Beauchamp and Childress’ definition of autonomous decision‐making includes the conditions of intentionality, understanding, and non‐control. In genetics, however, a relational conception of autonomy has been increasingly recognized. This article aims to empirically assess aspects of social influence in genetic testing decision‐making and to connect these with principlist and relational theories of autonomy. We interviewed 18 adult genetic counsellees without capacity issues considering predictive genetic testing for cancer predisposition for themselves and two counselling physicians in Switzerland. We conducted a qualitative analysis, (...) building on a grounded theory study about predictive genetic testing decision‐making. We found that some participants agreed to predictive genetic testing predominantly because relatives wanted them to do it, with some even acting contrary to their own convictions. Others, in contrast, based their decision on purely individualistic reasons but expressed difficulties in explaining their decision to their social environment. Healthcare professionals had a critical influence on decision‐making in many cases without being manipulative, as perceived by counsellees. Still, cases of coercion and social pressure occurred within social relationships. In conclusion, predictive genetic testing decision‐making includes relational and individualistic aspects, and both are compatible with autonomous decision‐making. While the principlist and relational notions of autonomy compete on a theoretical level, they are two sides of the same coin when used as analytical lenses for genetic testing decision‐making. Social acceptance of refusal of testing should be improved to mitigate social pressure. Individuals should be encouraged to decide for themselves how much their social environment influences their decision regarding predictive genetic testing. (shrink)

The representation of history continues to evolve in the domain of museum exhibitions. This evolution is informed in part by the creation of new display methods—many of which depart from the traditional conventions used to achieve the “museum effect”—in part by an increased attention to the museum–visitor relationship. In this context the ethical force of bearing witness, at times a crucial aspect of the museum experience, has emerged as a particularly compelling issue. In seeking to represent and address atrocity, injustice, (...) and the abrogation of human rights, museums have the potential to become “sites of conscience” and to encourage “historical consciousness.” Through a series of three exhibitions devoted to slavery, the New-York Historical Society demonstrated how such sites can be constructed and how objects can be deployed to represent extreme or “limit cases.” In this review/essay I investigate and interrogate these exhibitions, looking closely at the use of objects as a source of “indirect testimony” and at the “dialogical situation” that might arise in an encounter among objects, exhibit narratives, and visitors. Thinking in terms of point of view, I look at the variety of rhetorical platforms from which objects speak in these exhibitions; thinking in terms of syntax, I look at the effects of ordering and of the radical juxtaposition of objects; thinking in terms of irony, I look at the provocations of double-voiced narratives and at how objects are used to support those historical sentences. (shrink)

Dance is regarded as visual art form by common arts and science perspectives. Definitions of dance as means of communication agree that its message is conveyed by the dancer/choreographer via the human body for the observer, leaving no doubt that dance is performed to be watched. Brain activation elicited by the visual perception of dance has also become a topic of interest in cognitive neuroscience, with regards to action observation in the context of learning, expertise and aesthetics. The view that (...) the aesthetic experience of dance is primarily a visual one is still shared by many artists and cultural institutions, yet there is growing interest in making dance performances accessible for individuals with visual impairment / blindness. Means of supporting the non-visual experience of dance include verbal (audio description), auditive (choreographed body sounds, movement sonification), and haptic (touch tour) techniques, applied for different purposes by artists and researchers, with three main objectives: to strengthen the cultural participation of a non-sighted audience in the cultural and aesthetic experience of dance; to expand the scope of dance as an artistic research laboratory toward novel ways of perceiving what dance can convey; and to inspire new lines of (neuro-cognitive) research beyond watching dance. Reviewing literature from different disciplines and drawing on the personal experience of an inclusive performance of Simon Mayer's “Sons of Sissy,” we argue that a non-exclusively visual approach can be enriching and promising for all three perspectives and conclude by proposing hypotheses for multidisciplinary lines of research. (shrink)

This article examines how local experiments and negotiation processes contribute to social and field-level learning. The analysis is framed within the niche development literature, which offers a framework for analyzing the relation between projects in local contexts and the transfer of local experiences into generally applicable rules. The authors examine 2 case studies drawn from a meta-analysis of 27 new energy projects. The case studies, both pertaining to biogas projects for local municipalities, illustrate the diversity of applications for a technology (...) through processes of local variation and selection. The authors examine the diversity of expectations and the negotiation and alignment of these expectations underlying the diversity of local solutions. Moreover, the authors address how the transfer of lessons from individual local experiments can follow different pathways and yet always require due attention to the social and cultural limits to the transferability of solutions. (shrink)

