As the implementation of new approaches and procedures of medical ethics is as complex and resource-consuming as in other fields, strategies and activities must be carefully planned to use the available means and funds responsibly. Which facilitators and barriers influence the implementation of a medical ethics decision-making model in daily routine? Up to now, there has been little examination of these factors in this field. A medical ethics decision-making model called METAP was introduced on three intensive care units and two (...) geriatric wards. An evaluation study was performed from 7 months after deployment of the project until two and a half years. Quantitative and qualitative methods including a questionnaire, semi-structured face-to-face and group-interviews were used. Sixty-three participants from different professional groups took part in 33 face-to-face and 9 group interviews, and 122 questionnaires could be analysed. The facilitating factors most frequently mentioned were: acceptance and presence of the model, support given by the medical and nursing management, an existing or developing ethics culture, perception of a need for a medical ethics decision-making model, and engaged staff members. Lack of presence and acceptance, insufficient time resources and staff, poor inter-professional collaboration, absence of ethical competence, and not recognizing ethical problems were identified as inhibiting the implementation of the METAP model. However, the results of the questionnaire as well as of explicit inquiry showed that the respondents stated to have had enough time and staff available to use METAP if necessary. Facilitators and barriers of the implementation of a medical ethics decision-making model are quite similar to that of medical guidelines. The planning for implementing an ethics model or guideline can, therefore, benefit from the extensive literature and experience concerning the implementation of medical guidelines. Lack of time and staff can be overcome when people are convinced that the benefits justify the effort. (shrink)

Ethische Leitlinien für die klinische Praxis erfreuen sich zunehmender Beliebtheit. Damit klinisch-ethische Leitlinien aber überhaupt erfolgreich wirksam werden können, ist noch Pionierarbeit zu leisten. Solche Leitlinien müssen wissenschaftlich stärker fundiert und ihre praktische Anwendbarkeit muss verbessert werden. In dieser Arbeit werden die ersten Schritte des Projekts METAP zur methodischen Entwicklung und praktischen Implementierung einer Leitlinie für eine patientengerechte Versorgung am Krankenbett beschrieben und zur Diskussion gestellt. Das Projekt orientiert sich methodisch an der Entwicklung medizinischer Leitlinien und generiert damit eine forschungs- (...) und konsensgestützte Leitlinie, die systematischer Evaluation und Modifikation unterliegt und Rechenschaft über ihre wissenschaftliche Fundierung gibt. Zusätzlich zur Leitlinie bietet das Projekt in der Form eines Handbuchs ein Entscheidungsfindungsverfahren an, welches unter anderem deliberative Aspekte unterstützt. Das Handbuch konzentriert sich auf ethische Fragen der Mikroallokation und liefert darüber hinaus Informationen über empirische, ethische und rechtliche Grundlagen für Therapieentscheidungen. Anhand eines Eskalationsmodells können unterschiedliche Instrumente nach Bedarf als ethische Lösungsstrategien eingesetzt werden, von der Kurzfassung im Kitteltaschenformat („Leporello“) mit den wichtigsten Fakten, weiterführenden Texten und Empfehlungen mit normativen und prozeduralen Hinweisen, über stationsinterne Lösungsversuche bis hin zum Ethikkonsil. Klinische Partner sind von Beginn an aktiv in den Entwicklungsprozess eingebunden und verbessern so die Praxistauglichkeit und Akzeptanz sowie die Ausrichtung des Instrumentariums an den tatsächlichen Bedürfnissen. Dieses partnerschaftliche, partizipative Vorgehen scheint eine wichtige Voraussetzung dafür zu sein, dass METAP in der Klinik Fuß fassen konnte. (shrink)

In this article, I address the question of whether science can and should be seen as a common good. For this purpose, the first section focuses on the notion of knowledge and examines its main characteristics. I discuss and assess the core view of analytic epistemology, that knowledge is, basically, justified true belief. On the basis of this analysis, I then develop an alternative, multi-dimensional theory of the nature of knowledge. Section 2 reviews and evaluates several answers to the question (...) of what to understand by the notion of a common good. It discusses both economic and socio-political interpretations of this notion. In Section 3, I develop an alternative account of the common good of scientific knowledge. This knowledge constitutes a common good if it is both non-exhaustible and in the public interest. The two notions are equally important, but in this article, the focus is on the former. For reasons of space, a detailed discussion of the latter is impossible; it will be provided in a forthcoming book. My answer to the question posed in the title of this article builds on the critical discussion of extant views in Sections 1 and 2: some aspects of these views are included in this alternative account, while others are shown to be unhelpful or untenable. The final section discusses some practical implications of this account for the politics of science. The main conclusion is that scientific research should not be privatized through patenting its products. (shrink)

