70 found
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  1.  11
    Tineke A. Abma, Bert Molewijk & Guy A. M. Widdershoven (2009). Good Care in Ongoing Dialogue. Improving the Quality of Care Through Moral Deliberation and Responsive Evaluation. Health Care Analysis 17 (3):217-235.
    Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...)
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  2.  33
    Guy Widdershoven, Tineke Abma & Bert Molewijk (2009). Empirical Ethics as Dialogical Practice. Bioethics 23 (4):236-248.
    In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation (...)
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  3.  21
    Guy Widdershoven (ed.) (2008). Empirical Ethics in Psychiatry. Oxford University Press.
    Psychiatry presents a unique array of difficult ethical questions. However, a major challenge is to approach psychiatry in a way that does justice to the real ethical issues. Recently there has been a growing body of research in empirical psychiatric ethics, and an increased interest in how empirical and philosophical methods can be combined. Empirical Ethics in Psychiatry demonstrates how ethics can engage more closely with the reality of psychiatric practice and shows how empirical methodologies from the social sciences can (...)
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  4.  21
    Tineke A. Abma, Vivianne E. Baur, Bert Molewijk & Guy A. M. Widdershoven (2010). Inter-Ethics: Towards an Interactive and Interdependent Bioethics. Bioethics 24 (5):242-255.
    Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and (...)
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  5.  8
    Lieke van Der Scheer & Guy Widdershoven (2004). Integrated Empirical Ethics: Loss of Normativity? [REVIEW] Medicine, Health Care and Philosophy 7 (1):71-79.
    An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically (...)
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  6.  19
    Bert Molewijk, Dick Kleinlugtenbelt, Scott Pugh & Guy Widdershoven (2011). Emotions and Clinical Ethics Support. A Moral Inquiry Into Emotions in Moral Case Deliberation. HEC Forum 23 (4):257-268.
    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...)
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  7.  30
    Tineke Abma, Anne Bruijn, Tinie Kardol, Jos Schols & Guy Widdershoven (2012). Responsibilities in Elderly Care: Mr Powell's Narrative of Duty and Relations. Bioethics 26 (1):22-31.
    In Western countries a considerable number of older people move to a residential home when their health declines. Institutionalization often results in increased dependence, inactivity and loss of identity or self-worth (dignity). This raises the moral question as to how older, institutionalized people can remain autonomous as far as continuing to live in line with their own values is concerned. Following Walker's meta-ethical framework on the assignment of responsibilities, we suggest that instead of directing all older people towards more autonomy (...)
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  8.  34
    Jenny Slatman & Guy Widdershoven (2009). Being Whole After Amputation. American Journal of Bioethics 9 (1):48 – 49.
  9.  9
    Guy Widdershoven, Bert Molewijk & Tineke Abma (2009). Improving Care and Ethics: A Plea for Interactive Empirical Ethics. American Journal of Bioethics 9 (6):99-101.
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  10.  7
    Tineke Abma & Guy Widdershoven (2014). Dialogical Ethics and Responsive Evaluation as a Framework for Patient Participation. American Journal of Bioethics 14 (6):27-29.
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  11.  5
    Bert Molewijk, Maarten Verkerk, Henk Milius & Guy Widdershoven (2008). Implementing Moral Case Deliberation in a Psychiatric Hospital: Process and Outcome. [REVIEW] Medicine, Health Care and Philosophy 11 (1):43-56.
    Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation process.Methods The implementation process is both monitored and supported by an (...)
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  12.  32
    Bert Molewijk, Dick Kleinlugtenbelt & Guy Widdershoven (2011). The Role of Emotions in Moral Case Deliberation: Theory, Practice, and Methodology. Bioethics 25 (7):383-393.
    In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation.According to Aristotle, emotions are an original and integral part (...)
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  13.  3
    Froukje C. Weidema, Bert Ac Molewijk, Frans Kamsteeg & Guy Am Widdershoven (2013). Aims and Harvest of Moral Case Deliberation. Nursing Ethics 20 (6):617-631.
