Gerontologists have proposed different concepts for ageing well such as ‘successful ageing’, ‘active ageing’, and ‘healthy ageing’. These conceptions are primarily focused on maintaining health and preventing disease. But they also raise the questions: what is a good life in old age and how can it be achieved? While medical in origin, these concepts and strategies for ageing well also contain ethical advice for individuals and societies on how to act regarding ageing and old age. This connection between gerontology and (...) ethics is overlooked by both schools of thought. We thus develop this research programme for a systematic geroethics in four steps. First, we analyze ‘successful ageing’ as put forward by Rowe and Kahn as a paradigmatic example of a gerontological conception of ageing well. Then, in a second step, we move from criticisms within gerontology to an ethical perspective; in particular, we want to clarify the problem of the claim of universal validity of conceptions of the good life. In a third constructive step, we explain how the ‘capabilities approach’ could be applied in this context as a normative foundation for the implicit normative assumptions of gerontological conceptions of ageing well, such as a particular choice of functionings, the ethical relevance of human agency, and the resulting claims of individuals towards society. Finally, using a concept developed by the German philosopher Ursula Wolf, we systematically develop the different aspects of the connection between ageing well and the theory of the good life in their full complexity and show their interconnectedness. (shrink)

The human being’s mastery of itself, on which the self is founded, practically always involves the annihilation of the subject in whose service that mastery is maintained, because the substance which is mastered, suppressed, and disintegrated by self-preservation is nothing other than the living entity.

Some of the recent criticisms published during and after the last revision process of the Declaration of Helsinki are directed at its basic legitimacy. In this article we want to have a closer look at the two criticisms we consider to be the most fundamental. The first criticism questions the legitimate authorship of the World Medical Association to publish a document such as the Declaration. The second fundamental criticism we want to examine argues that the last revision process failed to (...) meet the standards for fair, democratic procedures. Although both criticisms deny the formal legitimacy of the Declaration in the most fundamental way, they have never been addressed in detail in a single article. We refute most of the related arguments. However, acknowledging some of the points made, improvements for future revision processes and versions of the Declaration of Helsinki are outlined. (shrink)

Social Justice, Health Inequities, and Access to New Age-Related Interventions Content Type Journal Article Category Original Paper Pages 281-295 DOI 10.1007/s12376-009-0027-3 Authors Hans-Jörg Ehni, University of Tuebingen, Tuebingen, Baden-Württemberg Germany Georg Marckmann, University of Tuebingen, Tuebingen, Baden-Württemberg Germany Journal Medicine Studies Online ISSN 1876-4541 Print ISSN 1876-4533 Journal Volume Volume 1 Journal Issue Volume 1, Number 3.

The vast majority of empirical research on stakeholder management has traditionally focused on multinational corporations. Only in recent years, scholars have begun to pay attention to the stakeholder management concept in relation to small- and medium-sized enterprises (SMEs). The few existing studies in this area, however, discuss SMEs as a context free category or remain focused on single country analysis. This cross-national empirical research investigates SME owner-managers' perceptions of stakeholder management in six European countries. The comparative analysis is followed by (...) a discussion of how institutional, cultural and linguistic contexts can influence owner-managers' sensemaking of stakeholder management. Our study questions the universality of specific management terms and proposes that more attention should be paid to the institutional, cultural and linguistic environments that shape economic activity in different parts of Europe. (shrink)

In March 2020, the rapid increase in severe COVID‐19 cases overwhelmed the healthcare systems in several European countries. The capacities for artificial ventilation in intensive care units were too scarce to care for patients with acute respiratory disorder connected to the disease. Several professional associations published COVID‐19 triage recommendations in an extremely short time: in 21 days between March 6 and March 27. In this article, we compare recommendations from five European countries, which combine medical and ethical reflections on this (...) situation in some detail. Our aim is to provide a detailed overview on the ethical elements of the recommendations, the differences between them and their coherence. In more general terms we want to identify shortcomings in regard to a common European response to the current situation. (shrink)

Alternsprävention mit Hilfe von biotechnologischen Eingriffen ist der Biologie des Alterns oder Biogerontologie bereits im Laborversuch bei unterschiedlichen Organismen gelungen. Durch die Manipulation einzelner Gene, durch die sogenannte Kalorienrestriktion, d. h. einem Labortier werden nur 70 % der Kalorien zur Verfügung gestellt, die es sonst zu sich nehmen würde, und durch Pharmazeutika wurde die Lebensspanne von Labororganismen wie Nematoden oder Hefen bis zu zehnfach verlängert. Vergleichbare Eingriffe sollen ebenfalls beim Menschen möglich sein, was speziesübergreifende, ähnliche Mechanismen der Alterung nahelegen.

