ZusammenfassungDie Medikalisierung des Sterbens hat dazu geführt, dass ein „guter Tod“ zunehmend auch von medizinischen Interventionen erwartet wird. Die Möglichkeiten einer „terminalen Sedierung“ bis zum Tode werden von vielen als Ausweg angesehen, wenn bei unerträglichem Leid und aussichtsloser Prognose der Wunsch nach aktiver Sterbehilfe angesprochen wird. Durch eine Sedierung können zwar bei schwerstkranken Patienten schwerste therapierefraktäre Leidenszustände effektiv gelindert werden. Diese Therapieoption kann aber auch in der Absicht angewendet werden, den Todeseintritt medizinisch zu beschleunigen, so dass im Zusammenhang mit der (...) Euthanasiedebatte auch das Thema der terminalen Sedierung kontrovers diskutiert wird. Richtlinien zu Indikation, Technik und Dokumentation sind notwendig, um Stellenwert und Grenzen der terminalen Sedierung im Rahmen der palliativen Betreuung am Lebensende zu verdeutlichen und durch Transparenz Fehlentwicklungen zu vermeiden. (shrink)

Die Medikalisierung des Sterbens hat dazu geführt, dass ein „guter Tod“ zunehmend auch von medizinischen Interventionen erwartet wird. Die Möglichkeiten einer „terminalen Sedierung“ bis zum Tode werden von vielen als Ausweg angesehen, wenn bei unerträglichem Leid und aussichtsloser Prognose der Wunsch nach aktiver Sterbehilfe angesprochen wird. Durch eine Sedierung können zwar bei schwerstkranken Patienten schwerste therapierefraktäre Leidenszustände effektiv gelindert werden. Diese Therapieoption kann aber auch in der Absicht angewendet werden, den Todeseintritt medizinisch zu beschleunigen, so dass im Zusammenhang mit der (...) Euthanasiedebatte auch das Thema der terminalen Sedierung kontrovers diskutiert wird. Richtlinien zu Indikation, Technik und Dokumentation sind notwendig, um Stellenwert und Grenzen der terminalen Sedierung im Rahmen der palliativen Betreuung am Lebensende zu verdeutlichen und durch Transparenz Fehlentwicklungen zu vermeiden. (shrink)

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to the 411 (...) DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome measures Types (...) and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

Wie wollen wir sterben? Diese Frage steht im Mittelpunkt zahlreicher Diskurse und Publikationen: Was ist ein 'guter Tod' fuer den individuellen Patienten, was versteht unsere Gesellschaft darunter? Welche 'Sterbekultur' hat die Gegenwart? Autoren aus Medizin, Philosophie, Theologie, Psychologie, Soziologie, Geschichte, Ethik, Palliativmedizin, Hospizbewegung und weiteren Gebieten diskutieren im vorliegenden Band eine sinnvolle und menschenwuerdige Gestaltung am Lebensende. Der Vorschlag der Herausgeber zu einer "Ars moriendi nova" als neue Sterbekultur wird interdisziplinär eingebettet und mit Bezug zur gesellschaftlichen Praxis erörtert.

Der erste der auf vier Bände angelegten Sichtungen der Bestimmung,Leben' stellt in chronologischer Folge wichtige Grundkonstellationen des Begriffsfeldes Leben von Aristoteles bis Schelling vor. Exemplarisch wird herausgearbeitet, wie in der europäischen Kulturgeschichte vom Leben geredet wurde, wann und weshalb der Lebensbegriff an Bedeutung gewann und warum die Rede vom Leben mit einer eigenen Konfliktgeschichte verbunden ist. Von besonderem Interesse sind dabei jene Diskussionen, die für christliche Traditionen direkt oder latent relevant wurden. Damit soll den Lebensdiskursen innerhalb der bioethischen Debatten ein (...) diese anregendes Gegengewicht gegeben werden. Denn um entscheiden zu können, was zum Wohl von Lebewesen mit Lebendem getan und gelassen werden sollte, dürfte hilfreich sein, zu klären, was genau gesteigert, geschützt, renaturalisiert, kultiviert oder in Frieden gelassen werden soll. Mit Beiträgen von:Petra Bahr, Christoph Ellsiepen, Matthias Freudenberg, Gerald Hartung, Christina Hoegen-Rohls, Tom Kleffmann, Dietrich Korsch, Christof Landmesser, Christoph Markschies, Peter McLaughlin, Jörn Müller, Hanns Nissing, Enno Rudolph, Stephan Schaede, Konrad Schmid, Christian Senkel, Joachim von Soosten, Philipp Stoellger. (shrink)

Basée sur le principe de la reconnaissance de l'autre culture, cette réflexion anthropologique comporte une double dimension éthique et politique, qui s'est traduite, dans le concret de l'histoire, par l'engagement anticolonialiste de ...

Counter to the popular impression that Adam Smith was a champion of selfishness and greed, Jerry Muller shows that the Inquiry into the Nature and Causes of the Wealth of Nations maintained that markets served to promote the well-being of ...

