ZusammenfassungDie Arzneimittelzulassung und der Aufnahmeprozess zur Kostenerstattung sollen die Entwicklung und Vermarktung von pharmazeutischen Innovationen mit Patientennutzen nicht behindern, zugleich aber die Wirtschaftlichkeit der Arzneimittelversorgung für die Kostenträger nicht gefährden. Eine Anpassung der Verfahren an die Merkmale personalisierter Arzneimittel erscheint notwendig. Dabei ist allerdings zu fragen, ob eine ungerechtfertigte Privilegierung erfolgt. In den USA und in der EU werden die jeweiligen Zulassungsverfahren für Arzneimittel und Tests schrittweise angepasst und integriert. Zulassung und Erstattungsentscheidungen sollen koordiniert werden. Eine Privilegierung, wie bei Arzneimitteln (...) für seltene Indikationen, findet jedoch für personalisierte Medizin nicht statt. Es bestehen keine unzumutbaren Hürden für die Hersteller. Zurückhaltung bei der Entwicklung innovativer Produkte wäre deshalb nicht gerechtfertigt. (shrink)

Die Arzneimittelzulassung und der Aufnahmeprozess zur Kostenerstattung sollen die Entwicklung und Vermarktung von pharmazeutischen Innovationen mit Patientennutzen nicht behindern, zugleich aber die Wirtschaftlichkeit der Arzneimittelversorgung für die Kostenträger nicht gefährden. Eine Anpassung der Verfahren an die Merkmale personalisierter Arzneimittel erscheint notwendig. Dabei ist allerdings zu fragen, ob eine ungerechtfertigte Privilegierung erfolgt. In den USA und in der EU werden die jeweiligen Zulassungsverfahren für Arzneimittel und Tests schrittweise angepasst und integriert. Zulassung und Erstattungsentscheidungen sollen koordiniert werden. Eine Privilegierung, wie bei Arzneimitteln (...) für seltene Indikationen (Orphan Drugs), findet jedoch für personalisierte Medizin nicht statt. Es bestehen keine unzumutbaren Hürden für die Hersteller. Zurückhaltung bei der Entwicklung innovativer Produkte wäre deshalb nicht gerechtfertigt. (shrink)

Contemporary culture trivializes the "seven deadly sins," or vices, as if they have no serious moral or spiritual implications. Glittering Vices clears this misconception by exploring the traditional meanings of gluttony, sloth, lust, and others. It offers a brief history of how the vices were compiled and an eye opening explication of how each sin manifests itself in various destructive behaviors. Readers gain practical understanding of how the vices shape our culture today and how to correctly identify and eliminate the (...) deeply rooted patterns of sin that are work in their own lives. This accessible book is essential for any reader interested in spiritual disciplines and character formation. Excerpt Very simply, a virtue (or vice) is acquired through practice repeated activity that increases our proficiency at the activity and gradually forms our character. . . . We often need external incentives and sanctions to get us through the initial stages of the process, when our old, entrenched desires still pull us toward the opposite behavior. But with encouragement, discipline, and often a role model or mentor, practice can make things feel more natural and enjoyable as we gradually develop the internal values and desires corresponding to our outward behavior. Virtue often develops, that is, from the outside in. This is why, when we want to reform our character from vice to virtue, we often need to practice and persevere in regular spiritual disciplines and formational practices for a lengthy period of time. (shrink)

Wilfrid Sellars's iconic exposé of the ‘myth of the given’ taught us that experience must present the world to us as normatively laden, in the sense that the contents of experience must license inferences, rule out and justify various beliefs, and rationalize actions. Somehow our beliefs must be governed by the objects as they present themselves to us. Often this requirement is cashed out using language that attributes agent-like properties to objects: we are described as ‘accountable to’ objects, while objects (...) ‘hold us’ to standards, and so forth. But such language is either deeply anti-naturalistic or trades on a set of metaphors in need of a literal translation. We offer an explanation of how the material features of the world, as received in experience, can rationally constrain our beliefs and practices—one that makes no recourse to this imagery. In particular, we examine the structure of ostensive practices (that is, practices of directing one another's attention to objects and features of the world) and the distinctive role they play in making us jointly beholden to how things actually are. (shrink)

Care workers and families often engage in deception in everyday interactions with people affected by dementia. While benevolent deception can be justified, there are often more respectful and less risky ways to help people with dementia seeking to make sense of their lives.

