct access to all these organizational elements. We discuss partial organization for CSR by analyzing how standards and cross-sector partnerships (...) make selective use of organizational elements. We maintain that an important feature of the increasing institutionalization of CSR—not only within businesses but also among non-governmental, governmental, and professional actors—is the rise of partial forms of organization. We discuss the contributions to this Special Issue in the context of our theorization of complete/partial organization for CSR and outline avenues for further research. (shrink)

This paper argues for an account of fictional force, the central characteristic of the kind of non-assertoric speech act that authors of fictions are engaged in. A distinction is drawn between what is true in a fiction and the _fictional record_ comprising what the audience has been told. The papers argues that to utter a sentence with fictional force is to intend that its content be added to a fictional record. It is shown that this view accounts for phenomena such (...) as conversational implicatures in fictional discourse. Moreover, the view is seen to provide an attractive way of distinguishing fictional utterances from assertoric utterances. As a consequence, this account of fictional force offers a satisfactory way of distinguishing fiction from lying. (shrink)

This paper outlines an account of the ethics of lying, which accommodates two main ideas about lying. The first of these, Anti-Deceptionalism, is the view that lying does not necessarily involve intentions to deceive. The second, Anti-Absolutism, is the view that lying is not always morally wrong. It is argued that lying is not wrong in itself, but rather the wrong in lying is explained by different factors in different cases. In some cases such factors may include deceptive intentions on (...) the part of the liar. In other cases, where such intentions are not found, the wrong in lying may be explained by other factors. Moreover, it is argued that the interaction between considerations against lying and considerations against telling the truth are sensitive to the practical interests of those lied to. When the topic of the lie in question matters little to the victim's rational decision making, the threshold for when considerations against telling the truth can outweigh considerations against lying are lowered. This account is seen to explain why lying to avoid little harm is sometimes permissible, and sometimes not. (shrink)

Predictive processing models of cognition are promising an elegant way to unite action, perception, and learning. However, in the current formulations, they are species-unspecific and have very little particularly human about them. I propose to examine how, in this framework, humans can be able to massively interact and to build shared worlds that are both material and symbolic.

Jenseits von Gut und Böse ist ein Werk, mit dem Nietzsche einen neuen Ton fand, um so die „Philosophie der Zukunft“ zu initiieren. Es untergräbt gewohnte Gewissheiten in fundamentalphilosophischer, religiöser, moralischer und politischer Hinsicht. Zugleich verspricht es, die Perspektiven, das Leben der Leser grundlegend zu verändern. Signalbegriffe wie „Wille zur Macht“ und „Sklaven-Moral“ dürfen nicht als feste Lehren missverstanden werden.

Modern Philosophy of Science has not yet recognized the significance of physical invariance principles for science and daily life. In this paper we investigate as a simple example, how time independence or time translational invariance of natural laws determines the time scale. We start with informal definitions of the invariance of concepts and laws. We then ask if time independence is an essential feature of natural laws or if time dependent laws are plausible without loss of predictive relevance. In section (...) 3 we investigate the question wether time independence of natural laws is a matter of convention. In sections 5-7 the determination of the time scale by time translational invariance is studied. In section 8 we study the conditions under which this determination is unique. (shrink)

Inspired by Pohlers' local predicativity approach to Pure Proof Theory and Howard's ordinal analysis of bar recursion of type zero we present a short, technically smooth and constructive strong normalization proof for Gödel's system T of primitive recursive functionals of finite types by constructing an ε 0 -recursive function [] 0 : T → ω so that a reduces to b implies [a] $_0 > [b]_0$ . The construction of [] 0 is based on a careful analysis of the Howard-Schütte (...) treatment of Gödel's T and utilizes the collapsing function ψ: ε 0 → ω which has been developed by the author for a local predicativity style proof-theoretic analysis of PA. The construction of [] 0 is also crucially based on ideas developed in the 1995 paper "A proof of strongly uniform termination for Gödel's T by the method of local predicativity" by the author. The results on complexity bounds for the fragments of T which are obtained in this paper strengthen considerably the results of the 1995 paper. Indeed, for given n let T n be the subsystem of T in which the recursors have type level less than or equal to n+2. (By definition, case distinction functionals for every type are also contained in T n .) As a corollary of the main theorem of this paper we obtain (reobtain?) optimal bounds for the T n -derivation lengths in terms of ω n+2 -descent recursive functions. The derivation lengths of type one functionals from T n (hence also their computational complexities) are classified optimally in terms of $ -descent recursive functions. In particular we obtain (reobtain?) that the derivation lengths function of a type one functional a ∈ T 0 is primitive recursive, thus any type one functional a in T 0 defines a primitive recursive function. Similarly we also obtain (reobtain?) a full classification of T 1 in terms of multiple recursion. As proof-theoretic corollaries we reobtain the classification of the IΣ n+1 -provably recursive functions. Taking advantage from our finitistic and constructive treatment of the terms of Gödel's T we reobtain additionally (without employing continuous cut elimination techniques) that PRA + PRWO ( $\varepsilon_0) \vdash \Pi^0_2$ - Refl(PA) and PRA + PRWO ( $\omega_{n+2}) \vdash \Pi^0_2$ - Refl(I Σ n+1 ), hence PRA + PRWO( $\epsilon_0) \vdash$ Con(PA) and PRA + PRWO( $\omega_{n+2}) \vdash$ Con(IΣ n+1 ). For programmatic reasons we outline in the introduction a vision of how to apply a certain type of infinitary methods to questions of finitary mathematics and recursion theory. We also indicate some connections between ordinals, term rewriting, recursion theory and computational complexity. (shrink)

