The current debate over the global distribution of COVID-19 vaccines once again highlights the many shortcomings of the modern intellectual property system, especially when it comes to equitable access to medicines. This essay argues that the conceptual center of struggles over access to new pharmaceuticals rests in the IP system's colonial legacy, which perceives the world as uncharted territory that is ripe for discovery and ownership. This vision of the world as a blank canvas, or terra nullius, sets aside any (...) other models of ownership and devalues other traditional modes of relating to territory and nature. Several examples show the long-lasting exclusionary effects of this hidden legacy of colonial conquest in the field of public health, ranging from the spiraling price of insulin to the distribution of COVID-19 vaccines to the negotiation of sharing mechanisms for virus samples. In all of these cases, the continuing marginalization of other interests by the IP system can lead to exploitation, without either the “sources” of materials, such as those from whom the samples were taken, or the recipients of the eventual product having any say in matters of price and access. This legacy of fundamental exclusion needs to be recognized and addressed in order to arrive at more equitable solutions to public health emergencies such as the current pandemic. (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

In the recent debate on political normativity in political philosophy, two positions have emerged among so-called political realists. On the first ‘non-moral’ view, political normativity is understood as orthogonal to moral normativity. On the second ‘filter view’, moral norms and prescriptions may be ‘filtered through’ the realities of politics such that they are altered by politics’ constitutive features. While the former has been severely criticized, the latter has remained underdeveloped and vague. To take the debate on political normativity forward, the (...) aim in this paper is to explore what it could reasonably mean to claim that moral norms are filtered through politics and are aligned with its constitutive features. More specifically, we explore the role of moral norms in political theory. We take our starting-point in Larmore’s work and make two claims. First, we argue against Larmore’s claim – following political realists – that because political philosophy is concerned with the regulation of basic institutions and legal-political orders, it should primarily focus on political legitimacy rather than justice and always focus on legitimacy before justice. In our view, nothing in the constitutive features of politics supports such a conclusion. Second, we argue that any reasonable political theory relies on at least one moral premise, constituted by foundational principles (or values), which are independent of a society or polity. These are more basic than political principles in the sense that they put up the normative boundary conditions for such principles. (shrink)

If one of the most important aims of education on military ethics is to strengthen moral competence, we argue that it is important to base ethics education on virtue ethics, the Socratic attitude and the process of ?living learning?. This article illustrates this position by means of the example of a ?train the trainer? course on military ethics for Non-Commissioned Officers (NCOs), which is developed at the Netherlands Defence Academy, and uses a number of examples both from its structure and (...) from experiences from its actual use. (shrink)

Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

BackgroundResearch using data from medical care promises to advance medical science and improve healthcare. Academia is not the only sector that expects such research to be of great benefit. The research-based health industry is also interested in so-called ‘real-world’ health data to develop new drugs, medical technologies or data-based health applications. While access to medical data is handled very differently in different countries, and some empirical data suggest people are uncomfortable with the idea of companies accessing health information, this paper (...) aims to advance the ethical debate about secondary use of medical data generated in the public healthcare sector by for-profit companies for medical research (ReuseForPro).MethodsWe first clarify some basic concepts and our ethical-normative approach, then discuss and ethically evaluate potential claims and interests of relevant stakeholders: patients as data subjects in the public healthcare system, for-profit companies, the public, and physicians and their healthcare institutions. Finally, we address the tensions between legitimate claims of different stakeholders in order to suggest conditions that might ensure ethically sound ReuseForPro.ResultsWe conclude that there are good reasons to grant for-profit companies access to medical data if they meet certain conditions: among others they need to respect patients’ informational rights and their actions need to be compatible with the public’s interest in health benefit from ReuseForPro. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (shrink)

This article examines how corporate social responsibility (CSR) can serve as an external source of rents for governments that depend on foreign financing for state-building and development. The strategic, instrumental use of CSR has been overlooked in previous research on governments and CSR, especially in the Global South. To understand how CSR can serve as a lever for rents, the concept of “extraversion” is introduced to describe the way in which rent-seeking African governments instrumentalize their asymmetric external relations for political (...) and private benefit. The connection between CSR and rent-seeking is analyzed through a case study of large gas investments in Tanzania. The article finds that the government has set up regulation that enables local and central government authorities to appropriate, mediate, reclaim, or possibly trick CSR practices to gain rents. Based on the study, two contributions are made to the literature on CSR and governments. First, the instrumental use of CSR in the Global South is added to the variety of perspectives that can be taken when studying government agency. Second, CSR is conceptualized as a potential stream of rents for governments to exploit. The article ends with discussing that the outcome of CSR in a rent-seeking environment depends on whether the leveraged resources are managed well to support peaceful and locally beneficial economic development or whether they serve private accumulation through corruption. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Conscientious objection has spurred impassioned debate in many Western countries. Some Norwegian general practitioners (GPs) refuse to refer for abortion. Little is know about how the GPs carry out their refusals in practice, how they perceive their refusal to fit with their role as professionals, and how refusals impact patients. Empirical data can inform subsequent normative analysis.

