The future of medicine will be predictive, preventive, personalized, and participatory. Recent technological advancements bolster the realization of this vision, particularly through innovations in...

We present a model of computation for string functions over single-sorted, total algebraic structures and study some basic features of a general theory of computability within this framework. Our concept generalizes the Blum-Shub-Smale setting of computability over the reals and other rings. By dealing with strings of arbitrary length instead of tuples of fixed length, some suppositions of deeper results within former approaches to generalized recursion theory become superfluous. Moreover, this gives the basis for introducing computational complexity in a BSS-like (...) manner. Relationships both to classical computability and to Friedman's concept of eds computability are established. Two kinds of nondeterminism as well as several variants of recognizability are investigated with respect to interdependencies on each other and on properties of the underlying structures. For structures of finite signatures, there are universal programs with the usual characteristics. For the general case of not necessarily finite signature, this subject will be studied in a separate, forthcoming paper. (shrink)

This article tries to present a broad view on the values and ethicalissues that are at stake in efforts to rationalize health policy on thebasis of economic evaluations (like cost-effectiveness analysis) andrandomly controlled clinical trials. Though such a rationalization isgenerally seen as an objective and `value free' process, moral valuesoften play a hidden role, not only in the production of `evidence', butalso in the way this evidence is used in policy making. For example, thedefinition of effectiveness of medical treatment or (...) health care serviceis heavily dependent on dominant individual or social views about thegoals of the particular treatment or service. There is also a concernthat a reliance on EBM in health policy will occur at the expense ofwidely shared social values like equity and solidarity. Moreover, thereis a concern that when economic considerations and rational proceduresbecome more influential, various `outside' groups third parties likeinsurance companies and policy makers will get a stronger influence onmedical practice which may lead to a change in the patient-providerrelationship. The authors conclude that social values and patientpreference should be explicitly addressed when health policy making isbased on economic and other scientific evidence. (shrink)

Free and informed consent is generally acknowledged as the legal andethical basis for living organ donation, but assessments of livingdonors are not always an easy matter. Sometimes it is necessary toinvolve psychosomatics or ethics consultation to evaluate a prospectivedonor to make certain that the requirements for a voluntary andautonomous decision are met. The paper focuses on the conceptualquestions underlying this evaluation process. In order to illustrate howdifferent views of autonomy influence the decision if a donor's offer isethically acceptable, three cases (...) are presented – from Germany, theUnited States, and India. Each case features a person with questionabledecision-making capacity who offered to donate a kidney for a siblingwith severe renal insufficiency. Although the normative framework issimilar in the three countries, different or sometimes even contraryarguments for and against accepting the offer were brought forward. Thesubsequent analysis offers two explanations for the differences inargumentation and outcome in spite of the shared reference to autonomyas the guiding principle: (1) Decisions on the acceptability of a livingdonor cannot simply be deducted from the principle of autonomy but needto integrate contextual information; (2) understandings of the wayautonomy should be contextualized have an important influence on theevaluation of individual cases. Conclusion: Analyzing the conceptualassumptions about autonomy and its relationship to contextual factorscan help in working towards more transparent and better justifieddecisions in the assessment of living organ donors. (shrink)

Business Ethics: A European Review, EarlyView.

The aim of the paper is to present and evaluate Bolzano's theory of grounding, that is, his theory of the concept expressed and the relation brought into play by 'because'. In the first part of the paper (Sections 1-4) the concept of grounding is distinguished from and related to three other concepts: the concept of an epistemic reason}, the concept of causality, and the concept of deducibility (i.e., logical consequence). In its second part (Sections 5-7) Bolzano's positive account of grounding (...) is reconstructed in axiomatic form and critically discussed. (shrink)

Bioethics in a globalized world is meeting a number of challenges – fundamentalism in its different forms, and a focus on economic growth neglecting issues such as equity and sustainability, being prominent among them. How well are we as bioethicists equipped to make meaningful contributions in these times? The paper identifies a number of restraints and proceeds to probe potential resources such as the capability approach, care ethics, cosmopolitanism, and pragmatism. These elements serve to outline a perspective that focuses on (...) the preconditions for flourishing human relationships as a way to address bioethical challenges in a globalized world. (shrink)