    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (...)
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  14.  6
    Guy A. M. Widdershoven (2007). How to Combine Hermeneutics and Wide Reflective Equilibrium? Medicine, Health Care and Philosophy 10 (1):49-52.
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  15.  7
    Merel A. Visse, Truus Teunissen, Albert Peters, Guy A. M. Widdershoven & Tineke A. Abma (2010). Dialogue for Air, Air for Dialogue: Towards Shared Responsibilities in COPD Practice. Health Care Analysis 18 (4):358-373.
    For the past several years patients have been expected to play a key role in their recovery. Self management and disease management have reached a hype status. Considering these recent trends what does this mean for the division of responsibilities between doctors and patients? What kind of role should healthcare providers play? With findings based on a qualitative research project of an innovative practice for people with Chronic Obstructive Pulmonary Disease (COPD) we reflect on these questions. In-depth interviews conducted with (...)
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  16.  24
    Tineke A. Abma, Barth Oeseburg, Guy Am Widdershoven, Minke Goldsteen & Marian A. Verkerk (2005). Two Women with Multiple Sclerosis and Their Caregivers: Conflicting Normative Expectations. Nursing Ethics 12 (5):479-492.
    It is not uncommon that nurses are unable to meet the normative expectations of chronically ill patients. The purpose of this article is to describe and illustrate Walker’s expressive-collaborative view of morality to interpret the normative expectations of two women with multiple sclerosis. Both women present themselves as autonomous persons who make their own choices, but who also have to rely on others for many aspects of their lives, for example, to find a new balance between work and social contacts (...)
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  17.  17
    Minke Goldsteen, Tineke Abma, Barth Oeseburg, Marian Verkerk, Frans Verhey & Guy Widdershoven (2007). What is It to Be a Daughter? Identities Under Pressure in Dementia Care. Bioethics 21 (1):1–12.
  18. Michael Benatar, Leslie Cannold, Dena Davis, Merle Spriggs, Julian Savulescu, Heather Draper, Neil Evans, Richard Hull, Stephen Wilkinson, David Wasserman, Donna Dickenson, Guy Widdershoven, Françoise Baylis, Stephen Coleman, Rosemarie Tong, Hilde Lindemann, David Neil & Alex John London (2006). Cutting to the Core: Exploring the Ethics of Contested Surgeries. Rowman & Littlefield Publishers.
    When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.
     
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  19.  6
    Donna Dickenson & Guy Widdershoven (2001). Ethical Issues in Limb Transplants. Bioethics 15 (2):110–124.
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  20.  13
    Merel Visse, Guy A. M. Widdershoven & Tineke A. Abma (2012). Moral Learning in an Integrated Social and Healthcare Service Network. Health Care Analysis 20 (3):281-296.
    The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should do what, with (...)
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  21.  7
    Gerben Meynen, Dick F. Swaab & Guy Widdershoven (2012). Nocebo and Informed Consent in the Internet Era. American Journal of Bioethics 12 (3):31-33.
    The American Journal of Bioethics, Volume 12, Issue 3, Page 31-33, March 2012.
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  22. Guy Widdershoven, John McMillan, Tony Hope & van der Scheer & Lieke (2008). Introduction. In Guy Widdershoven, John McMillan, Tony Hope & Lieke van der Scheer (eds.), Empirical Ethics in Psychiatry. OUP Oxford
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  23.  2
    Guy Widdershoven (2005). Interpretation and Dialogue in Hermeneutic Ethics. In Richard E. Ashcroft (ed.), Case Analysis in Clinical Ethics. Cambridge University Press 57--76.
  24.  8
    Guy Widdershoven, Annemie Halsema & Jenny Slatman (2010). Sex and Enhancement: A Phenomenological-Existential View. American Journal of Bioethics 10 (7):20-22.
