BackgroundIn gender-affirming medical care (GAMC), ethical challenges in decision-making are ubiquitous. These challenges are becoming more pressing due to exponentially increasing referrals, politico-legal contestation, and divergent normative views regarding decisional roles and models. Little is known, however, about what ethical challenges related to decision-making healthcare professionals (HCPs) themselves face in their daily work in GAMC and how these relate to, for example, the subjective nature of Gender Incongruence (GI), the multidisciplinary character of GAMC and the role HCPs play in assessing (...) GI and eligibility for interventions. Given the relevance and urgency of these questions, we conducted a qualitative study among HCPs providing GAMC to transgender adults in the Netherlands.MethodsIn this qualitative research, we conducted 11 semi-structured interviews between May 2020 and February 2021 with HCPs (six mental health professionals, two HCPs in endocrinology, two in plastic surgery, and one in nursing) working in two distinct GAMC settings. We purposively sampled for professional background and years of experience in GAMC. We analyzed our interview data using thematic analysis. As some respondents were more inclined to speak about what should or ought to be done to arrive at good or right decision-making, we identified both ethical challenges and norms. Furthermore, in our analysis, we differentiated between respondents’ explicit and implicit ethical challenges and norms and ascertained the specific context in which these challenges emerged.ResultsRespondents’ ethical challenges and norms centered on (1) dividing and defining decisional roles and bounds, (2) negotiating decision-making in a (multidisciplinary) team, and (3) navigating various decision-making temporalities. These themes arose in the context of uncertainties regarding (1) GAMC’s guidelines, evidence, and outcomes, as well as (2) the boundaries and assessment of GI.ConclusionsThis interview study provides detailed empirical insight into both the explicit and implicit ethical challenges that HCPs experience and their ethical norms regarding decision-making. It also describes how uncertainties and (implicit) normativities concerning GAMC and GI pre-structure the moral environment in which these challenges and norms manifest. We provide normative reflections and recommendations on handling these ethical challenges in a way that is sensitive to the context in which they arise. (shrink)

Borsboom and colleagues have recently proposed a “network theory” of psychiatric disorders that conceptualizes psychiatric disorders as relatively stable networks of causally interacting symptoms. They have also claimed that the network theory should include non-symptom variables such as environmental factors. How are environmental factors incorporated in the network theory, and what kind of explanations of psychiatric disorders can such an “extended” network theory provide? The aim of this article is to critically examine what explanatory strategies the network theory that includes (...) both symptoms and environmental factors can accommodate. We first analyze how proponents of the network theory conceptualize the relations between symptoms and between symptoms and environmental factors. Their claims suggest that the network theory could provide insight into the causal mechanisms underlying psychiatric disorders. We assess these claims in light of network analysis, Woodward’s interventionist theory, and mechanistic explanation, and show that they can only be satisfied with additional assumptions and requirements. Then, we examine their claim that network characteristics may explain the dynamics of psychiatric disorders by means of a topological explanatory strategy. We argue that the network theory could accommodate topological explanations of symptom networks, but we also point out that this poses some difficulties. Finally, we suggest that a multilayer network account of psychiatric disorders might allow for the integration of symptoms and non-symptom factors related to psychiatric disorders and could accommodate both causal/mechanistic and topological explanations. (shrink)

The review by De Bie et al. (2023) provides an overview of the current ethical literature on artificial womb technology (AWT). Two characteristics stand out, and provide the basis for our commentar...

Aristotle's highly influential work on the soul, entitled De anima, formed part of the core curriculum of medieval universities and was discussed intensively. It covers a range of topics in philosophical psychology, such as the relationship between mind and body and the nature of abstract thought. However, there is a key difference in scope between the so-called "science of the soul," based on Aristotle, and modern philosophical psychology. This book starts from a basic premise accepted by all medieval commentators, namely (...) that the science of the soul studies not just human beings but all living beings. As such, its methodology and approach must also apply to plants and animals. The Science of the Soul discusses how philosophers from Thomas Aquinas to Pierre d'Ailly dealt with the difficult task of giving a unified account of life and traces the various stages in the transformation of the science of the soul between 1260 and 1360. The emerging picture is that of a gradual disruption of the unified approach to the soul, which will ultimately lead to the emergence of psychology as a separate discipline. (shrink)

Paul applies apocalyptic language not only to the End and Christ's parousia but also to the gospel he proclaims and the faith it creates. The whole of God's saving activity in Jesus Christ, from beginning to end, is apocalyptic.

In the Critique of Pure Reason and elsewhere, Kant uses the term ‘object’ in various ways and often without clearly signaling its different meanings. As a result, it is hard to gauge the extent to which Kant’s account of the object of cognition breaks new ground. In this article, I take the Critique to establish what is required to generate an object of cognition per se soleley by examining the various ways in which the human mind can objectify the content (...) of its representations. To clarify this endeavor, I distinguish four different ways in which the term ‘object’ is used in the Critique, namely, to refer to (1) material things, (2) the content of any type of thought, (3) the mind-immanent correlate of a cognition in the broad sense of the term, and (4) the mind-immanent correlate of a cognition in the strict sense of the term. On my reading, the fourth meaning of the term ‘object’ is key to the Transcendental Deduction and completes Kant’s unprecedented conception of the cognitive acts by means of which the human mind produces objects of cognition out of a manifold of representations. (shrink)

Confrontatie van enkele varianten van de fenomenologische methode met de ideologie-kritiek, de hermeneutiek en de retoriek.