Thought: A Journal of Philosophy, Volume 8, Issue 4, Page 240-249, December 2019.

Gödel’s first incompleteness result from 1931 states that there are true assertions about the natural numbers which do not follow from the Peano axioms. Since 1931 many researchers have been looking for natural examples of such assertions and breakthroughs were obtained in the seventies by Jeff Paris [Some independence results for Peano arithmetic. J. Symbolic Logic 43 725–731] , Handbook of Mathematical Logic, North-Holland, Amsterdam, 1977] and Laurie Kirby [L. Kirby, Jeff Paris, Accessible independence results for Peano Arithmetic, Bull. of (...) the LMS 14 285–293]) and Harvey Friedman [S.G. Simpson, Non-provability of certain combinatorial properties of finite trees, in: Harvey Friedman’s Research on the Foundations of Mathematics, North-Holland, Amsterdam, 1985, pp. 87–117; R. Smith, The consistency strength of some finite forms of the Higman and Kruskal theorems, in: Harvey Friedman’s Research on the Foundations of Mathematics, North-Holland, Amsterdam, 1985, pp. 119–136] who produced the first mathematically interesting independence results in Ramsey theory and well-order and well-quasi-order theory .In this article we investigate Friedman-style principles of combinatorial well-foundedness for the ordinals below ε0. These principles state that there is a uniform bound on the length of decreasing sequences of ordinals which satisfy an elementary recursive growth rate condition with respect to their Gödel numbers.For these independence principles we classify their phase transitions, i.e. we classify exactly the bounding conditions which lead from provability to unprovability in the induced combinatorial well-foundedness principles.As Gödel numbering for ordinals we choose the one which is induced naturally from Gödel’s coding of finite sequences from his classical 1931 paper on his incompleteness results.This choice makes the investigation highly non-trivial but rewarding and we succeed in our objectives by using an intricate and surprising interplay between analytic combinatorics and the theory of descent recursive functions. For obtaining the required bounds on count functions for ordinals we use a classical 1961 Tauberian theorem of Parameswaran which apparently is far remote from Gödel’s theorem. (shrink)

Up to now only three lunar tables by Leonhard Euler (1707–1783), published in 1745, 1746, and 1772, were known. For a long time, however, it was assumed that the first two of these tables were identical. The author compared these tables with each other and proved the contrary. This fact also transpires from an examination of their history, which was reconstructed using Euler’s correspondence. In addition, evidence has been found in Euler’s voluminous scientific correspondence and in contemporary publications of the (...) eighteenth century that, between 1742 and 1750, Euler published additional lunar tables anonymously. The author proved Euler’s authorship of at least five lunar tables containing some 100 pages, which were neither recorded in the list of his works nor published in the Leonhardi Euleri Opera Omnia. (shrink)

The main contention of this article is that, since the 20th century, violence has gradually turned into a purely technological concept. This great change amounts to a paradigm shift which can be traced back to Johan Galtung’s seminal article “Violence, Peace, and Peace Research” (1969). First, I show why the traditional view of violence revolving around the notions of force, intent and harm has been thrown into crisis by the technological evolution of the Western world. Second, I indicate how Galtung’s (...) thorough redefinition of violence as “the cause of the difference between the potential and the actual” proves more compatible to technological societies. Finally, I suggest that this new definition of violence has become ever more appealing today in the age of artificial intelligence. (shrink)

