Die vorliegende Studie empfiehlt, Leistungsansprüche für Personen mit interventionsfordernden Risiken anhand einer neuen Rechtskategorie, der ‚risikoadaptieren Prävention‘, abzubilden. Spätestens seit dem bioinformatischen Innovationsschub kann eine risikoadaptierte Anwendung von prophylaktischen Maßnahmen umfassend gewährleistet werden. Jedoch können die gegebenen Rechtskategorien das medizinische Anwendungsfeld nicht adäquat steuern. Die Autoren Friedhelm Meier, Anke Harney, Kerstin Rhiem, Anja Neumann, Silke Neusser, Matthias Braun, Jürgen Wasem, Rita Schmutzler, Stefan Huster und Peter Dabrock haben zusammen im BMBF geförderten Projekt SYSKON. Re-Konfiguration von Gesundheit und Krankheit. (...) Ethische, psychosoziale, rechtliche und gesundheitsökonomische Herausforderungen der Systemmedizin die vorliegende Governance Perspective erarbeitet. This book is published open access under a CC BY 4.0 license. (shrink)

ZusammenfassungDie finanziellen Ressourcen im deutschen Gesundheitssystem sind begrenzt. Diese Mittelknappheit führt im Rahmen der ärztlichen Tätigkeit zu medizinischen, ökonomischen, juristischen und ethischen Problemen, welche sich in den kommenden Jahren weiter verschärfen dürften. Aus ethischer Perspektive sind die Probleme einer gerechten Verteilung knapper Ressourcen sowie mögliche Rollen- oder Gewissenskonflikte der ärztlichen Profession besonders relevant. Mit Hilfe von qualitativen Interviewstudien lässt sich der aktuelle ärztliche Umgang mit der Mittelknappheit in der klinischen Versorgung in seiner Komplexität und seinen ethisch relevanten Aspekten untersuchen. An (...) fünf Kliniken mit unterschiedlichem Versorgungsauftrag wurden Tiefeninterviews mit fünfzehn leitenden Ärzten in den Bereichen Intensivmedizin und Kardiologie durchgeführt. Die auf Tonband aufgezeichneten Interviews wurden nach dem Verfahren der Grounded Theory ausgewertet. Die Ärzte berichten ein heterogenes Spektrum von Einflussfaktoren, Konsequenzen und Reaktionen im Zusammenhang mit ihrem Handeln bei Mittelknappheit. Zuteilungskriterien wie der medizinische Nutzen oder die Kosteneffektivität werden von den befragten Ärzten sehr unterschiedlich interpretiert und führen damit möglicherweise zu inkonsistenten Allokationsentscheidungen. Gleichzeitig bestätigen die Untersuchungen aber auch, dass die Ärzte nicht leichtfertig mit den Allokationsentscheidungen umgehen, im Gegenteil: Die Mittelknappheit und die dadurch hervorgerufenen Verteilungsprobleme können zu Gewissenskonflikten, emotionalem Stress und Gefühlen der Überforderung führen. Um Lösungskonzepte für ethische Probleme im Umgang mit der Mittelknappheit in der klinischen Praxis entwickeln und erfolgreich implementieren zu können, müssen die in dieser Arbeit systematisch zusammengestellten Verständnisweisen, Einflussfaktoren und Konsequenzen im Zusammenhang mit dem Kostendruck berücksichtigt werden. (shrink)

