According to the so-called metaphysical conception of analyticity, analytic truths are true in virtue of meaning (or content) alone and independently of (extralinguistic) facts. Quine and Boghossian have tried to present a conclusive argument against the metaphysical conception of analyticity. In effect, they tried to show that the metaphysical conception inevitably leads into a highly implausible view about the truthmakers of analytic truths. We would like to show that their argument fails, since it relies on an ambiguity of the notion (...) of 'independence of (extralinguistic) facts'. If one distinguishes between variation independence and existence independence, the unwelcome view about the truthmakers of analytic truths no longer follows. Thus, there is at best a challenge, but no conclusive argument. The door to the metaphysical conception of analyticity is still open. (shrink)

The long ongoing and partly heated debate on the concept of disease has not led to any consensus on the status of this apparently essential concept for modern health care. The arguments range from claims that the disease concept is vague, slippery, elusive, or complex, and to statements that the concept is indefinable and unnecessary. The unsettled status of the concept of disease is challenging not only to health care where diagnosing, treating, and curing disease are core aims, but also (...) to the branch of philosophy that tries to clarify concepts. This article discusses three claims about the concept of disease: that it is vague, complex, and that it is indefinable. It investigates what is meant by these claims, what their implications are, and whether the claims are sound or not. It is argued that some of the arguments are flawed and miss important points about concept analysis. This does not mean, however, that disease is a clear concept with a crisp definition. It only rules out speculative claims that disease necessarily is vague, complex, and indefinable. It appears at least as hard to show that disease is indefinable as it is to define it. (shrink)

The point of departure for this article is a review of the discussion between Twaddle and Nordenfelt on the concepts of disease, illness, and sickness, and the objective is to investigate the fruitfulness of these concepts. It is argued that disease, illness, and sickness represent different perspectives on human ailment and that they can be applied to analyze both epistemic and normative challenges to modern medicine. In particular the analysis reveals epistemic and normative differences between the concepts. Furthermore, the article (...) demonstrates, against Nordenfelt's claim, that the concepts of disease, illness, and sickness can exist without a general theory of health. Additionally, the complexity of different perspectives on human ailment also explains why it is so difficult to give strict definitions of basic concepts within modern health care. (shrink)

According to the expressivist argument the choice to use biotechnologies to prevent the birth of individuals with specific disabilities is an expression of disvalue for existing people with this disability. The argument has stirred a lively debate and has recently received renewed attention. This article starts with presenting the expressivist argument and its core elements. It then goes on to present and examine the counter-arguments before it addresses some aspects that have gained surprisingly little attention. The analysis demonstrates that the (...) expressivist argument has a wide range of underpinnings and that counter-arguments tend to focus on only a few of these. It also reveals an important aspect that appears to have been ignored, i.e., that people do not select foetuses based on chromosomes or other biological traits, but based on characteristics of living persons with specific disabilities. This makes it more difficult to undermine the claim that negative selection of foetuses expresses a disvaluing of persons with such disabilities. It leaves the expressivist argument with a strong bite still. (shrink)

The idea of truthmakers is important for doing serious metaphysics, since a truthmaker principle can give us important guidance in finding out what we would like to include into our ontology. Recently, David Lewis has argued against Armstrong’s argument that a plausible truthmaker principle requires us to accept facts. I would like to take a close look at the argument. I will argue in detail that the Humean principle of recombination on which Lewis relies is not plausible (independently of the (...) issue of facts). Then I will show that the right truthmaker principle that vindicates facts is superior to the modified truthmaker principle that Lewis has proposed. This will lead into the topic of being and existence. It turns out that truthmaking and facts are plausible, well suited for one another, and very coherent with a plausible conception of being. (shrink)

Between 1819 and 1832 Friedrich Schleiermacher was giving lectures on the life of Jesus at the University of Berlin. The following article includes two partial editions, which document the introductory parts of the lectures from 1819/20 and 1829/30. Both are based on manuscripts written by Schleiermacher’s listeners. Especially to explore the development of Schleiermacher’s conceptual considerations this two partial editions should be a useful addition to the new critical edition of Schleiermacher’s Vorlesungen über das Leben Jesu published in 2018 by (...) Walter Jaeschke (KGA II/15). (shrink)

The concepts of health and disease are crucial in defining the aim and the limits of modern medicine. Accordingly it is important to understand them and their relationship. However, there appears to be a discrepancy between scholars in philosophy of medicine and health care professionals with regard to these concepts. This article investigates health care professionals’ concepts of health and disease and the relationship between them. In order to do so, four different models are described and analyzed: the ideal model, (...) the holistic model, the medical model and the disjunctive model. The analysis reveals that each model has its pros and cons, and that health care professionals appear to apply more than one models. Furthermore, the models and the way health care professionals’ use them may be helpful for scholars in philosophy of medicine with regard to developing theories and communicating them to health care professionals. (shrink)