Die rasanten technischen Fortschritte in der Genomforschung ermöglichen heute schon die Sequenzierung des einzelnen menschlichen Genoms in wenigen Tagen und zu vertretbaren Kosten. In der Krebsforschung ermöglicht die genetische Sequenzanalyse, zunehmend die Defekte zu identifizieren, die für das Tumorwachstum bei jedem einzelnen Patienten verantwortlich sind. Auf dieser Basis können zielgerichteter Therapien entwickelt werden. Diese Forschung wirft jedoch auch neue, ethische Fragen auf. Diesen normativen Fragen widmet sich in Heidelberg das interdisziplinäre EURAT Projekt mit dem Ziel, ethisch und rechtlich informierte Lösungen (...) zu formulieren und zu etablieren.Dieser Beitrag gibt zum einen einen Überblick über die ethischen und klinischen Fragen, die für den Aufklärungs- und Einwilligungsprozess in die biobankbasierte Genomforschung relevant sind. Zum anderen wird als organisationsethische Antwort auf die Frage, wie eine Forschungsinstitution den verantwortungsvollen Umgang mit genetischen Informationen in Biobanken über die verschiedenen Berufsgruppen und beteiligten Institute hinweg sichern kann, ein Verhaltenskodex vorgestellt. Eine gut begründete, informierte Zustimmung und ein Verhaltenskodex sind beides Elemente einer „Best Practice Leitlinie“ und sollen den verantwortlichen Umgang aller beteiligten Mitarbeiter mit sensiblen genetischen Daten prägen. (shrink)

"The Tao that can be spoken of is not the real Way," reads a famous line from the Tao-te-ching. But although the Tao cannot be described by words, words can allow us to catch a fleeting glimpse of that mysterious energy of the universe which is the source of life. The readings in this book are a beginner's entree into the vast treasury of writings from the sacred Chinese tradition, consisting of original translations of excerpts from the Taoist canon. Brief (...) introductions and notes on the translation accompany the selections from the classics; books of devotional and mystical Taoism; texts of internal alchemy; stories of Taoist immortals, magicians, and sorcerers; ethical tracts; chants and rituals; and teachings on meditation and methods of longevity. (shrink)

Considered by many Taoists and non-Taoists alike to be an essential guide to living, Lao-tzu's Treatise on the Response of the Tao was written by the twelfth-century sage Le Ying-chang. Presenting foundational teachings and practices of the Action and Karma school of Taoism, it is replete with folk stories illustrating the teachings and an introductory essay that discusses the more esoteric meaning of the passages. Told with clarity and depth, these seminal Taoist teachings offer guidance on leading a balanced healthy (...) life. (shrink)

Canadian video game developer BioWare’s critically acclaimed Mass Effect video game series has been called the most important science fiction universe of a generation. Whether or not one is inclined to agree, it cannot be denied that Mass Effect matters. It matters not only because of its brilliant narrative and the difficult questions it asks, but also because, as bioethicist Kyle Munkittrick writes, it reflects society as a whole. Mass Effect is a sci-fi epic in the truest sense, spanning over (...) years and across hundreds of planets tucked away in the darkest corners of the galaxy, populated with dozens of species with their own histories, beliefs, cultures, and technologies. Academics and dedicated fans have explored the numerous facets of the game, from its philosophy to time and temporality, fandom ethnographies, and ethics. This article proposes to explore the boundaries of alien sex and the desire for alien others as represented in sci-fi role playing games, and their reinterpretation by fans. Science fiction role playing games in particular enable the production of sexual modalities outside of the constraints of heterosexual norms. Alien sex, animal sex, or monstrous sex are common tropes in fantasy and sci-fi media—the vampire, the werewolf, and monstrous non/in-humans are eroticized and construed conduits of a mainly female sexual desire. However, the example I would like to approach is slightly more radical, both in terms of execution and in terms of media audience response: examples of “alien sex” as illustrated in the Mass Effect video game series, whose canonical representation of alien-human romances invite some interesting questions about either the potential exacerbation, or the rendering-unintelligible of sexual difference, as well as about cross-species desire and about the ontology of the natural and the artificial. (shrink)

Correspondence testing to research discrimination in the marketplace has become common and the use of internet applications has allowed researchers to send greater numbers of applications. While qu...

