ABSTRACTThe principle of informed refusal poses a specific problem when it is invoked by a pregnant woman who, in spite of having accepted her pregnancy, refuses the diagnostic and/or therapeutic measures that would ensure the well‐being of her endangered fetus. Guidelines issued by professional bodies in the developed world are conflicting: either they allow autonomy and informed consent to be overruled to the benefit of the fetus, or they recommend the full respect of these principles. A number of medical ethicists (...) advocate the overruling of alleged irrational or unreasonable refusal for the benefit of the fetus. The present essay supports the view of fetal rights to health and to life based on the principle that an ‘accepted’ fetus is a ‘third person’. In developing countries, however, the implementation of the latter principle is likely to be in conflict with a ‘communitarian’ perception of the individual – in this case, the pregnant woman. Within the scope of the limitations to the right to autonomy of J.S. Mill's ‘harm principle’, the South African Patients’ Charter makes provision for informed refusal. The fact that, in practice, it is not implemented illustrates the well‐known difficulty of applying Western bioethical principles in real life in the developing world. (shrink)

This article is essentially a commentary on a little-known text by `Alain' (whose real name was Emile-Auguste Chartier), successively entitled Les marchands de sommeil and Vigiles de l'esprit. This piece of work, initially a prize-giving speech to students in a Parisian lycée, was rewritten by Alain many years later during the Second World War. It describes with acute intelligence and in a splendid metaphoric language the enduring and compelling proposition that the formation of critical judgement should be the ultimate purpose (...) of all teaching. (shrink)

Largely, the concept of energy or vital force, as first analysed by Placide Tempels in Bantu Philosophy, permeates most African ontology systems, worldviews and life views. The Ntomba Chief is chosen because of his above average vital force. This puts him in the position of intermediary between the Supreme Being, the ancestors, and his subordinates. The waning of his energy is incompatible with his position because his energy is that of his tribe. When installed, he takes an oath that, when (...) this happens, he has to accept mohilo, the ‘hastening of death’. In the Chief's case, the hastening of death is not intended to relieve his pain, as it would be with other creatures. The Chief's dying a natural death would result in the loss of the entire community's vital force. Therefore, he has to be killed ritually to avoid that risk. That the Chief agrees to be killed – via a form of advanced directive – poses an ethical dilemma for a Western observer. From the Ntomba perspective, however, where the energy is being, and being is energy, it is the only way to preserve and protect the community's raison d’être. (shrink)

The History and Culture of Iran and Central Asia from the Pre-Islamic to the Islamic Period. Edited by D. G. Tor and Minoru inaba. Notre Dame, IN: University of Notre Dame Press, 2022. Pp. xiv + 349. $90.

ABSTRACT The principle of informed refusal poses a specific problem when it is invoked by a pregnant woman who, in spite of having accepted her pregnancy, refuses the diagnostic and/or therapeutic measures that would ensure the well‐being of her endangered fetus. Guidelines issued by professional bodies in the developed world are conflicting: either they allow autonomy and informed consent to be overruled to the benefit of the fetus, or they recommend the full respect of these principles. A number of medical (...) ethicists advocate the overruling of alleged irrational or unreasonable refusal for the benefit of the fetus. The present essay supports the view of fetal rights to health and to life based on the principle that an ‘accepted’ fetus is a ‘third person’. In developing countries, however, the implementation of the latter principle is likely to be in conflict with a ‘communitarian’ perception of the individual – in this case, the pregnant woman. Within the scope of the limitations to the right to autonomy of J.S. Mill's ‘harm principle’, the South African Patients’ Charter makes provision for informed refusal. The fact that, in practice, it is not implemented illustrates the well‐known difficulty of applying Western bioethical principles in real life in the developing world. (shrink)

This article deals with the concept of sentience, and more specifically with the argument from sentience as it is used by utilitarians in the abortion debate and in the advocacy of animal rights. It is argued that sentience is more than feeling pleasure and pain (with empha sis on pain), and that pain is an inborn protection required to fit into the world rather than the substance of evil. S. Afr. J. Philos. Vol.23(3) 2004: 292-301.