Organisations increasingly use digital nudges to influence their workforces’ behaviour without coercion or incentives. This can expose employees to arbitrary domination by infringing on their autonomy through manipulation and indoctrination. Nudges might furthermore give rise to the phenomenon of “organised immaturity.” Adopting a balanced approach between overly optimistic and dystopian standpoints, I propose a framework for determining the moral permissibility of digital nudging in the workplace. In this regard, I argue that not only should organisations provide pre-discursive justification of nudges (...) but they should also ensure that employees can challenge their implementation whenever necessary through legitimation procedures. Building on Rainer Forst’s concept of the right to justification, this article offers a way to combine contract- and deliberation-based theories for addressing questions in business ethics. I further introduce the concept of meta-autonomy as a capacity that employees can acquire to counter threats of arbitrary domination and to mitigate organised immaturity. (shrink)

Philosophers have often posited a foundational calling voice, such that hearing its call constitutes subjects as responsive and responsible negotiators of normative claims. I give the name ldquo;transcendental conscience to that which speaks in this founding, constitutive voice. The role of transcendental conscience is not – or not merely – to normatively bind the subject, but to constitute the possibility of the subject's being bound by any particular, contentful normative claims in the first place. I explore the ontological and temporal (...) status of transcendental conscience, using Heidegger's account of conscience in Being and Time as my textual touchstone. I ask what performative structure the call of conscience might have that would enable it to constitute normative responsiveness, and I raise some temporal conundrums surrounding this structure. I argue that it is incoherent to attempt to give a literal, chronological account of the origin of normative grip and response. I suggest that we can best understand the founding calls of conscience, not as literal events occurring in regular time, but as events that can only show up retrospectively, as occurring in an ever-receding, unlocalizable past, and that these calls can only be figured mythically and metaphorically. Appropriating a Derridean term, I claim that the voice of transcendental conscience must be that of a lsquo;ghost, whose call binds us by haunting us – a haunting that is no less transcendentally necessary for its inability to be translated into a literal historical event. (shrink)

In the article “On Avoiding Deep Dementia,” Norman Cantor defends a position that I suspect many readers share. In my years writing and speaking on advance directives and dementia, I've found that most people support one of two positions. They are convinced either that advance choices should control the treatment dementia patients receive or that the welfare of a person with dementia should sometimes take priority over earlier choices. As Cantor points out, I support the second position.I agree with several (...) of Cantor's arguments. Where Cantor and I part ways is over the degree of control that advance directives should exert over the care of persons with moderate dementia. Although I don't welcome the prospect of living with dementia, I believe that people with the condition should be represented in the debate over treatment standards. It's not surprising that many, perhaps most, people unaffected by dementia think that their preferences should control the care they would receive as dementia patients. But people taking this position are neglecting the concerns and interests they may have as dementia patients. (shrink)