  25.  0
    Albine Moser, Rob Houtepen, Cor Spreeuwenberg & Guy Widdershoven (2010). Realizing Autonomy in Responsive Relationships. Medicine, Health Care and Philosophy 13 (3):215-223.
    The goal of this article is to augment the ethical discussion among nurses with the findings from empirical research on autonomy of older adults with type 2 diabetes mellitus. There are many factors influencing autonomy. These include: health conditions, treatment, knowledge, experience and skills, personal approach as well as familial patterns, type of relationship, life history and social context. Fifteen older adults with type 2 diabetes mellitus were interviewed in a nurse-led diabetes clinic. These participants perceive three processes which support (...)
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  26.  3
    Halime Celik, Toine Lagro‐Janssen, Ineke Klinge, Trudy Van Der Weijden & Guy Widdershoven (2009). Maintaining Gender Sensitivity in the Family Practice: Facilitators and Barriers. Journal of Evaluation in Clinical Practice 15 (6):1220-1225.
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  27.  0
    Albine Moser, Rob Houtepen, Harry van der Bruggen, Cor Spreeuwenberg & Guy Widdershoven (2009). Autonomous Decision Making and Moral Capacities. Nursing Ethics 16 (2):203-218.
    This article examines how people with type 2 diabetes perceive autonomous decision making and which moral capacities they consider important in diabetes nurses' support of autonomous decision making. Fifteen older adults with type 2 diabetes were interviewed in a nurse-led unit. First, the data were analysed using the grounded theory method. The participants described a variety of decision-making processes in the nurse and family care-giver context. Later, descriptions of the decision-making processes were analysed using hermeneutic text interpretation. We suggest first- (...)
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  28.  4
    Elleke Landeweer, Tineke Abma, Jolijn Santegoeds & Guy Widdershoven (2008). Psychiatry in the Age of Neuroscience: The Impact on Clinical Practice and Lives of Patients. Poiesis and Praxis 6 (1-2):43-55.
    Due to the progress being made in the neurosciences, higher expectations for the use of medication, even against the patient’s will, are arising in mental hospitals. In this article, we will discuss whether the neurosciences and new psychopharmacological solutions really support patients who suffer from mental illnesses. To answer this question, we will focus on the perspective of patients and their experiences with psychiatric (coercive) treatments. The analysis of one person’s story shows that other issues besides appropriate medication are important (...)
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  29.  4
    Tineke A. Abma & Guy Am Widdershoven (2006). Moral Deliberation in Psychiatric Nursing Practice. Nursing Ethics 13 (5):546-557.
    Moral deliberation has been receiving more attention in nursing ethics. Several ethical conversation models have been developed. This article explores the feasibility of the so-called CARE (Considerations, Actions, Reasons, Experiences) model as a framework for moral deliberation in psychiatric nursing practice. This model was used in combination with narrative and dialogical approaches to foster discourse between various stakeholders about coercion in a closed admission clinic in a mental hospital in the Netherlands. The findings demonstrate that the CARE model provides a (...)
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  30.  55
    Elleke Landeweer, Tineke A. Abma, Linda Dauwerse & Guy A. M. Widdershoven (2011). Triad Collaboration in Psychiatry: Privacy and Confidentiality Revisited. International Journal of Feminist Approaches to Bioethics 4 (1):121-139.
    Recently, there has been increased interest in the involvement of family members in treating psychiatric patients who are involuntarily admitted into mental hospitals (Goodwin and Happel 2006; Wilkinson and McAndrew 2008). Family is, for instance, expected to be of use in preventing escalations and aggression on the wards by giving information about patient needs and providing support to the patient. Yet, in practice, family is not routinely involved in the treatment process, and is not even regularly informed about situations (Marshall (...)
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  31.  11
    Lieke van Der Scheer & Guy Widdershoven (2004). A Response to Levitt and Molewijk. Medicine, Health Care and Philosophy 7 (1):89-91.
