In the past few years in the Netherlands and other multi-ethnic democratic states we hear sharp political and intellectual criticism on the philosophical idea of a ‘multicultural society’. In this article, the author questions the criticism of several liberal and conservative political philosophers, who in their approach give attention to the genealogy of multiculturalism. While a liberal as Brian Barry sees multiculturalism as a regression, the conservative Roger Scruton on the other hand considers this political and intellectual phenomenon as a (...) bridge too far, a symptom of the disintegration of the modern nation. The author argues that these criticisms are forcing us to abandon a form of multiculturalism that considers ‘toleration’ as the highest principle. The ‘toleration-multiculturalist’ gets entangled in inconsistencies and moral paradoxes, as soon as he wants to determine his position towards intolerant and immodest variations of the Volksgeist, the cultural homogeneity and identity. The underlying problem in the discussion among liberals, conservatives and multiculturalists is the ontological vulnerability of cultures. This vulnerability has to do with the fact that cultures, traditions and identities are dependant on the constructive work of autonomous interpreters. Therefore a permanent dialogue with the past is necessary. While nationalists and multiculturalists are inclined to eliminate this vulnerability by fixating and immunizing the cultural and national identity, the liberals are neutralizing the cultural loyalties of people through the privatisation of identities. In contrast to these positions the author pleads for a form of democracy in which the rituals of democracy mediate the permanent dissensus about the meaning of nevertheless being a national community. (shrink)

In the past few years in the Netherlands and other multi-ethnic democratic states we hear sharp political and intellectual criticism on the philosophical idea of a ‘multicultural society’. In this article, the author questions the criticism of several liberal and conservative political philosophers, who in their approach give attention to the genealogy of multiculturalism. While a liberal as Brian Barry sees multiculturalism as a regression, the conservative Roger Scruton on the other hand considers this political and intellectual phenomenon as a (...) bridge too far, a symptom of the disintegration of the modern nation. The author argues that these criticisms are forcing us to abandon a form of multiculturalism that considers ‘toleration’ as the highest principle. The ‘toleration-multiculturalist’ gets entangled in inconsistencies and moral paradoxes, as soon as he wants to determine his position towards intolerant and immodest variations of the Volksgeist, the cultural homogeneity and identity. The underlying problem in the discussion among liberals, conservatives and multiculturalists is the ontological vulnerability of cultures. This vulnerability has to do with the fact that cultures, traditions and identities are dependant on the constructive work of autonomous interpreters. Therefore a permanent dialogue with the past is necessary. While nationalists and multiculturalists are inclined to eliminate this vulnerability by fixating and immunizing the cultural and national identity, the liberals are neutralizing the cultural loyalties of people through the privatisation of identities. In contrast to these positions the author pleads for a form of democracy in which the rituals of democracy mediate the permanent dissensus about the meaning of nevertheless being a national community. (shrink)

De geopolitieke spanningen aan het begin van de eenentwintigste eeuw hebben een nieuwe interesse in het werk van Carl Schmitt gewekt. Dat geldt ook voor zijn benadering van het vraagstuk van de relatie tussen religie en politiek. Schmitt zoekt hierbij aansluiting bij zulke uiteenlopende en incompatibele auteurs als Juan Donoso Cortes en Thomas Hobbes. Vooral recent onderzoek heeft duidelijk gemaakt dat Schmitts juridisch-politieke denken inderdaad steunt op een aantal politiek-theologische premissen. Toch moeten we de actualiteit van zijn werk vooral zoeken (...) bij zijn politiek-filosofische probleemstelling die aanhaakt bij Thomas Hobbes. Schmitt kan ons vooral leren dat de privatisering van de religies als middel voor hun politieke neutralisering haar grenzen heeft, vooral in een democratische politieke orde. (shrink)