Diagnostik und Klassifikation der akuten myeloischen Leukämie (AML) beruhen auf zytologischen und zytogenetischen Charakteristika. Eine Individualisierung der Diagnostik und Therapie wird für AML mit normalem Karyotyp (CN-AML) durch den Nachweis spezifischer Genmutationen zunehmend ermöglicht. In einem systematischen Literaturreview und Metanalyse wurde die Mutation FLT3-ITD bei CN-AML untersucht. Eine systematische Literaturrecherche aller Veröffentlichungen der Datenbanken Embase, Pubmed, Healthstar, BIOSIS, ISI Web of Knowledge und Cochrane wurde für den Zeitraum 2000 bis März 2012 im Hinblick auf die Mutation FLT3-ITD bei Patienten mit (...) CN-AML und einem Alter von 15–65 Jahren durchgeführt. Der Literaturrecherche folgte eine Literaturselektion, eine Datenextraktion und eine qualitative sowie quantitative Informationssynthese in Form einer Metaanalyse. Achtzehn Veröffentlichungen konnten in die qualitative Analyse zur CN-AML eingeschlossen werden. Daten von 3 Publikationen zum Gesamtüberleben mit insgesamt 1.203 Patienten gingen mit Bezug auf den Marker FLT3-ITD in die Metaanalyse ein. Für FLT3-ITD zeigte sich eine statistisch signifikante schlechtere Prognose mit einer hazard ratio von 2,19 für das Gesamtüberleben bei CN-AML. FLT3-ITD ist im Vergleich zum Wildtyp mit einer schlechteren Prognose in Bezug auf den Krankheitsverlauf bei AML assoziiert. Die Analyse von FLT3 sollte bei der AML berücksichtigt werden. (shrink)

This book represents the views of one of the greatest mathematicians of the twentieth century on the analogies between computing machines and the living human brain.

In light of new biomedical technologies, such as artificial reproduction, stem cell research, genetic selection and design, the question of what we owe to future persons-and unborn life more generally-is as contested as ever. In A Theory of Unborn Life: From Abortion to Genetic Manipulation, author Anja J. Karnein provides a novel theory that shows how our commitments to persons can help us make sense of our obligations to unborn life. We should treat embryos that will develop into persons (...) in anticipation of these persons. But how viable is this theory? Moreover, what does it mean to treat embryos in anticipation of the future persons they will develop into? Exploring the attractiveness of this approach for Germany and the U.S. - two countries with very different legal approaches to valuing unborn life-Karnein comes to startling conclusions to some of today's greatest ethical and legal debates. (shrink)

The focus of this article is on elderly patients’ and nursing staff perceptions of privacy in the care of elderly patients/residents in five European countries. Privacy includes physical, social and informational elements. The results show that perceptions of privacy were strongest in the UK (Scotland) and weakest in Greece. Country comparisons revealed statistically significant differences between the perceptions of elderly patients and also between those of nurses working in the same ward or long-term care facility. Perceptions of privacy by patients (...) and their nursing staff were quite similar in Finland, Germany and the UK. In contrast, in Greece and Spain these perceptions were different: nurses believed that they took account of their patients’ privacy needs more often than the patients themselves felt this was the case. Among Spanish and UK patients, an association was found between lower levels of independence and comparatively less positive perceptions of privacy. No associations were established between nurses’ perceptions and their demographic factors. This is the third of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented. (shrink)

This study analyses the social and political discourses related to environment and sustainable development in Costa Rica. The central interest is on those development institutions and ideologies that promote social interventions in the name of sustainable development, and on those social processes and economic relations on which the discursive formation of environment and sustainability is articulated. Four different kinds of ideologies of environmental sustainability are analysed: Environmentalism for Nature, Environmentalism for Profit, Environmentalism for the People, and Alternative Environmentalism. The study (...) highlights the complexity of political discourses that construct the relationship between nature and society, and the multiplicity of the means by which the control over natural resources, within the internally differentiated development apparatus, is defined. (shrink)

Wilke et al. make significant headway in gaining a better understanding of the influence affect cues may have on action perception and judgement. In our view their account also brings up a row of important questions demanding further research. This concerns the role of conceptual and non-conceptual content and the different effects emotions of the same valence may play in the perception and judgement of action.

