Health checks identify disease in individuals without a medical indication. More and more checks are offered by more providers on more risk factors and diseases, so we may speak of an omnipresence of health checks. Current ethical evaluation of health checks considers checks on an individual basis only. However, omnipresent checks have effects over and above the effects of individual health checks. They might give the impression that health is entirely manageable by individual actions and strengthen the norm of individual (...) responsibility for health to the point where people hold themselves and others responsible for health outcomes they cannot reasonably be held accountable for. This process of so-called ‘over-responsibilization’ may result in increased feelings of guilt over health, decreased health solidarity and unfairly distributed health outcomes. Moreover, effects on privacy and peace of mind may be observed. Taking into account all possible harms and benefits of health checks in their ethical evaluation requires evaluation of health checks on an individual basis as well as on the level of all checks. Therefore, we urge the amendment of existing ethical evaluation to include the effects of an omnipresence of health checks. We make a first attempt at the formulation of amended criteria. (shrink)

Health checks identify disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as ‘personal health checks’. Health check providers’ perspective of ‘good’ health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for ‘good’ health checks, and the role these criteria play in their practices. Providers unanimously formulate a (...) number of minimal criteria: Checks must focus on treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health checks potential conflicts between criteria and underlying values should be explicated, guidance in weighing of criteria should be provided and the larger context should be taken into account: other actors than providers need to take up responsibility, and ideally benefits and harms of health checks should be weighed against other measures targeting disease. (shrink)

Health checks or health screenings identify disease in people without a specific medical indication. So far, the perspective of health check users has remained underexposed in discussions about the ethics and regulation of health checks. In 2017, we conducted a qualitative study with lay people from the Netherlands. We asked what participants consider characteristics of good and bad health checks, and whether they saw a role for the Dutch government. Participants consider a good predictive value the most important characteristic of (...) a good health check. Information before, during and after the test, knowledgeable and reliable providers, tests for treatable disease, respect for privacy, no unnecessary health risks and accessibility are also mentioned as criteria for good health checks. Participants make many assumptions about health check offers. They assume health checks provide certainty about the presence or absence of disease, that health checks offer opportunities for health benefits and that the privacy of health check data is guaranteed. In their choice for provider and test they tend to rely more on heuristics than information. Participants trust physicians to put the interest of potential health check users first and expect the Dutch government to intervene if providers other than physicians failed to do so by offering tests with a low predictive value, or tests that may harm people, or by infringing the privacy of users. Assumptions of participants are not always justified, but they may influence the choice to participate. This is problematic because choices for checks with a low predictive value that do not provide health benefits may create uncertainty and may cause harm to health; an outcome diametrically opposite to the one intended. Also, this may impair the relationship of trust with physicians and the Dutch government. To further and protect autonomous choice and to maintain trust, we recommend the following measures to timely adjust false expectations: advertisements that give an accurate impression of health check offers, and the installation of a quality mark. (shrink)

Cardiovascular health checks test risk factors for cardiovascular disease. They are offered to improve health: in case of an increased risk, participants receive lifestyle advice and medication. With this review, we investigate what is known about the reasons why people do or do not test for CVD risk factors. To what extent do these reasons relate to health monitoring and/or improvement? And do reasons differ in different contexts in which health checks are offered? We conducted a literature search and included (...) 22 papers in which we identified a broad range of motives. We conclude that people have reasons to test related to health improvement and reasons other than health improvement, practical reasons related to the way health checks are offered play an important role and motives should be understood in the context of the situation in which health checks are offered. Our results are relevant for public health officials and providers of health checks: first, if people undergo testing for reasons unrelated to health, this could explain why participation in health checks does not necessarily lead to health improvement. Second, efforts to improve uptake not necessarily serve justice and may hamper informed consent. (shrink)

If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

In 'Een handvol filosofen' staan de filosofen centraal die sinds de oprichting van de Vrije Universiteit in 1880 aan deze instelling verbonden zijn geweest. Het gaat hierbij niet alleen om de inhoud van hun werk, maar ook om de personen zelf. Er waren filosofiedocenten die zich met de universiteit identificeerden en zich volledig konden ontplooien. Er waren er echter ook voor wie dit niet gold, die geïsoleerd of in gewetensnood raakten. Veel filosofiestudenten waren actief betrokken bij wat er in hun (...) faculteit gebeurde. Zij namen initiatieven, protesteerden soms tegen de gang van zaken en kozen partij in conflictsituaties. Sinds het eind van de jaren zestig van de twintigste eeuw verloor de Vrije Universiteit geleidelijk haar christelijk karakter. Tegenwoordig werken alle stafleden vanuit hun eigen motivatie mee aan een hoofdzakelijk seculier geworden universiteit, die ruimte biedt voor religieuze en levensbeschouwelijke diversiteit. (shrink)

