Bioethicists tend to focus on the individual as the relevant moral subject. Yet, in highly complex and socially differentiated healthcare systems a number of social groups, each committed to a common cause, are involved in medical decisions and sometimes even try to influence bioethical discourses according to their own agenda. We argue that the significance of these collective actors is unjustifiably neglected in bioethics. The growing influence of collective actors in the fields of biopolitics and bioethics leads us to pursue (...) the question as to how collective moral claims can be characterized and justified. We pay particular attention to elaborating the circumstances under which collective actors can claim ‘collective agency.’ Specifically, we develop four normative-practical criteria for collective agency in order to determine the conditions that must be given to reasonably speak of ‘collective autonomy’. For this purpose, we analyze patient organizations and families, which represent two quite different kinds of groups and can both be conceived as collective actors of high relevance for bioethical practice. Finally, we discuss some practical implications and explain why the existence of a shared practice of trust is of immediate normative relevance in this respect. (shrink)

During gestation, fetomaternal exchange occurs in the villous tree (labyrinth) of the placenta. Development of this structure depends on tightly coordinated cellular processes of branching morphogenesis and differentiation of specialized trophoblast cells. The basal chorionic trophoblast (BCT) cell layer that localizes next to the chorioallantoic interface is of critical importance for labyrinth morphogenesis in rodents. Gcm1‐positive cell clusters within this layer initiate branching morphogenesis thereby guiding allantoic fetal blood vessels towards maternal blood sinuses. Later these cells differentiate and contribute to (...) the syncytiotrophoblast of the fetomaternal barrier. Additional cells within the BCT layer sustain continued morphogenesis, possibly through a repopulating progenitor population. Several mouse mutants highlight the importance of a structurally intact BCT epithelium, and a growing number of studies addresses its patterning and epithelial architecture. Here, we review and discuss emerging concepts in labyrinth development focussing on the biology of the BCT cell layer. (shrink)

When facing a choice between saving one person and saving many, some people have argued that fairness requires us to decide without aggregating numbers; rather we should decide by coin toss or some form of lottery, or alternatively we should straightforwardly save the greater number but justify this in a non-aggregating contractualist way. This paper expands the debate beyond well-known number cases to previously under-considered probability cases, in which not (only) the numbers of people, but (also) the probabilities of success (...) for saving people vary. It is shown that, in these latter cases, both the coin toss and the lottery lead to what is called an awkward conclusion, which makes probabilities count in a problematic way. Attempts to avoid this conclusion are shown to lead into difficulties as well. Finally, it is shown that while the greater number method cannot be justified on contractualist grounds for probability cases, it may be replaced by another decision method which is so justified. This decision method is extensionally equivalent to maximising expected value and seems to be the least problematic way of dealing with probability cases in a non-aggregating manner. (shrink)

As the pre-eminent Enlightenment philosopher, Kant famously calls on all humans to make up their own minds, independently from the constraints imposed on them by others. Kant's focus, however, is on universal human reason, and he tells us little about what makes us individual persons. In this book, Katharina T. Kraus explores Kant's distinctive account of psychological personhood by unfolding how, according to Kant, we come to know ourselves as such persons. Drawing on Kant's Critical works and on his (...) Lectures and Reflections, Kraus develops the first textually comprehensive and systematically coherent account of our capacity for what Kant calls 'inner experience'. The novel view of self-knowledge and self-formation in Kant that she offers addresses present-day issues in philosophy of mind and will be relevant for contemporary philosophical debates. It will be of interest to scholars of the history of philosophy, as well as of philosophy of mind and psychology. (shrink)

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

German medical schools have not yet sufficiently introduced students to the field of good scientific practice. In order to prevent scientific misconduct and to foster scientific integrity, courses on GSP must be an integral part of the curriculum of medical students. Based on a review of the literature, teaching units and materials for two courses on GSP were developed and tested in a pilot course. The pilot course was accompanied by a pre-post evaluation that assessed students’ knowledge and attitudes towards (...) scientific integrity and scientific misconduct. A syllabus was designed that comprised the following six topics: theoretical foundations of GSP; scientific publishing; empirical data; scientific supervision and teamwork; clinical research; personal interests. The comparison pre versus post-intervention yielded statistically significant changes in regard to the participants’ knowledge and attitude toward all forms of scientific misconduct treated in the course. As the majority of participants was not familiar with the fundamental regulations or guidelines of GSP, it seems crucial to train students in actively applying such norms to real-world conflicts. Students’ unfamiliarity with the fundamentals of GSP can be linked to the fact that many students have already experienced forms of scientific misconduct. Thus, GSP syllabi should be closely adjusted to a student’s realm of experience. All in all, courses on GSP can be seen as a potential means to increase the number of young scholars. (shrink)