In the Netherlands, the traditional and famous ‘culture of tolerance’ in the past few years surprisingly became associated with the laxity, half-heartedness, even negligence and indifference with regard to serious problems in a multi-ethnic society. For the time being, a polemical use of the term dominates: tolerance as an aspect of our western ‘superiority’ against barbaric fundamentalism. To regain some grip on the – at least in the Netherlands – apparently ‘hollow’, even politically and morally dubious concept of tolerance, the (...) author returns to the genealogical ‘founding forge’ of the term, the civil war fought in the name of religion in sixteenth- and seventeenth-century Europe. He demonstrates that tolerance was a key-category in a tiring, centuries-old process during which a ‘Gordian knot’ – the congruence of political power and religious faith – was being abandoned. The historical case-study of the dissident preacher John Bunyan and the early Quakers in seventeenth-century England shows, that during the Age of religious Discord political, social and religious themes are inseparably intertwined, not only from the point of view of the defenders of the status quo, but also from the standpoint of the religious dissidents and their ‘illegal’ preaching. In the intellectual history one can witness the birth of the early-modern concept of a minimal, political concept of tolerance. In a negative sense, this was a departure from attempts to uphold or restore the unity of ‘true faith’ by political coercion. In a positive sense it implied the sufferance of dissident faith and religious practices by a political power ‘in order to prevent the worse from happening’. In this process, political power became more and more an autonomous institution, above society. This minimal, political concept of tolerance has been surpassed by the state-sanctioned, juridical freedom of religion. This implies the democratic disjunction of truth and justice, that is, the recognition of an equal, reciprocal right of everyone to live and articulate his or her own truth. This legislation must be supported by a civic and social culture in which tolerance as an ethical virtue is being practiced and cherished. The most exacting form of tolerance is an attitude which tries to overcome the democratic disjunction of truth and justice, in the direction of an ‘oikoumene of religions’ or a ‘fusion of horizons’. But this subtle attitude can easily slip into an ‘idolatry of difference’ and a laissez faire-tolerance, as seemed to have happened in the Netherlands. In the final parts of this introductory essay the author presents the four articles in this thematic edition of Bijdragen: studies on Cusanus, Spinoza and Leibniz regarding tolerance, and an essay on the problems of dealing with alterity. The author concludes with the contemporary dilemma of tolerance. Should the future form of tolerance be based on universalism accompanied with the political neutralization and privatization of religion, nation, culture? Or should tolerance in a globalizing world be fed from particular traditions and sources? (shrink)

In the Netherlands, the traditional and famous ‘culture of tolerance’ in the past few years surprisingly became associated with the laxity, half-heartedness, even negligence and indifference with regard to serious problems in a multi-ethnic society. For the time being, a polemical use of the term dominates: tolerance as an aspect of our western ‘superiority’ against barbaric fundamentalism. To regain some grip on the – at least in the Netherlands – apparently ‘hollow’, even politically and morally dubious concept of tolerance, the (...) author returns to the genealogical ‘founding forge’ of the term, the civil war fought in the name of religion in sixteenth- and seventeenth-century Europe. He demonstrates that tolerance was a key-category in a tiring, centuries-old process during which a ‘Gordian knot’ – the congruence of political power and religious faith – was being abandoned. The historical case-study of the dissident preacher John Bunyan and the early Quakers in seventeenth-century England shows, that during the Age of religious Discord political, social and religious themes are inseparably intertwined, not only from the point of view of the defenders of the status quo, but also from the standpoint of the religious dissidents and their ‘illegal’ preaching. In the intellectual history one can witness the birth of the early-modern concept of a minimal, political concept of tolerance. In a negative sense, this was a departure from attempts to uphold or restore the unity of ‘true faith’ by political coercion. In a positive sense it implied the sufferance of dissident faith and religious practices by a political power ‘in order to prevent the worse from happening’. In this process, political power became more and more an autonomous institution, above society. This minimal, political concept of tolerance has been surpassed by the state-sanctioned, juridical freedom of religion. This implies the democratic disjunction of truth and justice, that is, the recognition of an equal, reciprocal right of everyone to live and articulate his or her own truth. This legislation must be supported by a civic and social culture in which tolerance as an ethical virtue is being practiced and cherished. The most exacting form of tolerance is an attitude which tries to overcome the democratic disjunction of truth and justice, in the direction of an ‘oikoumene of religions’ or a ‘fusion of horizons’. But this subtle attitude can easily slip into an ‘idolatry of difference’ and a laissez faire-tolerance, as seemed to have happened in the Netherlands. In the final parts of this introductory essay the author presents the four articles in this thematic edition of Bijdragen: studies on Cusanus, Spinoza and Leibniz regarding tolerance, and an essay on the problems of dealing with alterity. The author concludes with the contemporary dilemma of tolerance. Should the future form of tolerance be based on universalism accompanied with the political neutralization and privatization of religion, nation, culture? Or should tolerance in a globalizing world be fed from particular traditions and sources? (shrink)