We propose a dynamic logic of lying, wherein a ‘lie that $$\varphi$$ ’ is an action in the sense of dynamic modal logic, that is interpreted as a state transformer relative to the formula $$\varphi$$. The states that are being transformed are pointed Kripke models encoding the uncertainty of agents about their beliefs. Lies can be about factual propositions but also about modal formulas, such as the beliefs of other agents or the belief consequences of the lies of (...) other agents. We distinguish two speaker perspectives: an outside observer who is lying to an agent that is modelled in the system, and an agent who is lying to another agent, and where both are modelled in the system. We distinguish three addressee perspectives: the credulous agent who believes everything that it is told, the skeptical agent who only believes what it is told if that is consistent with its current beliefs, and the belief revising agent who believes everything that it is told by consistently revising its current, possibly conflicting, beliefs. The logics have complete axiomatizations, which can most elegantly be shown by way of their embedding in what is known as action model logic or in the extension of that logic to belief revision. (shrink)

In German discussions over the last twenty years of the difference between what it is to be a body (in German: Leibsein) and what it is to have a body (Körperhaben), many have been concerned to remind us that we owe this conceptual distinction to the philosophical anthropologist Helmuth Plessner. He introduces the distinction in an essay from 1925—written in collaboration with the Dutch behavioral researcher Frederick Jacob Buytendijk—“Die Deutung des mimischen Ausdrucks. Ein Beitrag zur Lehre vom Bewusstsein des anderen (...) Ichs” (“The Interpretation of Mimetic Expressions: A Contribution to Understanding One’s Consciousness of Other Subjects”). Buytendijk later explained that it was Plessner who worked out the .. (shrink)

The narrative of the Death of Emperor Hundun 混沌, who finally perishes from the seventh hole that his two fellow Emperors have drilled into his formless body to do him the favor of supplying him with a face, famously concludes the seven Inner Chapters of the Zhuangzi 莊子.1 Perhaps the sudden demise of the story’s protagonist is meant to signal paradoxically to the reader that he or she, too, has, unwittingly, now come to an end and reached a stage of (...) no return. With the completion of the seventh chapter, seven deep holes have been drilled into one’s head and have transformed one irredeemably. Zhuangzi, too, may have repaid the kindness of those who took him home with equal kindness and deprived them of their... (shrink)

Dass deutsche Ärzte während des Nationalsozialismus hunderttausende Menschen zwangsweise sterilisieren halfen und viele zehntausend Psychiatriepatienten und Anstaltsbewohner töteten, bleibt bis heute verstörend. Solche Verbrechen waren nur möglich, weil, neben politischen und gesellschaftlichen Bedingungen, Komplexität vereinfachende Ideologien auf einer Massenebene an individuelle regressive Abwehrstrukturen der Täter anknüpften. In der Psychiatrie des NS entfaltete sich das destruktive Potential der kollektiv geteilten Phantasmen von Reinheit und Nation. Anhand von historischen Kreuzungspunkten lässt sich zeigen, dass sozialpsychologische Dynamiken und gesellschaftliche Prozesse sich wechselseitig radikalisierten. Diese (...) Radikalisierungsprozesse werden an drei Wegmarken aufgezeigt: 1933, als das Zwangssterilisationsgesetz verabschiedet wurde, 1942, als die zentrale Vernichtungsaktion gegen psychisch kranke Menschen in dezentraler Weise fortgesetzt wurde, und 1947, als die zaghaften Versuche der Aufklärung in bleiernes Schweigen übergingen. Dabei wird u.a. auf die Schriften von Annemarie Wettley zurückgegriffen, die sich als eine der wenigen mit ihren Taten auseinanderzusetzen versuchte. (shrink)

