The doctor-patient relationship has evolved to respect “the autonomy and patients’ rights”. One of the cornerstones in such autonomy is the opportunity for patients to draw living wills, also known as advance directives. However, information about AD available to patients remains scarce largely due to the lack of involvement of General practitioners for several reasons. The aim of our study was to evaluate current general practitioner residents’ behavior concerning their role in informing their patients about AD. We built a French (...) nationwide survey from GPR class of 2012 to 2014. Two thousand three hundred ten residents completed our survey. 89.8% declared their willingness to offer patients the opportunity of writing AD. When asked about the usefulness of AD, 73.6% of residents responded that these are a suitable help for patients, but 19.7% considered that AD are essentially geared towards frail patients. Among residents who want to inform patients about AD, 14.7% wanted to involve all patients. Only 20.5% thought that elderly people should be systematically informed about AD. When the question involves other frail people in various disease areas, information seems relevant for 60.1% of GPR considering patient with cancer or malignant hematologic disease and for 56.2% about patients affected by neurodegenerative disease. When considering the routine use of AD, 20.5% of GPR would take them into account only if they are in agreement with the patient’s decision. The results of the survey indicate that GPR would rather choose to decide who should be informed about AD, and when to take AD into account for ethical concerns. (shrink)

BackgroundThe ageing of the population and the increased number of chronic diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training. Our aim was to know how they feel about taking care of dying patients, as end-of-life care are very different from the clinical activity (...) they are trained to.MethodsWe surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days.Results525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were: a reduction of unreasonable obstinacy (or therapeutic overkill, two terms defined in French law as curative treatment without reasonable hope of efficiency) (59.6%), patient’s (210 answers, 40%) and relative’s communication (information of patients and relatives about the severity of the disease and risk of death) (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychologic follow up should be instituted for those working in “at risk” hospital settings.ConclusionSelf-perception management of dying patients by GP resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life. (shrink)

In this article ethical issues are discussed which play a role in pharmacogenetics. Developments in pharmacogenetics have a large impact on many different practices such as clinical trials, the practice of medicine and society at large. In clinical trials, questions rise regarding the exclusion of genetic subgroups that may be non- or poor-responders to the experimental drug. Also, the question is asked how pharmaceutical companies should deal with their growing knowledge about the relations between genetic variation and adverse effects. Moreover, (...) pharmacogenetics may provide disease-specific predictive information which may have a significant impact on the relations between physicians, patients and their relatives in the practice of medicine. Here, issues also arise regarding responsibility of patients and physicians for health and disease. In the society at large, the high costs of new pharmacogenetic possibilities lead to questions concerning solidarity and fair distribution on a national as well as an international level. It is concluded that in the near future, ethical research should be focused on the themes responsibility, inclusion and exclusion and global justice. (shrink)

Eric Crégheur, Jeffery Aubin, Alice Fanguet, Gavin McDowell, Louis Painchaud, Paul-Hubert Poirier, Simon St-Arnault-Chiasson, Philippe Therrien, Benoît Tissot et Yann Vadnais.

For Descartes, knowledge exists as ideas in the mind that represent the world. In a radical critique, Hubert Dreyfus and Charles Taylor argue that knowledge consists of much more than the representations we formulate in our minds. They affirm our direct contact with reality—both the physical and the social world—and our shared understanding of it.

Dit boek is een hommage aan de filosoof Hubert Dethier (°21 juli 1933), die we zeker in de rij kunnen plaatsen van denkers als Jaap Kruithof, Hans Achterhuis en Etienne Vermeersch. Deze hommage is geen chronologische biografie. Het is daarentegen wel een verhaal waarin het leven van Hubert Dethier verweven wordt met de geschiedenis van zijn denken. Een denken dat zich situeert in de tweede helft van de vorige eeuw en het begin van de huidige eeuw en zich (...) moeiteloos projecteert naar de toekomst. Ontegensprekelijk een woelige en gewelddadige periode, maar ook een tijdgewricht van hoop en verwachting van het “nieuwe”.0. (shrink)

In diesem Aufsatz möchte ich einen Überblick über unser heutiges Wissen bezüglich der Übersetzung der Elemente Euklids ins Lateinische geben. Cicero hat als Quästor in Sizilien das Grab des Archimedes aufgesucht und instandsetzen lassen, er nennt gelegentlich Euklid und Archimedes und er zitiert in Academica I, Buch II, § 116, die Definitionen von Punkt und Linie. Vor dem 6.