Whereas the concept of ‘tolerance’ was a marginal category from the end of the sixteenth century, it has become a political key concept today. Have we not all become strangers and foreigners? As such the concept of ‘strangeness’ has lost its relevance. In recent times we witness a new turn in the dialectics of tolerance. It becomes a political and polemical category allowing for a distinct segregation between ‘them’ and ‘we’. The concept explains ‘why we are civilized and they are (...) barbarian’ . Therefore we must ask ourselves how tolerance can be saved. (shrink)

I. The Seduction of Immanence The vocabulary of humanism—in which concepts such as “man,” “humane,” and “humanity” figure prominently—has always been contentious. The sarcasm of the nineteenth-century Catholic conservative thinker Joseph de Maistre with regard to the abstraction-tainted works of revolutionary thinkers, has become famous: “In my life I have met Frenchmen, Italians, and Russians, but Man, I solemnly declare, I have never met before; perhaps he exists, but not to my personal knowledge.”1These concepts acquire a practical, political, and even (...) polemical meaning when acted upon in the name of man, human rights, and finally humanity against “inhuman” practices…. (shrink)

There are two basic positions where tolerance as political strategy and moral viewpoint is rejected or made redundant. We are hostile to tolerance when we hold that we are defending an objective truth—religious or secular—which should also be defended and maintained by means of political and legal power. And tolerance become superfluous also when the affirmation of plurality becomes total, and tolerance identical to a vive la difference. As recent developments in my own country—the Netherlands—have demonstrated, the political outcome of (...) this last position is remarkably enough not necessarily an all-inclusive relativistic tolerance. It may just as well be one of intolerance towards ‘believers’ of all kinds, in short: tolerance becomes polemical and belligerent. Turning to religious fundamentalism or ultra-orthodoxy could then become a possible reaction to this relativistic and subjectivist position, as demonstrated in Isaac Bashevis Singer’s novel The Penitent. Between these two positions of hostility or indifference towards tolerance, we can situate that democratic attitude which may rightly be called ‘tolerance’. As ethical position, the tolerant citizen accepts the democratic disjunction between my truth and the symmetrical justice between citizens. As political strategy, a tolerant democratic regime is based upon a political act of exclusion of what I will here call ‘political fundamentalism’. (shrink)

In this contribution, the author argues that there are in our European tradition two fundamental conceptions of politics since the French Revolution. We can call them the politics as the art of co-existence, and the politics of dénouement. Both conceptions also have a very different stance towards the traditional religions: for the first one mentioned freedom of religion is constitutive, for the second one religion must serve the state or can even be made redundant. Paradigmatic in this respect was the (...) communist treatment of religion as a relic of the past that will disappear when historic reason makes our society transparant . Here politics transforms in a quasi-eschatological political religion. In the twientieth century neo-marxist philosophers say farewell to this kind of politics and begin to rediscover religious inheritances and theological motives. Today two other positions towards religions are noticeable: the utilitaristic reductionist treatment of religion as a need , and ‘Enlightment fundamentalism’ which continues the rationalist communist conception of religion as a relic of the past. The author criticises both tendencies, and defends a ‘politics without dénouement’ which correspondents to a ‘religion without guarantee’. In closing the author argues that the recent populist politics either dream of a new alliance between religion and/or ‘culture’ and the state, or – in a strange inversion of the multicultural ideals of the nineties – promote a purely polemical identity against an ‘alien’ religion, i.c. Islam. Here the author claims that both tendencies fail to recognize the real nature of the new problems. (shrink)

