Using the occasion of the publication of a Blackwell anthology in the philosophy of technology, Philosophy of Technology: The Technological Condition (2003), as a key to the contemporary role of this subdiscipline, this article reviews the current state-of-this-art. Both philosophy of science and philosophy of technology are twentieth century inventions, but each has followed a somewhat different set of philosophical traditions and pursued sometimes divergent questions. Here the primary developments of recent philosophy of technology are (...) examined with emphasis upon issues which might also be of greater interest to philosophers of science. These include epistemological, but also environmental and cultural issues. The bibliographical spread includes references to some fifty recent books in the field. (shrink)
This paper examines the recent history of State-level policies in the United States for knowledge-based economic development, and identifies an emerging model based on technology creation. This new model goes beyond traditional investments in technology transfer and prioritizes cutting-edge scientific research in economically relevant fields. As research-intensive universities are indispensable for technology creation, these policies have yielded substantial new investments in university science.
In this paper, we recommend expanding infertility insurance mandates to people who may become infertile because of cancer treatments. Such an expansion would ensure cancer patients can receive fertility preservation technology (FPT) prior to commencing treatment. We base our proposal for extending coverage to cancer patients on the infertility mandate in Massachusetts because it is one of the most inclusive. While we use Massachusetts as a model, our arguments and analysis of possible routes to coverage can be applied to (...) all states' seeking inclusive coverage for infertility treatment. Furthermore, our proposal can also be applied to people with other diseases who may be rendered infertile by treatment. (shrink)
A central theme within political theory is the rational management of society based on science and technology. This idea involves several problems concerning the philosophy of technology and social engineering. Some of these difficulties, which are discussed in this essay, are (1) the scientific identification of objective needs and what we can do with it with respect to rational choice, (2) expert-management versus user-management in technical matters, (3) the nature of technology and its consequences for planning, and (...) (4) the nature of technology and its consequences for democratic social engineering. (shrink)
Recent debates over the persistence of family farms have focused on the importance of “naturalistic” obstacles to the capitalist development of agriculture. According to these arguments, the existence of these barriers in some realms of agricultural production precludes the development of wage labor. I argue, however, that in many instances these obstacles are based primarily on political factors. To demonstrate this thesis I illustrate how the tobacco program until recently has proved to be an obstacle to consolidation and structural change (...) in tobacco production. The tobacco program has conditioned the extent of technological development and structural change in tobacco production. From the 1940s to the 1970s, the tobacco program maintained a system of small-scale producers and discouraged technological change in the industry. Changes in the program in the 1970s and 1980s, however, have contributed to the rapid mechanization and structural change among tobacco producers. Many of the “obstacles” to consolidation were overcome not by technological change, but by weakened political support for the tobacco program. These results suggest that in addition to economic and technological considerations, we need to assess more carefully the political foundations of the capitalist development of agriculture. (shrink)
This book provides a comprehensive introduction to the human, social and economic aspects of science and technology. It examines a broad range of issues from a variety of perspectives, using examples and experiences from Australia and around the world. The authors present complex issues in an accessible and engaging form. Topics include the responsibilities of scientists, ethical dilemmas and controversies, the Industrial Revolution, economic issues, public policy, and science and technology in developing countries. The book ends with a (...) thoughtful and provocative look towards the future. It includes extensive guides to further reading, as well as a useful section on information searching skills. This book will provoke, engage, inform and stimulate thoughtful discussion about culture, society and science. Broad and interdisciplinary, it will be of considerable value to students and teachers. (shrink)
Analyses of the role of technological development in agriculture are central to an understanding of social change in agri-food systems. The objective of this paper is to contribute to the formation of a broader perspective of how farmers are positioning themselves with respect to controversial agricultural technologies through an empirical analysis of Washington State farmers’ willingness or unwillingness to try Genetically Modified Organisms (GMOs) technology on their farms. The use of this type of biotechnology in farming has been (...) criticized for its potential harmful effects on natural environments and socio-cultural systems, while proponents highlight the possibilities for increasing production with minimal use of other inputs. An analysis of the extent of farmers’ expressed willingness to use GMOs provides an opportunity to better understand how their diverse thoughts about controversial agricultural technologies are shaped not only by their own experiences but also by social context. The present study does this by analyzing data from a farm survey conducted on a random sample of farmers from across Washington State. The results show that the production practices farmers utilize and the market strategies they employ may be at least as useful as farmers’ socio-economic characteristics in explaining what types of farmers appear to be more or less interested in potentially using this technology. Furthermore, the relationship between level of formal education and willingness to use GMOs is not straightforward. It may hide differences between farmers with respect to where and how they received their formal education as well as the type(s) of knowledge they gained. It is argued that future research should recognize the diversity that exists in farmers’ interests vis-á-vis particular technologies and should also explore how these interests are shaped by farmers’ past and present social networks and life experiences. (shrink)