In the wake of the emergence and rapid development of nanoethics there swiftly followed fundamental criticism: nanoethics was said to have become much too involved with speculative developments and was concerning itself too little with actually pending questions of nanotechnology design and applications. If this diagnosis is true, then large parts of nanoethics are misguided. Such fundamental criticism must surely either result in a radical reorientation of nanoethics or be refuted for good reasons. In this paper, I will examine the (...) critics’ central arguments and, building on this scrutiny, formulate an answer to these alternatives. The results lead to conclusions which allow explaining and unfolding the thesis of this paper that instead of speculative nanoethics we should better speak of and develop explorative philosophy of nanotechnology. (shrink)

Name der Zeitschrift: Deutsche Zeitschrift für Philosophie Jahrgang: 64 Heft: 6 Seiten: 951-977.

Parallel to the public discussion on the benefits and risks of nanotechnology, a debate on the ethics of nanotechnology has begun. It has been postulated that a new “nano-ethics” is necessary. In this debate, the — positive as well as negative — visionary and speculative innovations which are brought into connection with nanotechnology stand in the foreground. In this contribution, an attempt is made to discover new ethical aspects of nanotechnology in a more systematic manner than has been the case. (...) It turns out that there are hardly any completely new ethical aspects raised by nanotechnology. It is much rather primarily a case of gradual shifts of emphasis and of relevance in questions which, in principle, are already known and which give reason for ethical discussions on nanotechnology. In a certain manner, structurally novel ethical aspects arise through the important role played by visions in the public discourse. New questions are also posed by the fact that previously separate lines of ethical reflection converge in the field of nanotechnology. The proposal of an independent “nano-ethics”, however, seems exaggerated. (shrink)

Many international courts have developed into institutions of public authority; this begs the question of their legitimation. This Article addresses their democratic legitimation and argues that Articles 9-12 of the E.U. Treaty provide a promising blueprint for its conceptualization, fusing theories focused on representation, participation and deliberation. This fusion points the way towards conceiving and developing the democratic credentials of institutions beyond the state in general. Soft law used by international judges, their election, procedure and reasoning will appear in a (...) new light. (shrink)

Confabulations are memories of events and experiences that have never actually happened. Such false memories have fascinated scientists for over a century, and in recent years been the subject of much debate. This is the first book to provide an in-depth analysis of an extraordinary and controversial subject.

Living organ donation has developed into an important therapeutic option in transplantation medicine. However, there are some medico-ethical problems that come along with the increasing reliance on this organ source. One of these concerns is based on the observation that many more women than men function as living organ donors. Whereas discrimination and differential access have been extensively discussed in the context of cadaveric transplantation and other areas of health care, the issue of gender imbalance in living organ donation has (...) received less attention. This paper presents relevant data from the Eurotransplant and UNOS transplantation systems and discusses possible explanations for the documented gender discrepancies. The conclusion calls for are view of existing practice guidelines in order to secure effective protection of particularly vulnerable potential donors and an equitable donor-recipient-ratio in living organ donation. (shrink)

Notions of democracy and nationhood constitute the pivotal legacy of the American Revolution, but to understand their development one must move beyond a purely American context. Citizens of a Common Intellectual Homeland explores the simultaneous emergence of modern concepts of democracy and the nation on both sides of the Atlantic during the age of revolutions. Armin Mattes argues that in their origin the two concepts were indistinguishable because they arose from a common revolutionary impulse directed against the prevailing hierarchical (...) political and social order. The author shows how the reconceptualization of democracy and the nation, which resulted from this revolutionary impulse, received its decisive form from the French Revolution. Although the French Revolution was instrumental in redefining the two terms, however, neither were these changes confined to France, nor did the new meanings merely radiate from France to other countries. To illustrate the transatlantic emergence of these ideas, Mattes considers the works of pairs of prominent intellectual contemporaries--one in America and the other in Europe--each writing on a common topic. The thinkers and topics include Thomas Paine and Edmund Burke on the transatlantic revolutions, John Adams and Friedrich von Gentz on the mixed constitution, James Madison and Immanuel Kant on perpetual peace, and Thomas Jefferson and Destutt de Tracy on the nation. Mattes's approach highlights the significant impact that the French Revolution had on the evolution of thought in the period, demonstrating that the emergence and early development of modern concepts of democracy and the nation in America were intimately tied to revolutionary events and processes in the larger Atlantic world. Preparation of this volume has been supported by the Thomas Jefferson Foundation. Jeffersonian America. (shrink)

Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design, development and deployment of AI systems to support decision-making around (...) cardiopulmonary resuscitation and the determination of a patient’s Do Not Attempt to Resuscitate status (also known as code status). The COVID-19 pandemic has made us keenly aware of the difficulties physicians encounter when they have to act quickly in stressful situations without knowing what their patient would have wanted. We discuss the results of an interview study conducted with healthcare professionals in a university hospital aimed at understanding the status quo of resuscitation decision processes while exploring a potential role for AI systems in decision-making around code status. Our data suggest that (1) current practices are fraught with challenges such as insufficient knowledge regarding patient preferences, time pressure and personal bias guiding care considerations and (2) there is considerable openness among clinicians to consider the use of AI-based decision support. We suggest a model for how AI can contribute to improve decision-making around resuscitation and propose a set of ethically relevant preconditions—conceptual, methodological and procedural—that need to be considered in further development and implementation efforts. (shrink)

Artificial intelligence (AI) systems are quickly gaining ground in healthcare and clinical decision-making. However, it is still unclear in what way AI can or should support decision-making that is based on incapacitated patients’ values and goals of care, which often requires input from clinicians and loved ones. Although the use of algorithms to predict patients’ most likely preferred treatment has been discussed in the medical ethics literature, no example has been realised in clinical practice. This is due, arguably, to the (...) lack of a structured approach to the epistemological, ethical and pragmatic challenges arising from the design and use of such algorithms. The present paper offers a new perspective on the problem by suggesting that preference predicting AIs be viewed as sociotechnical systems with distinctive life-cycles. We explore how both known and novel challenges map onto the different stages of development, highlighting interdisciplinary strategies for their resolution. (shrink)

The role of ethics in technology development has been often questioned, especially in the early days of societal reflection of technology. However, the situation has changed dramatically. Ethical consideration now is generally declared to be indispensable in shaping technology in a socially acceptable and sustainable way. The expectations of ethics are large; often even a kind of “New Ethics” is postulated. In the present paper an over-estimation of the role of ethics for technology development is rejected. It is argued that (...) ethical reflection is, indeed, indispensable in certain problem areas and situation types; but there is, on the other hand, space for technology development free from the requirement for ethical reflection. The absence of a requirement for ethical reflection, however, always has to be considered relative to some “morale provisoire” (provisional morality) as an accepted normative framework within which technology development may occur without explicit ethical reflection. If this framework, however, is doubted or is shown to be insufficient the situation changes completely. Ethical reflection in this case becomes necessary, to consider this normative framework in order to offer modifications or supplements. (shrink)

In their book Unto Others, Sober and Wilson argue that various evolutionary considerations (based on the logic of natural selection) lend support to the truth of psychological altruism. However, recently, Stephen Stich has raised a number of challenges to their reasoning: in particular, he claims that three out of the four evolutionary arguments they give are internally unconvincing, and that the one that is initially plausible fails to take into account recent findings from cognitive science and thus leaves open a (...) number of egoistic responses. These challenges make it necessary to reassess the plausibility of Sober & Wilson’s evolutionary account—which is what I aim to do in this paper. In particular, I try to show that, as a matter of fact, Sober & Wilson’s case remains compelling, as some of Stich’s concerns rest on a confusion, and those that do not are not sufficiently strong to establish all the conclusions he is after. The upshot is that no reason has been given to abandon the view that evolutionary theory has advanced the debate surrounding psychological altruism. (shrink)