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  32.  3
    Lazare Benaroyo & Guy Widdershoven (2004). Competence in Mental Health Care: A Hermeneutic Perspective. [REVIEW] Health Care Analysis 12 (4):295-306.
    In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the world and give (...)
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  33.  0
    Harry Van Der Bruggen & Guy Widdershoven (2005). Being a Parkinson's Patient: Immobile and Unpredictably Whimsical Literature and Existential Analysis. [REVIEW] Medicine, Health Care and Philosophy 7 (3):289-301.
    What is characteristic of being aParkinson’s patient? This article intends toanswer this question by means of an analysis ofnovels about people with Parkinson’s disease,personal accounts, and scientific publications.The texts were analyzed from anexistential-phenomenological perspective, usingan adapted version of the existential analysis.Being a Parkinson’s patient is apparentlycharacterized by an existential paradox: lifeappears simultaneously immobile andunpredictably whimsical. This may manifestitself in the person’s corporeality, in hisbeing-in-time and in-space, in his relating tothings and events, his life-world, and in hisbeing-together-with-others as an individual.Finally, some (...)
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  34.  3
    Margreet Stolper, Bert Molewijk & Guy Widdershoven (2015). Learning by Doing. Training Health Care Professionals to Become Facilitator of Moral Case Deliberation. HEC Forum 27 (1):47-59.
    Moral case deliberation is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire (...)
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  35.  7
    Linda Dauwerse, Froukje Weidema, Tineke Abma, Bert Molewijk & Guy Widdershoven (2014). Implicit and Explicit Clinical Ethics Support in The Netherlands: A Mixed Methods Overview Study. [REVIEW] HEC Forum 26 (2):95-109.
    Internationally, the prevalence of clinical ethics support (CES) in health care has increased over the years. Previous research on CES focused primarily on ethics committees and ethics consultation, mostly within the context of hospital care. The purpose of this article is to investigate the prevalence of different kinds of CES in various Dutch health care domains, including hospital care, mental health care, elderly care and care for people with an intellectual disability. A mixed methods design was used including two survey (...)
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  36.  5
    Mia Svantesson, Jan Karlsson, Pierre Boitte, Jan Schildman, Linda Dauwerse, Guy Widdershoven, Reidar Pedersen, Martijn Huisman & Bert Molewijk (2014). Outcomes of Moral Case Deliberation - the Development of an Evaluation Instrument for Clinical Ethics Support (the Euro-MCD). BMC Medical Ethics 15 (1):30.
    Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...)
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  37.  5
    Sandra van der Dam, Bert Molewijk, Guy Widdershoven & Tineke Abma (2014). Ethics Support in Institutional Elderly Care: A Review of the Literature. [REVIEW] Journal of Medical Ethics 40 (9):625-631.
    Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases . Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: ‘institutional bodies’ ; ‘frameworks’ ; ‘educational programmes and moral case deliberation’; and ‘written (...)
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  38.  27
    Rouven Porz & Guy Widdershoven (2011). Predictive Testing and Existential Absurdity: Resonances Between Experiences Around Genetic Diagnosis and the Philosophy of Albert Camus. Bioethics 25 (6):342-350.
    Predictive genetic testing may confront those affected with difficult life situations that they have not experienced before. These life situations may be interpreted as ‘absurd’. In this paper we present a case study of a predictive test situation, showing the perspective of a woman going through the process of deciding for or against taking the test, and struggling with feelings of alienation. To interpret her experiences, we refer to the concept of absurdity, developed by the French Philosopher Albert Camus. Camus' (...)
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  39.  21
    Guy A. M. Widdershoven (1992). Hermeneutics and Relativism: Wittgenstein, Gadamer, Habermas. Theoretical and Philosophical Psychology 12 (1):1-11.