Current environmental problems and technological risks are a challenge for a new institutional arrangement of the value spheres of Science, Politics and Morality. Distinguished authors from different European countries and America provide a cross-disciplinary perspective on the problems of political decision making under the conditions of scientific uncertainty. cases from biotechnology and the environmental sciences are discussed. The papers collected for this volume address the following themes: (i) controversies about risks and political decision making; (ii) concepts of science for policy; (...) (iii) the use of social science in the policy making process; (iv) ethical problems with developments in science and technology; (v) public and state interests in the development and control of technology. (shrink)
A school that adopts a curriculum, that aims for a holistic understanding of technology, does so because it produces a better educated person than a curriculum which does not. How do we know when we are teaching technology holistically and why must we do so? Increasingly, more is asked of technology educators to be holistic in the understanding conveyed to learners of technology itself in order to make better informed technical and design decisions in a wider (...) range of applied settings. The ability of the learner to naturally consider social and environmental factors, for example, when seeking solutions is seen by some State education systems in Australia as fundamental to a genuine education in technology (New South Wales Board of Studies, 2000 & 2002). In philosophy, the holist position asserts that to understand the particular one must understand its relation to the whole and that only through reflection of one's sensation based applications can genuine knowledge be critically affirmed (Matthews, 1980, p.87 & p.93). The combined apparently independent paths of the State and the Holist positions set a compelling scene not only for the socio-economic necessity for holistic technology education in the curriculum but also for Technology's status as a key curriculum agent in the knowledge formation process of educated individuals. -/- This paper asserts that the general elements of Applied Setting (including Time), Human (as Agent), Tool and Environment are well placed to be the necessary basics to any holistic human technological activity. How and why these elements work together, their schema, will be referred to in this paper as the 'Basic Principles'. The paper presents the thesis that Technology cannot be reduced to less than these general elements and as such, Technology is their product. We therefore may need to understand and teach these elements and their relations to each other explicitly, in ways that reveal the utility of such understanding when making technical choices and design decisions for all the genres of technology and at all their scales of application and discovery. The case is made for technology to not merely be a 'know how' learning experience, but necessarily also a holistic 'know why' learning experience essential for developing and transferring technological knowledge. (shrink)
Technologies can be not only contentious—overthrowing existing ways of doing things—but also morally contentious—forcing deep reflection on personal values and societal norms. This article investigates that what may impede the acceptance of a technology and/or the development of the field that supports or exploits it, the lines between which often become blurred in the face of morally contentious content. Using a unique dataset with historically important timing—the United States Biotechnology Study fielded just 9 months after the public announcement of (...) the successful cloning of the first mammal (i.e., Dolly the sheep)—we find that microlevel factors (i.e., conservative Christianity) predict unfavorable judgments of the technology-field intersection while macrolevel representations [i.e., exposure to Science, Technology, Engineering, and Mathematics disciplines and media coverage] predict more favorable judgments. (shrink)
Technology design has social as well as technical determinants. These social factors, such as the political context and social philosophy, vary historically and cross-nationally. The work upon which this paper is based addresses the nature of process technology design in the United States and focuses on the underlying assumptions that guide technology design, based on both historical analysis and survey and case studies of current design practices. Central to this work is an analysis of how the US (...) approaches compare to some of the other industrial nations and the assumptions and implications of different social design concepts such as human-centered design, skill-based design, and human factors. (shrink)
Expert systems are being developed in a multitude of domains worldwide. The usage of expert systems within organizations is growing; however, many expert systems projects still fail due to poor ‘institutionalization’ practices. This paper addresses various strategies for providing the transfer of expert systems technology within organizations. Specifically, this paper will address expert system technology transfer strategies using examples from United States and Mexican organizations.