Human intuition and perception are basic and essential phenomena of consciousness. As such, they will never be replicated by computers. This is the challenging notion of Hubert Dreyfus, Ph. D., archcritic of the artificial intelligence establishment. It's important to emphasize that he doesn't believe that AI is fundamentally impossible, only that the current research program is fatally flawed. Instead, he argues that to get a device (or devices) with human-like intelligence would require them to have a human-like being in (...) the world, which would require them to have bodies more or less like ours, and social acculturation (i.e. a society) more or less like ours. This helps to explain the practical problems in implementing artificial intelligence algorithms. (shrink)

For fifty years Hubert Dreyfus has done pioneering work which brings phenomenology and existentialism to bear on the philosophical and scientific study of the mind. This is a selection of his most influential essays, developing his critique of the representational model of the mind in analytical philosophy of mind and mainstream cognitive science.

Religiose Vielfalt ist nicht erst eine Erscheinung der "westlichen Moderne". Vielmehr existierten schon in fruhen Zeiten und an verschiedenen Orten der Welt oft mehrere Religionen nebeneinander, sei es dass diese unterschiedlichen Ursprungs waren oder sich aufgrund divergierender Auffassungen der religiosen Akteure innerhalb einer gemeinsamen Tradition ausdifferenzierten. Nicht immer war und ist diese Koexistenz eine friedliche. Die Religion der anderen wird haufig als "deviant" wahrgenommen oder gar als "nonkonformistisch" stigmatisiert und sanktioniert, bis hin zur physischen Vernichtung der "Devianten". Im vorliegenden Band (...) gehen vierzehn ausgewiesene Wissenschaftler_innen aus den Fachgebieten Religionswissenschaft, Soziologie, Sinologie und Judaistik aus ihrer jeweiligen fachlichen Perspektive und anhand diverser Fallbeispiele aus Geschichte und Gegenwart der Frage nach, unter welchen Umstanden, aus welchen Grunden und mit welchen Folgen religiose Pluralitat als Problem wahrgenommen wird. Das Buch verbindet so systematische Fragestellungen mit empirischen Fallbeispielen und liefert damit eine ausgezeichnete Grundlage fur die Erforschung des gesellschaftlichen Umgangs mit religioser Pluralitat. (shrink)

The ontological models framework distinguishes ψ-ontic from ψ-epistemic wave- functions. It is, in general, quite straightforward to categorize the wave-function of a certain quantum theory. Nevertheless, there has been a debate about the ontological status of the wave-function in the statistical interpretation of quantum mechanics: is it ψ-epistemic and incomplete or ψ-ontic and complete? I will argue that the wave- function in this interpretation is best regarded as ψ-ontic and incomplete.

What does it take to understand a phenomenon ideally, or to the highest conceivable extent? In this paper, we answer this question by arguing for five necessary conditions for ideal understanding: (i) representational accuracy, (ii) intelligibility, (iii) truth, (iv) reasonable endorsement, and (v) fitting. Even if one disagrees that there is some form of ideal understanding, these five conditions can be regarded as sufficient conditions for a particularly deep level of understanding. We then argue that grasping, novel predictions, and transparency (...) are not reasonable conditions for ideal understanding. (shrink)

_Internet_ is een van de eerste boeken waarin het filosofische inzicht -van Plato tot Kierkegaard - betrokken wordt op het debat over de mogelijkheden en onmogelijkheden van het internet. Dreyfus laat zien dat de onstoffelijke, 'vrij zwevende' websurfer zijn oorsprong vindt in Descartes' scheiding van geest en lichaam, en hoe Kierkegaards inzichten in de opkomst van het moderne leespubliek vooruitlopen op de nieuwsgierige, maar elk risico vermijdende internet-junkie. Uitgaande van recente onderzoeken naar het isolement dat veel internetgebruikers ervaren, toont Dreyfus (...) aan hoe het internet, door zijn nadruk op privé-ervaringen, gebruikers berooft van wezenlijke, belichaamde vermogens zoals vertrouwen, stemmingen en betrokkenheid bij met anderen gedeelde lokale aangelegenheden. _Internet_ is verplichte kost voor iedereen die on line is en is geïnteressseerd in onze plaats in de 'e-revolutie'. (shrink)

