Clinical ethics support services are experiencing a phase of flourishing and of growing recognition. At the same time, however, the expectations regarding the acceptance and the integration of traditional CES services into clinical processes are not met. Ethics rounds as an additional instrument or as an alternative to traditional clinical ethics support strategies might have the potential to address both deficits. By implementing ethics rounds, we were able to better address the needs of the clinical sections and to develop a (...) more comprehensive account of ethics quality in our hospital, which covers the level of decisions and actions, and also the level of systems and processes and aspects of ethical leadership. (shrink)

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

This is the first of three parts of an introduction to the philosophy of climate science. In this first part about observing climate change, the topics of definitions of climate and climate change, data sets and data models, detection of climate change, and attribution of climate change will be discussed.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

On the observational equivalence of continuous-time deterministic and indeterministic descriptions Content Type Journal Article Pages 193-225 DOI 10.1007/s13194-010-0011-5 Authors Charlotte Werndl, Department of Philosophy, Logic and Scientific Method, London School of Economics, Houghton Street, London, WC2A 2AE UK Journal European Journal for Philosophy of Science Online ISSN 1879-4920 Print ISSN 1879-4912 Journal Volume Volume 1 Journal Issue Volume 1, Number 2.

The progress of electronic health technologies and biobanks holds enormous promise for efficient research. Evidence shows that studies based on sharing and secondary use of data/samples have the potential to significantly advance medical knowledge. However, sharing of such resources for international collaboration is hampered by the lack of clarity about ethical and legal requirements for transfer of data and samples across international borders. Here, the International Clinical Trial Center Network reports the legal and ethical requirements governing data and sample exchange (...) across four continents. The most recurring requirement is ethical approval, whereas only in specific conditions approval of national health authorities is required. Informed consent is not required in all sharing situations. However, waiver of informed consent is only allowed in certain countries/regions and under certain circumstances. The current legal and ethical landscape appears to be very complex and under constant evolution. Regulations differ between countries/regions and are often incomplete, leading to uncertainty. With this work, ICN illuminates the unmet need for a single international collaborative framework to facilitate DSE. Harmonising requirements for global DSE will reduce inefficiency and waste in research. There are many challenges to realising this ambitious vision, including inconsistent terminology and definitions, and heterogeneous and dynamic legal constraints. Here, we identify areas of agreement and significant difference as a necessary first step towards facilitating international collaboration. We propose the establishment of a working group to continue the comparison across jurisdictions, create a standardised glossary and define a set of basic principles and fundamental requirements for DSE. (shrink)

This essay examines the impact of linguistic choices on the perception and regulation of assisted dying, particularly in Canada. It argues that euphemistic terms like “medical assistance in dying” and its acronym, “MAID,” serve to normalize the practice, potentially obscuring its moral gravity. This contrasts with what is seen in Belgium and the Netherlands, where terms like “euthanasia” are used, as well as in France and the United Kingdom, where terminology remains divisive and contested. By tracing the evolution of these (...) terms and what they reveal about different cultural and legal approaches, this essay sheds light on the politics of language in end-of-life discourses. It suggests that the shift toward euphemistic language reflects a broader discomfort with death that can shape public attitudes and legal frameworks. It calls for a more transparent, philosophically grounded approach to terminology and suggests that continued debate about semantics is necessary to capture the complexities and ethical significance of assisted dying. (shrink)

The aim of the article is to illustrate concrete problems in the asymmetrical nurse–patient power relationship. It is an ethical demand that the nurse is faced with the challenges that the power in the relation is administered so that the patient's room for action is expanded and trust maintained. It is an essential message in care philosophy, but in clinical practice, success is not always achievable. A hidden and more or less unconscious restriction of the patient's room for action may (...) result in the excesses of care. Three selected aspects: dependence, trust, and power described by the Danish philosopher K.E. Løgstrup and the Norwegian nursing philosopher Kari Martinsen's care philosophy has inspired this empirically based examination of some current barriers in the asymmetrical nurse–patient relationship. On the basis of qualitative interviews with six patients and six nurses, the research thus provides an identifying and problem‐exploratory examination of some current obstacles in which the handling of trust and power reflects the excesses of care. The findings develop three themes. ‘Being a burden’ acknowledges that the balance of power will always tip to the nurse's advantage. The second theme, ‘Doing only what's absolutely necessary’, shows how a fixation with ‘technicalism’ creates a distance between people that may constrain the patient's room for action. The last theme is concerning the nurse's ability to navigate between closeness and distance is essential in avoiding ‘the excesses of care’, paternalism, and overprotectiveness. A situation in which distance takes the upper hand and care turns into paternalism. A different situation would arise if the nurse's emotions became sentimental or intimate with the result that closeness gets the upper hand. To avoid a harmful exercise of power and the excesses of care, the findings have demonstrated that a relationship‐based caring is a demand for situation‐specific sensitive attention skills. (shrink)

BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...) the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.MethodsThis study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation.ResultsData was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows:Interprofessional well-being in team interactionson a team level;Professional comfort when dealing with moral challengeson a personal level; andImproved quality of care for the child and the familyon a care level.ConclusionsHealthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support. (shrink)

Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in (...) the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison. (shrink)

Behavioral evidence for the COVIS dual‐process model of category learning has been widely reported in over a hundred publications (Ashby & Valentin, ). It is generally accepted that the validity of such evidence depends on the accurate identification of individual participants' categorization strategies, a task that usually falls to Decision Bound analysis (Maddox & Ashby, ). Here, we examine the accuracy of this analysis in a series of model‐recovery simulations. In Simulation 1, over a third of simulated participants using an (...) Explicit (conjunctive) strategy were misidentified as using a Procedural strategy. In Simulation 2, nearly all simulated participants using a Procedural strategy were misidentified as using an Explicit strategy. In Simulation 3, we re‐examined a recently reported COVIS‐supporting dissociation (Smith et al., ) and found that these misidentification errors permit an alternative, single‐process, explanation of the results. Implications for due process in the future evaluation of dual‐process theories, including recommendations for future practice, are discussed. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

“Today I made the ascent of the highest mountain in this region, which for good reasons is called Ventosum, guided only by the desire to see the extraordinary altitude of the place”. Petrarch's ascent of the Mont Ventoux in 1336, or rather his account of it, established the mountain as a distinctive place for experiencing and understanding nature and self. Since then, the mountain has been sought out in increasing numbers by those pursuing spiritual elevation, bodily exertion, and/or scientific investigation. (...) To this day, a pilgrimage church, several hotels, and an observatory are characteristically perched atop Mont Ventoux. And it is famous among cyclists as a legendarily difficultétapeof the Tour de France. (shrink)

Bewegungseinschränkende Maßnahmen werden in verschiedenen medizinischen Institutionen angewendet, um das Verhalten von Patienten durch physische bzw. mechanische oder chemische Eingriffe zu beeinflussen. Solche Maßnahmen stellen eine Art Freiheitsentziehung dar und bedürfen daher immer einer Rechtfertigung. Die Frage nach der Indikation für bewegungseinschränkende Maßnahmen ist abzuklären, da ein standardmäßiger Gebrauch nicht Ziel einer Behandlung sein sollte. Gesetze können als Richtschnur für behandelnde Ärzte und Pflegepersonal dienen. In der Schweiz ist am 1. Januar 2013 erstmals eine gesetzliche Regelung zu bewegungseinschränkenden Maßnahmen eingeführt (...) worden. Hauptziel dieser neuen Artikel im Schweizerischen Zivilgesetzbuch (Artikel 383 ff. ZGB) ist die Stärkung von Autonomie und persönlicher Freiheit von Patienten. Es ist wichtig, Vorschriften zu hinterfragen bzw. deren Auswirkungen für die betroffenen Personen zu analysieren und einen kritischen Dialog zu führen. Die vorliegende Publikation betrachtet bewegungseinschränkende Maßnahmen aus zwei verschiedenen Perspektiven: einerseits anhand einer medizinethischen Debatte, andererseits anhand einer Analyse der gesetzlichen Regelung in der Schweiz. Die neuen Artikel umfassen eine detaillierte Regelung zur „Einschränkung der Bewegungsfreiheit“. Dennoch schließen sie nicht alle bestehenden Regelungslücken. Die neue Schweizer Gesetzgebung kann daher nur als ein erster Schritt in die richtige Richtung betrachtet werden. Ausführungen zur praktischen Anwendung sind dringend nötig und sollten so schnell wie möglich ausgearbeitet werden. (shrink)

