HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In principle, all (...) schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies. (shrink)

Legal professionals in Malawi rely on a limited number of textbooks, outdated law reports and inadequate library services. Most documents available are in image form, are un-structured, i.e. contain no useful legal meta-data, summaries, keynotes, and do not support a system of citation that is essential to legal research. While advances in document processing and machine learning have benefited many fields, legal research is still only marginally affected. In this interdisciplinary research, the authors build semi-automatic tools for creating a corpus (...) of Malawi criminal law decisions annotated with legal meta-data, case and law citations. We used this corpus to extract legal meta-data, including law and case citations as used in Malawi by employing machine learning tools, spaCy and Gensim LDA. We set the foundation for a new methodology for classifying Malawi criminal case law according to the recently introduced International Classification of Crime for Statistical Purposes (ICCS). (shrink)

BackgroundThere have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health (ANH) nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also need an embedded process that can identify, characterise and manage ethical issues as the research work develops, as such more embedded and dynamic ethics processes are needed. This work builds on notions of ‘ethics in practice’ (...) by developing an approach to facilitate ethical reflection within large research programmes. This study explores the application of a novel ‘real-time research ethics approach’ (RTREA) and how this can support ethical mindfulness. This involves embedding ethical analysis and decision-making within research implementation, with a continuous dialogue between participants and researchers. The aim is to improve ethical responsiveness and participant experience, which in turn may ethically support adherence and retention. In this case study, a bioethics team (BT) was embedded in a community-based randomised, controlled trial conducted in rural Malawi, titled the ‘Addressing Hidden Hunger with Agronomy’. To identify ethical issues, the researchers conducted ten focus group discussions, fourteen in-depth interviews with key informants, two workshops, observed two sensitisation and three activity meetings conducted by the trial team, and analysed fifteen reports from pre-trial to trial implementation.ResultsThe RTREA facilitated the identification of social and ethical concerns and made researchers aware of participants’ ‘lived research experience’. To address concerns and experiences, the BT worked with researchers to facilitate conversation spaces where social and ethical issues were discussed. Conversation spaces were designed to create partnerships and promote participatory methods to capture trial participants’ (TPs) perspectives and experiences.ConclusionsThe use of RTREA showed the value of real-time and continuous engagement between TPs and researchers. These real-time processes could be embedded to complement traditional ethical guidance and expert opinions. A deeper engagement appeared to support greater operationalising of principles of inclusion, empowerment, and participant autonomy and supported researchers ‘ethical mindfulness’ which in turn may support instrumental outcomes of high recruitment, retention, and adherence levels. (shrink)

BackgroundThe participant recruitment process is a key ethical pivot point when conducting robust research. There is a need to continuously review and improve recruitment processes in research trials and to build fair and effective partnerships between researchers and participants as an important core element in ensuring the ethical delivery of high-quality research. When participants make a fair, informed, and voluntary decision to enroll in a study, they agree to fulfill their roles. However, supporting study participants to fulfill study requirements is (...) an important ethical obligation for researchers, yet evidenced as challenging to achieve. This paper reports on participants’ motivations to volunteer and remain part of a dietary study conducted in Kasungu District, Malawi.MethodsWe conducted twenty in-depth interviews (with chiefs, religious leaders, trial participants, and health surveillance assistants), five systematic ethnographic observations, and fourteen focus group discussions with trial participants and their partners. Interviews were audio-recorded and transcribed verbatim. We used a grounded theory methodology to analyse data that included coding, detailed memo writing, and data interpretation.FindingsThe findings reveal that many participants had concerns during the trial. Thematically, experiences included anxieties, mistrust of researchers, rumours, fears of exploitation, and misconceptions. Anonymous concerns collected from the participants were reported to the trial team which enabled the researchers to appropriately support participants. Despite initial concerns, participants described being supported and expressed motivation to take up their role.ConclusionThese findings highlight a diverse map of multiple notions of what is ethically relevant and what can impact participation and retention within a study. The study has revealed how embedding a responsive approach to address participants’ concerns and ethical issues can support trust relationships. We argue for the need to employ embedded ethics strategies that enhance informed consent, focus on participants’ needs and positive experiences, and support researchers to fulfill their roles. This work highlights the need for research ethics committees to focus on the risks of undue influence and prevent exploitation especially in settings with a high asymmetry in resources and power between researcher and participant groups.Trial Registration: The Addressing Hidden Hunger with Agronomy (Malawi) trial was registered on 5th March 2019 (ISCRTN85899451). (shrink)

