A corpus of 60 articles published in Spanish, English, and Portuguese was analyzed to account for the integrative literature review on the concept of vulnerability from bioethics, identifying the following thematic trends: risk, susceptibility, autonomy, and culture in people and communities. The methodological approach has been mainly qualitative. We found that the disciplines that most addressed the concept belong to the human and social sciences. The authors recommend conducting studies of the concept from people’s perspectives and that ethics committees review (...) the informed consent and information guides according to these results. The categories give way to the concept of vulnerability, which must be analyzed beyond principlism in bioethics. (shrink)

The emerging concept of systems medicine (or ‘P4 medicine’—predictive, preventive, personalized and participatory) is at the vanguard of the post-genomic movement towards ‘precision medicine’. It is the medical application of systems biology, the biological study of wholes. Of particular interest, P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist. This article analyzes its concept of holism, both with regard to methods and conceptualization of health and disease. Rather than representing a medical (...) holism associated with basic humanistic ideas, we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology. We argue that this holism, which is aimed at disease prevention and health optimization, points towards an expanded form of medicalization, which we call ‘holistic medicalization’: Each person’s whole life process is defined in biomedical, technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is all-encompassing. It is directed at all levels of functioning, from the molecular to the social, continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health. We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society, which we call ‘the medicalization of health and life itself’. We explicate this holistic medicalization, discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine (quaternary prevention). (shrink)

Ethical constructivism holds that truths about the relation between rationality, morality, and agency are best understood as constructed by correct reasoning, rather than discovered or invented. Unlike other metaphors used in metaethics, construction brings to light the generative and dynamic dimension of practical reason. On the resultant picture, practical reasoning is not only productive but also self-transforming, and socially empowering. The main task of this volume is to illustrate how constructivism has substantially modified and expanded the agenda of metaethics by (...) refocusing on rational agency and its constitutive principles. In particular, this volume identifies, compares and discusses the prospects and failures of the main strands of constructivism regarding the powers of reason in responding to the challenges of contingency. While Kantian, Humean, Aristotelian, and Hegelian theories sharply differ in their constructivist strategies, they provide compelling accounts of the rational articulation required for an inclusive and unified ethical community. (shrink)

Systems medicine, which is based on computational modelling of biological systems, is emerging as an increasingly prominent part of the personalized medicine movement. It is often promoted as ‘P4 medicine’. In this article, we test promises made by some of its proponents that systems medicine will be able to develop a scientific, quantitative metric for wellness that will eliminate the purported vagueness, ambiguity, and incompleteness—that is, normativity—of previous health definitions. We do so by examining the most concrete and relevant evidence (...) for such a metric available: a patent that describes a systems medicine method for assessing health and disease. We find that although systems medicine is promoted as heralding an era of transformative scientific objectivity, its definition of health seems at present still normatively based. As such, we argue that it will be open to influence from various stakeholders and that its purported objectivity may conceal important scientific, philosophical, and political issues. We also argue that this is an example of a general trend within biomedicine to create overly hopeful visions and expectations for the future. (shrink)

A program for the simulation of rational social normative trust, predictive `trust,' and predictive reliance between agents will be introduced. It offers a tool for social scientists or a trust component for multi-agent simulations/multi-agent systems, which need to include trust between agents to guide the decisions about the course of action. It is based on an analysis of rational social normative trust (RSNTR) (revised version of M. Tuomela 2002), which is presented and briefly argued. For collective agents, belief conditions for (...) collective agency should be added. For the various forms of trust agents must have (at least) subjectively rational reasons to believe that the conditions of the trust account are fulfilled. A list of such reasons (of varied weights), e.g., given by empirical research, can manually be built into a parameter file or be generated by a calling program in a fixed format. From this list of reasons the program randomly generates a belief base for the agents of the artificial society. Reasons can be chained together so that one set of reasons satisfies several belief conditions. The program checks if the conditions are fulfilled for the artificial agents' social normative trust/predictive `trust'/`predictive reliance' in another agent that he will perform an action X. Each outcome is logged to a result file. In conclusion we discuss various aspects of the application of a trust component of the suggested kind in empirical research, social simulation, and multi-agent systems. (shrink)