This paper will critically engage with Daniel Buckley's argument against “evidential minimalism” (EM), i.e., the claim that necessarily, bits of evidence (are or) provide epistemic reasons for belief. Buckley argues that in some cases, a subject has strong evidence that p (and fulfills further minimal conditions), does not believe p, but nevertheless is not epistemically criticizable and has no epistemic reason to believe p. I will defend EM by pointing out that Buckley's argument trades on an ambiguity between a strong (...) and a weak notion of criticizability. (shrink)

Biobank research is potentially fruitful. It is argued that broad consent is acceptable for future research on biological material because a) the benefit is high, b) it pays respect to people’s autonomy, c) it is consistent with current practices and d) because the risk is low. Furthermore, broad consent should be allowed if information is handled safely, people can withdraw and expanded research should be approved by an ethics review board. However, these arguments are flawed and the criteria for broad (...) consent are either too restrictive to allow any research or fail to address important challenges with biobank research. Broad consent for biobank research can hide substantial ethical challenges and threaten trust in research. This does not mean that biobank research should be abandoned or that people cannot authorise future research on donated biological material. (shrink)

This paper defends the view that in a certain sense evidence is normative. Neither a bit of evidence nor the fact that it is evidence for a certain proposition is a normative fact, but it is still the case that evidence provides normative reason for belief. An argument for the main thesis will be presented. It will rely on evidentialist norms of belief and a Broomean conception of normative reasons. Two important objections will be discussed, one from A. Steglich-Petersen on (...) whether having evidence is sufficient for having a normative reason for belief and another one from S. Street. (shrink)

V.v. Weizsäcker, Mediziner und Philosoph, versucht mit der Einführung des Subjekts in die Medizin ein neues Verständnis des Menschlichen im Menschen zu eröffnen. Der Autor stellt das breite Feld des v. Weizsäckerschen Denkens dar, um dadurch für ein Gespräch zwischen Medizin und Pädagogik das Material zu unterbreiten und auf Schwerpunktverlagerungen in den Wissenschaften vom Menschen aufmerksam zu machen.

Human actions have diverse consequences. Some consequences are intended, others are considered side effects, although they too, such as climate-damaging CO2 emissions, can be ethically relevant. Ethically speaking, considering consequences in a differentiated way is therefore clearly unavoidable. After discussing the influential concepts of utilitarianism and moral theology, the author presents his own approach to considering consequences.

According to Ramsey and colleagues the main constituent psychological processes of innovation are response to novelty, exploration, and the ability to recognize a novel solution. I fully support this view but point out that novelty reactions are often context-specific. I will expand on this and discuss the possible consequences of context-specific novelty reactions on the emergence of innovations.

This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as “a field of study following specific and well-established methodological rules” bioethics is not a specific discipline as there are no explicit “well-established methodological rules.” The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological rules within subdisciplines or for specific tasks. As this does not appear to be the case, the article examines whether (...) bioethics’ adherence to specific quality criteria (instead of methodological rules) or pursuing of a common goal can make it qualify as a discipline. Unfortunately, the result is negative. Then, the article scrutinizes whether referring to bioethics institutions and professional qualifications can ascertain bioethics as a discipline. However, this makes the definition of bioethics circular. The article ends by admitting that bioethics can qualify as a discipline according to broader definitions of discipline, for example, as an “area of knowledge, research and education.” However, this would reduce bioethics’ potential for demarcation and identity-building. Thus, to consolidate the discipline of bioethics and increase its impact, we should explicate and elaborate on its methodology. (shrink)

Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that “[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content.” While some of the commentaries misconstrued her claim (...) and argue against strawmen, others forcefully maintained that the concept of dignity has functions beyond “respect for persons and their autonomy.” One important point that came out of the debate is that dignity is a generic concept that covers more ground than “respect for persons or their autonomy.” In particular, dignity seems to have a wide range of protective functions as well as having reciprocal, relational, and social aspects. Dignity appears more attributional and norm‐formative than respect for persons and autonomy. While the claim that dignity is unclear, vague, and can be used sloganistically seems highly relevant, it is argued that this vagueness fulfils important functions in ethics. Moreover, dismissing dignity because of its lack of clarity has implications for “respect for persons” and “autonomy,” which are also used vaguely and sloganistically. No doubt medical ethics should use as a clear concept as the context requires. Nonetheless, dignity still seems to be a widely used generic concept in ethical debates and doing as much ethical work as “respect for persons” or “respect for autonomy.” Therefore, the death of dignity seems to be greatly exaggerated. (shrink)