Background: Despite the growing potential of mobile-based technologies, innovative interventions targeting the reduction of acute stress in daily life remain under-researched. Music listening is an easy-to-administer activity that is associated with lower levels of biological and self-reported stress. However, the application of music as an intervention in moments of acute stress in daily life remains to be examined. We developed a just-in-time intervention delivering music in moments of stressful experiences in daily life and tested its feasibility using a mixed methods (...) approach.Methods: In this uncontrolled pilot study, the ecological momentary music intervention was tested by 10 chronically stressed women aged 23.5 ± 3.3 years. Over 18 consecutive days, whenever participants reported stressful experiences, they were encouraged to listen to a self-compiled playlist. Subjective stress levels and saliva samples were assessed at three time points per stress report. We analyzed app-based log data, in-the-moment responses, questionnaire data, and semi-structured interview data.Results: On average, participants’ compliance with the study protocol lay at 70%. Overall, 65 stressful experiences were reported, 51 of which were followed by music listening, for an average duration of 12:53 min. Complete data were provided for 46 stressful experiences. Participants reported immediate relaxation and distraction through music listening. The interviews revealed that the intervention was easy to use and that music listening in moments of perceived stress was viewed as a new and pleasant activity. Several aspects of the protocol were identified, which should be improved in future studies.Conclusion: Since repeated stressful experiences in daily life can pose a threat to physical and mental integrity, interventions that are easily applicable and deliver support when needed most are necessary. Following minor adaptations, the EMMI can be considered as a feasible approach to target psychobiological stress responses in daily life, which is worthy of investigation in future larger-scale trials. (shrink)

Bilder spielen in allen Schulfächern immer schon eine zentrale Rolle. Die intellektuellen Energien, die in den Bildungs- und Erziehungswissenschaften aufgewendet werden, um Fragen des Einsatzes von Bildern zu beantworten, wirken daher beachtlich. Eingeklammert bleiben dabei bisher jedoch Phänomene der Unsichtbarkeit, obwohl sie grundlegend für alles Bildliche sind. Denn sie gehören zu jener Dimension, die wir als "latent" bezeichnen. Eine Auseinandersetzung mit den Funktionen von Bildern in Lehrkontexten kann deshalb nur erfolgreich sein, wenn die philosophischen Debatten über "Latenz", die zwischen dem (...) Zeitalter der Aufklärung und dem frühen 21. Jahrhundert stattgefunden haben, Eingang in die bildungswissenschaftliche Theoriebildung finden. (shrink)

Philosophy &Public Affairs, Volume 50, Issue 3, Page 271-300, Summer 2022.

What is the wrong behind the widely criticized presentist bias of democracies? In this paper I argue that it is not that future generations are excluded from present-day democratic decision-making quite generally. Rather, I claim that due to the unique risks associated with representing future generations and the limitations on affecting future generations both institutionally and causally, the focus ought to be on including them on a more specific, narrower, set of issues, namely only those that threaten to lead to (...) their domination. I identify such issues as those that may end up being purpose-determining: that may subject future generations to previous generations’ will by forcing them to exert a substantial amount of their energies on dealing with problems caused by their predecessors. I conclude by reflecting on the extent to which political representation together with providing avenues of contestation can minimize the risk of intergenerational domination. (shrink)

The agri-food system is facing a range of social-ecological threats, many of which are caused and amplified by industrial agriculture. In response, numerous sustainable agriculture narratives have emerged, proposing solutions to the challenges facing the agri-food system. One such narrative that has recently risen to prominence is regenerative agriculture. However, the drivers for the rapid emergence of regenerative agriculture are not well understood. Furthermore, its transformative potential for supporting a more sustainable agri-food system is underexplored. Through a genealogical analysis of (...) four prominent sustainable agriculture narratives; organic agriculture, conservation agriculture, sustainable intensification, and agroecology; we consider how regenerative agriculture’s growing momentum can be contextualised within existing narratives and explore the implications this might have for its transformative potential. This analysis reveals that the genealogies of these sustainable agriculture narratives have led to a number of contestations and complementarities which have coalesced to drive the emergence of regenerative agriculture. We also find that, in contrast to agroecology, regenerative agriculture shares with other Global North narratives a limited scope for offering transformative pathways for agricultural production. This is largely due to their inadequate consideration of power and equity issues in the agri-food system. We argue that regenerative agriculture therefore risks inhibiting deeper agri-food system transformations that address both social and ecological challenges and is not the unifying sustainable agriculture narrative it claims to be. Nonetheless, regenerative agriculture could contribute towards a broader plurality of sustainable agriculture narratives that collectively might enable a transformation to a more sustainable, diverse, and just agri-food system. (shrink)