I give an account of Max Weber's views concerning the basis of the objectivity of the cultural sciences. In this connection, I offer a critical discussion of his distinction between different "value spheres," each with its own "intrinsic logic." I then consider parallels between Weber's "value spheres" and central elements of Bourdieu's field theory and Luhmann's systems theory, and try to show to what extent Bourdieu's and Luhmann's problems, and the solutions they suggest, can be seen as similar to Weber's. (...) I conclude by a general consideration of Weber's, Bourdieu's, and Luhmann's approach to the problem of objectivity. Key Words: Max Weber • Pierre Bourdieu • Niklas Luhmann • social differentiation • objectivity • value spheres • inherent logic • field theory • systems theory. (shrink)

SummaryThe philosophical core of a psychological theory of cognitive processes is developped and commented, focussing on the problem of intentionality, this term being taken in the normal and in the phenomenological sense. Actions, perceived processes, their states and results, operations and concepts are seen as related insofar as they all establish relations between elements, are generated by construction and can be objectivated. These acts and/or the objectives that control them, are intentional insofar as their structure is activated. Such activation is (...) characteristic of living systems. Intentionality sensu Brentano/Husserl is limited to acts of presentation, a contemplative conception which lacks the constructivity and the dynamism of our pragmatistic concept of action and thought. (shrink)

Bei Nietzsches Texten handelt es sich häufig um Reaktionen auf seine breitgestreuten Lektüren. Sein Lesen ist zugleich ein Schreiben, und es verläuft ebenso selektiv und assoziativ wie aneignend: So werden unter Nietzsches Hand etwa Lesefrüchte aus naturwissenschaftlichen Lexika ästhetischen Überlegungen einverleibt oder ethno-anthropologische Fachbücher im Kontext philosophiegeschichtlicher Einordnungsversuche zitiert. Die Interpretation von Nietzsches Schriften ist daher stets auf eine philologisch-differenzierte Quellenarbeit angewiesen, die zugleich auch philosophisch-hermeneutischen Ansprüchen genügt. Nur so findet die spezifische Gemengelage aus Eigenem und Fremdem in Nietzsches Texten (...) ebenso adäquate Berücksichtigung wie die Vielzahl der handschriftlichen Lesespuren in den bis heute erhaltenen Büchern aus seiner persönlichen Bibliothek. In einer Reihe von Überblicksdarstellungen und exemplarischen Fallstudien unternimmt es der Band, Nietzsche im Spiegel seiner Lektüren als äußerst produktiven wie kreativen Leser zu charakterisieren, dessen Voraussetzungsreichtum nicht überschätzt werden kann. (shrink)

The authors believe that the questions raised at the beginning of Frege’s On Sense and Reference – ‘Is [identity] a relation? A relation between objects, or between names or signs of objects?’ – set the course for a long-lasting but not at all satisfying discussion. For the disputants tend to advocate, either a ‘name-view’ of identity in a straightforward but rudimentary and logically untenable form, or else a version of an ‘object-view’ that makes all too light of the analysandum–analysans distinction (...) and hence is damned to analytical barrenness. In contrast, by unfolding the underlying idea of the original ‘name-view’, the authors offer three alternative and mutually compatible interpretations of identity that may best be characterized as the ‘name-based’, the ‘hybrid’ and the ‘sense-based’ variant of a ‘concept-view of identity’. At the same time, however, these interpretations may well be considered variants of a non-barren ‘object-view’. (shrink)

This book is the best and most comprehensive treatment we have of Leibniz' study of natural languages, on the same high level of scholarship, knowledge, and insight as the essay Sigrid von der Schulenburg published in 1937. With its rich detail and source references, it is indispensable both to Leibniz scholars and to students of the history of the study of language. The editor's careful indices make it possible to use the book also as a work of reference. The reviewer (...) shows that the chief impulse to Leibniz' study of languages was the need to disprove the Swedish thesis of the northern origin of the Germanic languages. (shrink)

Was sind 'äußere' und 'innere' Bilder? Wie entstehen sie? Was sind ihre Korrelate? Seit der Antike bewegen diese Fragen Philosophie, Rhetorik, Literatur- und Kunstwissenschaft, gegenwärtig auch die Medien- und Intermedialitätsforschung und Neurowissenschaften. Als Beitrag zu Bild- und Literaturwissenschaften sowie Visual Studies bietet der Band interdisziplinäre Untersuchungen der Bewegung vom Sehen über das An-schauen zu Anschaulichkeit und Anschauung. Die Beiträge zeigen Verflechtungen zwischen Epistemologie und Ästhetik auf, erhellen Fragen von Imagination und Stil, stellen neue Bezüge zwischen unterschiedlichen Künsten, Medien und Ausdrucks-formen (...) her und bieten neue Einsichten in die visuell-imaginativen Dimensionen von Wissen, Erkenntnis und Erfahrung. (shrink)