Introduction: Platonic dramatology -- The political and philosophical problems. Using pre-Socratic philosophy to support political reform: the Athenian stranger ; Plato's Parmenides: Parmenides' critique of Socrates and Plato's critique of Parmenides ; Becoming Socrates ; Socrates interrogates his contemporaries about the noble and good -- Paradigms of philosophy. Socrates' positive teaching ; Timaeus-Critias: completing or challenging Socratic political philosophy? ; Socratic practice -- The trial and death of Socrates. The limits of human intelligence ; The Eleatic challenge ; The trial (...) and death of Socrates -- Conclusion: Why Plato made Socrates his hero. (shrink)

"Using hundreds of examples from newsrooms large and small, author Ron F. Smith challenges readers to determine how they would face moral dilemmas on the job. Chapters evaluate the search for principles, accountability, truth and objectivity, errors and corrections, diversity, "faking" the news, reporters and their sources, privacy, the government watch, deception, compassion, the business of news, journalists and their communities, and financial concerns. New to this edition: a chapter on improving coverage of minorities, expanded discussion of broadcast journalism and (...) reporting on the Internet, and stories from recent front pages and TV news programs."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

In this philosophically sophisticated and historically significant work, John H. Zammito reconstructs Kant's composition of The Critique of Judgment and reveals that it underwent three major transformations before publication. He shows that Kant not only made his "cognitive" turn, expanding the project from a "Critique of Taste" to a Critique of Judgment but he also made an "ethical" turn. This "ethical" turn was provoked by controversies in German philosophical and religious culture, in particular the writings of Johann Herder and the (...) Sturm und Drang movement in art and science, as well as the related pantheism controversy. Such topicality made the Third Critique pivotal in creating a "Kantian" movement in the 1790s, leading directly to German Idealism and Romanticism. The austerity and grandeur of Kant's philosophical writings sometimes make it hard to recognize them as the products of a historical individual situated in the particular constellation of his time and society. Here Kant emerges as a concrete historical figure struggling to preserve the achievements of cosmopolitan Aufkl-rung against challenges in natural science, religion, and politics in the late 1780s. More specifically Zammito suggests that Kant's Third Critique was animated throughout by a fierce personal rivalry with Herder and by a strong commitment to traditional Christian ideas of God and human moral freedom. "A work of extraordinary erudition. Zammito's study is both comprehensive and novel, connecting Kant's work with the aesthetic and religious controversies of the late eighteenth century. He seems to have read everything. I know of no comparable historical study of Kant's Third Critique."-Arnulf Zweig, translator and editor of Kant's ;IPhilosophical Correspondence, 1759-1799;X "An intricate, subtle, and exciting explanation of how Kant's thinking developed and adjusted to new challenges over the decade from the first edition of the Critique of Pure Reason to the appearance of the Critique of Judgment. "--John W. Burbidge, Review of Metaphysics "There has been for a long time a serious gap in English commentary on Kant's Critique of Judgment Zammito's book finally fills it. All students and scholars of Kant will want to consult it."--Frederick Beiser, Times Literary Supplement. (shrink)

Awareness of, and respect for differences of gender, race, religion, language, and culture have liberated many oppressed groups from the hegemony of white, Western males. However, respect for previously denigrated collective identities should not be allowed to confine individuals to identities constructed around one main component used for political mobilisation, or to identities that depend on a priority of properties that are not optional, like race, gender, and language. In this article I want to sketch an approach for accommodating different (...) kinds of identity within a multicultural constitutional democracy. From a vantage point provided by a definition and explanation of personal identity, I want to show how people define, construct and change their personal identities to make themselves into unique individuals. Next I show how democratic political institutions and the personal identities of individuals reciprocally influence one another. In the final section I sketch ways in which diverse personal identities ought to be accommodated in multicultural constitutional democracies. The conclusion is that a society which gives its members the liberty, space, and opportunity to freely construct their own identities might avoid the formation of closed groups committed exclusively to their own sectional interests. (shrink)