The World According to Kant offers an interpretation of Immanuel Kant’s critical idealism, as developed in the Critique of Pure Reason and associated texts. Critical idealism is understood as an ontological position, which comprises transcendental idealism, empirical realism, and a number of other basic ontological theses. According to Kant, the world, understood as the sum total of everything that has reality, comprises several levels of reality, most importantly, the transcendental level and the empirical level. The transcendental level is a mind-independent (...) level at which things in themselves exist. The empirical level is a fully mind-dependent level at which appearances exist, which are intentional objects of experience. Empirical objects and empirical minds are appearances, and empirical space and time are constituted by the spatial and temporal determinations of appearances. On the proposed interpretation, Kant is thus a genuine idealist about empirical objects, empirical minds, and space and time. But in contrast to other intentional objects, appearances genuinely exist, which is due both to the special character of experience compared to other kinds of representations such as illusions or dreams, and to the grounding of appearances in things themselves. This is why, on the proposed interpretation, Kant is also a genuine realist about empirical objects, empirical minds, and empirical space and time. This book develops the indicated interpretation, spells out Kant’s case for critical idealism thus understood, pinpoints the differences between critical idealism and ‘ordinary’ idealism, such as Berkley’s, and clarifies the relation between Kant’s conception of things in themselves and the conception of things in themselves by other philosophers, in particular, Kant’s Leibniz-Wolffian predecessors. -/- PS from the author: I maintain a list of errata plus corrections on my website (which can easily be found by googling my name). If you discover additional errors, typos, or unfortunate formulations, I would be grateful to hear from you. -/- . (shrink)

This paper investigates how a performative understanding of a woman’s right to care can become part of a feminist politics which is able to transcend the well-worn dichotomies we find both within and without feminist literature, such as difference versus equality, difference versus repronormativity, and rights as freedom versus rights as domination. Drawing on my own research, I argue that claiming the right to care does not simply push women more deeply into motherhood resulting in even more control and regulation (...) of their lives, but that claiming care rights enables women to speak for themselves. Following the work of Linda Zerilli this paper argues that claiming women’s rights should, above all, be viewed as performative activities which contribute to democratic practices. (shrink)

Many people claim that music is a universal language considering the impact and beneficial results that it usually triggers, whereas others reject the idea due to contextual or cultural sentiments and parameters that must be considered. Both sides’ arguments make sense but, despite skepticism, music should be considered as a universal language, which becomes clear by depicting it in the context of peacebuilding and by exploring its linguistics and therapeutic effects, through various domains such as philosophy, music theory and the (...) contemporary world. The author argues that considering the counter-arguments and balancing it with this central claim, it is possible to reach an inspiring and complementary common ground between performing arts as music and philosophy. (shrink)

The view that agents are not obliged to do more than their initial fair shares when their fellow duty bearers fail to comply has prominent defenders, including Liam Murphy and David Miller. While Murphy thinks that asking agents to take up other agents’ slack would be unfair, Miller claims that slack-taking cannot be required because primary responsibility does not migrate from noncompliers to compliers. This paper argues, by contrast, that there are a number of circumstances in which there is a (...) duty to take up the slack even though it is unfair and even though responsibility stays where it is. The central claim is that what agents owe to third parties is a separate issue from how they relate to fellow duty bearers. This proposal also runs counter to familiar defenses of slack-taking that weigh its unfairness against the moral importance of the interests at stake for third parties. (shrink)