The polling system of «Polls» in Belgium is a typical process of the political life. Its purpose is to elaborate into the political parties the voting lists, either with internal polling processes, or by mecanisms of cooptation, or simply by choices corresponding to the establishment of the Belgian society.The pre-voting process seems to be relevant and adapted to the technique of the proportional repartition of votes between the lists of the parties.In fact, only several organizations of the Belgian Socialist Party (...) utilize regularly this process for the structure of their lists of candidates before the legislature votes.It is a postulat of the political Democracy in Belgium of which the specific result is to reinforce the oligarchies. (shrink)

A Critique of Artificial Reason Hubert L. Dreyfus . HUBERT L. DREYFUS What Computers Still Can't Do Thi s One XZKQ-GSY-8KDG What. WHAT COMPUTERS STILL CAN'T DO Front Cover.

This volume presents a selection of Hubert Dreyfus's pioneering work in bringing phenomenology and existentialism to bear on the philosophical and scientific study of the mind. Each of the thirteen essays interprets, develops, and extends the insights of his predecessors working in the European philosophical tradition. One of Dreyfus' central contributions to reading the historical canon of philosophy comes from his recognition that great philosophers help us to understand the -background practices- of a culture - the practices that shape (...) and embody our most basic understanding of ourselves and the things and situations we encounter in our world. Background practices are all too often overlooked completely, or else their importance is misunderstood. Each chapter in this volume shows in one way or another how a broad range of philosophical topics can only be properly understood when we recognize how they are grounded in the background practices that shape our lives and give meaning to our activities, our tasks, our normative commitments, our aims and our goals. (shrink)

Les Presses universitaires de France ont publié, en 1994, une Encyclopédie universelle de philosophie, dans laquelle Hubert Mono Ndjana est présenté comme un spécialiste de la pensée des hommes politiques. Il avait en effet traduit en français Obiang Nguema Mbasogo en 1980 (Un Pari pour la liberté), publié un ouvrage en 1985 sur le chef d'Etat de son pays (L'Idée sociale chez Paul Biya), et deux autres sur la pensée et le pays de Kim Il Sung (Révolution et création (...) et Regard sur la Corée), en 1987. Sa pensée s'est également et abondamment préoccupée de la question du politique et des préoccupations épistémologiques. L'entretien que Jean-Philippe Nguemeta a eu le génie d'initier auprès d'Hubert Mono Ndjana permettra au lecteur d'avoir une vue synoptique de ce philosophe attentif, qui a passé toute sa vie à enseigner, sans négliger les grandes questions de son temps. Un décryptage exhaustif des énigmes de la civilisation, utile pour la culture générale et l'éducation... (shrink)

This book is the first to provide a sustained, coherent analysis of Foucault's work as a whole. To demonstrate the sense in which Foucault's work is beyond structuralism and hermeneutics, the authors unfold a careful, analytical exposition of his oeuvre. They argue that during the of Foucault's work became a sustained and largely successful effort to develop a new method - "interpretative analytics" - capable of explaining both the logic of structuralism's claim to be an objective science and the apparent (...) validity of the hermeneutical counterclaim that the human sciences can proceed only by understanding the deepest meaning of the subject and his tradition. (shrink)

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are “stored”, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

In previous work I urged that the perceptual experience we rational animals enjoy is informed by capacities that belong to our rationality, and - in passing - that something similar holds for our intentional action. In his Presidential Address, Hubert Dreyfus argued that I thereby embraced a myth, "the Myth of the Mental". According to Dreyfus, I cannot accommodate the phenomenology of unreflective bodily coping, and its importance as a background for the conceptual capacities exercised in reflective intellectual activity. (...) My paper responds to this accusation. Dreyfus misreads my invocation of Aristotle, and is thereby led to suppose, wrongly, that I conceive rationality as detached, brought to bear on practical predicaments from a standpoint other than one of immersion in them. I urge that even unreflective bodily coping, on the part of rational animals, is informed by their rationality. Dreyfus mentions Heidegger’s distinction, which is picked up by Gadamer, between being oriented towards the world and merely inhabiting an environment. But he sets it aside, whereas it is crucial for the issue between us. Engaged bodily coping involves responsiveness to affordances, and responsiveness to affordances on the part of rational animals belongs to their relation to the world. I explain how the idea that conceptual capacities are actualized in our perceptual experience is connected with the thought that our perceptual experience opens us to the world. Finally, I suggest that the real myth in this area is the conception of rationality underlying Dreyfus’s resistance to my picture. (shrink)