This is a short discussion review of Wolfgang Spohn, The Laws of Belief, Oxford UP 2012. I argue, first, that it is important to account for incomparabilities in the plausibilities of possible worlds or propositions, and second, that the meaning of input parameters specifying the degree to which a proposition is to be accepted should be independent of the agent's belief state.

The Chinese Mādhyamikas Seng Zhao 374–414, Jizang 549–623, and Zhiyi 538–597 try to demonstrate that the linguistic strategies in the textual transmission of the Buddha’s teaching give us access to a sense of “liberation” which reaches beyond language. For them, this ineffable sense is what constitutes the dharma in the shape of sūtra and śāstra. Liberation is considered the constitutive but hidden “root” of all the teachings transmitted via the canonical word, those again account for the Buddha’s “traces” guiding back (...) to the meaning of that root. The practitioner’s comprehension of the dharma must embrace this circular mutuality of “root and traces,” reconciling speech with silence. The article discusses two philosophical aspects: Chinese Madhyamaka semantics and pragmatics exploring the various signifying functions in our use of language, and the hermeneutical approach that the Chinese masters develop in their exegetical works to unravel such a sense of “liberation” in reference to the textual transmission of Indian Mahāyāna thought. (shrink)

This volume answers the question: Why do we believe what we believe? It examines current research on the concept of beliefs, and the development in our understanding of the process of believing. It takes into account empirical findings in the field of neuroscience regarding the processes that underlie beliefs, and discusses the notion that beyond the interactive exploratory analysis of sensory information from the complex outside world, humans engage in an evaluative analysis by which they attribute personal meaning and relevance (...) to the probabilistic representations of objects and events. Beliefs exert a strong influence on behaviour, decision-making, and identifying and solving problems. Despite their importance, beliefs have until recently not been at the centre of scientific interest. In fact, "belief" is an ill-defined phenomenon. From a transdisciplinary perspective the actual approaches to understanding belief seem incompatible as they attempt to highlight such different topics as "belief - religion", "belief - spirituality", "belief - faith", "belief - knowledge", "belief - attitude", "belief - disbelief", "belief - illusion", and "believing - brain function". This situation contradicts the idea that belief is close to pathological phenomena and that it should be eliminated from scientific discussions. Rather, believing is fundamental for understanding the many problems of every-day life. In fact, the book shows that beliefs are relevant for politics, international affairs, economy, law, or religions also in modern societies. This book presents the increasing scientific interest in beliefs and believing, and reflects the change in focus from the content aspect of belief towards the fluid nature of believing. (shrink)

Anhand der Erinnerungskultur der NS-Psychiatrieverbrechen in den ersten Nachkriegsjahrzehnten wird der Frage nachgegangen, wie sich Erinnern und Gedenken gestalten lassen. Erinnern, Gedenken und Bewusstsein stehen in dynamischer Beziehung zueinander: Je nach Perspektive, ob der des Opfers oder des Täters, war das, was erinnert, wessen gedacht und was bewusst wurde bzw. unbewusst bleiben musste, sehr unterschiedlich. Durchgesetzt hat sich das Täter-Opfer-Narrativ der deutschen Nachkriegs-Psychiater, das die verstörende Realität, als Wissenschaft, als Institution und als Individuen so willfährig für ein verbrecherisches Regime gewesen (...) zu sein, verleugnen wollte. An dieser spezifischen »Erinnerungskultur« wird gezeigt, dass Erinnern und Gedenken Konstruktionen aus der Jetztzeit über die Vergangenheit sind und von der jeweiligen Gegenwart des Erzählenden geformt werden. Eine Aufführung der »Antigone« in der Erlanger psychiatrischen Anstalt 1946 wird als Rahmen gewählt, um die sich aus der Erinnerungskultur der NS-Psychiatrieverbrechen ergebenden ethischen Fragestellungen auf einer anderen Ebene zu betrachten. (shrink)