Der finanzielle Druck auf die Krankenhäuser in Deutschland führt zu einer Ökonomisierung medizinischer Entscheidungen, die die Qualität der Patientenversorgung beeinträchtigt und das Gesundheitspersonal erheblich belastet. Der vorliegende Beitrag untersucht, welche Möglichkeiten ein organisationsethischer Ansatz bietet, den Herausforderungen durch die Ökonomisierung zu begegnen. Ausgewählte empirische Befunde sollen zunächst verdeutlichen, welche Auswirkungen die Ökonomisierung auf die Patientenversorgung und das Personal in den Krankenhäusern hat. Zudem liefern sie erste Hinweise auf mögliche Handlungsspielräume für die Krankenhäuser. Dabei wird deutlich, dass die Ökonomisierung einen organisationsethischen (...) Ansatz erfordert, der die Handlungsspielräume auf der Mesoebene, d. h. auf der Ebene der einzelnen Krankenhäuser nutzt. Der organisationsethische Ansatz wird in seinen Grundzügen vorgestellt und dann im Sinne eines Wertemanagements als Lösungsperspektive für die Herausforderungen der Ökonomisierung konkretisiert. Abschließend entwickelt der Beitrag Perspektiven, wie klinische Ethikkomitees mit organisationsethischer Arbeit den negativen Auswirkungen der Ökonomisierung auf die Patientenversorgung und das Personal im Krankenhaus entgegenwirken können. (shrink)

Trust constitutes a fundamental strategy to deal with risks and uncertainty in complex societies. In line with the vast literature stressing the importance of trust in doctor–patient relationships, trust is therefore regularly suggested as a way of dealing with the risks of medical artificial intelligence (AI). Yet, this approach has come under charge from different angles. At least two lines of thought can be distinguished: (1) that trusting AI is conceptually confused, that is, that we cannot trust AI; and (2) (...) that it is also dangerous, that is, that we should not trust AI—particularly if the stakes are as high as they routinely are in medicine. In this paper, we aim to defend a notion of trust in the context of medical AI against both charges. To do so, we highlight the technically mediated intentions manifest in AI systems, rendering trust a conceptually plausible stance for dealing with them. Based on literature from human–robot interactions, psychology and sociology, we then propose a novel model to analyse notions of trust, distinguishing between three aspects: reliability, competence, and intentions. We discuss each aspect and make suggestions regarding how medical AI may become worthy of our trust. (shrink)

This is a much-needed reissue of the standard English translation of Hegel's Philosophy of Nature, originally published in 1970. The Philosophy of Nature is the second part of Hegel's Encyclopaedia of the Philosophical Sciences, all of which is now available in English from OUP (Part I being his Logic, Part III being his Philosophy of Mind). Hegel's aim in this work is to interpret the varied phenomena of Nature from the standpoint of a dialectical logic. Those who still think of (...) Hegel as a merely a priori philosopher will here find abundant evidence that he was keenly interested in and very well informed about empirical science. The Philosophy of Nature is integral to his philosophical system and deserves the most serious attention. Students and scholars of Hegel and the history of European philosophy will welcome the availability of this important text, which also includes a translation of Hegel's Zusatze or lecture notes. (shrink)

What makes our brain a brain? This is the central question posited in Unlocking the Brain. By providing a fascinating venture into different territories of neuroscience, psychiatry, and philosophy, the author takes a novel exploration of the brain's resting state in the context of the neural code, and its ability to yield consciousness.

