Während der größte Teil der Bevölkerung die kieferorthopädische Therapie, also die Veränderung der Zahn- bzw. Kieferstellung, als eine Behandlung betrachtet, die vor allem auf eine Verbesserung des Erscheinungsbildes zielt, sehen der kieferorthopädische und zahnärztliche Berufsstand sowie auch private und öffentliche Kostenträger in bestimmten Abweichungen von Zahn- oder Kieferstellungen eine Gefährdung der oralen Gesundheit und der Funktionsfähigkeit des Gebisses. Letztere Auffassung bestimmt das ärztliche Handeln in der Kieferorthopädie und begründet auch die Übernahme zumindest bestimmter Leistungen durch die gesetzlichen Krankenkassen. Anhand aktueller (...) wissenschaftlicher Erkenntnisse lassen sich jedoch in vielen Fällen keine (akuten oder potentiellen) gesundheitlichen oder essentiellen funktionellen Beeinträchtigungen und Risiken abweichender Zahnstellungen nachweisen. Ziel dieses Aufsatzes ist es, diesem Widerspruch nachzugehen. Im Folgenden werden wir aufzeigen, welche Faktoren die Anbieter kieferorthopädischer Leistungen beeinflussen, welches die entscheidenden Gründe und Grundlagen für die Behandlung sind und an welchen Kriterien sich die Leistungsübernahme durch die Krankenkassen orientiert. Dabei wird deutlich werden, dass die formalen Kriterien von Behandlung und Kostenübernahme, die tatsächliche Behandlungs- und Kostenerstattungspraxis, die Erwartungen derjenigen, die Behandlungsleistungen in Anspruch nehmen und der aktuelle Stand der Forschung zu erwartbaren Funktionsbeeinträchtigungen durch Zahnstellungsvariationen nicht zwanglos zu vereinbaren sind. Erforderlich erscheint ein interdisziplinärer normativer Diskurs über die Frage, wie die diagnostizierten Spannungen aufzulösen wären. Als Anregung für einen solchen Diskurs werden wir im Ausblick alternative Lösungsstrategien vorstellen. (shrink)

Patient-centeredness can be considered a popular, and at the same time “fuzzy”, concept. Scientists have proposed different definitions and models. The present article studies scientific publications that discuss the meaning of patient-centeredness to identify different “discourses” of patient-centeredness. Three discourses are presented; the first is labelled as “caring for patients”, the second as “empowering patients” and the third as “being responsive”. Each of these discourses has different things to say about the why of patient-centeredness; the patient’s identity; the role of (...) the healthcare professional; responsibilities for medical decision-making, and the role of health information. This article compares and contrasts the discourses in ways that allow us to see differences that matter for practitioners in healthcare. On the basis of a relational constructionist philosophy, it is argued that discursive diversity is both an inevitable and a potentially valuable aspect of conversations in healthcare. We are therefore invited to center the challenge of dealing with diversity in productive ways. This article ends with a discussion of the practical implications of the discourse analysis for projects that aim to make healthcare more patient-centered. Debates on patient-centered “Health Information Exchange” are used to explain the need for a recognition of different discourses of patient-centeredness and a reflexive stance towards them. (shrink)

The history of Italian Jews from 1861 to 1938 is often viewed as the period in which they totally assimilated into the Italian nation. This article, however, argues that rather than their assimilation it was a period of their integration into Italian society. Various approaches to this question are presented, including a review of the literature, with a view to reconsidering the relationship between Jewish culture and Italian culture, or rather non-Jewish culture. Italian Jewish history is shown not to be (...) separated from, but to be “internal” to Italian social, cultural, and political history—part of the dynamic process of change that occurred during this period not only in Italy but throughout Europe. (shrink)

The article takes into account the recent magisterium of the Church on capital punishment and dwells on the teachings of John Paul II which the Pope expanded in his encyclical Evangelium Vitae it was the latter document that called for , changes in the typical edition of the Cathechism of the Catholic Church . The author develops his reading of the Encyclical in four sections. He first dwells on human dignity and the primary right to being - understood in the (...) light of the biblical concept of humanity in Genesis and in the New Testament - as the basis for human co-existence. The key concept is the human person as created in the image and likeness of God. That image, though wounded by sin, has been redeemed by Christ and restored to communion with God and with others. It is Christ himself who enables the individual to live according to humanity's ratio essendi, to respect the dignity of others and to foster their inalienable right to be. The author then shows how the Christian understanding of justice is broader than that of'retributive' or 'vindictive' justice; believers can comprehend justice in close union with the commandment of love. The article draws the conclusion that, since the death penalty challenges God's sovereignty on the being of human individuals, it must be contrary to natural law. If capital punishment cannot be a case for vindictive justice, it cannot even be interpreted as legitimate self-defence. (shrink)