This article investigates structural aspects of source domains in metaphorical mappings with regard to their manifestation in public discourse data. Specifically, it analyses the organization of source concepts into mininarratives or "scenarios" that dominate the discourse manifestations of source domains. The material consists of examples from a bilingual corpus of British and German public debates about the &European Union.& The data show that while the two national samples share some basic mappings between the source and target domains, they each are (...) characterised further by specific scenarios that provide focal points for conceptualizing the target topic. The scenarios can also be shown to carry evaluative and attitudinal biases that are related to particular political dispositions and preferences of the respective national discourse communities. In conclusion, it will be argued that the analysis of scenarios is a necessary complement to the study of source domains and of domain-mappings in metaphorical language use. (shrink)

This book aims to lay bare the logical foundations of tractable reasoning. It draws on Marvin Minsky's seminal work on frames, which has been highly influential in computer science and, to a lesser extent, in cognitive science. Only very few people have explored ideas about frames in logic, which is why the investigation in this book breaks new ground. The apparent intractability of dynamic, inferential reasoning is an unsolved problem in both cognitive science and logic-oriented artificial intelligence. By means of (...) a logical investigation of frames and frame concepts, Andreas devises a novel logic of tractable reasoning, called frame logic. Moreover, he devises a novel belief revision scheme, which is tractable for frame logic. These tractability results shed new light on our logical and cognitive means to carry out dynamic, inferential reasoning. Modularity remains central for tractability, and so the author sets forth a logical variant of the massive modularity hypothesis in cognitive science. (shrink)

This article describes and refines an experiential distinction which has been highlighted by neuro-linguistic programming (NLP), perceptual positions. When you are imagining a past or future scene, you may perceive it (usually pre-reflectively) from three different viewpoints or perceptual positions. If you are looking at the world from your own point of view, through your own eyes, you are in the first perceptual position. If you are looking at the scene through another person's eyes, appreciating the other person's point of (...) view, you are in the second position. If you are seeing the world from an outside point of view, as an independent observer, you are in the third position. NLP highlighted the fact that our feelings change dramatically according to the perceptual position we adopt. Through a concrete example, Connirae Andreas shows that this distinction does not only concern visual perceptions, but also auditory and kinaesthetic perceptions. She also shows that our visual, auditory and kinaesthetic perceptions may be split in different perceptual positions at the same time, and that this misalignment may cause difficulties. Learning to 'align' our perceptual positions brings us greater wholeness, enables us to become more integrated. (shrink)

In den letzten Jahren hat sich eine Vielfalt unterschiedlicher Gremien zur Ethikberatung entwickelt: vom Konsil mit einem einzelnen Berater bis zum Ethikkomitee. In dem Band werden die Ethikberatung, ihre Entwicklung und Anwendung, sowie die Gründung von Gremien in Krankenhäusern, Pflegeeinrichtungen, Hospizen und von niedergelassenen Ärzten anhand von Fallbeispielen erläutert. Dabei schlagen die Autoren eine Brücke zwischen traditioneller philosophischer Ethik und anwendungsbezogener klinischer Ethik. Auch rechtliche Fragen werden erörtert.

Some things are reasons for us to perform certain actions. That it will spare you great pain in the future, for example, is a reason for you to go to the dentist now, and that you are already late for work is a reason for you not to read the next article in the morning paper. Why are such considerations reasons for or against certain actions? Constructivism offers an intriguing answer to this question. Its basic idea is often encapsulated in (...) the slogan that reasons are not discovered but made by us. This book elaborates the constructivist idea into a fully fledged account of practical reasons, makes its theoretical commitments explicit, and defends it against some well-known objections. It begins with an examination of the distinctive role that reason judgements play in the process of practical reasoning. This provides the resources for an anti-representationalist conception of the nature of those judgements, according to which they are true, if they are true, not because they accurately represent certain normative facts, but because of their role in sound reasoning. On the resulting view, a consideration owes its status as a reason to the truth of the corresponding reason judgement and thus, ultimately, to the soundness of a certain episode of reasoning. Consequently, our practical reasons exhibit a kind of mind-dependence, but this does not force us to deny their objectivity. (shrink)