In this paper, we approach the idea of group cognition from the perspective of the “extended mind” thesis, as a special case of the more general claim that systems larger than the individual human, but containing that human, are capable of cognition (Clark, 2008; Clark & Chalmers, 1998). Instead of deliberating about “the mark of the cognitive” (Adams & Aizawa, 2008), our discussion of group cognition is tied to particular cognitive capacities. We review recent studies of group problem-solving and group (...) memory which reveal that specific cognitive capacities that are commonly ascribed to individuals are also aptly ascribed at the level of groups. These case studies show how dense interactions among people within a group lead to both similarity-inducing and differentiating dynamics that affect the group's ability to solve problems. This supports our claim that groups have organization-dependent cognitive capacities that go beyond the simple aggregation of the cognitive capacities of individuals. Group cognition is thus an emergent phenomenon in the sense of Wimsatt (1986). We further argue that anybody who rejects our strategy for showing that cognitive properties can be instantiated at multiple levels in the organizational hierarchy on a priori grounds is a “demergentist,” and thus incurs the burden of proof for explaining why cognitive properties are “stuck” at a certain level of organizational structure. Finally, we show that our analysis of group cognition escapes the “coupling-constitution” charge that has been leveled against the extended mind thesis (Adams & Aizawa, 2008). (shrink)

Bioethics, Volume 36, Issue 2, Page 154-161, February 2022.

The article presents the conceptual groundwork for an understanding of the essentially improvisational dimension of human rationality. It aims to clarify how we should think about important concepts pertinent to central aspects of human practices, namely, the concepts of improvisation, normativity, habit, and freedom. In order to understand the sense in which human practices are essentially improvisational, it is first necessary to criticize misconceptions about improvisation as lack of preparation and creatio ex nihilo. Second, it is necessary to solve the (...) theoretical problems that derive from misunderstandings concerning the notions of normativity, habit, and freedom – misunderstandings that revolve around the idea that rationality is a form that is developed out of itself and thus works in a way similar to algorithms. One can only make sense of normativity, habit, and freedom if one understands that they all involve conflictual relationships with the world and with others, which in turn enables one to adequately take into account their constitutive connection to improvisation, properly understood. In outlining these conceptual connections, we want to prepare the foundations for an explanation of rational practices as improvisational practices. The article concludes by stating that human rational life is improvisatory because the conditions of human practice arise out of practice itself. (shrink)

This text was first published as ‘De nova methodo naturam ac motum fluidi electrici investigandi’ in Novi Commentarrii Societatis Regiae Scientiarum Gottingensis. Commentationes physicae et mathematicae classis 8 (Göttingen 1778: 168–80). It also appeared in a printing by Joann Christian Dieterich in Göttingen in 1778. Lichtenberg delivered this talk personally to the Royal Society of Sciences in Göttingen on 21 February 1778. Although Lichtenberg was not present, he had already informed the Royal Society of Lichtenberg’s discovery of the electrical figures (...) at a meeting on 3 May 1777. The present German version was first published in Lichtenberg’s Vermischte Schriften, vol. 9 (Physikalische und mathematische Schriften, vol. 4) (Göttingen, 1806) pp. 49–80. Wolgang Promies suggests that the German translation was likely done by Friedrich Christian Kries, who was a co-editor of the Vermischte Schriften and Lichtenberg’s student (see Georg Christoph Lichtenberg [1974], Schriften und Briefe, [ed. Wolfgang Promies (K II: Kommentar zu Band III)], Munich: Carl Hanser Verlag, p. 11). Lichtenberg was the first to propose the use of + and – to designate electricity in this article. (shrink)

Hegel's early philosophical essay demonstrates the need for a pure empiricism and complete formalism in scientific endeavor.

The Hegel Reader is the most comprehensive collection of Hegel's writings currently available in English.