Many Christians who argue against Christian materialism direct their arguments against what I call ‘Type-I materialism’, the thesis that I cannot exist without my organic body. I distinguish Type-I materialism from Type-II materialism, which entails only that I cannot exist without some body that supports certain mental functions. I set out a version of Type-II materialism, and argue for its superiority to Type-I materialism in an age of science. Moreover, I show that Type-II materialism can accommodate Christian doctrines like the (...) Resurrection of the Body, the Incarnation, and the intermediate state (if there is one). (shrink)
Teaching about technology, at all levels of education, can only be done properly when those who teach have a clear idea about what it is that they teach. In other words: they should be able to give a decent answer to the question: what is technology? In the philosophy of technology that question is explored. Therefore the philosophy of technology is a discipline with a high relevance for those who teach about technology. Literature in this (...) field, though, is not always easy to access for non-philosophers. This book provides an introduction to the philosophy of technology for such people. It offers a survey of the current state-of-affairs in the philosophy of technology, and also discusses the relevance of that for teaching about technology. The book can be used in introductory courses on the philosophy of technology in teacher education programs, engineering education programs, and by individual educators that are interested in the intriguing phenomenon of technology that is so important in our contemporary society. (shrink)
As we approach the end of the twentieth century, the ways in which knowledge--scientific, social, and cultural--is produced are undergoing fundamental changes. In The New Production of Knowledge, a distinguished group of authors analyze these changes as marking the transition from established institutions, disciplines, practices, and policies to a new mode of knowledge production. Identifying such elements as reflexivity, transdisciplinarity, and heterogeneity within this new mode, the authors consider their impact and interplay with the role of knowledge in social relations. (...) While the knowledge produced by research and development in science and technology is accorded central focus, the authors also outline the changing dimensions of social scientific and humanities knowledge and the relations between the production of knowledge and its dissemination through education. Placing science policy and scientific knowledge within the broader context of contemporary society, this book will be essential reading for all those concerned with the changing nature of knowledge, with the social study of science, with educational systems, and with the correlation between research and development and social, economic, and technological development. "Thought-provoking in its identification of issues that are global in scope; for policy makers in higher education, government, or the commercial sector." --Choice "By their insightful identification of the recent social transformation of knowledge production, the authors have been able to assert new imperatives for policy institutions. The lessons of the book are deep." --Alexis Jacquemin, Universite Catholique de Louvain and Advisor, Foreign Studies Unit, European Commission "Should we celebrate the emergence of a 'post-academic' mode of postmodern knowledge production of the post-industrial society of the 21st Century? Or should we turn away from it with increasing fear and loathing as we also uncover its contradictions. A generation of enthusiasts and/or critics will be indebted to the team of authors for exposing so forcefully the intimate connections between all the cognitive, educational, organizational, and commercial changes that are together revolutionizing the sciences, the technologies, and the humanities. This book will surely spark off a vigorous and fruitful debate about the meaning and purpose of knowledge in our culture." --Professor John Ziman, (Wendy, Janey at Ltd. is going to provide affiliation. Contact if you don't hear from her.) "Jointly authored by a team of distinguished scholars spanning a number of disciplines, The New Production of Knowledge maps the changes in the mode of knowledge production and the global impact of such transformations. . . . The authors succeed . . . at sketching out, in very large strokes, the emerging trends in knowledge production and their implications for future society. The macro focus of the book is a welcome change from the micro obsession of most sociologists of science, who have pretty much deconstructed institutions and even scientific knowledge out of existence." --Contemporary Sociology "This book is a timely contribution to current discussion on the breakdown of and need to renegotiate the social contract between science and society that Vannevar Bush and likeminded architects of science policy constructed immediately after World War II. It goes far beyond the usual scattering of fragmentary insights