We addressed the questions whether stimuli presented below the threshold of verbal awareness are nevertheless perceived and whether there are perceptual differences between the two cerebral hemispheres. Pictures of line drawn objects and animals were subliminally presented to each visual half-field for subsequent identification in a form as fragmented as possible. The performance of 40 healthy subjects was compared to that of 63 controls. Whereas identification performance after blank presentation in the experimental group did not differ from that of controls, (...) identification in a significantly more fragmented form was achieved after the presentation of the complete picture. This effect, however, occurred only after subliminal stimulation in the left visual field, i.e., of the right hemisphere. Our results show that pictures presented below the threshold of verbal awareness can be perceived, and that only the right hemisphere can perceive them and make use of the perception. It remains an open question whether this kind of hemispheric specialization represents a right hemisphere dominance for subliminal perception or reflects an inability of the left hemisphere to access and behaviorally use unaware percepts via fragmented picture identification, for which a right hemisphere advantage is known. (shrink)

The study examines how multinational organizations implement the concept of ethics and compliance programs into their businesses and the extent to which these programs were geared to the 2004 Amendments. The study explores the applicability of the 2004 Amendments and analyzes the instruments organizations use to successfully develop and maintain these programs. By including research from various fields, a theoretical framework was developed for implementing an ethics and compliance program that takes into account the 2004 Amendments.

Is argumentation essentially adversarial? The concept of a devil's advocate—a cooperative arguer who assumes the role of an opponent for the sake of the argument—serves as a lens to bring into clearer focus the ways that adversarial arguers can be virtuous and adversariality itself can contribute to argumentation's goals. It also shows the different ways arguments can be adversarial and the different ways that argumentation can be said to be "essentially" adversarial.

A realist view of numbers often rests on the following thesis: statements like ‘The number of moons of Jupiter is four’ are identity statements in which the copula is flanked by singular terms whose semantic function consists in referring to a number (henceforth: Identity). On the basis of Identity the realists argue that the assertive use of such statements commits us to numbers. Recently, some anti-realists have disputed this argument. According to them, Identity is false, and, thus, we may deny (...) that the relevant statements commit us to numbers. The present paper argues that the correct linguistic analysis of the relevant number statements supports the anti-realist view that Identity is false. However, as will further be shown, pace the anti-realist, this analysis does not establish that such statements do not commit us to numbers after all. (shrink)

Hume's explanation of our tendency to confuse calm passions with reason due to lack of feeling appears to present a tension with his claim that we cannot be mistaken about our own impressions. I argue that the calm/violent distinction cannot be understood in terms of presence/absence of feeling. Rather, for Hume the presence or absence of disruption and disordering of natural and/or customary modes of thought is the key distinction between the calm and violent passions. This reading provides new explanations (...) of our confusion of calm passions with reason, and the potential for calm passions to prevail over violent. (shrink)

Hegel introduced the Phenomenology of Mind as a work on the problem of knowledge. In the first chapter, entitled “Sense Certainty, or the This and Meaning,” he concluded that knowledge cannot consist of an immediate awareness of particulars ). The tradition discusses sense certainty in terms of this failure of immediate knowledge without, however, specifically addressing the problem of reference. Yet reference is distinct from knowledge in the sense that while there can be no knowledge of objects without reference, there (...) may be reference without knowledge. If that is the case, then the failure of immediate knowledge does not entitle us to conclude anything about the success or failure of reference. It is not surprising, then, that a few scholars have begun to examine sense certainty primarily as a thesis about reference. (shrink)

In this paper, we argue that ‘good care’ in residential nursing homes is enacted through different care practices that are either inspired by a ‘professional logic of care’ that aims for justice and non-maleficence in the professional treatment of residents, or by a ‘relational logic of care’, which attends to the relational quality and the meaning of interpersonal connectedness in people’s lives. Rather than favoring one care logic over the other, this paper indicates how important aspects of care are constantly (...) negotiated between different care practices. Based on the intricate everyday negotiations observed during an ethnographic field study at an elderly nursing home in Germany, the paper puts forth the argument that care is always a matter of tinkering with different, sometimes competing ‘goods’. This tinkering process, which unfolds through ‘intuitive deliberation’, ‘situated assessment’ and ‘affective juggling’ is then theorized along the conceptualization of a ‘practical ethics of care’: an ethics which makes no a priori judgments of what may be considered as good or bad care, but instead calls for momentary judgments that are pliable across changing situations. (shrink)

