An edited version of a talk between Urban and Toynbee on Radio Free Europe. The book concerns the nature of history as well as discussing Marxism and Christianity, the third world, and the effects of technology.

ZusammenfassungDer Artikel untersucht die Frage, ob es sinnvoll ist, Doping im Sport unter ärztlicher Kontrolle freizugeben. Dazu werden die Auswirkungen einer Freigabe untersucht, die stets nur eine begrenzte Freigabe wäre, allein wegen der Risiken. Die unangenehmen Begleiterscheinungen der Dopingkontrollen würden nicht entfallen. Die Auswirkungen einer Freigabe von Doping im Wettkampfsport wären entweder unsinnig oder aber mit Nachteilen behaftet. Es ist nicht notwendig, die Frage zu klären, was die „Idee des Sportes“ ausmacht und ob sie verändert werden darf. Allein unter praktischen (...) Aspekten zeigt sich, dass dem Sport mit einer Freigabe des Dopings keine Vorteile, aber viele Nachteile erwachsen. (shrink)

Urban fragt nach der Literaturkenntnis Edith Steins in ihrem Lesen, Interpretieren, Ubersetzen, Theoretisieren, Dichten und Zitieren und arbeitet Praferenzen, Identifikationen und Schwerpunkte heraus. Die erstmals so zusammengefuhrten und mit ausfuhrlichen Textzeugnissen versehenen Daten und Fakten zeigen, wie ihre Denkwelt und karmelitisch-klosterliche Existenzweise dadurch gepragt wurden. Zugleich wird so ihre spezifische Anthropologie erkennbar. Im zweiten Teil wird nach der Wirkung und bleibenden Aktualitat dieser Anthropologie gefragt. Die Erfahrungen von Kreuz und Leid, Schrecken und Grausamkeit beruhren nicht nur tiefgreifend die Gottes- und (...) Lebenserfahrung der Karmelitin Edith Stein, sondern auch literarische Bewaltigungen und Konzeptionen von Le Fort und Camus bis Goytisolo und jungst Jonathan Littell. (shrink)

Michel Bitbol offers a well-thought-out system of metaphysical coordinates. Despite the elegance and soundness of the proposed system, I nevertheless have concerns about the very need for a tailor-….

When the 15-year-old Auguste Böhmer, daughter of Caroline Schlegel and stepdaughter of August Wilhelm Schlegel, died on 12th July 1800, Friedrich Wilhelm Joseph Schelling was accused of being responsible for this tragic event, because he tried to treat her according to the medical system of John Brown. The ensuing scandal became a symbol for the danger of every progressive movement of that time: the Romantic literature, the natural philosophy of Schelling and Brownianism in its German version, represented by Andreas Röschlaub. (...) An attempt is made to analyse the social and political background of the scandal and to argue the historical meaning as a fight against a fundamental reform of medicine. (shrink)

This volume presents the theory of culture of the Russian‑born German Jewish social philosopher David Koigen (1879-1933). Heir to Hermann Cohen's neo‑Kantian interpretation of Judaism, he transforms the religion of reason into an ethical Intimitätsreligion. He draws upon a great variety of intellectual currents, among them, Max Scheler's philosophy of values, the historical sociology of Max Weber, the sociology of religion of Émile Durkheim, Ernst Troeltsch and Georg Simmel and American pragmatism. Influenced by his personal experience of marginality in German (...) academia yet the same time unconstrained by the dictates of the German Jewish discourse, Koigen shapes these theoretical strands into an original argument which unfolds along two trajectories: theodicy of culture and ethos. Distinguished from ethics, ethos identifies the non-formal factors that foster a group's sense of collective identity as it adapts to continuous change. From a Jewish perspective, ethos is grounded in the biblical covenant as the paradigm of a social contract and corporate liability. Although the normative content of the covenantal ethos is subject to gradual secularization, its metaphysical and existential assumptions, Koigen argues, continue to inform Jewish self-understanding. The concept of ethos identifies the dialectic of tradition as it shapes Jewish religious consciousness, and, in turn, is shaped by the evolving cultural and axiological sensibilities. In consonance, Jewish identity cannot be reduced to ethnicity or a purely secular culture. Urban develops these fragmentary and inchoate theories into a sociology of religious knowledge and suggests to read Koigen not just as a Jewish sociologist but as the first sociologist of Judaism who proposes to overcome the dogmatic anti-metaphysical stance of European sociology. (shrink)