into changing institutional landscapes, cognitive structures, or quality control mechanisms of present day science, and their linkages with society at large. Tapping a wide variety of sources, the authors provide a coherent picture of important new characteristics that, taken altogether, fundamentally challenge our traditional notions of what academic research is all about. This well-founded analysis of the social redistribution of knowledge and its associated power patterns helps articulate what otherwise tends to remain an--albeit widespread--intuition. Unless they adapt to the new situation, universities in the future will find the centers of gravity of knowledge production moving even further beyond their ken. Knowledge of the social and cognitive dynamics of science in research is much needed as a basis of science and technology policymaking. The New Production of Knowledge does a lot to fill this gap. Another unique feature is its discussion of the humanities, which are usually left out in works coming out of the social studies of science." --Aant Elzinga, University od Goteborg. (shrink)
Abstract In this paper, we explore how the application of technological tools has reshaped food production systems in ways that foster large-scale outbreaks of foodborne illness. Outbreaks of foodborne illness have received increasing attention in recent years, resulting in a growing awareness of the negative impacts associated with industrial food production. These trends indicate a need to examine systemic causes of outbreaks and how they are being addressed. In this paper, we analyze outbreaks linked to ground beef and salad greens. (...) These case studies are informed by personal interviews, site visits, and an extensive review of government documents and peer-reviewed literature. To explore these cases, we draw from actor-network theory and political economy to analyze the relationships between technological tools, the design of industrial production systems, and the emergence and spread of pathogenic bacteria. We also examine if current responses to outbreaks represent reflexive change. Lastly, we use the myth of Prometheus to discuss ethical issues regarding the use of technology in food production. Our findings indicate that current tools and systems were designed with a narrow focus on economic efficiency, while overlooking relationships with pathogenic bacteria and negative social impacts. In addition, we find that current responses to outbreaks do not represent reflexive change and a continued reliance on technological fixes to systemic problems may result in greater problems in the future. We argue that much can be learned from the myth of Prometheus. In particular, justice and reverence need to play a more significant role in guiding production decisions. Content Type Journal Article Category Articles Pages 1-26 DOI 10.1007/s10806-011-9357-8 Authors Diana Stuart, Kellogg Biological Station and Department of Sociology, Michigan State University, 3700 East Gull Lake Drive, Hickory Corners, MI 49060, USA Michelle R. Woroosz, Department of Agricultural Economics and Rural Sociology, Auburn University, 306A Comer Hall, Auburn, AL 36849, USA Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863. (shrink)
The institutionalization of ethics and the direct influence of politics on how ethics bodies frame their opinions have been widely recognized and explored in the last few years. Less attention has been paid to what kind of normative instrument ethics as an institutional phenomenon has become in the State under the rule of law, and which institutional powers it has depended on. This paper analyzes the rise of ethics in the European Union context, where ethics, constructed as an isolated (...) set of values, has been exploited for its symbolic capacity to evoke citizenship, has become quite formalized as to certain features, and has acquired the potential to redefine the traditional divisions of powers in the State under the rule of law. (shrink)
While the important challenges of public deliberations on emerging technologies are crucial to keep in mind, this paper argues that scholars and practitioners have reason to be more confident in their performance of participatory technology assessments (pTA). Drawing on evidence from the 2008 National Citizens’ Technology Forum (NCTF) conducted by the Center for Nanotechnology in Society at Arizona State University, this paper describes how pTA offers a combination of intensive and extensive qualities that are unique among modes (...) of engagement. In the NCTF, this combination led to significant learning and opinion changes, based on what can be characterized as a high-quality deliberation. The quality of the anticipatory knowledge required to address emerging technologies is always contested, but pTAs can be designed with outcomes in mind—especially when learning is understood as an outcome. (shrink)
This collection of essays by Sheila Jasanoff explores how democratic governments construct public reason, that is, the forms of evidence and argument used in making state decisions accountable to citizens.