Research collaboration beyond national jurisdiction is one aspect of the globalisation of health research. It has potential to complement researchers in terms of research skills, equipment and lack of adequate numbers of potential research subjects. Collaboration at an equal level of partnership though desirable, may not be practicable. Sometimes, human research specimens must be transported from one country to other. Where this occurs, there should be clear understanding between the collaborating research institutions regarding issues of access and control of the (...) specimens as well as the duration of storage of specimens. The researchers have the duty to inform the research participants about specimen storage and transport across national boundaries. While obtaining informed consent from study subjects if specimens are to be stored beyond the life of the present study could be the ideal, there still remains significant challenges in a multi-cultural world. (shrink)

The principle of individual medical confidentiality is one of the moral principles that Africa inherited unquestioningly from the West as part of Western medicine. The HIV/AIDS pandemic in Southern Africa has reduced the relevance of the principle of individual medical confidentiality. Individual medical confidentiality has especially presented challenges for practitioners among the Bantu communities that are well known for their social inter-connectedness and the way they value their extended family relations. Individual confidentiality has raised several unforeseen problems for persons living (...) with HIV/AIDS, ranging from stigma and isolation to feelings of dejection as it drives them away from their families as a way of trying to keep information about their conditions confidential. The involvement of family members in treatment decisions is in line with the philosophy of Ubuntu and serves to respect patients’ and families’ autonomy while at the same time benefiting the individual patient. (shrink)

Southern African countries have the highest HIV infection rates in the world. In most of the countries in the region, the rate among adults is at least 10%. The fight against HIV/AIDS has mostly been inadequate owing to the lack of proper consideration of ethical and cultural issues. In this article, the authors discuss the ethical and cultural dilemmas concerning HIV/AIDS, with Malawi as a case in point. It is argued that increasing financial resources alone, as exemplified by the Global (...) Fund to Fight AIDS, Tuberculosis and Malaria initiative, without proper attention to ethical issues, morals and appropriate legal obligations, are unlikely to reduce the spread of HIV in southern Africa. (shrink)

There is currently a global shortage of nurses. Developing countries such as Malawi are among those hardest hit by this shortage. The demands on available nurses have increased and at the same time there is a lack of interest in becoming a nurse owing to the poor working conditions among those still employed in the service. It is questionable if developed nations should recruit nurses from countries such as Malawi, where severe human resource constraints are being experienced. We argue in (...) this article that the current phenomenon of nurses leaving developing nations for western countries is complex. Human rights issues of individual autonomy and public interest are at stake. (shrink)

Tillie Olsen (1978) drew attention to an evident, yet underappreciated fact of writing, which is that it takes time: ‘Where the claims of creation cannot be primary, the results are atrophy; unfinished work; minor effort and accomplishment; silences’ (p. 13). Drawing from our experiences as a precariously employed PhD student and a postdoc in philosophy with parenting responsibilities, we want to address this type of silencing in a manner that stylistically corresponds to the exhaustion, lack of time, and lack of (...) leisure experienced by many caregivers in academia. For this, we want to record one of the few occasions in our daily routine where there is sufficient time and mental capacity to reflect on our own situation: the conversation at the kitchen table in the evening when the chores are done. Our contribution consists in a redacted transcription of this conversation for which we propose the term ‘autotheoretical dialogue’ (see Fournier 2021; Young 1997). Our dialogue covers topics such as: care in relation to class and gender (Lightman & Link 2021); teaching in higher education as a form of care work in contrast to the more prestigious work of research (Cardozo 2017); the precarious working conditions in academia and their relation to parenting (Spina et al. 2022); the ignorance and hostility towards parenthood in academia; the effects of this marginalisation like fatigue, self-doubt, and depression, but also the ambivalence that arises from the conflict of the joy of caring; and the institutional and cultural difficulties of reconciling academic work with parenthood. (shrink)

Artificial intelligence is currently changing many areas of society. Especially in health, where critical decisions are made, questions of control must be renegotiated: who is in control when an automated system makes clinically relevant decisions? Increasingly, the concept of meaningful human control (MHC) is being invoked for this purpose. However, it is unclear exactly how this concept is to be understood in health. Through a systematic review, we present the current state of the concept of MHC in health. The results (...) show that there is not yet a robust MHC concept for health. We propose a broader understanding of MHC along three strands of action: enabling, exercising and evaluating control. Taking into account these strands of action and the established rules and processes in the different health sectors, the MHC concept needs to be further developed to avoid falling into two gaps, which we have described as theoretical and labelling gaps. (shrink)