With healthcare systems under pressure from scarcity of resources and ever‐increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient representatives in priority setting bodies at the policy level. We (...) find that the standard justifications for patient representation, such as to achieve patient‐relevant decisions, empowerment of patients, securing legitimacy of decisions, and the analogy with democracy, all fall short of supporting patient representation in this context. We conclude by briefly outlining an alternative proposal for patient participation that involves patient consultants. (shrink)

Na presente investigação, objetivou-se analisar, a partir do referencial teórico e metodológico pós-estruturalista, os conceitos de Ciência, Tecnologia e Sociedade na trama com a educação e o ensino de Ciências. Como substrato teórico são utilizadas obras de Michel Foucault, Gilles Deleuze e Felix Guattari, ofertando pistas para ampliar a discussão destes conceitos. Na reunião dos saberes investigados, afirma-se um pensamento científico que desenvolve a produção de sentidos para a educação. Diante do exposto, pensa-se em um ensino, que crie estratégias de (...) existências, que reivindique a trama de teorias e práticas, operando os conteúdos científicos na Sociedade. (shrink)

O objetivo deste trabalho é discutir o que significa ler e escrever no pensamento de Friedrich Nietzsche. Criticando a supremacia da subjetividade que coloca o corpo em segundo plano, o filósofo revela que escrever é mais do que formar sentenças. Junto com o escrever, há uma maneira artística de um autor mostrar os próprios impulsos e vivências. E também o leitor deve prestar atenção e reconhecer nos textos sua própria experiência de vida. O estilo nietzschiano não é sistemático. Isso já (...) prova que ele se preocupou mais com seus próprios instintos criativos do que com as regras impostas pela tradição, dando uma nova perspectiva às artes de escrever, ler, interpretar e criar. (shrink)

This entry concerns Kant's conception of moral recognition, mutual recognition, and dignity.

Wildlife conservation aims to protect the natural world, plant and animal species, and the habitats they form part of and rely on for survival. More particularly, it focuses on species that are considered important, be it from economic, ecological and other perspectives, and preventing harm to these species. While conservation activities, based on common conservation values such as species fitness and biodiversity, are no doubt beneficial to animals in general, there seems to be a fundamental disjoint between this approach and (...) the mainstay of current ethical theories regarding animals, which focus on the treatment and welfare of individual entities. I will argue that the conflict between wildlife conservation and animal ethics arises both in the aims, as well as the application of conservation. In its aims, the focus on species as a whole often comes at a cost to individual animals, and in its application individual animals are often harmed as well. To demonstrate these two points, I will use the case study of the cloning and reintroduction of the currently extinct northern white rhino. I will then conclude that wildlife conservation, while aiming to benefit animals, is fundamentally at odds with any animal ethic that considers individual wellbeing as central. (shrink)

Este artículo explora la gestualidad multisensorial, háptica y motriz como forma de habitar las atmósferas. Contribuye al desarrollo de epistemologías relacionales sobre la dimensión corporal, al abordar la experiencia corporeizada vivida con entornos aéreos, materiales, ecológicos y sociales, en lugar de centrarse en el significado conceptual y semántico para su explicación. El marco conceptual, se basa en la teoría de las affordances, las ciencias cognitivas enactivas y la fenomenología, que ofrecen una vía para configurar la interacción piel-atmósfera. Consideramos la unidad (...) organismo-entorno y lo que en la literatura se identifica con el concepto de atmósfera sonora. Se introduce la noción de affordances multisensoriales y hápticas como encuentro sensual y atencional de la presencia, para argumentar que tanto el enfoque contemporáneo del cuerpo háptico y gestual con posibilidades afectivas y de movimiento, como la perspectiva estética y ecológico-social de la performatividad -aunque conceptualmente útiles-, pasan por alto la existencia de una fenomenología háptica del reino sensual de las atmósferas. Así, se describe el entrelazamiento de las experiencias sensibles y estéticas con territorios sonoros habitados desde la experiencia táctil. Se discute cómo lo sonoro y la materialidad se utilizan para vivir experiencias particulares del espacio dentro de uno específico: la instalación arpa de fricción. Finalmente, con base en la distinción entre la sensibilidad y la consciencia, se orienta hacia una pedagogía de experiencias háptico-sonoras durante procesos de aprendizaje, útil en contextos de educación corporeizada, estética y crítica. Y se ofrece un lugar para imaginar y escenificar este tipo de entornos de aprendizaje de una manera deliberada, con cualidades permeables, inmersivas, afectivas y colectivas, para acompañar en la co-creación de mundos alternativos. (shrink)