We provide a formally rigorous framework for integrating singular causation, as understood by Nuel Belnap's theory of causae causantes, and objective single case probabilities. The central notion is that of a causal probability space whose sample space consists of causal alternatives. Such a probability space is generally not isomorphic to a product space. We give a causally motivated statement of the Markov condition and an analysis of the concept of screening-off. 1. Causal dependencies and probabilities1.1Background: causation in branching space-times1.2What are (...) probabilities defined for?2. Basic transitions2.1Basics of basic transitions2.2Sets of basic transitions3. Causal probability theory3.1Some simple cases3.2General causal probabilities3.3Application: probability of suprema of a chain. (shrink)

In this study, we use a mixed methods research design to investigate how national cultural forces may impede or enhance the positive impact of females’ economic and political empowerment on increasing gender diversity of corporate boards. Using both a longitudinal correlation-based methodology and a configurational approach with fuzzy-set qualitative comparative analysis, we integrate theoretical mechanisms from gender schema and institutional theories to develop a mid-range theory about how female empowerment and national culture shape gender diversity on corporate boards around the (...) world. With our configurational approach, we conceptually and empirically model the complexity that is associated with the simultaneous interdependencies, both complementary and substitutive ones, between female empowerment processes and various cultural dimensions. Our findings contribute unique insights to research focused on board gender diversity as well as provide information for firm decision makers and policymakers about possible solutions for addressing the continuing issue of the underrepresentation of women on corporate boards. (shrink)

The work of Rainer Forst constitutes the third generation of the Habermasian School. In Das Recht auf Rechtfertigung [The right to justification] (2007) Forst develops a constructivist approach to justice in a serious effort to find a systematic basis for ‘critical theory’. In this article the relevant arguments of this approach are critically analysed. The position developed in the work of Forst appears to be characterized by a fundamental ambiguity because it oscillates between two irreconcilable points. On the one hand (...) Forst seems to admit the necessity of something like the ‘unconditionality of moral law’ presupposing a kind of Kantian transcendentalism beyond constructivism. But on the other hand, he turns back to a more Habermasian constructivist or proceduralist theory. The ambiguity implicit in Forst’s philosophy is that it does not find a compromise between these two approaches to discursive theory so it fluctuates between them, needing the logical support of both poles. (shrink)

The genus problem of populism presents one of the most vexing conceptual questions across the social sciences: Some theorists believe that populism is nothing more than an assembly of discursive patterns, while others maintain that populism is a strategy to gain political power. Then there are those that argue that populism is a thin ideology that lacks a coherent set of guiding principles. The paper intervenes in this debate in two ways: First, it offers a methodological apparatus for evaluating and (...) developing contested concepts such as populism. Second, it puts forward and defends the claim that populism can be fruitfully understood as a coherent ideology that rests on four foundational principles. These principles, I will argue, are necessary for explaining the paradigmatic beliefs and dispositions exhibited by exponents of populism. One of the key characteristics of populism, on the account developed in this paper, is its peculiar epistemic stance. (shrink)

The aim of this paper is to establish that free agency, which is a capacity of many animals including human beings, is compatible with indeterminism: an indeterministic world allows for the existence of free agency. The question of the compatibility of free agency and indeterminism is less discussed than its mirror image, the question of the compatibility of free agency and determinism. It is, however, of great importance for our self-conception as free agents in our (arguably) indeterministic world. We begin (...) by explicating the notions of indeterminism and free agency and by clarifying the interrelation of free agency and the human-specific notion of free will. We then situate our claim of the compatibility of free agency and indeterminism precisely in the landscape of the current debate on freedom and determinism, exposing an unhappy asymmetry in that debate. Then we proceed to make our case by describing the mathematically precise, physically motivated model of projective simulation, which employs indeterminism as a central resource for agency modeling. We argue that an indeterministic process of deliberation modeled by the dynamics of projective simulation can exemplify free agency under indeterminism, thereby establishing our compatibility claim: Free agency can develop and thrive in an indeterministic world. (shrink)

Merleau-Ponty wrote prolifically throughout his life on psychology, aesthetics, and politics, on pedagogy, physics, and painting. Between his appointment to the Université de Lyon in 1945 and his sudden death in Paris in 1961—a copy of Descartes’ Dioptrique on the desk in front of him—the survey of courses he taught is dizzying in scope. For all its promise, however, the interdisciplinary nature of Merleau-Ponty’s work, and the abruptness of its end, raises the question of how these projects connect. The question (...) is encouraged by Merleau-Ponty’s own notes, which indicate that the book he was working on at the time of his death was meant to return to problems left “insoluble” in Phenomenology of Perception (VI 200). Did he hope this work would supersede the Phenomenology? to correct for its false start? to press on in the same direction? (shrink)

Essay Review of two books of A.N. Maxwell, last of the Neo-Popperians: The Comprehensibility of the Universe (1998) and The Human World in the Physical Universe (2001).

The theory of branching space-times, put forward by Belnap, considers indeterminism as local in space and time. In the axiomatic foundations of that theory, so-called choice points mark the points at which the possible future can turn out in different ways. Working under the assumption of choice points is suitable for many applications, but has an unwelcome topological consequence that makes it difficult to employ branching space-times to represent a range of possible physical space-times. Therefore it is interesting to develop (...) a branching space-times theory without choice points. This is what we set out to do in this paper, providing new foundations for branching space-times in terms of choice sets rather than choice points. After motivating and developing the resulting theory in formal detail, we show that it is possible to translate structures of one style into structures of the other style and vice versa. This result shows that the underlying idea of indeterminism as the branching of spatio-temporal histories is robust with respect to different implementations, making a choice between them a matter of expediency rather than of principle. (shrink)

Long description: Trotz ”Spatial Turn“ in den Kulturwissenschaften bildet die Verknüpfung von Raum, Wissen und Medien noch immer ein Forschungsdesiderat. Dem begegnet dieser Band, indem er die Wechselverhältnisse von räumlichen Zusammenhängen, medialen Konstellationen und Wissenskonstitution untersucht. Die medien- und geschichtswissenschaftlichen Beiträge analysieren sowohl räumliche und mediale Bedingungen wissenschaftlicher Praxis als auch Räume und Räumlichkeiten von Medien. Dabei richten sie den Blick vornehmlich auf die Konstruktionsweisen von Wissensräumen durch analoge und digitale Medien und fragen aus einer topologischen Perspektive nach der epistemischen (...) Relevanz medialer Anordnungen. (shrink)