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

ZusammenfassungDie demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

ZusammenfassungDie demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im Gesundheitswesen in Zukunft weiter verschärfen. Auch Deutschland steht eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Ein nur selten in diesem Kontext besprochenes Kriterium der Verteilung von Mitteln in der Gesundheitsversorgung ist die marginale Wirksamkeit medizinischer Leistungen. Im vorliegenden Beitrag wird dieses Kriterium vorgestellt und auf seine Fairness hin untersucht. Nach der kritischen Diskussion einiger Argumente gegen den offenen Einsatz von (...) Rationierungskriterien und einer Definition von marginaler Wirksamkeit in zwei unterschiedlichen Dimensionen werden verschiedene Vorzüge und eventuelle Nachteile des Kriteriums beleuchtet. (shrink)

This article opens with a discussion of incarceration in the time of Covid 19. The story of one of the inmates in the high-security prison of Puente Grande leads us back to the beginning of the fifteen-year-long imprisonment of an innocent and, with it, to a complex narrative. The story concerns the use of the juridical concepts of delincuencia organizada, racketeering, and kidnapping. As a charge it has been repeatedly implemented in what has come to be called la fabricaciόn de (...) culpables in Mexico, Columbia, Argentina, and Brazil. Although the legal terminology changes, false incarceration is hardly limited to Central and South America. This is therefore a cautionary tale about how charges – and people – are framed, and how the latter are tried on social and corporate media, even before their official trials begin. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global researchers were confronted with major challenges. The German National Pandemic Cohort Network (NAPKON) was launched in fall 2020 to effectively leverage resources and bundle research activities in the fight against the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the setup phase of NAPKON as an example for multicenter studies in Germany, highlighting challenges and optimization potential in connecting 59 university and nonuniversity study sites. We examined the ethics application (...) process of 121 ethics submissions considering durations, annotations, and outcomes. Study site activation and recruitment processes were investigated and related to the incidence of SARS-CoV-2 infections. For all initial ethics applications, the median time to a positive ethics vote was less than two weeks and 30 of these study sites (65%) joined NAPKON within less than three weeks each. Electronic instead of postal ethics submission (9.5 days (Q1: 5.75, Q3: 17) vs. 14 days (Q1: 11, Q3: 26), p value = 0.01) and adoption of the primary ethics vote significantly accelerated the ethics application process. Each study center enrolled a median of 37 patients during the 14-month observation period, with large differences depending on the health sector. We found a positive correlation between recruitment performance and COVID-19 incidence as well as hospitalization incidence. Our analysis highlighted the challenges and opportunities of the federated system in Germany. Digital ethics application tools, adoption of a primary ethics vote and standardized formal requirements lead to harmonized and thus faster study initiation processes during a pandemic. (shrink)

Social epistemologists should be well-equipped to explain and evaluate the growing vulnerabilities associated with filter bubbles, echo chambers, and group polarization in social media. However, almost all social epistemology has been built for social contexts that involve merely a speaker-hearer dyad. Filter bubbles, echo chambers, and group polarization all presuppose much larger and more complex network structures. In this paper, we lay the groundwork for a properly social epistemology that gives the role and structure of networks their due. In particular, (...) we formally define epistemic constructs that quantify the structural epistemic position of each node within an interconnected network. We argue for the epistemic value of a structure that we call the (m,k)-observer. We then present empirical evidence that (m,k)-observers are rare in social media discussions of controversial topics, which suggests that people suffer from serious problems of epistemic vulnerability. We conclude by arguing that social epistemologists and computer scientists should work together to develop minimal interventions that improve the structure of epistemic networks. (shrink)

The article explores E.M. Forster’s story The Machine Stops as an example of dystopian literature and its possible associations with the use of technology and with today’s cyber culture. Dystopian societies are often characterized by dehumanization and Forster’s novel raises questions about how we live in time and space; and how we establish relationships with the Other and with the world through technology. We suggest that the fear of technology depicted in dystopian literature indicates a fear that machines are mimicking (...) the roles that humans already play in relational encounters. Our relationship with machines frequently suggests a classical “I-it” situation. However, a genuine dialogue is where there is no master and where communication and understanding are achieved through the encounter and through openness to difference and to change. The article examines the ways machines and automata are imagined and become part of lived human existence, in the light of Martin Buber’s philosophy of dialogue and Merleau-Ponty’s phenomenology of perception and otherness. The problem seems to be how everyday technological interfaces can change the way we first perceive the world and the possibility that with certain types of mediation there is a loss of connection with the Other. It is argued that understanding dialogical conditions could help turn the relationship with technology into something more humane. Literature such as Forster’s is considered as an example of such a dialogical condition, suggesting ways of dealing with human dilemmas by exploring the field of possibilities. (shrink)