Texto presentado en el Congreso Internacional “Recepciones de Ortega y Gasset en Chile” celebrado en el Centro Cultural de España en Santiago durante los días 30 y 31 de mayo de 2018, en Santiago de Chile. Forma parte de la compilación recogida en número especial de la Revista de Filosofía Otrosiglo, en junio del 2023.

The articles of this volume address only some aspects of Nozick's philosophy: his conception of argument, knowledge, rationality, and identity. In examining Nozick's approach to these topics, one has to take issue, ultimately, with his peculiar conception of philosophy whose manifesto appears at the outset of Philosophical Explanations and is echoed in the introduction to philosophical method of Invariances . To transform philosophy into a science or build an impeccable deductive system was not Nozick's dream. He thought of philosophy as (...) aiming at explanation rather than proof. The goal in pursuing philosophy is not to establish one view, but to elaborate theories that can make us understand some phenomena better. (shrink)

A constructivist account of moral dilemmas and integrity.

In this book, I consider whether the hypothesis of moral dilemmas undermines ethics' pretensions to objectivity. I argue against the view that moral dilemmas challenge the very possibility of ethical theory, as a practical and theoretical enterprise. By examining Kantian, Intuitionist and Utilitarian arguments about moral dilemmas, I show that no ethical theory is capable of avoiding them. I further argue that an adequate ethical theory should admit dilemmas. Dilemmas do not reveal a logical or normative flaw in the theory (...) that permits them to arise, nor are they necessarily generated by subjective mistakes. Rather, dilemmas are a sign of the deliberative capacity of an agent who operates in non-ideal conditions of rationality and cooperation. The inevitability of moral dilemmas shows that we should reconsider the bounds of deliberation, and the purposes of ethical theory. My argument for the philosophical significance of moral dilemmas rests on the claim that an adequate ethical theory should make sense of moral phenomenology, and that moral phenomenology should to be understood from the perspective of an agent who conceives of herself as an agent. The view of moral dilemmas I advocate does not invite skepticism about ethical theory, but suggests that we redefine its scope and its many practical aims. (shrink)

Quilombo designa uma herança cultural e material tendo como referência presencial o sentimento de pertencimento a um lugar e à formação de um novo grupo social, pois não são definidos somente como espaço de resistência guerreira, mas também como representantes de recursos radicais de sobrevivência em grupo. No entanto, há uma desqualificação histórica que tem estigmatizado as comunidades quilombolas, o que contribui para as dificuldades de acesso a bens e serviços, gerando desigualdades, propulsoras de adoecimento que persistem até os dias (...) atuais, constituindo-se como condicionantes da saúde. Ao se considerar que a saúde representa um dos direitos básicos dos direitos humanos, um direito indissociável ao direito à vida, esta reflexão tem por objetivo apresentar e problematizar o papel do Estado Brasileiro na garantia da promoção da saúde da população quilombola, no que se refere mais diretamente às políticas públicas no âmbito da saúde. Para tanto, este trabalho é dividido em 4 parte: (i) buscou-se problematizar a importância da revisão histórica do conceito colonial sobre quilombo com efeitos político-jurídicos-sociais para o acesso à saúde pelas comunidades quilombolas; (ii) na segunda parte são apresentadas algumas noções de saúde ligadas as comunidades quilombolas; (iii) na terceira parte são apresentadas as ações do Movimento Negro Brasileiro na mobilização pelos direitos à saúde dos povos quilombolas; e (iv) são apresentadas as políticas públicas implementadas. (shrink)