Pragmatism has enjoyed a major resurgence in Anglo-American philosophy over the course of the last decade or two, and Robert Brandom’s work – particularly his 1994 tome Making it Explicit (MIE) – has been at the vanguard of this resurgence (Brandom 1994).2 But pragmatism comes in several surprisingly distinct flavours. Authors such as Hubert Dreyfus find their roots in certain parts of Heidegger and in phenomenologists such as Merleau-Ponty, and they privilege embodied, preconceptual skills as opposed to discursive practices as (...) the basic sites of meaning and agency (Dreyfus 1991; Dreyfus 1992; Todes 2001). With strong inheritances from Dewey and Wittgenstein, Richard Rorty has championed a pragmatism whose core emphasis is on the rejection of transcendental truth and high metaphysical theorizing (Rorty 1982), and this anti-theoretical banner has been taken up by several prominent ethicists, among others. For his part, Brandom, who purports to offer a systematic theory of language and meaning grounded on a foundation of pragmatic normative relationships between speakers, looks back instead to Sellars and Quine for his stripe of pragmatism. Near the start of MIE, he writes: The explanatory strategy pursued here is to begin with an account of social practices, identify the particular structure they must exhibit in order to qualify as specifically linguistic practices, and then consider what different sorts of semantic contents those practices can confer on states, performances, and expressions caught up in them in suitable ways. (Brandom 1994, xiii) Despite his professed pragmatism, Brandom is no foe of high theory or metanarratives, and he is vastly more interested in language and theoretical reason than in the rest of human bodily activity. For Brandom, inferentially articulated discourse forms an autonomous domain of normativity, while our bodily encounters with the world in perception and in action serve as language entry and exit points respectively.. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 4-6, March‐April 2022.

Charles S. Peirce’s and Sigmund Freud’s theories may be used to interpret Jean Cocteau’s film La Belle et la Bête (1946). This film has a specific set of codes which connote its filmic language. Cocteau uses fetishistic objects as symbols and icons to reflect the psychological meaning of the film’s narrative. Peirce’s icons and symbols include the connection a person may make through the conventions and expressions of language a person links with the object or idea being observed. Peirce’s semiotic (...) theory functions as a theory of communication. His theory refocuses on culture. Freud’s theories can be linked with ideas produced by Peirce in forming sign relations with the interpretation of the film and the role of imagination in the film. Especially important are Freud’s ideas of repression, conscious and unconscious as they relate to Cocteau’s filmic narrative and the film’s main character Belle. (shrink)

Moral perception, as the term is used in moral theory, is the perception of normatively contoured objects and states of affairs, where that perception enables us to engage in practical reason and judgment concerning these particulars. The idea that our capacity for moral perception is a crucial component of our capacity for moral reasoning and agency finds its most explicit origin in Aristotle, for whom virtue begins with the quality of perception. The focus on moral perception within moral theory has (...) made a comeback in the last few decades, especially in the hands of self-proclaimed neo-Aristotelians such as John McDowell, Martha Nussbaum, and Nancy Sherman. For these writers, our perceptual capacities are not static, and the laborious honing of our perceptual skills is a crucial moral task. On this picture, as Nancy Sherman puts it, “How to see becomes as much a matter of inquiry as what to do.”Moral particularists—including but not restricted to the neo-Aristotelians—have emphasized the centrality of moral perception to moral agency and judgment, as a corrective to moral theories that treat deliberation in terms of universal principles as the privileged keystone of moral agency. (shrink)

Background: Since presenteeism is related to numerous negative health and work-related effects, measures are required to reduce it. There are initial indications that how an organization deals with health has a decisive influence on employees’ presenteeism behavior.Aims: The concept of health-promoting collaboration was developed on the basis of these indications. As an extension of healthy leadership it includes not only the leader but also co-workers. In modern forms of collaboration, leaders cannot be assigned sole responsibility for employees’ health, since the (...) leader is often hardly visible or there is no longer a clear leader. The study examines the concept of health-promoting collaboration in relation to presenteeism. Relationships between health-promoting collaboration, well-being and work ability are also in focus, regarding presenteeism as a mediator.Methods: The data comprise the findings of a quantitative survey of 308 employees at a German university of applied sciences. Correlation and mediator analyses were conducted.Results: The results show a significant negative relationship between health-promoting collaboration and presenteeism. Significant positive relationships were found between health-promoting collaboration and both well-being and work ability. Presenteeism was identified as a mediator of these relationships.Conclusion: The relevance of health-promoting collaboration in reducing presenteeism was demonstrated and various starting points for practice were proposed. Future studies should investigate further this newly developed concept in relation to presenteeism. (shrink)