    Presents 3 hermeneutic answers to the problem of relativism. The 1st answer is drawn from L. Wittgenstein's anthropological hermeneutics. Wittgenstein went beyond relativism by making explicit universal anthropological categories that are specified differently in different cultures. The 2nd answer lies in H.-G. Gadamer's historical hermeneutics. By introducing the concepts of tradition and fusion of horizons, Gadamer evades both absolutism and relativism. The 3rd answer is developed by J. Habermas in his critical hermeneutics. By situating communicative action in the life-world, and (...)
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  40.  2
    Guy A. M. Widdershoven & Marli Huijer (2001). The Fragility of Care. Bijdragen 62 (3):304-316.
  41.  2
    Anneke Lucassen, Guy Widdershoven, Suzanne Metselaar, Angela Fenwick & Michael Parker (2014). Genetic Testing of Children: The Need for a Family Perspective. American Journal of Bioethics 14 (3):26-28.
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  42.  27
    Guy Widdershoven (1999). Cognitive Psychology and Hermeneutics: Two Approaches to Meaning and Mental Disorder. Philosophy, Psychiatry, and Psychology 6 (4):245-253.
  43.  4
    Guy Widdershoven & Lieke van der Scheer (2008). Theory and Methodology of Empirical Ethics : A Pragmatic Hermeneutic Perspective. In Empirical Ethics in Psychiatry. Oxford University Press
  44.  14
    Kathrin Ohnsorge & Guy Widdershoven (2011). Monological Versus Dialogical Consciousness – Two Epistemological Views on the Use of Theory in Clinical Ethical Practice. Bioethics 25 (7):361-369.
    In this article, we argue that a critical examination of epistemological and anthropological presuppositions might lead to a more fruitful use of theory in clinical-ethical practice. We differentiate between two views of conceptualizing ethics, referring to Charles Taylors' two epistemological models: ‘monological’ versus ‘dialogical consciousness’. We show that the conception of ethics in the model of ‘dialogical consciousness’ is radically different from the classical understanding of ethics in the model of ‘monological consciousness’. To reach accountable moral judgments, ethics cannot be (...)
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  45.  17
    Jenny Slatman, Annemie Halsema & Guy Widdershoven (2010). Sex and Enhancement: A Phenomenological-Existential View. American Journal of Bioethics 10 (7):20-22.
  46.  9
    Bert Molewijk & Guy A. M. Widdershoven (2012). Don't Solve the Issues! Cambridge Quarterly of Healthcare Ethics 21 (04):448-456.
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  47.  13
    Guy A. M. Widdershoven (2002). Beyond Autonomy and Beneficence. Ethical Perspectives 9 (2):96-102.
    Euthanasia and physician-assisted suicide are controversial issues in medical ethics and medical law. In the debate, several arguments against the moral acceptability and legal feasibility of active involvement of physicians in bringing about a patient’s death can be found.One argument refers back to the Ten Commandments: “Thou shall not kill”. Killing another human being is morally abject. According to the argument, this is certainly so for medical doctors, as can be seen in the Hippocratic Oath, which explicitly forbids abortion and (...)
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  48.  17
    Marli Huijer & Guy Widdershoven (2001). Desires in Palliative Medicine. Five Models of the Physician‐Patient Interaction on Palliative Treatment Related to Hellenistic Therapies of Desire. Ethical Theory and Moral Practice 4 (2):143-159.
    In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastatic lung carcinoma. By combining the models of the physician-patient relationship developed by Emanuel and Emanuel (1992) and the Hellenistic approaches to desires (...)
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  49.  1
    Suzanne Metselaar, Bert Molewijk & Guy Widdershoven (2015). Beyond Recommendation and Mediation: Moral Case Deliberation as Moral Learning in Dialogue. American Journal of Bioethics 15 (1):50-51.
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  50.  11
    Guy A. M. Widdershoven (2000). The Doctor-Patient Relationship as a Gadamerian Dialogue: A Response to Arnason. Medicine, Health Care and Philosophy 3 (1):25-27.
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