HIV/AIDS is a major public health problem in Africa. Stigmatization, discrimination and lack of appropriate health care are among the commonest challenges that HIV infected persons and their families face. It has been suggested that among the tools available in the fight against stigmatization and discrimination is public disclosure of a person’s HIV seropositive status. While public disclosure of HIV status has a place in the fight against HIV and AIDS, especially by resulting in behavioural change among people who know (...) of an HIV infected person, we argue that such disclosure also has potential attendant harms. The posthumous disclosure of HIV status is particularly problematic. Public disclosure should be accompanied by appropriate individual counselling and preparation of the community to deal with the situation, and should have regard for cultural sensitivity after consideration of the risks and benefits to individuals, families and the community. Health practitioners should keep in mind that their main duty is to the best interest of the patient, the family and the community, in that order. (shrink)

zur fundierenden Rolle des Gefühls bei den Leistungen der Vernunft Eva-Maria Engelen. Eva-Maria Engelen Erkenntnis und Liebe Zur fundierenden Rolle des Gefühls bei den Leistungen der Vernunft Vandenhoeck & Ruprecht Eva-Maria ...

Socially responsible business and ethical behaviour of companies have been of interest to academia and practice for decades. But the focus has almost exclusively been on large corporations while small- and medium-sized enterprises (SME) have not received as much attention. Thus, this paper focuses on socially responsible business practices of SME entrepreneurs or owner–managers in Germany. Based on the assumption that decision-makers in SMEs are the central point where all business activities start, members of a German entrepreneurs association were approached (...) in the course of a qualitative and quantitative survey. They were asked to assess in what way their social responsibility is expressed in specific management practices towards selected stakeholder groups. These practices in turn were assumed to result in perceived positive reactions of the respective stakeholders and subsequently to positively influence the firm's financial performance, i.e. cost reductions and increase in profits. In the paper, a research model is presented that elaborates the relationship between an SME executive's social responsibility and the value creation of a firm, i.e. whether (personal) values create (economic) value. It was found that socially responsible management practices towards employees, customers and to a lesser extent society have a positive impact on the firm and its performance. As such, values can create additional value. (shrink)

It is shown in this article in how far one has to have a clear picture of Gödel’s philosophy and scientific thinking at hand (and also the philosophical positions of other philosophers in the history of Western Philosophy) in order to interpret one single Philosophical Remark by Gödel. As a single remark by Gödel (very often) mirrors his whole philosophical thinking, Gödel’s Philosophical Remarks can be seen as a philosophical monadology. This is so for two reasons mainly: Firstly, because it (...) pictures a monadology already via its form. And secondly, because Gödel wanted to establish in his Philosophical Remarks a modern monadology in adapting the philosophical principles of Leibniz’s monadology to modern science. This article will only deal with the first aspect that has been mentioned namely that a single remark by Gödel (very often) mirrors his whole philosophy (at the time) for example: set theory, perception and intuition of mathematical objects and axioms, the nature of the human mind, the concept and existence of God, and so on. This renders it extremely difficult to interpret Gödel’s philosophical remarks but interpreting it provides also a deep insight in Gödel’s philosophical thoughts. (shrink)

The article develops a theoretical framework that is capable of integrating the biological foundations of emotions with their cultural and semantic formation.

This paper outlines Jesse Prinz’s theory that emotions represent values by registering bodily changes, discusses two objections, and concludes that Prinz’s theory stands in need of modification: while emotions do represent values, they do not do so in the first place by registering bodily changes, but by processing information about how things we care about fare in the world. The function of bodily changes is primarily to motivate and prepare us for action.

Empathy as “Feelingly Grasping” Perhaps the central question concerning empathy is if and if so how it combines aspects of thinking and feeling. Indeed, the intellectual tradition of the past centuries has been marked by a dualism. Roughly speaking, there have been two pathways when it comes to understanding each other: 1) thinking or mind reading and 2) feeling or empathy. Nonetheless, one of the ongoing debates in psychology and philosophy concerns the question whether these two abilities, namely, understanding what (...) the other is thinking and “understanding” what the other is feeling, are separate or not. Most of the authors in this volume consider the cognitive and affective dimensions at work within empathy. Each author does this within and beyond their own field. Coming from the humanities, we propose the following definition for empathy: Empathy is a social feeling that consists in feelingly grasping or retracing the present, future, or past emotional state of the other; thus empathy is also called a vicarious emotion. We would like to highlight two aspects of this definition in particular: 1.) the peculiar position of “grasping” which involves a cognitive dimension and 2.) the social dimensions of relating to the emotions of another human being. (shrink)