In this paper I present an account of the rational abilities that make our decisions free. Following the lead of new dispositionalists, a leeway account of free decisions is developed, and the rational abilities that ground our abilities to decide otherwise are described in detail. A main result will be that the best account of the relevant rational abilities makes them two-way abilities: abilities to decide to do or not to do x in accordance with one’s apparent reasons. Dispositionalism about (...) rational abilities will be vindicated, since it helps to see why and how these two-way abilities entail an ability to decide otherwise and, thus, free will. (shrink)

There is a profound paradox in modern medical knowledge production: The more we know, the more we know that we (still) do not know. Nowhere is this more visible than in diagnostics and early detection of disease. As we identify ever more markers, predictors, precursors, and risk factors of disease ever earlier, we realize that we need knowledge about whether they develop into something experienced by the person and threatening to the person’s health. This study investigates how advancements in science (...) and technology alter one type of uncertainty, i.e., temporal uncertainty of disease diagnosis. As diagnosis is related to anamnesis and prognosis it identifies how uncertainties in all these fields are interconnected. In particular, the study finds that uncertainty in disease diagnosis has become more subject to prognostic uncertainty because diagnosis is more connected to technologically detected indicators and less closely connected to manifest and experienced disease. These temporal uncertainties pose basic epistemological and ethical challenges as they can result in overdiagnosis, overtreatment, unnecessary anxiety and fear, useless and even harmful diagnostic odysseys, as well as vast opportunity costs. The point is not to stop our quest for knowledge about disease but to encourage real diagnostic improvements that help more people in ever better manner as early as possible. To do so, we need to pay careful attention to specific types of temporal uncertainty in modern diagnostics. (shrink)

H. HOFMANN, La promessa della dignità umana. La dignità dell’uomo nella cultura giuridica tedesca.

The widespread application of technology in health care has imposed a broad range of challenges. The field of health technology assessment (HTA) is developed in order to face some of these challenges. However, this strategy has not been as successful as one could hope. One of the reasons for this is that social and ethical considerations have not been integrated in the HTA process. Nowadays however, such considerations have been included in many HTAs. Still, the conclusions and recommendations of the (...) HTAs are not followed. The reason for this may be that the methods for integrating ethics for HTA are not sufficiently developed, or that they are not adequate. This article presents a supplementary approach to the ethical inquiry in HTA. It is argued that a value analysis is crucial in order to address the ethical issues of health care technology in a fruitful way and to make viable decisions about such technology. (shrink)

Absorbing biography of the creative and destructive scientific genius and tragic life of Andr?-Marie Amp're.

Geographical variations are documented for a wide range of health care services. As many such variations cannot be explained by demographical or epidemiological differences, they are problematic with respect to distributive justice, quality of care, and health policy. Despite much attention, geographical variations prevail. One reason for this can be that the ethical issues of geographical variations are rarely addressed explicitly. Accordingly, the objective of this article is to analyse the ethical aspects of geographical variations in the provision of health (...) services. Applying a principlist approach the article identifies and addresses four specific ethical issues: injustice, harm, lack of beneficence, and paternalism. Then it investigates the normative leap from the description of geographical variations to the prescription of right care. Lastly, the article argues that professional approaches such as developing guidelines, checklists, appropriateness criteria, and standards of care are important measures when addressing geographical variations, but that such efforts should be accompanied and supported by ethical analysis. Hence, geographical variations are not only a healthcare provision, management, or a policy making problem, but an ethical one. Addressing the ethical issues with geographical variations is key for handling this crucial problem in the provision of health services. (shrink)

Philosophers disagree about the role of reflection for rationality, understood as the capacity to (properly) respond to genuine, normative reasons. Here, ‘reflection’ means the capacity for self-conscious normative meta-cognition. This article develops and rejects a novel argument – the argument from undercutting defeaters – in favor of the ‘one-level view’ that holds that having the concept of a belief (and of a reason) is necessary for responding to reasons. It will be argued that the ‘two-level view’, which allows for rational (...) subjects that can only non-reflectively respond to reasons, is supported by considerations dealing with the role of responding to reasons for rational action. Rationality is not as unified as the one-level view wants to have it. We start with the non-reflective way of rationally forming beliefs and then grow into the reflective way. (shrink)

Although the “right not to know” is well established in international regulations, it has been heavily debated. Ubiquitous results from extended exome and genome analysis have challenged the right not to know...