En las décadas de 1970 y 1980, se dieron sendos debates entre marxismo y feminismo a través de las lecturas de intelectuales feministas socialistas, radicales y marxistas, con el objetivo de reflexionar sobre “la cuestión de la mujer” en el sistema capitalista. Estas escritoras pensaron el “trabajo” en las producciones de Marx y construyeron, primero, la categoría de “trabajo doméstico” y, después, la de “trabajo de reproducción”. Luego, en las primeras décadas del siglo XXI, surgieron nuevas lecturas feministas de los (...) escritos marxistas a través de la categoría de “trabajo de reproducción”, que se nutrieron de los debates de las décadas anteriores. En los últimos años, en un contexto de visibilización de la violencia de género, así como de las luchas de los movimientos de mujeres y feministas en todo el mundo, las luchas por el reconocimiento de las tareas domésticas y de cuidado como trabajo se volvieron centrales. Entonces, resulta fructífero explorar las reflexiones de autoras feministas marxistas respecto del “trabajo” en Marx. Este artículo tiene como objetivo explorar las reflexiones de las intelectuales feministas que retoman la teoría marxista para pensar el trabajo femenino en el siglo XXI. Para ello, retomo las producciones de aquellas escritoras que vuelven a las obras marxianas y exponen tanto los aportes como las críticas hacia la teoría del pensador alemán, no sin antes revisar brevemente el legado de los debates que se dieron en los 70 y 80, en cuanto nutren el análisis de los feminismos marxistas actuales. (shrink)

In der Schrift Geist und Buchstab in der Philosophie stellt sich Fichte die Frage, was der Geist sei, und referiert die von Schiller zu diesem Problem eingenommene Position. Schillers Antwort auf die Frage, warum einige Werke uns mehr anziehen als andere, stellt Fichte jedoch nicht völlig zufrieden. Für Schiller kommt die Mitteilbarkeit des Werkes aus seinem allgemeinen Sein, wobei Verallgemeinerung das Opfern des Einzelnen bedeutet, um zum Gemeinsinn der Menschheit zu gelangen. Dagegen spielt für die Position Fichtes das Verständnis der (...) Individualität eine besondere Rolle. Fichte geht es darum, die Individualität nicht zu opfern, sondern die enge Verbindung von Finden und Mitteilen auszudrücken. Die Individualität weist auf die Gleichzeitigkeit von Äußerlichkeit und Innerlichkeit, wobei das Finden gleichzeitig dazu da ist, sie zum Ausdruck zu bringen. Diese in Geist und Buchstab aufgestellten Behauptungen Fichtes haben ihre Grundlage in der Wissenschaftslehre. Dort hat Fichte nämlich begriffen, wie der Weg, aus dem Entgegengesetztsein zwischen Ich und Nicht-Ich, zwischen Unendlich und Endlich, zwischen Unbestimmbarkeit und Bestimmbarkeit, die Dimension des Aufeinderfolgens - im Sinne des Opferns eines der Momente des Entgegengesetztseins, etwa der Individualität bei Schiller - verlassen muß, um zur Dimension der Gleichzeitigkeit, d.h. der inneren Relation der gegensätzlichen Momente, zu gelangen. Die Relation ist das, was Fichte erlaubt, aus der Sackgasse zwischen Idealismus und Realismus, in der der theoretische Teil der Wissenschaftslehre steckte, herauszukommen. Der Ausweg aus dem irreduziblen Gegensatz wird gleichzeitig mit dem Übergang vom theoretischen zum praktischen Teil vollzogen. (shrink)

This chapter accounts for the epistemic role of constitutive norms of practical rationality from a Kantian constructivist perspective.