In a number of very influential publications, Epstein and Hoover (among other authors) have recently argued that a thoroughly micro-foundationalist approach towards economics is unconvincing for metaphysical reasons. However, as we show in this article, this metaphysical/social ontological approach to the debate fails to resolve the status of micro-foundations in the practice of economic modelling. To overcome this, we argue that endogenizing a model—that is, providing micro-foundations for it—correlates with making that model more complex. Specifically, we show that models with (...) more micro-foundations tend to have more parameters or variables. This matters, as there are well-established methodological reasons for preferring models with fewer parameters or variables—ceteris paribus. We therefore conclude that, from a practice-based point of view, micro-foundations are only defensible to the extent that they significantly improve the ability of the relevant model to fit the data of interest. In this way, we arrive at a practice-based, methodological reconceptualization of the debate surrounding the need for micro-foundations in economics. (shrink)

Transplanting organs from emotionally related donors has become a fairly routine procedure in many countries. However, donors have to be chosen carefully in order to avoid not just medically, but also morally, questionable outcomes. This paper draws attention to vulnerabilities that may affect the voluntariness of the donor's decision. Suggestions are made as to how to approach the evaluation and selection of potential donors.

Far-reaching promises made by nanotechnology have raised the question of whether we are on the way to understanding human beings more and more as belonging to the realm of technology. In this paper, an increasing need to understand the technological re-conceptualization of human beings is diagnosed whenever increasingly “technical” interpretations of humans as mechanical entities are disseminated. And this can be observed at present in the framework of nanobiotechnology, a foremost “technical” self-description where a technical language is adopted. The arena (...) in which the decision is made on increasing the use of technological understanding to define mankind will not be found in the surgery room in which one works with implants, nor the NBIC-laboratory, in which “nerve plugs” are supposed to be developed. The thesis of this paper is that such arena is rather related to the manner in which concepts of humanity are associated with it, how we think and talk about ourselves, and which consequences we draw out of it. (shrink)

Dynamic stability of the knee and weakness of the extensor muscles are considered to be the most important functional limitations after anterior cruciate ligament injury, probably due to changes at the central level of motor control rather than at the peripheral level. Despite general technological advances, fewer contraindicative surgical procedures, and extensive postoperative rehabilitation, up to 65% of patients fail to return to their preinjury level of sports, and only half were able to return to competitive sport. Later, it becomes (...) clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after ACL reconstruction even years after surgery. Therefore, new therapeutic tools targeting the central neural system, i.e., the higher centers of motor control, should be investigated and integrated into current rehabilitation practice. To improve motor performance when overt movement cannot be fully performed, several techniques have been developed to increase physical and mental activation without the need to perform overt movements. Among the most popular cognitive techniques used to increase physical performance are motor imagery and action observation practices. This review, which examines the available evidence, presents the underlying mechanisms of the efficacy of cognitive interventions and provides guidelines for their use at home. (shrink)

There are different possibilities for defining the areas for the application of ethics to engineering. They range from descriptive analysis of engineers’ relationship to moral criteria and extend to normative issues on how engineers should design more “sustainable” technology. In this paper, a frame of reference is proposed, which makes it possible to elaborate in a transparent manner goals for analysis of the scope of ethics in engineering. Its point of departure is marked by two questions: 1) which types of (...) situation in the practice of engineering require ethical reflection? and 2) to what extent are engineers expected to assume moral responsibility in the practice of their profession? The answers to both of these questions presuppose reflection on the societal processes of setting definitions and of making ascriptions. Understanding these processes of societal “construction” of demands for ethical reflection in engineering and of engineers’ moral responsibilities should be an important objective of the analysis of ethics in engineering. (shrink)