A promise to do some action seems to create a binding obligation to do that action. And yet, paradoxically, an obligation seems not to be a fact that we can create or bring into existence; we can create an obligation only by creating or bringing into existence something else. The only way to avoid the paradox is to show that the act of promising creates something other than an obligation, which nonetheless binds us to perform the action in question. After (...) considering and rejecting various options such as the promisee's expectation and the promisor's resolve, Prichard locates the bindingness of a promise in a prior general promise, which allows the noises we make when promising to generate an obligation to perform the promised action. (shrink)

This article presents a response to Richard Rorty's paper "Is Philosophy Relevant to Business Ethics?" The author questions Rorty's views on the depreciation of the role of philosophy in applied ethics, and outlines four reasons why philosophy retains its relevance. The author addresses the role of moral reasoning in the development of the moral imagination. The author also concludes that humans have the means necessary to make moral progress and are capable of moral reasoning, and need only to develop a (...) strong moral imagination. (shrink)

This groundbreaking volume casts light on the long shadow of naturalistic monism in modern thought and culture. When monism's philosophical proposition - the unity of all matter and thought in a single, universal substance - fused with scientific empiricism and Darwinism in the mid-nineteenth century, it led to the formation of a powerful worldview articulated in the work of figures such as Ernst Haeckel. The compelling essays collected here, written by leading international scholars, investigate the articulation of monism in science, (...) philosophy, and religion and its impact on a range of social movements, from socialism and early feminism to imperialism and eugenics. The result is a broad and comprehensive chronological, disciplinary, and geographic map of a century of monism, as well as a bellwether for innovative new directions in the interdisciplinary study of science, religion, philosophy, and culture. (shrink)

Many people are worried about the harmful effects of climate change but nevertheless enjoy some activities that contribute to the emission of greenhouse gas (driving, flying, eating meat, etc.), the main cause of climate change. How should such people make choices between engaging in and refraining from enjoyable greenhouse-gas-emitting activities? In this chapter, we look at the answer provided by decision theory. Some scholars think that the right answer is given by interactive decision theory, or game theory; and moreover think (...) that since private climate decisions are instances of the prisoner’s dilemma, one rationally should engage in these activities provided that one enjoys them. Others think that the right answer is given by expected utility theory, the best-known version of individual decision theory under risk and uncertainty. In this chapter, we review these different answers, with a special focus on the latter answer and the debate it has generated. (shrink)

Both Carnap and Quine made significant contributions to the philosophy of mathematics despite their diversedviews. Carnap endorsed the dichotomy between analytic and synthetic knowledge and classified certainmathematical questions as internal questions appealing to logic and convention. On the contrary, Quine wasopposed to the analytic-synthetic distinction and promoted a holistic view of scientific inquiry. The purpose of thispaper is to argue that in light of the recent advancement of experimental mathematics such as Monte Carlosimulations, limiting mathematical inquiry to the domain of (...) logic is unjustified. Robustness studies implemented inMonte Carlo Studies demonstrate that mathematics is on par with other experimental-based sciences. (shrink)

This is the first sustained, whole-Bible treatment on the theme of meeting God face to face. Starting with Genesis and ending with Revelation, the author systematically covers the major events in salvation history, all of which reveal the beauty of encountering God's grace in abundance.

The article examines philosophical conceptions of responsibility found in the contributions of Martin Buber, Hans Jonas and Emmanuel Levinas. It argues that, despite the significant differences of these contributions, they all share important goals, significant structural features, and corresponding challenges. All three thinkers try to overcome the solipsistic limitations of Edmund Husserl’s phenomenology as well as the egocentrism of Heidegger’s concept of "solicitude" or "self-care." All three try to overcome the Kantian subject-object dichotomy. All three understand responsibility as a bipolar (...) relation only. In consequence, all of them face similar challenges resulting from new forms of dichotomies and the exclusion of “thirdness” that are the result of their conceptual decisions. (shrink)

In this book, Phillip Wiebe examines religious, spiritual, and mystical experiences, assessing how these experiences appear to implicate a spiritual order. Despite the current prevalence of naturalism and atheism, he argues that experiences purporting to have a religious or spiritual significance deserve close empirical investigation. Wiebe surveys the broad scope of religious experience and considers different types of evidence that might give rise to a belief in phenomena such as spirits, paranormal events, God, and an afterlife. He demonstrates that there (...) are different explanations and interpretations of religious experiences, both because they are typically personal accounts, and they suggest a reality that is often unobservable. Wiebe also addresses how to evaluate evidence for theories that postulate unobservables in general, and a Theory of Spirits in particular. Calling for more rigorous investigation of these phenomena, Wiebe frames the study of religious experience among other accepted social sciences that seek to understand religion. (shrink)