Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

BackgroundAn important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians (...) to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention.MethodsWe examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist.ResultsPhysicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%).ConclusionDutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues. (shrink)

The Remmelink Committee published its report on medical decisions at the end of life in the Netherlands in September 1991. As a result, the Dutch debate about physician aid‐in‐dying has been broadened to include life‐terminating acts that have not been explicitly requested by the patient.

The Remmelink Committee published its report on medical decisions at the end of life in the Netherlands in September 1991. As a result, the Dutch debate about physician aid‐in‐dying has been broadened to include life‐terminating acts that have not been explicitly requested by the patient.

This is the publication of a brief unknown text of one page, written by Paul Maas in October 1935, in which the very first definition and analysis of ‘separative’ and ‘conjunctive errors’ are given. What we have before us is in fact the germ of the seminal essay Leitfehler und stemmatische Typen which Maas published two years later in the “Byzantinische Zeitschrift”.

This self-contained treatise, originally published in 1947 by Holt, Rinehart and Winston, examines fundamental features of nature in order to lay the groundwork for providing a solution to the major problems of ethics.

This book offers an updated and comprehensive phenomenology of norms and normativity. It is the first volume that systematically tackles both the normativity of experiencing and various experiences of norms. Part I begins with a discussion of the methodological resources that phenomenology offers for the critique of epistemological, social and cultural norms. It argues that these resources are powerful and have largely been neglected in contemporary philosophy as well as social and human sciences. The second part deepens the discussion by (...) studying the existential and moral-philosophical foundations of practical normativity. It takes on the task of illuminating the origins of normativity and offers phenomenological alternatives to the neo-Kantian and neo-Hegelian approaches that dominate contemporary debates on the sources of normativity. The final part proceeds from practical normativity to the analysis of the guiding powers of values, perceptual norms, instincts and drives. These are different forms of intentionality that in various manners contribute to the constitution of human practices. By clarifying their divergences and their interrelations, the volume demonstrates that normativity is not one phenomenon but a complex set of various phenomena, with multiple origins and sources. Contemporary Phenomenologies of Normativity will be of interest to researchers and advanced students working on issues of normativity in phenomenology, epistemology, ethics, and social philosophy. (shrink)

v. 1. 1955-1960.--v. 2. 1960-1964.--v. 3. March-November 1964.--v. 4. November 26, 1964-September 2, 1965.--v. 5. September 3, 1965-August 27, 1968.--v. 6. August 28, 1968-May 22, 1971.--v. 7. April 13, 1975-June 21, 1976.--v. 7, pt. 2. September 17, 1977-February 26, 1978.--v. 8. April 28, 1978-July 28, 1980 -- v. 9. August 16, 1980-March 15, 1984 -- v. 11. January 19, 1986-May 27, 1987.

The options in a decision problem generally have outcomes with common features. Putting aside the common features simplifies deliberations, but the simplification requires a philosophical justification that this book provides.

Feyerabrend argues that intellectual progress relies on the creativity of the scientist, against the authority of science.

Zusammenfassungen der Referate in französischer Sprache.

In the first part of this paper some general theses concerning the difference between logic and mathematics are defended. In the second part four different views for a possible demarcation between logic and mathematics are stated.

An agent often does not have precise probabilities or utilities to guide resolution of a decision problem. I advance a principle of rationality for making decisions in such cases. To begin, I represent the doxastic and conative state of an agent with a set of pairs of a probability assignment and a utility assignment. Then I support a decision principle that allows any act that maximizes expected utility according to some pair of assignments in the set. Assuming that computation of (...) an option's expected utility uses comprehensive possible outcomes that include the option's risk, no consideration supports a stricter requirement. (shrink)