The paper argues that colouring is a conventional ingredient of literal meaning characterized by a considerable degree of semantic under-determination and a high degree of context-sensitivity. The positive, though tentative, suggestion made in the paper is that whereas in the case of words such as "but" and "damn" we are dealing with words lacking in specificity, in the case of pejoratives in general, and racist jargon in particular, we are dealing with words that express concepts that purport to describe the (...) world as being in a certain way. The circumstance that in certain contexts of utterance colouring can be cancelled out, does not show that it forms a detachable part of a word's literal meaning. It only shows that to account for the interplay between context, literal meaning and assertoric content is much trickier than meets the eye. (shrink)

Under what conditions do motherhood penalties emerge in countries undergoing transition from state socialism to capitalism? This analysis identifies the ways managers in global financial firms employ gendered assumptions in constructing and implementing labor practices among highly skilled professional workers in Hungary. Relying on 33 in-depth interviews with employers as well as interviews with headhunting firms, labor and employment lawyers, and analysis of antidiscrimination cases brought before Hungary’s Equal Treatment Authority between 2004 and 2008, we identify several strategies global employers (...) use to shed, demote, and marginalize professional mothers. By demonstrating the salience of motherhood as a status characteristic in the postsocialist labor market, our work contributes to existing scholarship on motherhood penalties. Our work also extends this scholarship by showing how the salience of motherhood is strongly conditioned by state-level arrangements that shape the opportunity context in which employers design and carry out employment practices. (shrink)

After describing the philosophical background of Kerry's work, an account is given of the way Kerry proposed to supplement Bolzano's conception of logic with a psychological account of the mental acts underlying mathematical judgements.In his writings Kerry criticized Frege's work and Kerry's views were then attacked by Frege.The following two issues were central to this controversy: (a) the relation between the content of a concept and the object of a concept; (b) the logical roles of the definite article. Not only (...) did Frege in 1892 offer an unconvincing solution to Kerry's puzzle concerning 'the concept horse' but he also overlooked the many criticisms levelled by Kerry against the notion of an (indefinite) extension on which his own definition of number was based. (shrink)

The concept of revolution marks the ultimate horizon of modern politics. It is instantiated by sites of both hope and horror. Within progressive thought, “revolution” often perpetuates entrenched philosophical problems: a teleological philosophy of history, economic reductionism, and normative paternalism. At a time of resurgent uprisings, how can revolution be reconceptualized to grasp the dynamics of social transformation and disentangle revolutionary practice from authoritarian usurpation? Eva von Redecker reconsiders critical theory’s understanding of radical change in order to offer a bold (...) new account of how revolution occurs. She argues that revolutions are not singular events but extended processes: beginning from the interstices of society, they succeed by gradually rearticulating social structures toward a new paradigm. Developing a theoretical account of social transformation, Praxis and Revolution incorporates a wide range of insights, from the Frankfurt School to queer theory and intersectionality. Its revised materialism furnishes prefigurative politics with their social conditions and performative critique with its collective force. Von Redecker revisits the French Revolution to show how change arises from struggle in everyday social practice. She illustrates the argument through rich literary examples—a ménage à trois inside a prison, a radical knitting circle, a queer affinity group, and petitioners pleading with the executioner—that forge a feminist, open-ended model of revolution. Praxis and Revolution urges readers not only to understand revolutions differently but also to situate them elsewhere: in collective contexts that aim to storm manifold Bastilles—but from within. (shrink)