ABSTRACT Definition of the problem: The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. Arguments and conclusion: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over‐work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments (...) for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians. (shrink)

Um das Ansehen von medizinischen Forschern ist es in der westlichen Welt nicht überall gut bestellt. In den 1990er-Jahren gelangte das Thema »Medizinischer Forschungsbetrug« erstmals in den USA in das öffentliche Bewusstsein. Eine Debatte um begünstigende Strukturen und denkbare Kontrollinstrumente zur Eindämmung von Missbrauch entbrannte – in Deutschland blieb ein solcher Diskurs bis zur Jahrhundertwende zunächst aus. Der Band nimmt wissenschaftlich arbeitende Ärzte, die ethischen Anforderungen, denen sie sich ausgesetzt sehen, und das System, in dem sie arbeiten, in den Fokus. (...) Stella Elaine Urbans Analyse von Betrugsfällen deckt wissenschaftsimmanente und individuelle Fallstricke auf, die unredliche Forschung begünstigen. Es zeigt sich, dass die wissenschaftliche Integrität unterstützt und geschützt werden muss, um das Vertrauen in die Medizin wiederherzustellen. (shrink)

Im Transit ist eine subjektorientierte Analyse von Transnationalisierungsprozessen in der Wissenschaft.In dieser exploariven Studie werden das Lehr- und Lernsetting eines außergewöhnlichen Rahmen-Experiments zur Transnationalisierung der ...

Der Beitrag untersucht die ethischen Konflikte, die einer Regelung der Arbeitszeit von Ärzten zugrunde liegen. Als oberstes ethisches Prinzip ist die Vermeidung von Schäden zu beachten, die durch Überarbeitung der Ärzte sowie durch übermäßige Aufteilung der Arbeit entstehen. Zudem sind andere ethische Prinzipien zu berücksichtigen, insbesondere die Schadensvermeidung und Nutzenmehrung für zukünftige Patienten sowie für die Ärzte. Der Beitrag begründet Präferenzen bei konfligierenden ethischen Prinzipien und untersucht überdies die strukturellen Schwierigkeiten, die unvermeidlich bei der Regelung einer komplexen Tätigkeit, wie der (...) ärztlichen, anfallen. (shrink)

To what extent can postmodern developments be observed in modern medicine and which theories of postmodern philosophy can we draw on with regard to medicine's theoretical problem? This article explores these questions with special emphasis on the epistemological status of medicine, the concept of disease, and the anthropological model. It is examined whether medicine's inherent duty to act can be questioned in the light of the plurality that characterizes postmodernity. It is concluded that, according to postmodern philosophy, medicine should be (...) characterized by a justified variety of paradigms. Cooperation within the variety must continue to be guaranteed, always in favor of the constitutive moral duty of medicine. (shrink)

In reference to historical developments, this article introduces the topic of this special issue of Theoretical Medicine and Bioethics, that is, the relationship(s) between theory and practice. The authors emphasize the need for scientific research in this neglected area for the sake of both clinical practice and medical education.

La désinstitutionnalisation des services de santé mentale a créé un espace pour la création de solutions nouvelles et communautaires dans les pays occidentaux. Toutefois, le domaine semble encore manquer de dispositifs idéologiques et pratiques cohérentes. Cet article a pour objectif d’examiner les caractéristiques des services de logement conçus pour soutenir les individus atteints d’un handicap psychique en Suède, et s’appuie sur les expériences des prestataires de services locaux. L’accent est mis sur le cadre organisationnel des services, l’orientation principale et le (...) contenu conceptuel. L’article se fonde sur une étude de cas sur de multiples individus et portant sur dix municipalités suédoises. Les données consistent principalement en des entretiens avec des informateurs clés de l’organisation de services sociaux. Les conclusions soulignent l’émergence d’une nouvelle génération d’utilisateurs de services ayant des besoins complexes et qui remettent en question à la fois l’organisation et la nature des services offerts. Les foyers collectifs et l’aide au logement mobile ont été considérés comme les piliers de l’offre de services. Toutefois, un certain nombre de solutions locales pragmatiques ont également été identifiées, ainsi que des initiatives ayant pour objectif de réduire l’étendue des structures de type institutionnel. (shrink)