Kaum ein anderer Begriff wird unterschiedlicher, ja gegensätzlicher verwendet als der Gottesbegriff. Nicht immer behaupten Gläubige, was Atheisten leugnen, und nicht immer bestreiten Atheisten, wozu sich Gläubige bekennen. Diese radikale Umstrittenheit des Gottesbegriffs stellt die Frage nach dem "wahren Antlitz Gottes", nach dem Verständnis dessen, was das Wort "Gott" wirklich bedeutet. Laesst sich überhaupt nachvollziehbar benennen, was dieses Wort meint, oder entzieht sich seine Bedeutung nicht jedem menschlichen Verstäendnis? Was heisst es denn, wenn wir sagen, Gott sei Person, allmächtig, allwissend, (...) gätig, dreifaltig? Worauf müssen wir achten, wenn wir über Gott reden, damit wir uns nichts vormachen? Das Buch hilft zu erkennen, auf welchen Gottesbegriff Verlass ist, so dass wir unser Leben darauf setzen können. (shrink)

The role of normative reflection and the possibilities of ethical inquiry in technology assessment have been under discussion in the TA community for several years. As an outcome of this discussion the necessity of explicitly dealing with normativity in TA has widely been acknowledged. However, it is still quite unclear in which way this should be done. This paper is dedicated to the role (and limitations) of ethical expertise in this field, especially in HTA. By methodological analysis an approach is (...) developed to show how entry points for ethical expertise could be identified. The result is that ethical expertise can inform moral debates by uncovering underlying assumptions, by making the normative structure of argumentation transparent, and by weighing the strength of the arguments. In this way moral debates in HTA can become more transparent and opened to argumentative reasoning instead of consisting of bargaining processes determined by power distributions. Ethical reflection, however, does not replace decision-making. (shrink)

Moral Sanctuary is used in this paper as a metaphor for any theory which makes actions immune from moral criticism. Three arguments favoring moral sanctuaries for business activities are countered. Two of the arguments rest on faulty analogies. One compares business activities to games, another to the behavior of machines. The third rests on the claim that business is a unique activity. This position is rejected by a reductio ad absurdum argument; it entails the immunity of all professional activities from (...) moral judgment. I argue that business managers are accountable to the combined requirements of professionalism and democratic citizenship, notions which are briefly described at the conclusion of the paper. (shrink)

Schon seit ihrer Gründung in den 1970er-Jahren ist die Reihe Germanistische Linguistik (RGL) exponiertes Forum des Faches, dessen Namen sie im Titel führt. Hinsichtlich der thematischen Breite (Sprachebenen, Varietäten, Kommunikationsformen, Epochen), der Forschungsperspektiven (Theorie und Empirie, Grundlagenforschung und Anwendung, Inter- und Transdisziplinarität) und des methodologischen Spektrums ist die Reihe offen angelegt. Das Aufgreifen neuer Trends hat in ihr ebenso Platz wie das Fortführen von Bewährtem. Die Publikationsformen reichen von Monographien und Sammelbänden bis zu Wörterbüchern. Wissenschaftlicher Beirat (ab November 2011): Prof. (...) Dr. Karin Donhauser (Berlin) Prof. Dr. Stephan Elspaß (Augsburg) Prof. Dr. Helmuth Feilke (Gießen) Prof. Dr. Jürg Fleischer (Marburg) Prof. Dr. Stephan Habscheid (Siegen) Prof. Dr. Rüdiger Harnisch (Passau). (shrink)