In questo studio non si condivide l’opinione, dominante per molti decenni, che il cosiddetto dualismo cartesiano sia dovuto ad un "malinteso", che può chiamarsi originario, dato che a rimanerne coinvolti furono alcuni tra i primi seguaci della filosofia di Cartesio. Una presa di posizione, questa, che, già sviluppata in altri precedenti lavori, viene qui riproposta relativamente a H. Gouhier, lo studioso che più di ogni altro, con ricchezza di documenti e sottigliezza di analisi interpretative, ha sostenuto la tesi del "malinteso" (...) e ha individuato nella dottrina della terza nozione primitiva la spiegazione autenticamente cartesiana del rapporto sussistente tra anima e corpo. Una interpretazione di cui nel presentge studio si mostra tutta la debolezza, soprattutto se la si considera alla luce dell’altra dottrina, anch’essa cartesiana, ma di gran lunga più articolata, che fa del rapporto tra anima e corpo un nesso da spiegarsi in analogia al rapporto che nel linguaggio intercorre tra il segno e il suo significato. (shrink)

Gianfranco Ravasi ha voluto "ripensare" ciò che era già stato indagato e meditato durante la lunga avventura del pensiero umano, a partire dalle culture primitive e dalle antiche civiltà. E ha analizzato le due sorgenti che alimentano il concetto occidentale di anima: le Sacre Scritture e la cultura greca, con i miti di Psiche e di Orfeo e pensatori come Platone, Aristotele e Plotino. Giunti alla fine di questa riflessione ci si rende conto che la storia dell'anima coincide con (...) la storia dell'uomo, creatura di Dio. E un dubbio affiora: che l'agitarsi febbrile dell'umanità contemporanea non sia un avanzare ma un insensibile retrocedere, o uno strano volteggiare sempre sullo stesso spazio, e che proprio “l'anima, con la sua fame di eterno e di infinito” sia ciò che invece ci costringerà a muoverci “sempre oltre, verso un Oltre illimitato”. (shrink)

It is by now common knowledge that analytic philosophy has its roots, at least partially, in phenomenology. It is less known that analytic philosophy has inherited part of its original antipsychologism precisely from phenomenology, or rather from early phenomenology. The present article traces the historical brackground of antipsychologism, starting with the debate on the philosophical foundations of psychology during the 19th century. It appears that naturalistic antipsychologism, the early phenomenologists position, has to be distinguished from transcendental antipsychologism, as it was (...) promoted most prominently by Husserl after 1907. The article explains how this divide emerged from different conceptions of the specificity of the philosophical inquiry into the mind, as opposed to its psychological study. Adopting the naturalistic approach, the early phenomenological as well as the analytical school have reacted to the antipsychologistic challange by eliminating subjective elements from the content of the mind. (shrink)

O positivismo jurídico é predominantemente ensinado e aplicado há décadas por profissionais da área jurídica brasileira, geralmente com referência à construção teórica de Hans Kelsen (1881-1973), deixando à margem muitos outros estudos que oferecem importantes formulações e conceitos para a compreensão do Direito contemporâneo. Este artigo se junta a algumas poucas pesquisas sobre outros referenciais teóricos acerca do positivismo jurídico, analisando a regra de reconhecimento no pensamento teórico de Herbert Hart (1907-1992), apresentando-a como incremento e superação da teoria imperativista de (...) John Austin (1790-1859). A partir de pesquisa bibliográfica, mostramos que, em Hart, a regra de reconhecimento (modalidade de regra secundária) apresenta-se indispensável para a certeza necessária ao Direito, bem como para aferir a validade do sistema jurídico. (shrink)

In Heidegger’s thought, it is possible to recognize an accurate reflection about the pain that afflicts modern man, as well as a particular indication for its cure. In pain, man experiences his being destined to metaphysics like something incurable, which requires to think the topology of the gift of being. Pain and convalescence will be exposed in that topology, under the light of The Turn [die Kehre], The Event [Ereignis] and the line between Overcoming [Überwindung] and Twisting [Verwindung] of Metaphysics, (...) in order to recognize that, in Heidegger’s reflection, it is in pain “itself” where the cure of the incurable can be possible: the passion of human finitude, the experience of the giving of being and the care of nothingness. Before overcoming [überwunden] the Metaphysics, with its intention of appropriate the being, Metaphsyisics must be reestablished [verwunden] in its inappropriate truth. (shrink)

In this highly readable and compact introduction to Durkheim's thought, Gianfranco Poggi examines all of Durkheim's central works and assesses their significance today, a century after his death. Poggi's analyses includes a study of what Durkheim meant by 'society' and an evaluation of Durkheim's contributions to both political sociology and the sociology of law. Poggi's clear and concise reappraisal of one of the most important modern thinkers will be essential reading for students of sociology and an invaluable guide for (...) anyone studying the ways modern societies function. (shrink)