Food insecurity, and its extreme form, hunger, occur whenever the accessibility to an adequate supply of nutritional and safe foods becomes restricted or unpredictable. They are recurring problems in certain regions of the US, as well as in many parts of the world. According to nation-wide surveys conducted by the US Bureau of the Census, between 1996 and 1998 an estimated 9.7% of US households were classified as food insecure (6.2% being food insecure without evidence of hunger, and 3.5% being (...) food insecure with moderate to severe hunger). This means that approximately 10 million households each year did not always have access to enough food to meet basic needs. A potential tool in the fight against food insecurity and hunger is information technology (IT), since its use and range of application continue to grow at astonishing rates. The study presented here examined the question of how information technology, particularly the Internet, can be used to promote food security. The study used an action science research approach, and a case study strategy, with the food security system of Oktibbeha County, Mississippi selected as the case for study. The research design was a two-phase process. Phase one consisted of a needs assessment among food assistance organizations in Oktibbeha County, and included interviews of key food assistance personnel. Phase one also included a survey of IT subject matter experts to seek their opinions about the current state of Web-based information technology. Phase two involved an analysis of various IT implementation issues, as well as the development of a Web-based food security information system prototype tool. The needs assessment results indicated that (a) certain food security system and information needs existed among the food assistance organizations in Oktibbeha County, and (b) appropriate information technologies existed that could be applied to these needs. The food security needs related to better communication and coordination of information, such as program information, food site inventory information, client history information, food donation information, and nutrition education information. In regard to technology development, a variety of scenarios were examined. These included client-side approaches, server-side approaches, simple e-mail-based systems, Java-based systems, systems based on the Common Gateway Interface (CGI), and commercial database systems. In applying the needs assessment and survey results, the researcher developed a prototype Web site (including a series of online database tools) that could be used to promote food security in counties such as Oktibbeha County. The results of this research show that appropriate, Internet-based, IT holds promise for the reduction of certain social problems, such as food insecurity and hunger. (shrink)
The Social Construction of Technology (SCOT) theory offers a useful conceptual framework for examining the social and cultural factors that may contribute to or detract from the successful integration of computer technology into educational environments. This theory, which grew out of studies in the history of technology and the sociology of science, suggests methods for studying the phenomenon of technological development, such as identifying the relevant social groups involved in the development process and the factors that either (...) leave the technology in a state of interpretive flexibility or bring the interpretation of the technology to closure. This paper uses a SCOT approach to explore how personal and institutional beliefs can shape the ways in which technologies are used by teachers and students, and to identify the social, epistemological, cognitive and motivational factors that need to be considered as computer technology becomes an integral part of the educational experience. (shrink)
Robust technological enhancement of core cognitive capacities is now a realistic possibility. From the perspective of neutralism, the view that justifications for public policy should be neutral between reasonable conceptions of the good, only members of a subset of the ethical concerns serve as legitimate justifications for public policy regarding robust technological enhancement. This paper provides a framework for the legitimate use of ethical concerns in justifying public policy decisions regarding these enhancement technologies by evaluating the ethical concerns that arise (...) in the context of testing such technologies on nonhuman animals. Traditional issues in bioethics, as well as novel concerns such as the possibility of moral status enhancement, are evaluated from the perspective of neutralism. (shrink)
This paper addresses the issue of "new technologies", ie essentially biotechnologies and nanotechnologies. Refute will be two opposing views. The first (in general technophile), considers that every technique is morally good: but its use is susceptible to moral evaluation. The second (usually technophobic), sees the new technologies such transgressions of the natural order that has the right to oppose on principle to these technical operations and scientific investigations that make them possible.
Studying knowledge utilization and related processes calls for a conceptual framework. We look at the actors that engage in these processes in a specific field of human activity, and the interfaces and linkages between them, as a Knowledge and Information System (KIS). Although this KIS perspective originates from agriculture it also can be applied to other knowledge domains. Evidence gathered shows that for a KIS to be effective the actors (e.g., researchers, extensionalists, and clients) must act synergically. This inspired us (...) to look for basic KIS principles that indicate opportunities for intervention. This article provides a brief state-of-the-art overview, presents some insights gained to date; and states the main issues for the use of information technology in knowledge management. (shrink)
There is surprisingly little attention in Information Technology ethics to respect for persons, either as an ethical issue or as a core value of IT ethics or as a conceptual tool for discussing ethical issues of IT. In this, IT ethics is very different from another field of applied ethics, bioethics, where respect is a core value and conceptual tool. This paper argues that there is value in thinking about ethical issues related to information technologies, especially, though not exclusively, (...) issues concerning identity and identity management, explicitly in terms of respect for persons understood as a core value of IT ethics. After explicating respect for persons, the paper identifies a number of ways in which putting the concept of respect for persons explicitly at the center of both IT practice and IT ethics could be valuable, then examines some of the implicit and problematic assumptions about persons, their identities, and respect that are built into the design, implementation, and use of information technologies and are taken for granted in discussions in IT ethics. The discussion concludes by asking how better conceptions of respect for persons might be better employed in IT contexts or brought better to bear on specific issues concerning identity in IT contexts. (shrink)
