Introduction Substitute decision making on behalf of incapable patients is based on the ethical principle of ‘respect for autonomy’. This study was conducted to assess patients' wishes and preferences in terms of a substitute decision maker and determinants of such preferences. Methods The authors conducted a cross-sectional study and selected samples randomly from patients presenting at Farabi Eye Hospital clinics who were 18 years of age or older. Questionnaires were completed through interviews. Results 200 patients between the ages of 18 (...) and 83 years were interviewed. About 52% (N=105) were men and 73% (N=77) were married. Among married patients, the spouse was chosen as the substitute decision maker in only 51% of cases. Single men preferred their father first in 36% (N=9) of cases, while single girls chose their father in 5.6% (N=1) of cases and their most prevalent choice was other unmentioned people (33.3%, N=6). Most patients (93.5%) wished to be asked about their substitute decision maker when hospitalised. Conclusion The results of this study show that the people we usually consult for decisions concerning patient treatment are significantly different from the patients' preferred substitute decision makers. The authors suggest patients be allowed to choose their substitute decision maker while conscious. (shrink)

ZusammenfassungBeim Versuch, ein natürliches System der Wirklichkeit zu entwerfen, wird von der Vorstellung eines Schichtenbaus und von der kategorialen Erkenntnisweise im Sinne Nicolai Hartmanns ausgegangen. Dabei erweist sich einmal mehr die grundlegende Bedeutung der Gegensätzlichkeit in ihren verschiedenen Erscheinungsweisen. Insbesondere ist die Erfassung der Gesamtwirklichkeit nur unter einem Doppelaspekt möglich. Der diskursiv‐luminose Aspekt einer vierfach geschichteten, vieldimensionalen und raumzeitlich aufgespaltenen Wirklichkeit steht dem intuitiv‐numinosen Aspekt mit seiner schöpferischen, dem Raumzeitlichen entrückten Einheitsschau komplementär gegenüber. Erst beide Aspekte umfassen gemeinsam das Ganze (...) der Wirklichkeit.Der Schichtenbau der Wirklichkeit führt gleichzeitig, in Weiterentwicklung älterer Ideen, zu einer « natürlichen » Systematik der Wissenschaften, die einer jeden ihr Gebièt, aber auch ihre Schranken zuweist.RésuméPour essayer d'ébauchcr un système naturel de la réalité on part de la notion d'une structure stratifiée et d'une conception catégoriale de la connaissance telle que la conçolt Nicolai Hartmann. A ce propos se manifeste une fois de plus l'importance primordiale de l'opposition des contraires dans ses diverses manifestations. On ne peut en particulier comprendre la réalité dans sa totalité que sous un double aspect. A l'aspect discursif‐lumineux d'une réalité à quatre couches, multidimensionnelle divisée dans l'espacetemps, s'oppose de façon complémentaire l'aspect intuitif‐numineux avec sa vue créatrice d'un tout qui échappe à l'espace‐temps. Seule la conjonction de ces deux aspects embrasse la réalité tout entière.La structure stratifiée de la réalité aboutit tout en élargissant d'anciennes idées, à une systématique des sciences qui assigne à chacune à la fois son domaine et ses limites. (shrink)

Self-understanding is to a great extent defined by narrative: who we are as human beings is determined by the stories we, and others, tell about ourselves. Yet many are unable to compose coherent personal narratives, as their experiences do not fall within the scope of an accepted conceptual framework. Survivors of trauma are particularly apt to fall into this “narrative rift,” where there can be no words to describe, and hence can be no assimilation of, their experiences. Using the example (...) of child sexual abuse, and drawing on the work of Bass, Spence, Schafer, and Guignon, I propose an examination of the nature of narrative fragmentation itself. Philosophical counselling may succeed where psychoanalysis might not: for where the latter has theoretical commitments to specific narratives, the former, through its reluctance to force epistemological or metaphysical assumptions on the narrator, may well facilitate a more comprehensive self-understanding. (shrink)

Open peer commentary on the article “Perception-Action Mutuality Obviates Mental Construction” by Martin Flament Fultot, Lin Nie & Claudia Carello. Upshot: In this commentary, I focus on several issues concerning the notion of presentation. I argue that Fultot, Nie and Carello do not pay sufficient attention to these problems, despite the fact that Gibson, compared here with Husserl, may be regarded as one of those thinkers who made an important contribution to this.

There is a significant lack of clarity among critical realists in the language they use to discuss perception. In this paper I illustrate this lack of clarity and then argue that a critical realist view of perception is best understood as conceiving of perception as an active process in direct contact with the world. I connect this view with the thought of Maurice Merleau-Ponty’s views of perception and embodiment and argue that seeing this point has implications for our understanding of (...) perception by offering a path through the direct/indirect debate. It suggests challenges both to the definition of knowledge as justified true belief and to the reduction of knowledge to effectiveness. It bears on the question of truth insofar as it challenges the view that truth can be reduced to propositions. (shrink)

I. Language and Phenomenon /. Phenomenon We always have to start with the beginning, and the beginning is the factual — what is actually there — and being ...