Back in 1950, while a physics major at Harvard, I wandered into C.I. Lewis’s epistemology course. There, Lewis was confidently expounding the need for an indubitable Given to ground knowledge, and he was explaining where that ground was to be found. I was so impressed that I immediately switched majors from ungrounded physics to grounded philosophy.

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are stored, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

McDowell's claim that "in mature human beings, embodied coping is permeated with mindedness",1 suggests a new version of the mentalist myth which, like the others, is untrue to the phenomenon. The phenomena show that embodied skills, when we are fully absorbed in enacting them, have a kind of non-mental content that is non-conceptual, non-propositional, non-rational and non-linguistic. This is not to deny that we can monitor our activity while performing it. For solving problems, learning a new skill, receiving coaching, and (...) so forth, such monitoring is invaluable. But monitoring what we are doing as we are doing it degrades performance to at best competence. On McDowell's view, there is no way to account for such a degradation in performance since the same sort of content would be involved whether we were fully absorbed in or paying attention to what we were doing. McDowell claims that it is an advantage of his conceptualism that it avoids any foundationalist attempt to build up the objective world on the basis of an indubitable Given or any other ground-floor experience. And, indeed, if the world is all that is the case and our minds are unproblematically open to it, all experience is on the same footing. But one must distinguish motor intentionality, and the interrelated solicitations our coping body is intertwined with, from conceptual intentionality and the world of propositional structures it opens onto. The existential phenomenologist can then agree with McDowell in rejecting traditional foundationalisms, while yet affirming and describing the ground-floor role of motor intentionality in providing the support on which all forms of conceptual intentionality are based. (shrink)

Essays discuss the themes of worldliness, affectedness, understanding, and the care-structure found in Heidegger's work on the nature of existence.

It is generally argued that if the wave-function in the de Broglie–Bohm theory is a physical field, it must be a field in configuration space. Nevertheless, it is possible to interpret the wave-function as a multi-field in three-dimensional space. This approach hasn’t received the attention yet it really deserves. The aim of this paper is threefold: first, we show that the wave-function is naturally and straightforwardly construed as a multi-field; second, we show why this interpretation is superior to other interpretations (...) discussed in the literature; third, we clarify common misconceptions. (shrink)

I want to combine two hitherto largely independent research projects, scientific understanding and mechanistic explanations. Understanding is not only achieved by answering why-questions, that is, by providing scientific explanations, but also by answering what-questions, that is, by providing what I call scientific descriptions. Based on this distinction, I develop three forms of understanding: understanding-what, understanding-why, and understanding-how. I argue that understanding-how is a particularly deep form of understanding, because it is based on mechanistic explanations, which answer why something happens in (...) virtue of what it is made of. I apply the three forms of understanding to two case studies: first, to the historical development of thermodynamics and, second, to the differences between the Clausius and the Boltzmann entropy in explaining thermodynamic processes. (shrink)

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are “stored”, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

Philosophers now seem to agree that frequentism is an untenable strategy to explain the meaning of probabilities. Nevertheless, I want to revive frequentism, and I will do so by grounding probabilities on typicality in the same way as the thermodynamic arrow of time can be grounded on typicality within statistical mechanics. This account, which I will call typicality frequentism, will evade the major criticisms raised against previous forms of frequentism. In this theory, probabilities arise within a physical theory from statistical (...) behavior of almost all initial conditions. The main advantage of typicality frequentism is that it shows which kinds of probabilities (that also have empirical relevance) can be derived from physics. Although one cannot recover all probability talk in this account, this is rather a virtue than a vice, because it shows which types of probabilities can in fact arise from physics and which types need to be explained in different ways, thereby opening the path for a pluralistic account of probabilities. (shrink)

MICHAEL WHEELER Cambridge, MA: MIT Press, 2005432 pages, ISBN: 0262232405 (hbk); $35.001.When I was teaching at MIT in the 1960s, students from the Artificial Intelligence Laboratory would come to...