The ethical aspects of placebo control in clinical trials have been extensively and controversially debated in the last decade. However, a thorough analytical comparison of the different existing international regulations, their terminologies and their ethical principles concerning placebo, is still missing. The central issue in the ongoing controversy is the justification of placebo‐use, if proven treatment exists. All present versions of the examined guidelines propose such justifications, but each guideline differs from the others in relevant details. Therefore the conditions justifying (...) placebo‐use according to each guideline are the focus of our attention. We will first propose a formalized general principle that defines the ethical acceptability of placebo‐use. Then we will analyse three categories of conditions put forward by the different documents: the risk of harm or burden, compelling scientific reasons, and the availability of proven treatment. The analysis shows important normative discrepancies and contradictions between the examined guidelines. Especially striking is the fact that some guidelines allow the participants in clinical trials to be exposed to a risk of serious harm, while others do not. Finally, we try to show how the normative difference of each guideline could influence the decision of researchers or IRBs concerning the ethical acceptabililty of placebo‐use. (shrink)

The World Medical Association has announced that a new revision process of the Declaration of Helsinki has been started. This article will identify the criticisms that have been made in the bioethics literature, particularly since the last revision. In addition, criticisms are discussed that were made in the literature even before the last revision and have not fallen silent. The plausibility of the recommendation for a change in the Declaration of Helsinki is examined.

ABSTRACT The ethical aspects of placebo control in clinical trials have been extensively and controversially debated in the last decade. However, a thorough analytical comparison of the different existing international regulations, their terminologies and their ethical principles concerning placebo, is still missing. The central issue in the ongoing controversy is the justification of placebo‐use, if proven treatment exists. All present versions of the examined guidelines propose such justifications, but each guideline differs from the others in relevant details. Therefore the conditions (...) justifying placebo‐use according to each guideline are the focus of our attention. We will first propose a formalized general principle that defines the ethical acceptability of placebo‐use. Then we will analyse three categories of conditions put forward by the different documents: the risk of harm or burden, compelling scientific reasons, and the availability of proven treatment. The analysis shows important normative discrepancies and contradictions between the examined guidelines. Especially striking is the fact that some guidelines allow the participants in clinical trials to be exposed to a risk of serious harm, while others do not. Finally, we try to show how the normative difference of each guideline could influence the decision of researchers or IRBs concerning the ethical acceptabililty of placebo‐use. (shrink)

Die ethischen Aspekte der Verwendung von Placebos in klinischen Versuchsreihen wurden im letzten Jahrzehnt ausführlich und kontrovers diskutiert. Es fehlt dennoch eine gründliche vergleichende Analyse der verschiedenen internationalen Richtlinien, ihrer Terminologien und ihrer auf Placebo bezogenen Prinzipien. Das zentrale Problem ist die Rechtfertigung von Placebo bei einer nachgewiesen wirksamen Therapie. Alle aktuellen Versionen der untersuchten Richtlinien schlagen solche Rechtfertigungen vor, unterscheiden sich hierbei jedoch beträchtlich. Zunächst werden wir ein formales allgemeines Prinzip herausarbeiten. Dann werden wir drei verschiedene Kategorien von Kriterien (...) darstellen: das Schadensrisiko oder die Belastung, zwingende wissenschaftliche Gründe und die Erhältlichkeit einer nachgewiesen wirksamen Therapie. Die Analyse zeigt bedeutende normative Abweichungen und Widersprüche innerhalb und zwischen den einzelnen Richtlinien. Besonders frappierend ist es, dassmancheRichtlinien es erlauben, Versuchsteilnehmer dem Risiko eines schweren Schadens auszusetzen, während andere gerade dies untersagen. Abschließend versuchen wir zu zeigen, wie sich die normativen Unterschiede bei der Entscheidungsfindung von Forschern und Ethikkommissionen auswirken können. (shrink)

The treatment of the control group in externally sponsored clinical trials is the issue of one of the most heated debates in international research ethics. The paradigmatic cases are the mother-to-child HIV-transmission trials that took place in 16 developing countries in 1997, where the control group received a placebo while proven treatment was available in industrialized countries. From this circumstance results the controversy as to whether the sponsor and researchers of externally sponsored trials have to supply a treatment that is (...) usually not available in the host country. From the beginning of the debate the controversial level of treatment has been called “standard of care”. However, besides the disagreement about the quality of the care that has to be supplied, there is as yet no widely accepted clear meaning of this concept. This article examines the fundamental ambiguity of the term and its formal function as an ethical criterion including suggestions on its further use. (shrink)