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

Die Ausführungen zum Begriff der Liebe in Hegels Ästhetik lassen sich als Spuren der Auseinandersetzung Hegels mit der Vereinigungsphilosophie lesen. Nach der These dieses Aufsatzes enthält die Ästhetik diese Spuren also noch, obgleich Hegels Abschied von der Vereinigungsphilosophie längst vollzogen war, als die Vorlesungen zur Ästhetik entstanden sind. Die Begriffe Philosophie der Vereinigung und Vereinigungsphilosophie bezeichnen Positionen in der Philosophie des 18. Jahrhunderts, die sich mit der Selbstwerdung des Subjekts oder des Bewußtseins befassen und mit der für die Selbstwerdung erforderlichen (...) Hingabe an ein Äußeres, Anderes. Infolge der Hingabe an ein Äußeres, Anderes werden dem Selbst die Grenzen und der Grund seines Selbst bewußt. Das Selbst benötigt demnach das Andere, um zu sich selbst zu kommen. Die Hingabe an das Endliche außer uns, die erforderlich ist, um in Abgrenzung zum Anderen zu einem Selbst zu werden, wird als Liebe im Sinne des Eros bestimmt. Diese Liebe ist der Antrieb, die Vereinigung mit dem Erstrebten zu suchen und die Erkenntnis des Wahren zu fin Für die Selbstwerdung oder Selbsterkenntnis werden dabei, je nach philosophischer Konzeption, unterschiedliche Bereiche als Ort der Vereinigung angenommen: Der Bereich der Religion, der auf die Erkenntnis Gottes und der Seele abhebt, die nur in der Wiedervereinigung der Seele mit Gott im Jenseits zu erlangen ist. Oder der Bereich des Schönen, der für Hölderlins Philosophie der Vereinigung zentral ist. Die allen Formen der Vereinigungsphilosophie zugrundeliegende Frage ist die nach dem Verhältnis zwischen dem Selbst (oder der Seele) und dem Begehrten, das zur Selbstwerdung gebraucht wird. Das Projekt der Selbstwerdung stellt aber nicht nur das erklärte Anliegen der Vereinigungsphilosophie dar, sondern auch das der romantischen Kunst, die, so Hegel, zur reinen unendlichen Identität mit sich selbst führt und nur noch einen Gott, einen Geist, eine absolute Selbstständigkeit kennt. Es ist für diese Periode nach Hegel geradezu die Aufgabe der Kunst, den Prozeß hin zur Subjektivität darzustellen. (shrink)

Infants who suffer severe neglect fail to thrive emotionally as well as bodily. The absence of early coexistential structures that provide well-being leads to a narrowing of the child's perceptual and social developmental horizon. What is the nature of these early structures? In this essay, an ontology of well-being or housedness is elaborated through phenomenological reflections on breast-feeding and infant perception. Merleau-Ponty's ontology of the flesh makes a contribution to the ontology of well-being: it gives us a conceptual and evocative (...) language to describe human existence in its pre-verbal, syncretic, and non-dualistic manifestations. It also allows for a re-evaluation and re-interpretation of the results of current research in infant perception. Through the structures of infant perception we perceive the coexistential fit between infants, other human beings, and the world of things. An infant's fundamental housedness in the flesh is taken up and cultivated or destroyed by the child's social and cultural environment. (shrink)

Gefühl und Wissen wurden in der Philosophie meist als Gegensätze gesehen. So ist Wissen traditioneller Weise als begründete oder gerechtfertigte wahre Meinung definiert. Kann man, wenn man eine solche Definition zu Grunde legt, sagen, dass man weiß, dass man liebt? Was sollte als Begründung oder Rechtfertigung gelten können?

Wie werden in einzelnen Disziplinen Heureka-Effekte hervorgerufen? Wann leuchtet Wissenschaftlern in einem Fach ein Argument, ein Gedanke ein, wie werden sie davon überzeugt. Was sind die disziplinären Standards und wie sieht die Praxis im akademischen Alltag dazu aus? 15 Wissenschaftlerinnen und Wissenschaftler aus den Natur-, Geistes- und Sozialwissenschaften geben hierauf ihre Antworten in diesem Buch in einer Weise, dass alle, die das wissen wollen, sie auch verstehen.