Does cognition sometimes literally extend into the extra-organismic environment (Clark, 2003), or is it always “merely” environmentally embedded (Rupert, 2004)? Underlying this current border dispute is the question about how to individuate cognitive processes on principled grounds. Based on recent evidence about the active role of representation selection and construction in learning how to reason (Stenning, 2002), I raise the question: what makes two distinct, modality-specific pen-and-paper manipulations of external representations – diagrams versus sentences – cognitive processes of the same (...) kind, e.g. episodes of syllogistic reasoning? In response, I defend a “division of labor” hypothesis, according to which external representations are dependent on perceptually grounded neural representations and mechanisms to guide our behavior; these internal mechanisms, however, are dependent on external representations to have their syllogistic content fixed. Only their joint contributions qualify the extended computational process as an episode of syllogistic reasoning in good standing. (shrink)

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing (...) homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”. (shrink)

The author recalls a distinction between philosophy conceived as “analytics of truth” and philosophy as “ontology of the actual.” The latter might be seen as a diagnostics of our times. For this second type of philosophy questions of legitimation are prominent. According to the author, one can distinguish three main sources of legitimacy of beliefs and practices: religion, reason, and nature. Reason has been considered the most important legitimating ground as far as modernity is concerned. Nevertheless, it has never been (...) very clear what reason as a source of legitimation amounts to. The author, finally, points to the fact that, in times of increasing menace to the biosphere, “nature”– metaphorically speaking – may set a standard for human laws. (shrink)

Based on Fichte's conception of international law from the Grundlage des Naturrechts the article examines to what extent a League of nations is compatible with the sovereignty of a nation state. Fichte's concept of sovereignty refers to a republican notion of a state which guaranties the congruence of power and right. This principle leads to an internal tension, for the League presupposes the existence of sovereign states and in the same time curtails their competences. It manifests an instance of power (...) without the legitimation of the singular nations. Fichte avoids the paradoxes of the Kantian vision of a perpetual peace, because he develops a more complex concept of political power, but it remains to be a contradictory construction. In the Rechtslehre of 1812 however, Fichte follows consistently the principle of popular sovereignty and therefore waives an explicit contract among states. He thus meets the ideal of congruence of power and right and also outlines the requirements for a realistic conception of the legalization of relations between states.Ausgehend von Fichtes Grundriss des Völkerrechts, dem Abschluss der Grundlage des Naturrechts nach Principien der Wissenschaftslehre wird untersucht, inwiefern ein Völkerbund mit der Idee staatlicher Souveränität vereinbar ist. Fichtes Konzeption der Souveränität basiert auf einem republikanischen Staatsverständnis, das im Idealfall die Koinzidenz von Macht und Recht garantiert. Dieses Prinzip führt zu internen Spannungen, denn ein Bund setzt einerseits die Existenz souveräner Staaten voraus, greift aber andererseits in die Kompetenzen der Einzelstaaten ein, bildet also selbst eine Machtinstanz, ohne wie die Einzelstaaten über eine entsprechende Legitimation zu verfügen. Zwar vermeidet Fichte die Aporien der Kantischen Vision eines ewigen Friedens, weil er über einen komplexeren Machtbegriff verfügt, doch bleibt seine Konstruktion widersprüchlich. In der Rechtslehre von 1812 hält Fichte dann jedoch konsequent am Prinzip der Volkssouveränität fest und verzichtet deshalb auf einen expliziten Vertrag der Staaten untereinander. Damit trägt er dem Ideal der Kongruenz von Macht und Recht Rechnung und skizziert zugleich die Voraussetzungen für eine realistische Konzeption der Verrechtlichung der Verhältnisse zwischen den Staaten. (shrink)

L'Encyclopedie des sciences philosophiques de Hegel est la premiere, mais aussi la derniere pensee totale de la realite qui fonde sa necessite sur l'identite de l'identite a soi rigoureusement respectee de la pensee et de la difference d'avec soi consretement exploree de la realite; concept et experience triomphent ici conjointement. Cette premiere partie de l'ouvrage - la science de la logique - qui deploie dialectiquement toutes les significations organiquement enveloppees dans la pensee la plus simple qui soit, celle de l'etre (...) vise en toute affirmation, elle atteste l'immense pouvoir de l'esprit et par la fortifie en lui le courage de la verite. (shrink)

Journal of Philosophy of Education, Volume 56, Issue 3, Page 399-407, June 2022.