What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Second, we want to illustrate the added value of a novel method: in-depth analysis of a single article with the aim of deriving quality criteria. The (...) third and ultimate goal is to stimulate a broad and vivid debate on goodness in bioethics. An initial literature search reveals a range of diverse quality criteria. In order to expand on the realm of such quality criteria, we perform an in-depth analysis of an article that is acclaimed for being exemplary. The analysis results in eleven specific quality criteria for good bioethics in three categories: argumentative, empirical, and dialectic. Although we do not claim that the identified criteria are universal or absolute, we argue that they are fruitful for fueling a continuous constitutive debate on what is “good bioethics.” Identifying, debating, refining, and applying such criteria is an important part of defining and improving bioethics. (shrink)

How can we draw the line between health and disease? This crucial question of demarcation has immense practical implications and has troubled scholars for ages. The question will be addressed in three steps. First, I will present an important contribution by Rogers and Walker who argue forcefully that no line can be drawn between health and disease. However, a closer analysis of their argument reveals that a line-drawing problem for disease-related features does not necessarily imply a line-drawing problem for disease (...) as such. The second step analyzes some alternative approaches to drawing the line between health and disease. While these approaches do not provide full answers to the question, they indicate that the line-drawing question should not be dismissed too hastily. The third step investigates whether the line-drawing problem can find its solution in the concept of suffering. In particular, I investigate whether returning to the origin of medicine, with the primary and ultimate goal of reducing suffering, may provide sources of demarcation between health and disease. In fact, the reason why we pay attention to particular phenomena as characteristics of disease, consider certain processes to be relevant, and specific functions are classified as dys-functions, is that they are related to suffering. Accordingly, using suffering as a criterion of demarcation between health and disease may hinder a wide range of challenges with modern medicine, such as unwarranted expansion of disease, overdiagnosis, overtreatment, and medicalization. (shrink)

Ever since the works of Alfred Tarski and Frank Ramsey, two views on truth have seemed very attractive to many people. On the one hand, the correspondence theory of truth seemed to be quite promising, mostly, perhaps, for its ability to accomodate a realistic attitude towards truth. On the other hand, a minimalist conception seemed appropriate since it made things so simple and unmysterious. So even though there are many more theories of truth around - the identity theory, the prosentential (...) theory, etc. -, it is fair to say that these two views have acquired the status of the main contenders in the field. Most recently, John Searle and David Lewis have taken sides on the issue. Searle defends a new version of the correspondence theory which takes facts to be the correspondents of true statements, whereas Lewis wants to hold on to a minimalist conception of truth - allowing for an appendix of purely ontological claims that he extracts from the correspondence theory. What is new is that both have tried to see the correspondence theory not as a rival to the minimalist conception, but rather as essentially compatible with it. Still, in the end, Searle arrives at his version of the correspondence theory, and Lewis votes for minimalism. Both philosophers have sympathy with the spirit of the correspondence theory, to say the least. So one wonders why it is that they come to so different conclusions. Both start from the spirit of the correspondence theory, and both see it as essentially compatible with the heart of the minimalist conceptions, and still is there no agreement on what theory is to be accepted in the end. (shrink)

Excerpt from Empfindung und Vorstellung: Ein Beitrag zur Klarung Psychologischer Grundbegriffe Vor kurzem erschien eine Abhandlung von Carl Stumpf uber Empfindung und Vorstellung, welche auf Grund feinfuhliger Selbstbeobachtungen und unter Berucksichtigung der grossen einschlagigen Literatur in die vielen Winkel und Dunkelheiten dieses Problems der deskriptiven Psychologie hineinleuchtet. Unter sorgfaltiger Analyse der von den verschiedenen Beobachtern gegebenen Beschreibungen und scharfsinniger Untersuchung der logischen Durchfuhrbarkeit jeder einzelnen der bisher ausgesprochenen Auffassungen versucht diese Abhandlung die Frage zu klaren, worin der wesentliche Unterschied beider (...) Erlebnisarten besteht. Als Ergebnis gelangt Stumpf in der Hauptsache zu einer Rechtfertigung der altuberlieferten Auffassung, nach der ein "spezifischer" Unterschied zwischen Empfindung und Vorstellung nicht vorliegt, sich die Vorstellungen vielmehr vor allem durch ihre geringere Intensitat von den Empfindungen unter-scheiden. Ausser an Intensitat fehlt es den Vorstellungen im Gegensatz zu den Empfindungen an Fulle und Bestandigkeit, ferner sind sie dadurch charakterisiert, dass sie willkurlich leichter modifizierbar sind, dass ihnen gegenuber der Glaube an die Realitat fur das erlebende Bewusstsein einer Rechtfertigung bedarf, und dass sie durchschnittlich schwachere Gefuhlswirkungen mit sich fuhren. Vorstellungen stellen sich so den Empfindungen gegenuber als "Erscheinungen zweiter Ordnung" dar: in dem Inhalt der Erlebnisse, nicht in den Akten des Erlebens, ist ihre Verschiedenheit zu suchen. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.". (shrink)