Central figures of American mainstream philosophy have at crucial points in their work been concerned with the concreteness of actual reality, but have in various ways been deflected to primarily technical issues of philosophical analysis. It is possible, however, to see in these concerns a line of inquiry that leads to an examination of what is characteristic of actual reality today and of what is troubling and what is hopeful in it. Technology is a helpful term for the character (...) of contemporary reality, commodification for what is questionable and moments of completeness for what is promising in it. (shrink)
My objective in this paper is to address a handful of issues that typically get raised in discussions of philosophical anarchism. Some of these issues arise in discussions among partisans of anarchism, and some are more likely to be raised in efforts to defend the state against its opponents. My hope is to focus the argument in such a way as to make clearer the main issues that are at stake from the point of view of at least one (...) version of philosophical anarchism. (shrink)
STS research has devoted relatively little attention to the promotion and reception of science and technology by non-scientific actors and institutions. One consequence is that the relationship of science and technology to political power has tended to remain undertheorized. This article aims to fill that gap by introducing the concept of sociotechnical imaginaries. Through a comparative examination of the development and regulation of nuclear power in the US and South Korea, the article demonstrates the analytic potential of the (...) imaginaries concept. Although nuclear power and nationhood have long been imagined together in both countries, the nature of those imaginations has remained strikingly different. In the US, the state’s central move was to present itself as a responsible regulator of a potentially runaway technology that demands effective containment. In South Korea, the dominant imaginary was of atoms for development which the state not only imported but incorporated into its scientific, technological and political practices. In turn, these disparate imaginaries have underwritten very different responses to a variety of nuclear shocks and challenges, such as Three Mile Island (TMI), Chernobyl, and the spread of the anti-nuclear movement. (shrink)
This paper argues that the accelerating pace of life is reducing the time for thoughtful reflection, and in particular for contemplative scholarship, within the academy. It notes that the loss of time to think is occurring at exactly the moment when scholars, educators, and students have gained access to digital tools of great value to scholarship. It goes on to explore how and why both of these facts might be true, what it says about the nature of scholarship, and what (...) might be done to address this state of affairs. (shrink)
In Anarchy, State, and Utopia, Robert Nozick seeks to demonstrate that principles of justice in acquisition and transfer can be applied to justify the minimal state, and no state greater than the minimal state. That approach fails to acknowledge the critical role that forced exchanges play in overcoming a range of public goods and coordination problems. These ends are accomplished by taking property for which the owner is compensated in cash or in kind in an amount (...) that leaves him better off (by his own lights) than before the transaction. Forced exchanges use coercion to form the state, but the just compensation requirement guards against redistribution state imposed redistribution for collateral purposes. Once these forced exchanges are allowed to form a state, then they may be used thereafter to justify the powers of taxation and eminent domain used to support infrastructure (roads, sewers, public utilities) that neither the minimal state nor private markets can supply. Footnotesa I have benefited from comments at the workshop at the Social Sciences Division of the California Institute of Technology. My thanks to Justin Herring and Eric Murphy, The University of Chicago Law School, for their usual capable research assistance. (shrink)
Scholars in science and technology studies (STS) have recently been called upon to advise governments on the design of procedures for public engagement. Any such instrumental function should be carried out consistently with STS’s interpretive and normative obligations as a social science discipline. This article illustrates how such threefold integration can be achieved by reviewing current US participatory politics against a 70-year backdrop of tacit constitutional developments in governing science and technology. Two broad cycles of constitutional adjustment are (...) discerned: the first enlarging the scope of state action as well as public participation, with liberalized rules of access and sympathetic judicial review; the second cutting back on the role of the state, fostering the rise of an academic-industrial complex for technology transfer, and privatizing value debates through increasing delegation to professional ethicists. New rules for public engagement in the United Sates should take account of these historical developments and seek to counteract some of the anti-democratic tendencies observable in recent decades. (shrink)
Coma, vegetative state, lock-in syndrome and akinetic mutism are defined. Vegetative state is a state with no evidence of awareness of self or environment and showing cycles of sleep and wakefulness. PVS is an operational definition including time as a variable. PVS is a vegetative state that has endured or continued for at least one month. PVS can be diagnosed with a reasonable amount of medical certainty; however, the diagnosis of PVS must be kept separate from (...) the outcome. The patient outcome can be predicted based on etiology and age. Using outcome probabilities and etiology as criteria, patients can be subdivided in 5 groups and reasonable management guidelines can be suggested. Three levels of care can be provided to PVS patients: high technology, supportive and compassionate care. Pragmatic options for the various subgroups of patients are suggested. Management decisions will remain difficult for both the family and the health-care team. The role of the physician in these difficult cases is to share the decision-making with the family. (shrink)