We can understand objectivity, in the broadest sense of the term, as epistemic accountability to the real. Since at least the 1986 publication of Sandra Harding’s The Science Question in Feminism, so-called standpoint epistemologists have sought to build an understanding of such objectivity that does not essentially anchor it to a dislocated, ‘view from nowhere’ stance on the part of the judging subject. Instead, these theorists have argued that a proper understanding of objectivity must recognize that different agential standpoints offer (...) different access to objective truths, with some standpoints holding better epistemic potential than others. As Harding puts it, standpoint epistemology calls for “a critical evaluation of which social situations tend to generate the most objective knowledge claims” so as to identify those standpoints that “produce empirically more accurate descriptions and theoretically richer explanations” (1991, 142, 149). Which standpoints enable the most objectivity with respect to a particular inquiry is, for the standpoint theorists, always an empirical at least as much as a conceptual question; it requires attention to the actual, material relationship between knowers, knowledge practices, and objects known. Standpoint epistemology was developed primarily by self-identiªed feminist epistemologists. Virtually all developments of standpoint episte-. (shrink)

In this chapter, DeYoung looks at the culturally and historically recognized virtue of courage. She specifically questions how we should think of all the pictures of courage and where we might look for Christlike examples of courage. To do this, DeYoung explores courage as it relates to fear and love and then delves into how courage can be a Christian practice.

In 2022, the U.S. Supreme Court removed constitutional protection from the individual's right to end a pregnancy. In Dobbs v. Jackson Women's Health Organization, the Court invalidated previous rulings protecting that right as part of the individual liberty and privacy interests embedded in the U.S. Constitution. Now, many observers are speculating about the fate of other rights founded on those interests. The Dobbs ruling conflicts with the Court's 1990 Cruzan decision restricting the government's power to interfere with personal medical choices. (...) The language and reasoning in Dobbs and Cruzan offer guidance on how the Court might address future cases involving the right to refuse life‐sustaining treatment. The decisions also point to policy strategies for preserving that right. (shrink)

The postmodern criticism of music analysis remains unwittingly preoccupied with a false image of ‘the Whole’, or with the construction of unity precisely through privileging its opposite. At the centre of this discourse there often emerges a split between two things—analysis/aesthetics, part/whole, subject/object—where the question then becomes one of reconciliation: how can the analytical methods be subsumed into aesthetic discussions of subjectivity to better represent the ‘thing itself’? This problem is now a cross-disciplinary one, with criticism favouring the application of (...) ‘external’ disciplines to complement the ‘internal’ act of music analysis. This article takes Žizek’s comments on the difference between modernism and postmodernism as alienation and separation as its starting point in order to reconsider the effects of the supposedly postmodern concept of interdisciplinarity for music analysis. Through a critique of existing musico-psychoanalytic literature, it demonstrates the ways in which the interdisciplinary relation currently seems to occupy the space of an objet petit a in scholarship that is therefore marked by a failure restricted to the principles of alienation. If read alongside Žižek’s phenomenology of the subject however, rather than become a fetishized unity, this relation could be seen to construct the space for a self-reflexive musical subject, able to avoid false reconciliation through critical self- awareness, and could also therefore hold greater significance for an interdisciplinary musicology. (shrink)

The absent Arendt -- Arendt reading Aristotle -- Arendt reading Kant -- Arendt relating to Karl Jaspers -- Arendt thinking through Heidegger -- Arendt along with the existentialists -- Arendt as atypical -- Arendt in anticipation.