In this contribution, the author argues that there are in our European tradition two fundamental conceptions of politics since the French Revolution. We can call them the politics as the art of co-existence, and the politics of dénouement. Both conceptions also have a very different stance towards the traditional religions: for the first one mentioned freedom of religion is constitutive, for the second one religion must serve the state or can even be made redundant. Paradigmatic in this respect was the (...) communist treatment of religion as a relic of the past that will disappear when historic reason makes our society transparant. Here politics transforms in a quasi-eschatological political religion. In the twientieth century neo-marxist philosophers say farewell to this kind of politics and begin to rediscover religious inheritances and theological motives. Today two other positions towards religions are noticeable: the utilitaristic reductionist treatment of religion as a need, and ‘Enlightment fundamentalism’ which continues the rationalist communist conception of religion as a relic of the past. The author criticises both tendencies, and defends a ‘politics without dénouement’ which correspondents to a ‘religion without guarantee’. In closing the author argues that the recent populist politics either dream of a new alliance between religion and/or ‘culture’ and the state, or – in a strange inversion of the multicultural ideals of the nineties – promote a purely polemical identity against an ‘alien’ religion, i.c. Islam. Here the author claims that both tendencies fail to recognize the real nature of the new problems. (shrink)

The Last Judgement, heaven, hell, purgatory, the wrathful God: today, these notions seem to belong to a remote past we have - thank goodness! - left behind. The more remarkable is that, today, prisoners sometimes refer to the representation of God as Judge, as in the proposition ‘Only God can judge me’ you can find as graffito on a cell wall, or tattooed on the body of an inmate. Is this statement born from defiance of the constitutional state, from fundamentalism, (...) or from the fiction of an all-forgiving God? Nowadays, we, modern democrats, have a suspicion towards criminals and fanatics who seem to think that they can get away with an Only God can judge me. Much more common today is the reversal: not a judging God but people assuming judgement over God and over those who persist in referring to God. But the tradition of the ‘theodicee’ shows that this reversed movement of man judging God is not in the least a gesture limited to those outside the religions. In a theodicee, man summons God to appear in front of an imaginary tribunal, only for God to be defended and subsequently acquitted. As Odo Marquard argues, the modern problem of the theodicee – bringing into question God’s justice – in the end favoured atheism. Human autonomy which exonerates God by eliminating him, would imply something like an ‘atheism ad maiorem Dei gloriam’. But when humankind becomes responsible for the creation of its own history, God can no longer be summoned to any tribunal. Now only man can be summoned, and more particularly: humans which may be held accountable for the persistence of evil, responsible for our enduring discontent, obstacles of human progress or annoying remnants of the past. Here we find the beginning of the secularization of the Last Judgement. As Peter Sloterdijk argues, the vindictive God who judges and punishes at the end on times is succeeded by revolutionary groups from the nineteenth century onwards. These not only transform feelings of humiliated anger and powerlessness into those of pride and hope, but also into an effective force of revenge. In short, the theological constellation of rage and eternity has been succeeded by a political-psychological constellation of rage and history. Our representative democracy can be seen as an answer to the dangerous modern tendency to ‘tribunalising’ , because conditions of division and conflict are regarded as normal and lasting, and not as Fremdkörper or indicative of pathology. The Last Judgement becomes indefinitely suspended. However, a certain kind of ‘populism’ holds that unity and homogeneity can very well be made visible and audible’; and nowadays this seems to be accompanied by the longing to give evil, thus a form of negative transcendence, a face and parade it in front of the tribunal of the people. For prisoners, this is bad news. Against its background, the Only God can judge me may yet well up from a different source than that which I had suggested at the beginning of my argument. (shrink)