ABSTRACT:This paper explores how corporations, through their Corporate Social Responsibility (CSR) activities, can help to effect positive developmental change. We use research on institutional change, deinstitutionalization, and institutional work to develop our central theoretical framework. This framework allows us to suggest more explicitly how CSR can potentially be mobilized as a purposive form of institutional work aimed at disrupting existing institutions in favor of positive change. We take the gender institution in the Arab Middle East as a case in point. (...) Our suggestion is that the current context of the Arab Spring, which combined with increasingly obvious endogenous institutional contradictions, has created a fertile ground for shaping change processes within the gender institution. Finally, we provide concrete examples of CSR initiatives that regional corporate actors can engage in for positive developmental change supporting women. (shrink)

This study focuses on how moral aspects of purpose shape collaborative processes. It does so by analyzing the unfolding of 21 relationships between four nonprofits and their funders using a framework based on French pragmatist sociology to help uncover the deeply held, ideological and moral beliefs that underscore assumptions about what the overarching purpose of a collaborative effort is or should be. This study contributes to the literature on single and cross-sectoral collaboration by showing that the way partners handle and (...) reconcile differences about purpose is related to the forms of agreement likely to be achieved. It also suggests that certain forms of agreement are inherently more enduring than others. Taken as a whole, this study provides some plausible explanations as to why so many collaborations fail despite their seeming benefits for all the parties involved. (shrink)

Equilibrium is a central concept of statistical mechanics. In previous work we introduced the notions of a Boltzmannian alpha-epsilon-equilibrium and a Boltzmannian gamma-epsilon-equilibrium. This was done in a deterministic context. We now consider systems with a stochastic micro-dynamics and transfer these notions from the deterministic to the stochastic context. We then prove stochastic equivalents of the Dominance Theorem and the Prevalence Theorem. This establishes that also in stochastic systems equilibrium macro-regions are large in requisite sense.

This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my (...) defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts. (shrink)

The central question of this paper is: are deterministic and indeterministic descriptions observationally equivalent in the sense that they give the same predictions? I tackle this question for measure-theoretic deterministic systems and stochastic processes, both of which are ubiquitous in science. I first show that for many measure-theoretic deterministic systems there is a stochastic process which is observationally equivalent to the deterministic system. Conversely, I show that for all stochastic processes there is a measure-theoretic deterministic system which is observationally equivalent (...) to the stochastic process. Still, one might guess that the measure-theoretic deterministic systems which are observationally equivalent to stochastic processes used in science do not include any deterministic systems used in science. I argue that this is not so because deterministic systems used in science even give rise to Bernoulli processes. Despite this, one might guess that measure-theoretic deterministic systems used in science cannot give the same predictions at every observation level as stochastic processes used in science. By proving results in ergodic theory, I show that also this guess is misguided: there are several deterministic systems used in science which give the same predictions at every observation level as Markov processes. All these results show that measure-theoretic deterministic systems and stochastic processes are observationally equivalent more often than one might perhaps expect. Furthermore, I criticise the claims of the previous philosophy papers Suppes (1993, 1999), Suppes and de Barros (1996) and Winnie (1998) on observational equivalence. (shrink)

* INTRODUCTION This book seeks to add dimension to our understanding of Greek Skepticism by concentrating attention on a particular area that is of ...