The South African Choice on Termination of Pregnancy Act 92 of 1996 gives women the right to voluntary abortion on request. The reality factor, however, is that five years later there are still more ‘technically illegal’ abortions than legal ones. Amongst other factors, one of the main obstacles to access to this constitutionally enshrined human right is the right to conscientious objection/refusal. Although the right to conscientious objection is also a basic human right, the case of refusal to provide abortion (...) services on conscientious objection grounds should not be seen as absolute and inalienable, at least in the developing world. In the developed world, where referral to another service provider is for the most part accessible, a conscientious objector to abortion does not really put the abortion seeker’s life at risk. The same cannot be said in developing countries even when abortion is decriminalised. This is because referral procedures are fraught with major obstacles. Therefore, it is argued that the right to conscientious objection to abortion should be limited by the circumstances in which the request for abortion arises. (shrink)

The South African Choice on Termination of Pregnancy Act 92 of 1996 gives women the right to voluntary abortion on request. The reality factor, however, is that five years later there are still more ‘technically illegal’ abortions than legal ones. Amongst other factors, one of the main obstacles to access to this constitutionally enshrined human right is the right to conscientious objection/refusal. Although the right to conscientious objection is also a basic human right, the case of refusal to provide abortion (...) services on conscientious objection grounds should not be seen as absolute and inalienable, at least in the developing world. In the developed world, where referral to another service provider is for the most part accessible, a conscientious objector to abortion does not really put the abortion seeker’s life at risk. The same cannot be said in developing countries even when abortion is decriminalised. This is because referral procedures are fraught with major obstacles. Therefore, it is argued that the right to conscientious objection to abortion should be limited by the circumstances in which the request for abortion arises. (shrink)

Old age is not normally associated with innovativeness and technical prowess. To the contrary, when treating age as a distinct category, policy makers, innovation scholars, and companies typically regard younger people as drivers of innovation, and the early adoption of new technology. In this paper, we critically investigate this link between age, ineptness, and technology adoption using a case study of the diffusion of electric bikes in the Netherlands. We demonstrate how, during the first wave of e-bike acceptance, old age (...) was constructed as an arena in which important learning processes took place, and where older persons became early adopters of e-bikes. Theoretically, this paper speaks critically to the prolific literature on innovation diffusion and its treatment of adopter categories as generic concepts. Using age as a central dimension, our research highlights the situated and constructed nature of adopter categories, and thus challenges age-based assumptions about innovation and technology use by younger and older persons. These insights about what we term the rejuvenation of e-bikes help us rectify existing biases of older persons as an inherently problematic group of technology users. (shrink)

In this review, we provide an overview of the dynamic changes within the microbiota and its metabolites that are implicated in establishing and maintaining gastrointestinal homeostasis during various stages of microbial colonization. The gradual conversion of the gut microbiota toward a mutualistic microbial community involves replacement of pioneer gut colonizers with bacterial taxa that are characteristic for the adult gut. An important microbial signature of homeostasis in the adult gut is the prevalence and activity of a diverse spectrum of bacterial (...) species that produce beneficial metabolites through metabolic interactions between microbial groups. Deciphering these microbial signatures and their metabolites that govern short and long‐term equilibrium, as well as imbalances in host‐microbial relationships, may provide novel diagnostic tools and/or therapeutic targets for specific disorders associated with intestinal dysbiosis and loss of homeostasis. (shrink)