Is musical practice 'real' - and how is it connected with everyday life? Eva-Maria Houben shows that making music changes as soon as its meaning is not sought in a purpose-oriented production of results, but in performing music as an activity - indeed, as play. Musical practice, Eva-Maria Houben contends, should be understood as open and never finished. Such an emphasis on repetition can free us from perfection, productivity, and purpose, allowing meaning to unfold in specific situations, places, (...) and relationships. Thus understood, musical practice can become a form of life and a reality in its own right. (shrink)

BackgroundThis paper discusses the contentious issue of reuse of stored biological samples and data obtained from research participants in past clinical research to answer future ethical and scientifically valid research questions. Many countries have regulations and guidelines that guide the use and exportation of stored biological samples and data. However, there are variations in regulations and guidelines governing the reuse of stored biological samples and data in Sub-Saharan Africa including Malawi.DiscussionThe current research ethics regulations and guidelines in Malawi do not (...) allow indefinite storage and reuse of biological samples and data for future unspecified research. This comes even though the country has managed to answer pertinent research questions using stored biological samples and data. We acknowledge the limited technical expertise and equipment unavailable in Malawi that necessitates exportation of biological samples and data and the genuine concern raised by the regulatory authorities about the possible exploitation of biological samples and data by researchers. We also acknowledge that Malawi does not have bio-banks for storing biological samples and data for future research purposes. This creates room for possible exploitation of biological samples and data collected from research participants in primary research projects in Malawi. However, research ethics committees require completion and approval of material transfer agreements and data transfer agreements for biological samples and data collected for research purposes respectively and this requirement may partly address the concern raised by the regulatory authorities. Our concern though is that there is no such requirement for biological samples and data collected from patients for clinical or diagnostic purposes.SummaryIn conclusion, we propose developing a medical data and material transfer agreement for biological samples and data collected from patients for clinical or diagnostic purposes in both public and private health facilities that may end up in research centers outside Malawi. We also propose revision of the current research ethics regulations and guidelines in Malawi in order to allow secondary use of biological samples and data collected from primary research projects as a way of maximizing the use of collected samples and data. Finally, we call for consultation of all stakeholders within the Malawi research community when regulatory authorities are developing policies that govern research in Malawi. (shrink)

Breast milk and the placenta are phenomena of female human embodiment that challenge the philosophical notion of separate, sovereign subjects independent of other human be­ings and an objective world “out there.” A feminist phenomenological analysis, indebted to Merleau-Ponty and Irigaray, reveals placenta and milk to be intercorporeal, “chiasmic” forms of shared organic existence. This analysis is a philosophical and psychological exploration of “matrotopy,” i.e., the fact that humans eat their mothers through breast milk and placenta. This exploration, however, requires an (...) understanding of the larger environmental field which sustains the female body and its offspring. Environmental degradation, particularly through estrogen mimicking substances in plastics and pesticides, targets the endocrine system of developing fetuses and endangers the future of the human species from the inside. Invisible organo-chemical technologies pose a new and immediate danger and ethical challenge to women and men in the twenty-first century. A “placental ethics” respects the insertion of the human being into the dynamic field of nature; it calls for an awareness that, unless we develop a changed attitude toward technology, the gradual extinction of our species continues to happen in female bodies today. (shrink)

Georg Wilhelm Friedrich Hegel und die Weiter- und Höherenentwicklung seiner Ideen, von A. Abusch.-G.W.F. Hegel und seine Zeit (1770-1831). Eine Chronik.-G.W.F. Hegels Werke in Erstausgaben.-Aus Werken Hegels.-Marx, Engels, Lenin über Hegel.-Hegel Literatur in der DDR 1949-1969.-Hegel Literatur zum Hegel Jahr 1970.-Veranstaltungen aus Anlass des 200. Geburtstages von G.W.F. Hegel am 27. August 1970.

Two aspects about meaning and emotion are discussed in this paper. The first, which is the main focus of this paper, addresses the semantic shaping of emotions (semanticization). It will be shown how language acquisition leads to the semantic shaping of emotions. For this purpose I will first introduce the theory of language acquisition that has been developed mainly by Michael Tomasello and also by Donald Davidson. Then I will take basic emotions into account in order to show that language (...) plays a crucial role when it comes to the shaping of emotions and how we feel. The second aspect about meaning and emotion addresses the signification that an emotion might have for a person. One could also say that this aspect addresses the meaning an emotion has for a person. This issue will only play a minor part in my investigations. (shrink)