Handling the impacts and consequences of technology has become a problem of political, social and scientific relevance since the Sixties. The earlier assumption that technological evolution would automatically lead to social and human progress in an emphatic sense can no longer be sustained. The ambivalence of technology has become a standing topic in the public, philosophical and scientific debate .In this situation new challenges to technology policy are emerging. Functions of an `early warning' with respect to the risks or potentials (...) of new technologies or to ways of avoiding or, at least, resolving technology conflicts by compromise have been postulated . Technology policy pursued by parliament or government, therefore, is in need of scientific consultation . Since the Seventies a number of institutions in this field have been founded , either primarily as parliamentary bureaus of knowledge-transfer to the decision-makers , as networks with a low degree of institutionalization or as independent scientific institutes .The scientific discussion on how to acquire and establish orientational knowledge for decision-makers facing the ambivalence of technology is sectoralized into two branches: the ethics of technology and technology assessment . These two branches are based on fundamentally different assumptions concerning how to give orientation to technology policy: the philosophical ethics, of course, emphasizes the normative implications of decisions on technology and the importance of moral conflicts , while technology assessment relies mainly on sociological or economic research .Both approaches have largely been developed and practised without regard to one another. In Germany, at the beginning of the Nineties the conceptual discussion around these questions was initiated. At first, a lot of misunderstandings appeared, both parties fundamentally criticizing each other, often one denying the competence of the other to deal appropriately with technology problems . In this paper the conflict is analyzed by looking at the situation in Germany, summarizing and weighing the main arguments which have been brought up by TA and the ethical approach to technology.As a result it will be shown that both are partly right, whereby the relative weight of both approaches in their capacity to give orientation is dependent on contextual circumstances. A non-reductionistic overall approach must take into account the normative aspects of the ethics of technology when handling moral conflicts as well as the need for operationalization, concreteness and established knowledge about the processes of “managing technology in society” postulated by TA. (shrink)

recent defence of the massive modularity thesis. However, as this paper seeks to show, there are major flaws in its structure. If construed deductively, it is unsound: modular mental architecture is not necessarily the best architecture, and even if it were, this alone would not show that this architecture evolved. If construed inductively, it is not much more convincing, as it then appears to be too weak to support the kind of modularity Carruthers is concerned with. The upshot of this (...) is that whatever reason we might have for believing that the mind is massively modular, it is not based on the argument from design. Introduction Carruthers’ Argument from Design Modularity and Optimality: Problems for the Deductive Argument from Design Degrees of Modularity: Problems for the Inductive Argument from Design Conclusion CiteULike Connotea Del.icio.us What's this? (shrink)

Matters of hospital management do not figure prominently on the medical ethics agenda. However, management decisions that have to be taken in the area of hospital care are in fact riddled with ethical questions and do have significant impact on patients, staff members, and the community being served. In this decision making process evidence based medicine plays an increasingly important role as a tool for rationalising as well as rationing health care resources. In this article, ethical issues of hospital management (...) and the role of EBM will be explored, with particular reference to disease management programs, diagnosis related groups, and clinical pathways as recent developments in the German health care system. (shrink)

Finding out why we have beliefs and desires is important for a thorough understanding of the nature of our minds (and those of other animals). It is therefore unsurprising that several accounts have been presented that are meant to answer this question. At least in the philosophical literature, the most widely accepted of these are due to Kim Sterelny and Peter Godfrey-Smith, who argue that beliefs and desires evolved due to their enabling us to be behaviourally flexible in a way (...) that reflexes do not—which, they claim, is beneficial in epistemically complex environments. However, as I try to make clear in this paper, upon closer consideration, this kind of account turns out to be theoretically implausible. In the main, this is because it fails to give due credit to the powers of reflex-driven organisms, which can in fact be just as flexible in their behaviour as ones that are belief/desire-driven. In order to improve on this account, I therefore propose that beliefs and desires evolved, not due to their enabling us to do something completely different from what reflexive organisms can do, but rather due to their enabling us to do the same things better. Specifically, I argue that beliefs and desires evolved for making the generation of behaviour more efficient, since they can simplify the necessary cognitive labour considerably. I end by considering various implications of this account. (shrink)

Artificial intelligence has found its way into many areas of human life, serving a range of purposes. Sometimes AI tools are designed to help humans eliminate high-volume, tedious, routine tas...

I critically discuss a recent innovation in the debate surrounding the plausibility of rational choice theory : the appeal to evolutionary theory. Specifically, I assess Gigerenzer and colleagues’ claim that considerations based on natural selection show that, instead of making decisions in a RCT-like way, we rely on ‘simple heuristics’. As I try to make clearer here, though, Gigerenzer and colleagues’ arguments are unconvincing: we lack the needed information about our past to determine whether the premises on which they are (...) built are true—and, hence, we cannot tell whether they, in fact, speak against RCT. (shrink)