Wittgenstein famously criticizes the philosophical practice of analyzing the meaning of words outside their ordinary use in everyday language, whereby often self-made pseudo-problems arise. In order to shed further light on Wittgenstein’s critique, this article makes use of the Remarks on the Philosophy of Psychology. First, starting from the remark in Vol. I, §52, his criticism of the philosophical method of selection and generalization is explained in detail. Next, I give a brief outline of Wittgenstein’s own way of philosophizing by (...) reference to a selection of comments concerning the use of psychological words in everyday language, which will also further elucidate his critique. Finally, I enter into the question which significance everyday language according to Wittgenstein has for philosophy. (shrink)

The goal of this work is twofold. First, it aims to account for double genitive constructions in Serbian. Second, it aims to re-evaluate the DP hypothesis in light of their existence in Serbian. Based on evidence from the categorial status of possessives, argumenthood in the nominal domain, the morphosyntactic structure of nominalizations, and the assignment of the genitive case, it is argued that DP projection must be assumed in Serbian.

Asthereisa permanent shortage of human organs for transplantation purposes new methods to provide organs are being developed. The author deals with these new developments as there are artificial organs, genetically engineered animal organs and therapeutical cloning or embryonie stem cells to cultivate human organs. The goal of the article is to give an overview on these approaches and to summarize ethical aspects related to research, development and application of these methods.

When the first publication of Hans-Georg Gadamer's magnum opus Wahrheit und Methode came to life in I960, the work was initially received with a slight sense of puzzlement and yet concurrently acknowledged as monumental. The title, in English, Truth and Method, was regarded by the philosophical community both in Germany and abroad as being somewhat obscure, as Gadamer himself would later admit, but the ingeniousness of the book's content could hardly be debated. Since its initial publication, Truth and Method has, (...) respectively helped to expand and light up the horizon of modern hermeneutics by provoking, at once, a reconsideration of the phenomenon of understanding while, at the same time, enlivening the debate over scientific methodology and its exclusive claim to truth. The central aim of the present thesis has been to focus on Part I of Truth and Method, concentrating primarily on the 'guiding humanistic concepts' and the experience of truth in art, to clarify Gadamer's understanding of truth and to shed new light as to how the experience of tmth is to be grasped in relation to the human sciences, i.e. the humanities. The humanistic concepts, I believe, are vital to understanding the experience of truth. One reason, which leads me to this conclusion, is that in Truth and Method Gadamer begins his philosophical undertaking with the elucidation of the humanistic concepts rather than with a direct exposition of truth. By opening with the humanistic concepts, Gadamer seems to demonstrate subtly the phenomenological and ontological nature of knowledge and understanding. The outcome of this manoeuvre is that one comes to realise that truth does not simply belong to method and that it is not something which can be defined solely as 'absolute certainty'. Moreover, in my interview with Professor Gadamer, the humanistic concepts, he explained to me, are the most 'natural' and 'original' concepts. By natural and original he means that these concepts are intrinsic. They evolve from life as well as being a part of life, i.e. a way of living. Thus these concepts, he affirmed, represent 'a way of life' and a way to truth. Consequently, insofar as comprehending the phenomenon of truth, I believe any and every investigation of the concept of truth must begin with the understanding of the humanistic tradition. The following thesis however does not end simply with the humanistic concepts. It also devotes to examining the truth-claim or the 'truth-experience' of art. This part of the inquiry centres on two important questions: How are we to understand art? What does it mean to experience art? The challenge here has been to show how Gadamer overcomes Kant's subjectivation of the aesthetic experience and to demonstrate how and why Gadamer considers the experience of art as the 'self-presentation' of being. In surveying the various works of criticism I have tried to draw attention to what seem to me to be the most insightful comments and analyses. If 1 have failed in any way to supply proper acknowledgement to ideas, which might seem close to other critical works, I offer my apologies. As I am sure those in the research business know well, in reflection ideas often interfuse with one's own, making it difficult sometimes to discriminate between one's own ideas from another's. However, I have tried my best to keep from that error. (shrink)