Universalism vs. Communitarianism focuses on the question, raised by recent work in normative philosophy, of whether ethical norms are best derived and justified on the basis of universal or communitarian standards. It is unique in representing both Continental and American points of view and both the older and a younger generation of scholars. The essays introduce the key issues involved in universalism vs. communitarianism and take up ethics in historical perspective, practical reason and ethical responsibility, justification, application and history, and (...) communitarian alternatives. Based on a special issue of the Journal Philosophy and Social Criticism, the book includes two additional essays by Chantal Mouffe and by Hubert and Stuart Dreyfus. David Rasmussen is Professor of Philosophy at Boston College and editor of Philosophy and Social Criticism. Contents: introduction, David, Rasmussen. Universalisms: Procedural, Contextualist, and Prudential, Alessandro Ferrara. Beyond Liberalism and Communitarianism: Toward a Critical Theory of Social Justice, Gerald Doppelt. The Liberal/Communitarian Controversy and Communicative Ethics, Kenneth Baynes. Discourse Ethics and Civil Society, Jean Cohen. Equality, Political Order and Ethics: Hobbes and the Systematics of Democratic Rationality, Rolf Zimmermann. Atomism and Ethical Life: On Hegel's Critique of the French Revolution, Axel Honneth. The Gadamer-Habermas Debate Revisited: The Question of Ethics, Michael Kelly. What Is and What Is Not Practical Reason? Agnes Heller. Adorno, Heidegger, and Postmodernity, Hauke Brunkhorst. Impartial Application of Moral and Legal Norms: A Contribution to Discourse Ethics, Klaus Günther. An Ethics, Politics, and History, Jürgen Habermas in an interview conducted by Jean-Marc Ferry. Rawls: Political Philosophy without Politics, Chantal Mouffe. What Is Morality: A Phenomenological Account of the Development of Ethical Expertise, Hubert L Dreyfus, Stuart E. Dreyfus. Universalism and Communitarianism: A Bibliography, Michael Zilles. (shrink)