Over recent decades scholars have begun explicitly to acknowledge the importance of visual display in the formation of the fifteenth-century Burgundian “Theater State.” This remarkably apposite term, coined in the early 1980s by Wim Blockmans and Walter Prevenier, encapsulates the centrality of ceremony and ostentatious self-projection to both the political process of state building and the more personal imperative of identity construction in the Burgundian Netherlands under Duke Philip the Good . The specific sorts of display associated with the Theater (...) State in previous studies have tended to be larger-scale ceremonial events with an inherent performativity—rigorously staged entries, sharply choreographed jousts, elaborately themed dinners, joyously restrained wedding ceremonies, or grimly festive funeral processions—though the individual aspects of their makeup, that is, the texts written to accompany them, the images produced to illustrate them, or the costumes worn to celebrate them, all add to the lavish effect. But the role of these smaller-scale articulations of luxury in the shaping of a courtly identity in Burgundy has been infrequently discussed by critics; and the part played by literature and the material book in the fostering and sustaining of this spectacular culture has gone largely unacknowledged. (shrink)

This paper examines and contextualizes rituals and beliefs surrounding the cat demon. While the demon has been briefly discussed or referenced in earlier scholarship, there as yet exists no systematic attempt to understand how it is treated in various sources. The paper approaches the complex of practices and ideas associated with the cat demon as a unique and richly informative cultural phenomenon that is suggestive of tensions relating to gender and class. The paper begins with a close examination of materials (...) surrounding the most famous and well-documented case of cat demon practice, that involving Dugu Tuo, the half- brother of Empress Dugu of the Sui, before turning to medico-religious approaches and, finally, to transformations of the supernatural or demonic cat in post-Tang materials. (shrink)

In October 2013, Missouri officials abandoned a plan to execute a convicted murderer using a novel method—an injection of propofol. The name of this drug became a household word after propofol played a role in singer Michael Jackson's death, but this has been a popular therapeutic drug for many years. Clinicians use it in intensive care, surgery, and common procedures like colonoscopy. After deciding to halt the execution, Missouri governor Jay Nixon told corrections officials to come up with a different (...) lethal injection protocol. But that was not a simple assignment. Missouri had proposed using propofol because officials had faced barriers to obtaining the drugs previously used for executions. Corrections officials in death penalty states are finding it harder to secure drugs for lethal injection. (shrink)

This paper will examine intertextual references between the Dialogus of Tacitus and the letters of Pliny, in particular those regarding boar hunting. It will argue that there are clues in the letters of Pliny which can help us to understand the relationship between these two writers as well as the tone and purpose of the Dialogus. By studying Pliny's letters to Tacitus on hunting , one can see the specific reference to boars as an allusion to Marcus Aper, the chief (...) spokesperson for contemporary eloquence in the dialogue, indicating a degree of humor and irony in the Dialogus that is further displayed by the similarity of Pliny's opening exhortation in Epistle 1.6, ridebis et licet rideas, to the final words of the Dialogus, cum adrisissent, discessimus. Moreover, the dialogue between Pliny and Tacitus in Pliny's letters can be seen as an indication that the Dialogus itself may have been revised throughout the years, thus problematizing the debate about the “publication date” of the Dialogus. (shrink)

The empirical evidence for exploration underlying the appeal of imaginary worlds is mostly absent or contradictory. Openness, and the cognitive exploration it represents, provides a better account than the overall drive to explore predicted by evolutionary theory. Furthermore, exploration cannot explain why imaginary worlds foster frequent re-engagement.

This article demonstrates how meditation apps, such as Headspace and Calm, are imbricated within public discourse about technology addiction, exploring the consequences of this discourse on contemporary mental life. Based on ethnographic research with designers and users of meditation apps, I identify a promise put forth by meditation app companies that I call attention by design: a discursive strategy that frames attention as an antidote to technology addiction, which is ostensibly made possible when design is done right. I argue that (...) attention by design is a promise unfulfilled. Meditation app companies construct attention as socially valuable by endlessly pointing out its purported opposite, technology addiction. Attention by design is promissory in that it keeps promising even when it doesn’t deliver what it promises, compelling the user to return to a practice that represents socially desirable traits that can never be fully acquired—and that often recede further from reach as the person becomes distracted by other obligations and communication mediated through the smartphone. Despite this broken promise, users believe they are becoming more attentive. The promissory attention designed into meditation apps reflects a new form of governmentality, in which users receive a mental nudge to reinterpret similarly designed experiences as different. (shrink)