BACKGROUND: Delusions in schizophrenia are commonly approached as empirical false beliefs about everyday reality. Phenomenological accounts, by contrast, have suggested that delusions are more adequately understood as pertaining to a different kind of reality experience. How this alteration of reality experience should be characterised, which dimensions of experiential life are involved, and whether delusional reality might differ from standard reality in various ways is unclear and little is known about how patients with delusions value and relate to these experiential alterations. (...) This study aimed to investigate the nature of delusional reality experience, and its subjective apprehension, in individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis. METHODS: In this qualitative phenomenological study, we recruited individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis from two psychiatric-hospital services in Belgium using homogenous sampling. Criteria for participation were having undergone at least one psychotic episode with occurring delusional symptoms, present at least 1 year before participation, on the basis of clinical notes assessed by the attending psychiatrist; a schizophrenia-spectrum diagnosis, ascertained through clinical interview by the attending psychiatrist upon admission; being aged between 18 years and 65 years; and having the capacity to give informed consent. Exclusion criteria included worries concerning capacity to consent and risk of distress caused by participation. We did phenomenologically driven semi-structured interviews with the participants to explore the nature of delusional reality experience and their subjective valuation of these experiences. We used interpretative phenomenological analysis, a qualitative method tailored to the in-depth exploration of participants’ first-person perspective, to analyse their accounts. FINDINGS: Between March 2, 2020, and Sept 30, 2020, 18 adults participated in the interview study. The findings suggest that delusions are often embedded in wide-ranging alterations of basic reality experience, involving quasi-ineffable atmospheric and ontological qualities that undermine participants’ sense of the world as unambiguously real, fully present, and shared with others. We also found that delusional reality experience can differ from standard reality in various ways, across multiple dimensions, and that participants are often implicitly or explicitly aware of the distinction between delusional and standard reality. Delusional experience can have an enduring value and meaning that is not fully captured by a strictly medical perspective. INTERPRETATION: Increased awareness and recognition of the distinctive nature of delusional reality experience, in both clinical and research settings, can improve diagnostic accuracy, explanatory models, and therapeutic support for individuals with delusions whose lived realities are not always evident from an everyday perspective. FUNDING: FWO Flanders. TRANSLATION: For the Dutch translation of the abstract see Supplementary Materials section. (shrink)

Research on teachers’ professional identity integrates many constructs that are treated independently in most cases. This study described the associations between components of teacher professional identity and their association with teachers’ general pedagogical beliefs. Secondary teachers completed a survey about several components of their identity and general pedagogical beliefs. Multidimensional scaling revealed that the components could be mapped on two dimensions: form of motivation and degree of subject specificity. The resulting map revealed four meaningful groups of components. Furthermore, whereas direct (...) transmission general pedagogical beliefs were found to be strongly tied to an identity grounded in the subject taught, constructivist beliefs were independent of identity components. This study provides new insight into the stru... (shrink)

In this article, we reflect on our lived experience as co-facilitators of a promising intragroup anti-racism process within the Dutch Reformed Church (DRC) in South Africa. Firstly, we describe how this emergent process, referred to as ‘white work’, has developed since 2018 to include three focal areas: facilitation and training, research and the development of resources for faith leaders. Secondly, in the interest of localised, embodied diagnostic work, we mention relatively neglected strands of South African whiteness that have arisen through (...) this process of ‘white work’. We argue that this DRC ‘white work’ contributes to a more intersectional approach to dismantling whiteness. Finally, we propose that the dismantling potential of this ‘white work’ rests on three dimensions – raising consciousness, cultivating capacity and forming community – while stressing some of the challenges and limitations we have encountered in our process thus far.Contribution: This article contributes to both the diagnosis and dismantling of South African whiteness by presenting a narrative reflection on an emergent process among members of the DRC in South Africa. (shrink)

En posant avec clarté des questions de philosophie de l’esprit, d’ontologie et d’épistémologie, ce livre témoigne à la fois de l’intérêt réel de la danse comme objet philosophique et du rôle unique que peut jouer la philosophie dans une meilleure compréhension de cet art. Qu’est-ce que danser ? Que nous apprend le mouvement dansé sur la nature humaine et la relation entre le corps et l’esprit ? À quelles conditions une œuvre est-elle correctement interprétée par les danseurs et bien identifiée (...) par les spectateurs ? (shrink)