For Gianni Vattimo in his essay Belief , the widespread modern conviction that the longing for lucidity and religiosity are irreconcilable has today become questionable. In this article the author first discusses an actual instance of the philosophical yearning for lucidity, namely ‘cognitive melancholy'. This melancholia already appears in the sociologist Max Weber's diagnoses of the ‘disenchantment of the world' and of the separation of faith and kwowledge. The author sharpens somewhat further the dualism to which Weber pointed, and relates (...) it to Vattimo's attempt at softenung this dualism – of even abrogating it altogether by reconciling Christian religion with modernity. Some critical observations with regard of this attempt evoke the question of whether philosophical lucidity should not be pursued further than Vattimo does. In consequence of this the radical thrust of the Christian religion to which Vattimo claims to be returning can be percieved more clearly. (shrink)

Can gene editing and agroecology be complementary? Various formulations of this question now animate debates over the future of food systems, including in the UN Committee on World Food Security and at the UN Food Systems Summit. Previous analyses have discussed the risks of gene editing for agroecosystems, smallholders, and the concentration of wealth by and for agro-industry. This paper takes a different approach, unpacking the epistemic, socioeconomic, and ontological politics inherent in complementarity. I ask: How is complementarity understood? Who (...) is asking and defining this question? What are the politics of entertaining the debate at all? I sketch the epistemic foundations of science and technology that organize different notions of evidence used in agroecology and genetic engineering. On this base, I offer 8 angles on the compatibility question, exploring the historical contradictions that complementarity discourses reveal and the contemporary work they do. I work through questions of technological neutrality, “root cause” problems, working with nature, encoding racism, and dilemmas of ownership and access. These questions, I argue, require a reckoning with ontologies of coloniality-modernity, which help us get underneath—and beyond—the complementarity question. Finally, I offer a framework for thinking about and working toward technology sovereignty. (shrink)

Narratives of seed ‘loss’ and ‘persistence’ remain at loggerheads. Crop genetic diversity is rapidly eroding worldwide, we are told, and numerous studies support this claim. Other data, however, suggests an alternative storyline: far from disappearing, seed diversity persists around the world, resisting the homogenizing forces of modern capitalism. Which of these accounts is closer to the truth? As it turns out, crop biodiversity is more easily invoked than measured, more easily wielded than understood. In this essay, I contend that the (...) impasse reveals an error in the asking. We must, instead, look to the ontological, epistemic, and narrative dimensions of agrobiodiversity—and to the science, politics, and cultures of each. How is diversity empirically defined and measured? Who creates and categorizes diversity? Who does not? How is such knowledge mobilized in the accounts and narratives of different interest groups? Where, when, and why does a narrative hold true? This multi-dimensional view of agrobiodiversity makes space for a greater understanding of how diversity is created, maintained, and renewed. It suggests policy and institutional support for systems that engender such renewal of diversity, both in and ex situ. (shrink)

It has been argued that organizational structures (the way tasks are defined, allocated, and coordinated) can influence moral agency in organizations. In particular, low values on different structural parameters (functional concentration, specialization, separation, and formalization) are said to foster an organizational context (allowing for relating to the goals and output of the organization, moral deliberation, and social connectedness) that is conducive to moral agency. In this paper, we investigate the relation between the organizational structure and moral agency in the case (...) of a.s.r. (a large Dutch insurance company). While our empirical results fit the thesis that low values on structural parameters positively relate to moral agency, they also refine our understanding of the influence of structural parameters. In particular, our data suggest that the influence of functional concentration not only depends on whether it is low, but also on the type of criterion used for identifying business units; they suggest that the specific organizational context may put a limit to lowering design parameters and points at several non-structural factors that have an influence on the relation between structure and moral agency. In all, the paper contributes to a more detailed understanding of the conditions conducive to moral agency in organizations. (shrink)