This book develops an account of what substance is in terms of the notion of independence. As the authors note, there is a tradition of defining substance as independent that begins with Aristotle. But what notion of independence can provide an adequate definition of substance? The authors find traditional attempts to define independence, including Aristotle’s, inadequate on a number of grounds, and they propose an alternative account. As a preface to this undertaking, the authors consider and reject a number of (...) standard objections to their project, and as an afterword, they argue that the notion of spiritual substance is as intelligible as the notion of material substance. (shrink)

In Boltzmannian statistical mechanics macro-states supervene on micro-states. This leads to a partitioning of the state space of a system into regions of macroscopically indistinguishable micro-states. The largest of these regions is singled out as the equilibrium region of the system. What justifies this association? We review currently available answers to this question and find them wanting both for conceptual and for technical reasons. We propose a new conception of equilibrium and prove a mathematical theorem which establishes in full generality (...) -- i.e. without making any assumptions about the system's dynamics or the nature of the interactions between its components -- that the equilibrium macro-region is the largest macro-region. We then turn to the question of the approach to equilibrium, of which there exists no satisfactory general answer so far. In our account, this question is replaced by the question when an equilibrium state exists. We prove another -- again fully general -- theorem providing necessary and sufficient conditions for the existence of an equilibrium state. This theorem changes the way in which the question of the approach to equilibrium should be discussed: rather than launching a search for a crucial factor, the focus should be on finding triplets of macro-variables, dynamical conditions, and effective state spaces that satisfy the conditions of the theorem. (shrink)

Research on women's preponderance among animal rights advocates explains it exclusively as a product of women's socialization, emphasizing a relational orientation of care and nurturing that extends to animals. The authors propose a more structural explanation: Women's experiences with structural oppression make them more disposed to egalitarian ideology, which creates concern for animal rights. Using data from a 1993 national sample, the authors find that an egalitarian gender ideology is a key difference in women's and men's routes to animal rights (...) advocacy: It differentiates those more likely to endorse animal rights among women but not among men. Neither this ideology nor other variables in the analysis, however, account for women's greater overall support of animal rights in the combined sample. Reasons for this latter finding are explored. (shrink)

This paper addresses the actual practice of justifying definitions in mathematics. First, I introduce the main account of this issue, namely Lakatos's proof-generated definitions. Based on a case study of definitions of randomness in ergodic theory, I identify three other common ways of justifying definitions: natural-world justification, condition justification, and redundancy justification. Also, I clarify the interrelationships between the different kinds of justification. Finally, I point out how Lakatos's ideas are limited: they fail to show how various kinds of justification (...) can be found and can be reasonable, and they fail to acknowledge the interplay among the different kinds of justification. (shrink)

The notion of moral expertise poses a variety of challenges concerning both the question of existence of such experts and their identification by laypeople. I argue for a view of ethics expertise, based on moral understanding instead of on moral knowledge, that is less robust than genuine moral expertise and that does not rely on deference to testimony. I propose identification criteria that focus mainly on the awareness and communication of implicit biases and situated ignorance. According to the account of (...) ethics expertise presented in this paper, the expert's testimony is not an epistemic reason for the layperson's belief, but merely an epistemic influence. The epistemic reasons for the layperson's belief are largely independent from the expert. But there is still some epistemic risk involved in the proposed method of knowledge transfer, and therefore criteria for the identification of a trustworthy expert are necessary. The risk involved in knowledge transfer can be both due to willful manipulation and due to the expert's implicit biases and situated ignorance. While willful manipulation cannot really be avoided, the influence from biases and ignorance can be minimized. I argue that the best way to do this is if the expert is aware of their own biases and ignorance and communicates them. Combined with evidence of the expert's education in moral philosophy and experience with the topic in question, this gives the layperson the best chance to identify someone who can really help them consider all relevant aspects of a situation and come to a better justified decision. (shrink)

In a criminal trial, evidence is used to draw conclusions about what happened concerning a supposed crime. Traditionally, the three main approaches to modeling reasoning with evidence are argumentative, narrative and probabilistic approaches. Integrating these three approaches could arguably enhance the communication between an expert and a judge or jury. In previous work, techniques were proposed to represent narratives in a Bayesian network and to use narratives as a basis for systematizing the construction of a Bayesian network for a legal (...) case. In this paper, these techniques are combined to form a design method for constructing a Bayesian network based on narratives. This design method is evaluated by means of an extensive case study concerning the notorious Dutch case of the Anjum murders. (shrink)