Dalam kedua buku ini Jens Zimmermann mengamati bahwa Eropa telah dan sedang mengalami krisis identitas serta krisis kebudayaan. Hal ini disebabkan karena masyarakat Eropa melupakan akar identitas dan kebudayaannya, yaitu humanisme Kristiani. Zimmermann menawarkan suatu jalan keluar dari krisis, yaitu kembali ke akar identitas dan budaya Eropa, yaitu filsafat Kristiani tradisional yang berpusat pada inkarnasi. Hal ini akan menjadi pemecahan bagi berbagai krisis dan per- masalahan yang dihadapi Eropa dewasa ini. “Humanisme inkarnasional” menyatakan bahwa Allah menjadi manusia sehingga (...) manusia dapat mencapai realisasi dari imago Dei atau gambaran Allah. Hal ini menjadi dasar utama kebudayaan Barat. Menurut Zimmerman, pengertian kita tentang persona, yang menyeimbangkan antara diri individual dan diri sosial, keluhuran martabat manusia dan hak-haknya, kebebasan dan tanggung jawabnya, dibangun atas dasar ajaran mengenai inkarnasi. Demikian pula dengan tradisi yang menekankan nilai bahasa, kesusasteraan dan seni untuk pemahaman diri manusia, hubungan iman dan akal budi, serta pentingnya pendidikan watak terbentuk oleh humanisme, khususnya humanisme pada masa Renaissance. Berbeda dari para pakar Renaissance lainnya, yang menafsirkan kebudayaan Renaissance sebagai pintu masuk ke dalam kebudayaan sekular dan masa Pencerahan, Zimmermann berpandangan bahwa Renaissance didahului oleh dan merupakan kelanjutan dari gagasan Bapa-Bapa Gereja Abad Tengah yang menempatkan inkarnasi sebagai pusat dari humanisme. Pendidikan di masa Renaissance merupakan pembentuk kebudayaan Kristiani. Istilah Jerman Bildung mengungkapkan kesatuan antara pendidikan dan kebudayaan. Inilah kunci dari kesinambungan budaya Kristiani. “Tujuan saya ialah menunjukkan kesinambungan tema dalam humanisme dan pendidikan watak di mana estetika dan bahasa memainkan peran penting. Saya telah menunjukkan bahwa humanisme Renaissance terutama merupakan humanisme Kristiani, yang sangat tergantung pada pemikir Patristik, Kekristenan Platonik” (I, hlm. 159). Zimmermann tidak membahas bahwa dalam masa Pencerahan telah terjadi suatu “keterputusan” dengan tradisi Kristiani sebelumnya................... Jens Zimmermann telah berhasil merunut perkembangan huma- nisme Kristiani dan menjelaskan bagaimana identitas masyarakat Eropa serta kebudayaannya berakar pada humanisme Kristiani. Maka apabila masyarakat Eropa akan mengatasi krisis identitasnya dan kebudayaannya mereka harus kembali kepada akar-akarnya tersebut, yaitu humanisme Kristiani. Humanisme itu didasarkan pada inkarnasi Allah. Pandangan Zimmermann bergerak dalam kawasan abu-abu, antara teologi dan filsafat. Satu aspek yang dilalaikan oleh Zimmerman ialah pembahasan mengenai terjadinya berbagai tragedi kemanusiaan di Eropa, seperti holocaustum dan imperialisme. Zimmermann hanya menyebut sepintas mengenai Hitler. Peristiwa-peristiwa tragedi itu merupa- kan disrupsi dalam sejarah Eropa, yang memutus kesinambungan akar- akar Kristiani. Pembangunan identitas membutuhkan kesinambungan historis serta reinterpretasi terus-menerus. Apakah relevan untuk me- ngatasi krisis jaman sekarang dengan menghidupkan kembali akar-akar humanisme Kristiani tanpa menafsirkannya kembali dalam konteks ma- syarakat Eropa yang semakin menjadi plural? Pandangan Zimmermann mirip dengan pandangan Paus Benediktus XVI, yang mengingatkan kem-bali akar Kristiani budaya Eropa. (M. Sastrapratedja, Program Pasca- sarjana, sekolah Tinggi Filsafat Driyarkara, Jakarta). (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

Die MISCELLANEA MEDIAEVALIA präsentieren seit ihrer Gründung durch Paul Wilpert im Jahre 1962 Arbeiten des Thomas-Instituts der Universität zu Köln. Das Kernstück der Publikationsreihe bilden die Akten der im zweijährigen Rhythmus stattfindenden Kölner Mediaevistentagungen, die vor über 50 Jahren von Josef Koch, dem Gründungsdirektor des Instituts, ins Leben gerufen wurden. Der interdisziplinäre Charakter dieser Kongresse prägt auch die Tagungsakten: Die MISCELLANEA MEDIAEVALIA versammeln Beiträge aus allen mediävistischen Disziplinen - die mittelalterliche Geschichte, die Philosophie, die Theologie sowie die Kunst- und Literaturwissenschaften (...) sind Teile einer Gesamtbetrachtung des Mittelalters. (shrink)

Die MISCELLANEA MEDIAEVALIA präsentieren seit ihrer Gründung durch Paul Wilpert im Jahre 1962 Arbeiten des Thomas-Instituts der Universität zu Köln. Das Kernstück der Publikationsreihe bilden die Akten der im zweijährigen Rhythmus stattfindenden Kölner Mediaevistentagungen, die vor über 50 Jahren von Josef Koch, dem Gründungsdirektor des Instituts, ins Leben gerufen wurden. Der interdisziplinäre Charakter dieser Kongresse prägt auch die Tagungsakten: Die MISCELLANEA MEDIAEVALIA versammeln Beiträge aus allen mediävistischen Disziplinen - die mittelalterliche Geschichte, die Philosophie, die Theologie sowie die Kunst- und Literaturwissenschaften (...) sind Teile einer Gesamtbetrachtung des Mittelalters. (shrink)

What is the fruit of a searching dialogue between faith and reason? This book collects theological and philosophical perspectives on the richness of the faith-reason dialogue, including examples from literature, continental and analytic philosophy, worship and liturgy, and radical approaches to issues of racism and prejudice. The authors strongly resist the temptations to either disregard the faith-reason dialogue or take it for granted. Through their explorations and reflections they open up new vistas and horizons on a topic more necessary than (...) ever. (shrink)