Developmental psychology currently faces a deep puzzle: most children before 4 years of age fail elicited-response false-belief tasks, but preverbal infants demonstrate spontaneous false-belief understanding. Two main strategies are available: cultural constructivism and early-belief understanding. The latter view assumes that failure at elicited-response false-belief tasks need not reflect the inability to understand false beliefs. The burden of early-belief understanding is to explain why elicited-response false-belief tasks are so challenging for most children under 4 years of age. The goal of this (...) article is to offer a pragmatic framework whose purpose is to discharge this burden. (shrink)

This paper examines whether the posthumanist vision of a new level of life is a plausible idea or a mere utopia. On a philosophical metalevel, there is always a discussion about the anthropological and thus also ontological and natural philosophical assumptions underlying posthumanism, aimed at assessing the strong presuppositions informing the posthumanist goal of a next level of life. From the perspective of Helmuth Plessner’s grounding of the different levels of organic life in a philosophy of nature, theoretically substantiating the (...) new level appears less simple than current technophilosophical discussions surrounding posthumanism and the cyborgization of the human would have us think. Thus Jos De Mul, pursuing a line of argument that follows Plessner’s logic of levels culminating in excentric positionality, has attempted to designate the melding of the human with telepresence technologies as a new level going beyond excentric positionality. The contribution intervenes here. I will argue that De Mul did not in fact succeed in grounding a new level of life following Plessner’s logic of levels, and I will show along Plessners figure of doubleaspectivity why a further posthuman level cannot be grounded within the framework of Plessner’s levels. (shrink)

It has recently been pointed out that the cloudiness of the concept of authenticity as well as inflated ideologies of the ‘true self’ provide good reasons to criticize theories and ideals of authenticity. Nevertheless, there are also good reasons to defend an ethical ideal of authenticity, not least because of its critical and oppositional force, which is directed against experiences of self-abandonment and self-alienation. I will argue for an elaborated ethical ideal of authenticity: the ambitious ideal of a continuous self-reflective (...) process of ‘self-authentication’. For this purpose, the ideal of being authentic in expressing and unfolding one’s individual personality and characteristics will be combined with the ideal of being ‘an authentic person’ - whereby ‘a person’ is to be understood in a Kantian sense as an autonomous person who is reasonable and morally responsible. (shrink)

Supererogation seems to be an important concept of common sense morality. However, assuming the existence of such a category seems to pose a serious problem for Kantian Ethics, given the all-encompassing role of duty. In fact, Kant seems to deny the possibility of such acts when he states in the second critique that “[b]y exhortation to actions as noble, sublime, and magnanimous, minds are attuned to nothing but moral enthusiasm and exaggerated self-conceit; [...] they are led into the delusion that (...) it is not duty […] which constitutes the determining ground of their actions […]”. (KpV, AA V, 84f.). This paper’s aim is to show that even though it is not possible to include a category of supererogation within Kantian Ethics, the recognition of alleged supererogatory acts is not only a source of self-deception, as Kant seems to fear, but can also serve as a source of self-knowledge. Starting from the premise that within Kantian Ethics self-knowledge is indispensable to aspire to the duties of moral self-perfection, I will argue that supererogation is only a plausible concept regarding the observer-perspective: thus it describes an act that, given the observer's own moral development, seems to be beyond duty but for the agent herself is not. Given an observer has the insight that her judgment relies on her own deficiencies to act accordingly, this fulfills an epistemic function in the process of developing one’s own moral capacities. This seems to be a fairly proper phenomenological account of supererogation as it can, on the one hand, explain the common moral intuition that certain acts are supererogatory. While on the other hand, it can capture the empirical observation that agents of alleged supererogatory acts usually do not perceive their actions as supererogatory because the differing perspectives of the agent and the observer constitute an integral part of the given account. (shrink)

The book presents papers from leading proponents of realist, relativist, and constructivist positions in epistemology and the philosophy of language and ethics.

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aims of this literature review are to identify studies on end-of-life decision making in pediatrics, (...) to explore patient participation, and to assess the effects of such participation. Methods: Five databases—PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract—were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) and negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision-making processes, as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics. (shrink)

Katharina D. Giesel befasst sich mit den Fragen, was in den verschiedensten Sozialwissenschaften unter Leitbildern verstanden wird, wie diese Kategorie konzeptionell in Forschungs- und Handlungskonzepte eingebunden wird und inwiefern ...