Hobbes’s theory of authorisation poses numerous puzzles to scholars. The weightiest of these conundrums is a supposed contradiction between chapter 17 of Leviathan, that calls for unconditional submission to the sovereign, and chapter 21, that defends the liberties of the subject. This article offers a fresh perspective on the theory’s consistency, function and addressees. While existing research doubts the theory’s consistency, focuses on its immunisation function and on the subjects as the theory’s main addresses, the paper argues that Hobbes’s theory (...) of authorisation is consistent with the doctrine of the liberty of subjects, and that it serves the dual purpose of immunising the sovereign against criticism and disciplining the sovereign via a counsel of memento mori: A hitherto underexplored element of authorisation theory is a reminder of the mortality of sovereignty directed at the sovereign to convince him to make restricted use of his absolute right to rule. Hobbes’s theory of authorisation can thus be read as part of a complex argumentative strategy for peace, rooted in a ‘liberal absolutism’ which is not as paradoxical as it sounds, and which is reflected in the frontispiece by the friendly smile of the sovereign. (shrink)

The gendered assumptions embedded in the construction of the rational individual are well established in Western feminist thought but inapplicable to describe societies operating on different principles, such as East European state socialism. This article identifies the communist subject as the building block of communist political ideology and argues that this formulation was no less male biased than its counterpart, the rational individual under liberal capitalism. In state socialist Hungary this male bias came to be expressed differently: Women were integrated (...) into society through membership in a social group perceived as relatively homogeneous regarding interests and obligations and with gender-specific qualities and privileges. These qualities were considered inferior to men's since women—because of household responsibilities—were not capable of total devotion to the communist party. The author explores this construction of the female communist subject through a content analysis of classified materials from the archives of the Hungarian Socialist Workers' Party. (shrink)

Rorty's assessment of the origins of the analytic/continental divide is discussed and criticized on several grounds. Rorty's plea in favour of the philosophical quietism implicit in the pragmatists' dismissal of metaphysics rests on an uncritical faith in scientific progress. To emphasize the tensions implicit in the ideal of progress a novel interpretation of the significance of Faust's encounter with Sorge (Care) is offered and compared with Heidegger's construal of Sorge in Sein und Zeit . A better understanding of the analytic/continental (...) divide is gained if we concentrate on the impact of Nazism and Fascism on the philosophical tradition with which philosophers living on the Continent had to come to terms after the Second World War. In this respect Adorno's attitude to progress in general and to philosophy in particular is very instructive and can be usefully contrasted with Rorty's dismissal of metaphysics. (shrink)

This article explores Southern Saami reindeer herders’ experiences and contestations over state consultation and corporate dialogue during a conflict over the Øyfjellet wind energy project in Norway. Informed by a committed research approach and juxtaposition with findings from Indigenous peoples' territorial struggles in Latin-America, the article provides critical perspectives on governance practices in a Nordic-Saami green colonial context. The research draws on ethnography from a consultation meeting between Jillen Njaarke, the impacted reindeer herding community, and state authorities, as well as (...) diverse written material. The study suggests that the state- and corporate-led “dialogues” displaced the root cause of the conflict, revealed epistemic miscommunication, and perpetuated relations of domination which limited emancipatory effects for Jillen Njaarke. The premises and discourses underpinning the “dialogues” further reproduced racist notions which devalue ancestral Saami reindeer herding knowledges, practices, and landscape relations. These findings challenge dialogue as prescription of good governance and conflict resolution in a context where democracy and compliance with Indigenous peoples’ rights are perceived as high. (shrink)

Etude du phénomène du kitsch à travers les littératures et cultures d'Europe, d'Amérique du Nord et du Sud et du Japon.

_ Source: _Volume 30, Issue 2, pp 123 - 155 While there are old questions in research on Hobbes regarding which audience he addressed in each of his different works – e.g. there are speculations that _De Cive_ is addressed to scientists and _Leviathan_ to the English people – another question has rarely been discussed and only recently reconsidered: Might Hobbes have addressed different audiences also _within_ one and the same text, and if so, might he have intended to communicate (...) different messages to different readers? As ‘Straussian’ as this question might sound, it does not require us to impose external principles of hermeneutics on Hobbes’s texts. As this paper will argue, there is strong plausibility for the claim that Hobbes himself believes in the possibility and the necessity of ‘diversified communication’ or, to state it differently, to communicate different things to different people within one and the same text. By analysing Hobbes’s passion-grounded hermeneutics that is expressed both in Hobbes’s political writings and in his writings on science and on poetry, I show that it is very likely that Hobbes wrote ‘not all to all’ but instead designed different arguments for different people. Employing the heterogeneity principle in interpreting Hobbes’s texts might thus shed new light on some persistent puzzles of Hobbes’s political philosophy. (shrink)