This chapter contains sections titled: Introduction The Production of Arbitrary Differences Conflictual Ontological Oppositions Negativity Différance, Difference, and Contradiction Glas Conclusion.

Does philosophical critique have a future? What are its possibilities, limits, and presuppositions? Bringing together outstanding scholars from various traditions, this collection of essays is the first to examine the forms of critique that have shaped modern and contemporary continental thought. Through critical analyses of key texts by, among others, Spinoza, Kant, Hegel, Marx, Adorno, Habermas, Foucault, and Rancière, it traces the way critique has time and again geared itself towards new cultural, social, and political problems, shedding those of its (...) assumptions no longer deemed tenable. It is our hope that the many voices of critique that arise from the present volume will produce effects – new doubts, new insights, new challenges, or new resources – that none could have achieved on their own. (shrink)

Given the history of the twentieth century, it is understandable that many contemporary philosophers—in the wake of Kierkegaard, Marx, and Nietzsche—have turned against Hegel’s seemingly unbridled optimism. As I will argue in this chapter, however, Hegel’s account of modern civilizations is much less optimistic than his account of the past. Hegel’s hesitation as to the capacity of modernity to resolve its immanent conflicts preeminently emerges in his account of the oppositions between poverty and wealth and between the state and its (...) citizens. In this chapter I will focus on passages from the Essay on Natural Law, the Lectures on the Philosophy of History, and the Philosophy of Right that express this hesitation and, hence, complicate the prevailing view of Hegel’s philosophy of world history. (shrink)

English summary: In this volume, Jan-Hendryk de Boer investigates the upheaval in the world of scholars in the Roman-German Empire at the end of the fifteenth and beginning of the sixteenth centuries. He shows how during this time hegemonic humanism developed as a new discursive formation. This re-organised the humanistic movement as well as its relationship to scholasticism and ultimately the place of humanism in the scholarly world as a whole. After humanistic ideas were initially taken on board as (...) being relatively unproblematic, the representatives of hegemonic humanism, such as poets, grammarians and philologists, claimed that they alone were in possession of useful skills and relevant knowledge. In a cultural transfer of the corresponding developments in Italy, a scholastic-humanist antagonism was generated that is still reflected in today's research. German description: Jan-Hendryk de Boer untersucht in dieser Studie den Umbruch in der Gelehrtenwelt des romisch-deutschen Reichs am Ende des 15. und zu Beginn des 16. Jahrhunderts. Er zeigt, wie sich in diesem Zeitraum der hegemoniale Humanismus als eine neue diskursive Formation ausbildete. Diese organisierte die humanistische Bewegung wie auch deren Verhaltnis zur Scholastik und schliesslich den Ort des Humanismus in der Gelehrtenwelt insgesamt um. Nachdem humanistische Ideen zunachst relativ problemlos Aufnahme gefunden hatten, beanspruchten die Vertreter des hegemonialen Humanismus als Dichter, Grammatiker und Philologen fur sich allein, uber nutzliche Fertigkeiten und relevantes Wissen zu verfugen. In einem Kulturtransfer der entsprechenden italienischen Entwicklungen wurde so ein scholastisch-humanistischer Antagonismus erzeugt, der bis in die heutige Forschung nachwirkt. (shrink)

The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)

although mostly known to specialists nowadays, Kenelm Digby was a remarkable figure on the intellectual scene of the early seventeenth century. He has been described as “one of the most influential natural philosophers” of his time,1 and corresponded with many of the great scholars of his days, including Descartes, and the French pioneer of atomism, Pierre Gassendi. In the later years of his life, Digby, alongside men like Robert Boyle, became one of the founding members of the Royal Society.2Digby authored (...) one major work of philosophy: the Two Treatises of 1644. This work consisted of a long First Treatise on bodies, and a shorter, Second Treatise on the human soul. In the First Treatise, Digby argued... (shrink)

Dondeyne, A. Pluriformiteit en eenheid van de filosofie.--Peperzak, A. Wegwijzers naar een dialogiek?--Boer, T. de. De eindigheid van de mens en de oneindigheid van de waarheid.--Hollak, J. Wijsgerige reflecties over de scheppingsidee : St. Thomas, Hegel en de Grieken.--Plat, J. Kants kritiek op de rationele psychologie.--Melsen, A. van. Wijsgerige antropologie en de ontwikkeling van natuurwetenschap en techniek.--Buytendijk, F. Het pathisch aspect van de eindigheid.--Struyker Boudier, H. 's Bergbeklimmers einder.

Some bioethicists engage with empirical work on stakeholders’ values, attitudes, and experiences as a basis for theorizing ethics in the context of healthcare. Related to this empirical turn, a deb...