Feminist argumentation theorists have criticized the Dominant Adversarial Model in argumentation, according to which arguers should take proponent and opponent roles and argue against one another. The model is deficient because it creates disadvantages for feminine gendered persons in a way that causes significant epistemic and practical harms. In this paper, I argue that the problem that these critics have pointed out can be generalized: whenever an arguer is given a role in the argument the associated tasks and norms of (...) which she cannot fulfill, she is liable to suffer morally significant harms. One way to react to this problem is by requiring arguers to set up argument structures and allocate roles so that the argument will be reasons-reflective in as balanced a way as possible. However, I argue that this would create to heavy a burden. Arguers would then habitually have to take on roles that require them to divert time and energy away from the goals that they started arguing for and instead serve the goal of ideal reasons-reflectiveness. At least prima facie arguers should be able to legitimately devote their time and energy towards their own goals. This creates a problem: On the one hand, structures that create morally significant harms for some arguers should be avoided—on the other hand, arguers should be able to take argument-roles that allow them to devote themselves to their own argumentative goals. Fulfilling the second requirement for some arguers will often create the morally significant harms for their interlocutors. There are two possible solutions for this problem: first, arguers might be required to reach free, consensual agreements on the structure they will adopt for their argument and the way they will distribute argumentative roles. I reject this option as both fundamentally unfeasible and practically unrealistic, based on arguments developed by theorists like Krabbe and Jacobs. I argue that instead, we should take a liberal view on argument ethics. Arguers should abide by moral side constraints to their role taking. They should feel free to take roles that will allow them to concentrate on their argumentative goals, but only if this does not create a situation in which their interlocutors are pushed into a role that that they cannot effectively play. (shrink)

The hippocampal formation is known for its importance in conscious, declarative memory. Here, we report neuroimaging evidence in humans for an additional role of the hippocampal formation in nonconscious memory. We maskedly presented combinations of faces and written professions such that subjects were not aware of them. Nevertheless, the masked presentations activated many of the brain regions that unmasked presentations of these stimuli did. To induce a nonconscious retrieval of the faces and face-associated occupational information, subjects were instructed to view (...) the previously masked faces and to guess the professional category of each person—academic, artist, and workman. Guessing the professional category of previously masked versus new faces activated the left and right hippocampal formation and right perirhinal cortex as well as bilateral fusiform areas and fronto-temporal areas known to mediate the retrieval of semantic information. These activations within the semantic processing system suggest that conceptual knowledge acquired during masking was nonconsciously retrieved. Our data provide clues to an analogous role of the hippocampus in conscious and nonconscious memory. (shrink)

This paper compares between the evolution of financial reporting and corporate social responsibility reporting. Our comparison follows a framework of seven factors for exploring comparative accounting history put forth by Carnegie and Napier :689–718, 2002): Period, Places, People, Practices, Propagation, Products, and Profession. Using this framework allows for a comparison of similarities and differences as to how both types of reporting have evolved. Some of the defining moments in the evolution of financial reporting have yet to take place in the (...) development of CSR reporting; such as an event that legitimizes a CSR reporting standard or gives CSR reporting global recognition. The evolutionary process may not follow the same path as financial reporting did due to the varying stakeholders involved. However, there are enough similarities that still make the evolution of financial reporting a useful comparative tool to analyze the potential growth and development of CSR reporting. Financial reporting has evolved into a comparable and reliable market-based resource over the last 100 years. Relative to this timeline CSR reporting is still in its infancy. CSR reporting has come a long way since early reports were first issued, but there remain many deficiencies in comparability, consistency, reliability, and relevance. The results of this comparison provide some insight on the possible future development of CSR reporting. Our goal is that this paper contributes to an understanding of CSR reporting’s past and provides insights into CSR reporting’s present and future. (shrink)

A powerful objection against moral conventionalism says that it gives the wrong reasons for individual rights and duties. The reason why I must not break my promise to you, for example, should lie in the damage to you—rather than to the practice of promising or to all other participants in that practice. Common targets of this objection include the theories of Hobbes, Gauthier, Hooker, Binmore, and Rawls. I argue that the conventionalism of these theories is superficial; genuinely conventionalist theories are (...) not vulnerable to the objection; and genuine moral conventionalism is independently plausible. (shrink)