Symptom Checker Applications (SCA) are mobile applications often designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology. The aim of this scoping review is to identify the ELSA of SCA in the scientific literature. A scoping review was conducted to identify the ELSA (...) of SCA. Ten databases (e.g., Web of Science and PubMed) were used. Studies on SCA that address ELSA, written in English or German, were included in the review. The ELSA of SCA were extracted and synthesized using qualitative content analysis. A total of 25,061 references were identified, of which 39 were included in the analysis. The identified aspects were allotted to three main categories: (1) Technology; (2) Individual Level; and (3) Healthcare system. The results show that there are controversial debates in the literature on the ethical and social challenges of SCA usage. Furthermore, the debates are characterised by a lack of a specific legal perspective and empirical data. The review provides an overview on the spectrum of ELSA regarding SCA. It offers guidance to stakeholders in the healthcare system, for example, patients, healthcare professionals, and insurance providers and could be used in future empirical research to investigate the perspectives of those affected, such as users. (shrink)

Background Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users’ experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in (...) the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use? Methods A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis. Results Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others. Conclusions The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA. Trial registration German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020. (shrink)

Background: Research activities in sub-Saharan Africa may be limited to delegated tasks due to the strong control from Western collaborators, which could lead to scientific production of little value in terms of its impact on social and economic innovation in less developed areas. However, the current contexts of international biomedical research including the development of public-private partnerships and research institutions in Africa suggest that scientific activities are growing in sub-Saharan Africa. This study aims to describe the patterns of clinical research (...) activities at a sub-Saharan biomedical research center. Methods: In-depth interviews were conducted with a core group of researchers at the Medical Research Unit of the Albert Schweitzer Hospital from June 2009 to February 2010 in Lambarene, Gabon. Scientific activities running at the MRU as well as the implementation of ethical and regulatory standards were covered by the interview sessions. Results: The framework of clinical research includes transnational studies and research initiated locally. In transnational collaborations, a sub-Saharan research institution may be limited to producing confirmatory and late-stage data with little impact on economic and social innovation. However, ethical and regulatory guidelines are being implemented taking into consideration the local contexts. Similarly, the scientific content of studies designed by researchers at the MRU, if local needs are taken into account, may potentially contribute to a scientific production with long-term value on social and economic innovation in sub-Saharan Africa. Conclusion: Further research questions and methods in social sciences should comprehensively address the construction of scientific content with the social, economic and cultural contexts surrounding research activities. (shrink)

Definition of the problem Digital health technologies have gained significant importance in recent years. These technologies include symptom checker apps which use algorithms or artificial intelligence to provide users with analyses and recommendations based on their symptom input. Despite their widespread recognition, research shows mixed results regarding the accuracy of these apps, thus, limiting their current utility. The interdisciplinary CHECK.APP project examined the ethical, legal, and social aspects associated with symptom checker apps. Arguments The resulting recommendations presented here are directed (...) towards various stakeholders, including users, physicians, developers, and public institutions. It is crucial to adopt a critical stance towards the use of symptom checker apps, promote health literacy and eHealth literacy, and ensure transparency regarding the data basis and user experiences. Moreover, there is a need for reliable and independent information sources that allow users and physicians to stay informed about current developments in the digitalization of healthcare. At the same time, developers are encouraged to follow clear guidelines on transparency, quality assurance, and accessibility. Additionally, policymakers are recommended to ensure the voluntary use of symptom checker apps and to create conditions that strengthen the health literacy of the population. Conclusion The recommendations presented here outline how symptom checker apps can be used responsibly to maximize potential benefits and minimize risks. (shrink)

Advancements in biological ageing research have shown that age-related diseases may be fought more effectively in the future by directly intervening into the ageing process. This prospect is associated with hopes for solving problems of demographic change. It also addresses raising awareness for complex ethical, legal and social issues that have hardly been a topic of discussion to date. Therefore, as the objective of our project, an interdisciplinary discourse module entitled “Ethics of Biogerontology” was developed to initiate a social debate (...) on the ethical, legal, and societal implications of biogerontology. The discourse module focuses on competences and argumentation skills and was developed with experts from relevant disciplines, e.g. biogerontology, social gerontology, philosophy, geriatrics, and medical ethics. Concepts of age and ageing are tightly interlinked with biogerontology and are as such relevant as teaching contents of the discourse module. The course module was tested in eight discourse teaching projects in research, medicine, and education in various partner institutions and evaluated based on an ethical competence model. This article describes the conception, including the learning objectives, of such a teaching course and the associated teaching contents. It also gives a justification for their selection. Finally, we summarize the results of the evaluation. (shrink)

