BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

BackgroundThe UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer’s disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, (...) which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the ‘spatial intervention study’ of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. MethodsPeople with a suspected or confirmed diagnosis of dementia in Alzheimer’s disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed.DiscussionThe results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice.Trial registration: DRKS00030799. (shrink)

In Spinoza’s metaphysics, we encounter many puzzling doctrines that appear to entangle metaphysical notions with cognitive, logical, and epistemic ones. According to him, a substance is that which can be conceived through itself and a mode is that which is conceived through another. Thus, metaphysical notions, substance and mode, are defined through a notion that is either cognitive or logical, being conceived through. He defines an attribute as that which an intellect perceives as constituting the essence of a substance. Intellectual (...) perception, something cognitive, is used to define an attribute, something metaphysical. And he claims that if something exists there is a reason why it exists and if something doesn’t exist there is also a reason why it doesn’t. Thus, a reason, something cognitive or epistemic, is necessary for existence or nonexistence. What are we to make of the intimate connections that Spinoza sees between metaphysical, cognitive, logical, and epistemic notions? Between being and reason? In this book, I argue for what might be called a realist interpretation: although Spinoza is confident that the order of being mirrors the order of reason, he believes that they are two orders, not one. There is inherence over and above conceptual dependence; there is causation in addition to causal explanation; the world has a nature that we can grasp and that our way of grasping it does not interpose an impenetrable conceptual veil between it and us. (shrink)

In _Around the Day in Eighty Worlds_ Martin Savransky calls for a radical politics of the pluriverse amid the ongoing devastation of the present. Responding to an epoch marked by the history of colonialism and ecological devastation, Savransky draws on the pragmatic pluralism of William James to develop what Savransky calls a “pluralistic realism”—an understanding of the world as simultaneously one and many, ongoing and unfinished, underway and yet to be made. Savransky explores the radical multifariousness of reality by (...) weaving key aspects of James's thought together with divergent worlds and stories: of Magellan's circumnavigation, sorcery in Mozambique, God's felt presence among a group of evangelicals in California, visible spirits in Zambia, and ghosts in the wake of the 2011 tsunami in Japan. Throughout, he experiments with these storied worlds to dramatize new ways of approaching the politics of radical difference and the possibility of transforming reality. By exploring and constructing relations between James's pluralism and the ontological turn in anthropology, Savransky offers a new conceptualization of the pluriverse that fosters modes of thinking and living otherwise. (shrink)

Do free will beliefs influence moral judgments? Answers to this question from theoretical and empirical perspectives are controversial. This study attempted to replicate past research and offer theoretical insights by analyzing World Values Survey data from residents of 46 countries (n = 65,111 persons). Corroborating experimental findings, free will beliefs predicted intolerance of unethical behaviors and support for severe criminal punishment. Further, the link between free will beliefs and intolerance of unethical behavior was moderated by variations in countries’ institutional integrity, (...) defined as the degree to which countries had accountable, corruption-free public sectors. Free will beliefs predicted intolerance of unethical behaviors for residents of countries with high and moderate institutional integrity, but this correlation was not seen for countries with low institutional integrity. Free will beliefs predicted support for criminal punishment regardless of countries’ institutional integrity. Results were robust across different operationalizations of institutional integrity and with or without statistical control variables. (shrink)

Shakespeare's Coriolanus is one of the most brilliant political plays ever written. Despite its ancient Roman setting, it remains a perennially relevant study of the relationship between personality and politics. The Introduction to this new edition illuminates its relevance to Shakespeare'sown time and to later ages while also emphasizing the wide range of interpretations that are possible in performance.

Online supplement, "Mulsow: Additions to Notes drawn from the 2002 edition of Moderne aus dem Untergrund" full versions of nearly 300 notes that were truncated in the print edition. Hosted on H. C. Erik Midelfort's website. Martin Mulsow's seismic reinterpretation of the origins of the Enlightenment in Germany won awards and renown in its original German edition, and now H. C. Erik Midelfort's translation makes this sensational book available to English-speaking readers. In Enlightenment Underground, Mulsow shows that even in (...) the late seventeenth century some thinkers in Germany ventured to express extremely dangerous ideas, but did so as part of a secret underground. Scouring manuscript collections across northern Europe, Mulsow studied the writings of countless hitherto unknown radical jurists, theologians, historians, and dissident students who pushed for the secularization of legal, political, social, and religious knowledge. Often their works circulated in manuscript, anonymously, or as clandestinely published books. Working as a philosophical microhistorian, Mulsow has discovered the identities of several covert radicals and linked them to circles of young German scholars, many of whom were connected with the vibrant radical cultures of the Netherlands, England, and Denmark. The author reveals how radical ideas and contributions to intellectual doubt came from Socinians and Jews, church historians and biblical scholars, political theorists, and unemployed university students. He shows that misreadings of humorous or ironic works sometimes gave rise to unintended skeptical thoughts or corrosively political interpretations of Christianity. This landmark book overturns stereotypical views of the early Enlightenment in Germany as cautious, conservative, and moderate, and replaces them with a new portrait that reveals a movement far more radical, unintended, and puzzling than previously suspected. (shrink)

Kant will die beständige Möglichkeit des radikal Bösen mit dem zeitlich offenen Charakter des menschlichen Seins rechtfertigen. Jede zu machende Entscheidung setzt voraus, dass der die Selbstachtung ermöglichende gute Wille nicht automatisch die oberste Maxime meiner Handlung ist. So kann und muss der Mensch «bei lauter guten Handlungen dennoch böse» sein.

In [6] Messmer and Wood proved quantifier elimination for separably closed fields of finite Ershov invariant e equipped with a (certain) Hasse derivation. We propose a variant of their theory, using a sequence of e commuting Hasse derivations. In contrast to [6] our Hasse derivations are iterative.