Is it ever right to prescribe placebos to patients in clinical practice? The General Medical Council is ambivalent about the issue; the American Medical Association asserts that placebos can be administered only if the patient is (somehow) ‘informed’. The potential problem with placebos is that they may involve deception: indeed, if this is the case, an ethical tension arises over the patient's autonomy and the physician's requirement to be open and honest, and the notion that medical care should be the (...) primary concern. This paper examines the case of depression as an entry point for understanding the complexities of the prescription of placebos. Recent important meta-analyses of antidepressants claim that they are not significantly more effective in a clinical setting than placebos. Given that antidepressants have numerous adverse side effects and are hugely expensive, this provocative research has serious potential ethical and practical implications for patients and medical providers. Should placebos be prescribed in place of antidepressants? The case of depression highlights another important issue which medical ethical codes have hitherto overlooked: well-being is not synonymous with being realistic about oneself, one's circumstances and the future. While severely depressed individuals are unduly pessimistic about themselves and the world around them, treatment of depressed individuals can be deemed successful when patients have successfully attained those positive illusions that are indicative of psychological health. This is exactly what successful psychological treatments of depression seem to achieve. It is therefore possible that there may be a limited unavoidable role for deception in medicine. (shrink)

Charlotte Sabourin | : Cet article se penche sur la contribution de Gabrielle Suchon à la célèbre « querelle des femmes ». J’y démontre que, quoique Suchon défende l’égalité des deux sexes en ce qui a trait à leurs capacités à la liberté, à la science et à l’autorité, elle vise ultimement à montrer que les femmes peuvent se rendre supérieures aux hommes. Je montrerai que son projet d’élévation des femmes ne peut être accompli qu’en soustrayant les femmes à (...) l’influence des hommes, les relations entre les deux sexes étant foncièrement préjudiciables aux premières. | : This paper examines Gabrielle Suchon’s contribution to the famous “querelle des femmes”. I argue that although Suchon is a proponent of the equality of the sexes with respect to their capacities for freedom, science and authority, she ultimately suggests that there is a way in which women can make themselves superior to men. I will show that her project for the elevation of women can be accomplished only by isolating women from men, given that the relationships between the sexes will always be detrimental to women. (shrink)

This chapter offers a reinterpretation of Heidegger’s conception of the social world in order to overcome the tension between its conflicting positive and negative characterisations in Being and Time. Rejecting a purely positive or a purely negative reading of das Man, the chapter follows Stephen Mulhall in carving out a middle ground between the two. The chapter takes seriously Heidegger’s claim that it is possible for das Man to undergo an authentic transformation, exploring how best to conceive of this idea. (...) It is argued that the authentic transformation of das Man and the everyday way of being it engenders, is most productively understood with reference to Dasein’s relation to das Man and the way Dasein grasps the world as meaningful. Through this reading it is shown how both an authentic and an inauthentic mode of everydayness can be accommodated. The chapter concludes with an examination of the consequences of this interpretation, arguing for the critical and political potential of authenticity as an attentive and engaged mode of being-in-the-world. (shrink)

Torah, the name of the first five books of the ?sacred history? comprised by the Hebrew Bible, tends to be translated as ?Law? and to be affiliated with the separating ?Law of the Father.? But Torah means ?teaching.? Venerable tradition allies this teaching with feminine Wisdom, ?a tree of life.? Theories of poetic language elaborated by such scholars as Julia Kristeva and Hélène Cixous facilitate discovering beneath the Torah's fractured and labyrinthine surface a way of return to the mother. This (...) way is embodied in the inversions, textuality, and concentricity of the rhetorical trope of chiasmus, which exceeds the bounds of the Law to provide a form for the expression of ?woman's desire? and so for the feminine text. Exploring as such the doubly chiastic poem in which, when naming woman in Eden, a human being (adam) changes its name to man (iysh) challenges man's biblical history, while restoring the memory of interconnection with the mother and all life. Reduplications of this transformative moment expand upon sacred history in terms of the Torah's central injunction to love one's neighbor as oneself. (shrink)

Corballis seems to have not considered two points: (1) the importance of direct selection pressures for the evolution of handedness; and (2) the evolutionary significance of the polymorphism of handedness. We provide arguments for the need to explain handedness in terms of adaptation and natural selection.