This volume outlines a model of language that can be characterized as functionalist, usage-based, dynamic, and complex-adaptive. The core idea is that linguistic structure is not stable and uniform, but continually refreshed by the interaction between three components: usage, the communicative activities of speakers; conventionalization, the social processes triggered by these activities and feeding back into them; and entrenchment, the individual cognitive processes that are also linked to these activities in a feedback loop. Hans-Joerg Schmid explains how this multiple (...) feedback system works by extending his Entrenchment-and-Conventionalization Model, showing how the linguistic system is created, sustained, and continually adapted by the ongoing interaction between usage, conventionalization, and entrenchment. Fulfilling the promise of usage-based accounts, the model explains how exactly usage is transformed into collective and individual grammar and how these two grammars in turn feed back into usage.0The book is exceptionally broad in scope, with insights from a wide range of linguistic subdisciplines. It provides a coherent account of the role of multiple factors that influence language structure, variation, and change, including frequency, economy, identity, multilingualism, and language contact. (shrink)

Book notice Content Type Journal Article Pages 1-2 DOI 10.1007/s11016-011-9588-3 Authors Nicolas Rasmussen, School of History and Philosophy, University of NSW, Sydney, 2052 Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Buchkritik über: Chaim Perelman/Lucie Olbrechts-Tyteca: Die neue Rhetorik. Eine Abhandlung über das Argumentieren. Herausgegeben von Josef Kopperschmidt. Übersetzt von Freyr R. Varwig in Zusammenarbeit mit dem Herausgeber. Überarbeitet für die Drucklegung von Hans-Jörg Ehni in Zusammenarbeit mit dem Herausgeber, 2 Bände. Frommann-Holzboog Verlag, Stuttgart-Bad Canstatt 2004, 821 S.

in a nervous system of a given species. This chapter provides a critical perspective on the role of connectomes in neuroscientific practice and asks how the connectomic approach fits into a larger context in which network thinking permeates technology, infrastructure, social life, and the economy. In the first part of this chapter, we argue that, seen from the perspective of ongoing research, the notion of connectomes as “complete descriptions” is misguided. Our argument combines Rachel Ankeny’s analysis of neuroanatomical wiring diagrams (...) as “descriptive models” with Hans-Joerg Rheinberger’s notion of “epistemic objects,” i.e., targets of research that are still partially unknown. Combining these aspects we conclude that connectomes are constitutively epistemic objects: there just is no way to turn them into permanent and complete technical standards because the possibilities to map connection properties under different modeling assumptions are potentially inexhaustible. In the second part of the chapter, we use this understanding of connectomes as constitutively epistemic objects in order to critically assess the historical and political dimensions of current neuroscientific research. We argue that connectomics shows how the notion of the “brain as a network” has become the dominant metaphor of contemporary brain research. We further point out that this metaphor shares (potentially problematic) affinities to the form of contemporary “network societies.” We close by pointing out how the relation between connectomes and networks in society could be used in a more fruitful manner. (shrink)

Continental Philosophy of Science provides an expert guide to the major twentieth-century French and German philosophical thinking on science. A comprehensive introduction by the editor provides a unified interpretative survey of continental work on philosophy of science. Interpretative essays are complemented by key primary-source selections. Includes previously untranslated texts by Bergson, Bachelard, and Canguilhem and new translations of texts by Hegel and Cassirer. Contributors include Terry Pinkard, Jean Gayon, Richard Tieszen, Michael Friedman, Joseph Rouse, Mary Tiles, Hans-Jöerg Rheinberger, Linda (...) Alcoff, Todd May, Axel Honneth, and Penelope Deutscher. (shrink)

The Evangelical Academies are a forum to open debate on any matters relating to a furtherance of a responsible approach to future directions in society. The contribution discusses in the author's view in which way, for which reasons and on which sociallevels questions of ethics in economy have occured in the Academie's work. The author proposes to establish interdisciplinary teams developing norms to connect ethics and economy, and points out a nurober of tasks for the future work.

Der Band führt die Beiträge einer Reihe namhafter soziologischer Theoretiker zusammen, die sich mit dem Werk über die "Grundlagen der Sozialtheorie" von James S. Coleman auseinandersetzten. Die Edition dokumentiert die Vielzahl der Themen, denen Colemans Theorieentwurf neue und wichtige Anregungen verdankt. Besonders nachdrücklich diskutieren die Kommentatoren Colemans Bedeutung für die Weiterentwicklung der Theorien sozialer Normen, der Mikro-Makro-Problematik, der Theorie des Vertrauens, der Herrschaft und der Erziehung. Alle Beiträge nehmen Stellung zur Theorie rationalen Wahlhandelns, die James Coleman zur Fundierung seiner Handlungssystemanalysen (...) benutzt und die in jüngster Zeit zunehmend Raum und Beachtung gewinnt. (shrink)