Psychogenic non epileptic seizures (PNES) are clinical events of psychological nature. Video-electroencephalography monitoring (V-EEGM) is a valuable method for the diagnosis of PNES and may be combined with provocative tests to induce seizures. The use of placebo in provocative tests for the diagnosis of PNES is controversial because of associated deception, and contrasts with the use of truly decreasing epileptogenic threshold techniques such as hyperventilation and photo stimulation. We present a clinical case of a pregnant woman with a past history (...) of refractory epilepsy, admitted in the obstetric department due to unremitting seizures. In this clinical context, non-deceiving provocative tests such as hyperventilation and photo stimulation could be potentially harmful, nevertheless, the use of intravenous saline injection presented as a safer alternative to diagnose PNES and hence obviate an urgent caesarean. This case illustrates a disproportionate risk of causing harm when telling the truth, in comparison with the benefit of avoiding such risk, although deceiving the patient. This is a clinical example of how considerations concerning the use of placebo must be evaluated in an individual basis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Historical Violence, Censorship, and the Serial Killer: The Case of American PsychoCarla Freccero (bio)R.L.: Do you believe in God?B.E.E.: Are you asking me if I was raised in a religious family or if I go to church? I was raised an agnostic. I don’t know—I hate to fly, I have a fear of flying. That means either that I have no faith in air traffic controllers or that I’ve (...) done something really bad, and this is God’s way of getting at me. Maybe I’m caught in the middle.... But no, I don’t believe in God. That’s such a strange thing to admit in an interview.—Robert Love, “Psycho Analysis,” Rolling Stone interview with Bret Easton EllisBefore Capitol Hill acts on these dimwitted proposals, we should remember what the writer Bret Easton Ellis might have said, but didn’t: “Doing bad stuff is wrong.”—Ted Rall, “Meet the Cusp Kids”US mass media has become a much-publicized target of censorious commentary within American public culture in recent years. Censorship, as E. S. Burt notes, may take at least two forms: philosophical censorship, such as that discussed by Leo Strauss’s Persecution and the Art of Writing, and the more commonly applied form of US censorship enacted against “pornography” or “obscenity.” Philosophical censorship, in this reading, entails the state’s persecution of message-bearing texts or utterances that counter the doxa and threaten to disrupt the state, while the second form of censorship involves “a language use that falls outside the interpretive scheme defining the work as the intentional act of a moral being” [Burt 25]. In the United States, state censorship of the first kind may perhaps be practiced through the “incitement to riot” escape clause provision in the First Amendment, while obscenity censorship—in certain forms—is explicitly written into legislation as excluded from speech protection.Extending Strauss’s argument to the liberal state, Burt suggests in effect that these two forms of censorship become related insofar as the state’s censorious intent is directed not so much at the content of the expression as at the degree to which it confirms the axiom, what Burt calls the “very fundamental, convening assumption of the... liberal state” [25] that “virtue is knowledge” [see Strauss 25]. Thus obscenity is a form of expression that cannot be interpreted as productive knowledge but instead as a certain repetitive excess, “dirt for dirt’s sake” [Burt, quoting Judge Woolsey 28]. The problem here, of course, is that such distinctions do not apply comfortably to that category of utterance termed the literary, and especially to the use of figurative language, where “art for art’s sake” can be [End Page 44] seen precisely to resemble the nonproductivity of obscenity. The text I am going to discuss in depth here, Bret Easton Ellis’s American Psycho, has been attacked on both grounds—as an active (and violent) disruption of the doxa that is also obscenely nonproductive of knowledge—and as such, it serves as an illustrative, and I will argue, noncoincidental, case of “censorship” in the liberal state.It may be useful here to begin by surveying and making distinctions among the various popular and popularized censorships in recent US media: Ice-T’s “Cop Killer” was probably the most authentic case of “philosophical” censorship, even though its silencing did not derive directly from the state (the liberal state often does not function in some of the ways supposed when the definition of censorship is restricted to state censorship). “Cop Killer” is a song about killing policemen, and thus came closest—in the list I am going to propose of silenced works—to tempting the state’s retaliation. It was written and sung by a black man (a black man who often plays a gangster and a cop in popular films), in a genre already regarded as threateningly disruptive to the state: rap. The result is that the CD containing this song was pulled from the shelves of music stores and can no longer be purchased. There was no trial. The author withdrew his work from public circulation in the face of... (shrink)