Though scholarship has explored Karin Costelloe-Stephen’s contributions to the history of psychoanalysis, as well as her relations to the Bloomsbury Group, her philosophical work has been almost completely ignored. This paper will examine her debate with Bertrand Russell over his criticism of Bergson. Costelloe-Stephen had employed the terminology of early analytic philosophy in presenting a number of arguments in defence of Bergson’s views. Costelloe-Stephen would object, among other things, to Russell’s use of an experiment which, as she points out, was (...) first conducted by Carl Stumpf. Russell appeals to Stumpf's experiment in his attempt to prove that sense data are terms in logical relations, a thesis presupposed by the project of logical analysis outlined in Our Knowledge of the External World. A reformulated version of Costelloe-Stephen's argument put forth by this paper shows that Russell's argument fails to provide adequate proof for his thesis. Further modifications of the argument can also address a reconstruction (based on contemporary reports) of Russell's reply to Costelloe-Stephen. In his reply, Russell would use, already in 1914, the term ‘analytic philosophy’ in contrasting his and Moore’s approach to a continental one, exemplified by Bergson and Costelloe-Stephen. (shrink)

This paper is intended to give for a general mathematical audience a survey of intriguing connections between analytic combinatorics and logic. We define the ordinals below ε0 in non-logical terms and we survey a selection of recent results about the analytic combinatorics of these ordinals. Using a versatile and flexible compression technique we give applications to phase transitions for independence results, Hilbert’s basis theorem, local number theory, Ramsey theory, Hydra games, and Goodstein sequences. We discuss briefly universality and renormalization issues (...) in this context. Finally, we indicate how regularity properties of ordinal count functions can be used to prove logical limit laws. (shrink)

This article contributes to the historiography of scientific objectivity as well as to the broader attempt to historicize basic epistemic categories by examining the case of empirical psychology in eighteenth-century Germany. From the time when the philosopher Christian Wolff first presented empirical psychology in the late 1720s until Kantian philosophers elaborated on the topic towards the end of the century, the discourse hinged on discussions of how to obtain scientific knowledge of the soul. Whereas the work of Wolff and his (...) followers reflected established epistemic techniques for accomplishing this, from the early 1770s philosophers highlighted a new category of difficulties connected to the development of a systematic method of psychological self-observations. These difficulties, I argue, both complement and complicate the picture of how the subject became an obstacle to knowledge first in the mid-nineteenth century. (shrink)

Constellations, Volume 26, Issue 3, Page 384-390, September 2019.

The early Schlick developed an evolutionary biological account of play. He contrasted play with work. Where work encompasses all activity that is undertaken for the sake of some practical outcome, play renders what was previously a mere means into an end enjoyable in itself. Schlick thus distinguished between aesthetic, religious, scientific, and ethical game types. This paper shows that this typology underlies his later attempts to naturalize these fields, and allows us to clarify the relation between object-games and their description (...) within the scientific game. Schlick's demarcation between aesthetic and scientific games arguably prefigures the Vienna Circle's anti-metaphysical stance. (shrink)

In der vorliegenden Arbeit geht es um Entscheidungsspielräume und Entscheidungsprozesse von hauptamtlichen Hospizmitarbeiterinnen und -mitarbeitern in ethisch relevanten Situationen. Wie sich diese Prozesse und Spielräume konkret in der Praxis gestalten, erforschten wir mittels einer qualitativen Studie, die wir in drei Hospizen in Nordrhein-Westfalen durchführten. Als ethische Haupthandlungsfelder nannten die befragten Pflegekräfte die Medikation in der präfinalen Phase, den Umgang mit terminaler Sedierung und mit der Flüssigkeitszufuhr und Ernährung am Lebensende. Entscheidungen innerhalb dieser Felder werden i. d. R. kollektiv getroffen. Die (...) individuellen Entscheidungsspielräume der Mitarbeiterinnen und Mitarbeiter betreffen hauptsächlich den Pflegestil und das auf den Gast bezogene Zeitmanagement. Die Gestaltung dieser Entscheidungsspielräume hängt dabei häufig weniger von einem Rahmenkonzept ab, wie es Leitbilder oder Ethikkodizes nahelegen könnten, als vielmehr von einer Anspruchsanpassung der Pflegenden in der Praxis, wie es Modelle eingeschränkter Rationalität nahelegen. Damit übernehmen die Pflegekräfte in einem Hospiz eine sich selbst beratende wie korrigierende Funktion in ethischen Fragen, die angesichts des individuellen Sterbens eines Gastes immer wieder von Neuem ausgehandelt werden. (shrink)

abstract The argument that scarce health care resources should be distributed so that patients in ‘need’ are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this (...) account may not be a completely exhaustive reflection of what people mean when they refer to need, the three interpretations provide a starting‐point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs‐based priority setting to social welfare maximisation. (shrink)