Context: Philosophical and - more recently - empirical approaches to the study of mind have recognized the research of lived experience as crucial for the understanding of their subject matter. Such research is faced with self-referentiality: every attempt at examining the experience seems to change the experience in question. This so-called “excavation fallacy” has been taken by many to undermine the possibility of first-person inquiry as a form of scientific practice. Problem: What is the epistemic character and value of reflectively (...) acquired phenomenological data? Can the study of experience, despite the excavation fallacy, rely on the act of reflection on lived experience and make sense and use of its results? Method: Through a philosophical discourse, informed by empirical first-person inquiry, we explore the experiential structure of the act of reflection and the formation of the corresponding belief about past experience. Results: We present a provisional first-person model of the experiential dynamics of retrospective reflection, in which the reflective act is characterized as enaction of belief about past experience that co-determines - rather than distorts - its results. From a constructivist perspective on the inevitable interdependence between the act of observing and the observed, the excavation “fallacy” is recognized as an intrinsic characteristic of reflection. Reflection is described as an iterative, self-referential process, guided by a context- and subject-specific horizon of expectations. Implications: Knowing the characteristics of the formation of beliefs about experience is essential for understanding first-person data and for the possibility of their acquisition and use in scientific practice, particularly in the context of second-person approaches to the study of experience. Constructivist content: We relate the proposed understanding of reflection to constructivist epistemology and argue that constructivism provides an epistemological foundation for the empirical study of experience more suitable than the traditional epistemological objectivism of cognitive science. We suggest that the constructive nature of the process of reflection calls for a collaboration between the fields of constructivism, phenomenology, and first-person research, and points towards the potential for their mutual enrichment. (shrink)

Background: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy. Aim: To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care. Research design: The study has a (...) qualitative, inductive design. Participants and research context: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. Ethical considerations: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. Findings: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together. Discussion: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy. Conclusion: If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient. (shrink)

Definition of the problem The research and regulatory levels for data-intensive research in medicine are divergent. This results in a heterogeneous global field of regulating institutions with regionally unequal regulations, both in terms of the depth and restrictiveness of regulations. Despite or precisely because of the lack of globally binding regulation, nonbinding or only partially binding normative guidelines can also serve as orientation. But how should such normative regulation be designed in view of data-intensive research in medicine and what should (...) it be based on? Arguments The question of how concrete and in detail such research should be regulated can only be answered on a case-by-case basis for specific situations and institutions. Whether new norms or weightings of norms should be introduced, or whether the norms and their weightings should remain in place, can only be answered with reference to strong normative arguments. So far, there is a lack of compelling arguments in favour of new standards in view of data-intensive medical research. However, it is always necessary to translate norms, whether new or old, and apply them to a new method or technology. As in the past, both established and transparently communicated standards and an independent judgement on the application of these standards are therefore required. Conclusion In view of their particular suitability for this task, ethics committees should continue to be required and qualified as a procedural authority in the approval of data-intensive research in medicine; as an independent institution, they should make a judgement appropriate to the individual case on the basis of existing norms and standards. However, the changing practices of data-intensive research projects can also be reflected in new demands on research ethics committees, which should be addressed with reforms of their operating mode. (shrink)

BackgroundIndividuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues. The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial -design and methods. The main hypothesis is that participants receiving PIPCI will increase their (...) psychological flexibility compared to participants in the active control group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health compared to participants in the active control group and the waiting list control group.Materials and MethodsThis three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group, an active control group or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers and health care costs. Assessments will be performed at pre- and post-intervention, as well as at a 6-month follow-up.DiscussionThe development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia.Clinical Trial RegistrationClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)