This paper proposes a novel measure of civic norm compliance. We combine the literature on norm compliance from institutional economics and social philosophy. Institutional economics draws on survey data to measure civic norms, whereas social philosophy offers a theoretical framework that proves fruitful when used to operationalize civic norms. This paper shows that significantly different results emerge when the operationalization of civic norms in institutional economics draws on the theoretical framework that social philosophy offers. Furthermore, this study is relevant for (...) social philosophy too, as it shows the potential of survey data as a test-bed for philosophical theories of norm compliance. (shrink)

Live streaming platforms such as Twitch that facilitate participatory online communities have become an integral part of game culture. Users of these platforms are predominantly teenagers and young adults, who increasingly spend time socializing online rather than offline. This shift to online behavior can be a double-edged sword when coping with difficult periods in life such as relationship issues, the death of a loved one, or job loss. On the one hand, platforms such as Twitch offer pleasure, distraction, and relatedness (...) with others to help with coping, and the increased sense of anonymity and control could stimulate self-disclosure. However, the prevalence of trolling and memes may also discourage people from opening up, and relationships that are built online—especially those with microcelebrity streamers—could be perceived as more meaningful than they actually are. To create a deeper understanding of Twitch as a new media platform embedded in game culture, and how users perceive its potential as a coping mechanism, we have conducted a first exploration by means of a survey. The questions focused on general Twitch behavior, the difficult period in life, and the role of Twitch during this period. It was distributed online among people who considered themselves active Twitch users, and who had gone through a difficult period. Eighty-four participants completed the entire survey. The majority of participants indicated that Twitch helped them cope, and that it became a larger part of their lives during the difficult period compared to regular viewing. Recurring themes were the entertainment, distraction, and sense of community Twitch offers. Viewing behavior during difficult periods appears to remain largely the same in terms of the streamers that are watched, although time spent viewing increases, and there is a change toward more time spent actively watching rather than having the stream on in the background. With this work, we aim to create a deeper understanding of Twitch as a platform, and its importance for gamers that are going through difficult periods in life. (shrink)

The dominant view of the ventral and dorsal visual systems is that they subserve perception and action. De Wit, Van der Kamp, and Masters suggested that a more fundamental distinction might exist between the nature of information exploited by the systems. The present study distinguished between these accounts by asking participants to perform delayed matching , pointing and perceptual judgment responses to masked Müller–Lyer stimuli of varying length. Matching and pointing responses of participants who could not perceptually judge stimulus length (...) at brief durations remained sensitive to veridical stimulus length , but not the illusion , which was effective at long durations. Distinct thresholds for egocentric and allocentric information pick up were thus evident irrespective of whether perception or action responses were required. It was concluded that the dorsal and ventral systems may be delineated fundamentally by fast egocentric- and slower allocentric information pick up, respectively. (shrink)

This book presents an analysis of how speakers of typologically diverse languages report present-time situations. It begins from the assumption that there is a restriction on the use of the present tense to report present-time dynamic/perfective situations, while with stative/imperfective situations there are no such alignment problems. Astrid De Wit brings together cross-linguistic observations from English, French, the English-based creole language Sranan, and various Slavic languages, and relates them to the same phenomenon, the 'present perfective paradox'. The proposed analysis is (...) founded on the assumption that there is an epistemic alignment constraint preventing the identification and reporting of events in their entirety at the time of speaking. This book discusses the various strategies that the aforementioned languages have developed to resolve this conceptual difficulty, and demonstrates that many of the features of their tense-aspect systems can be regarded as the result of this conflict resolution. It also offers cognitively plausible explanations for the conceptual structures underlying the interactions attested between tense and aspect. (shrink)

The environmental economic response to mainstream neo-classical economics’ disconnect from the natural world was to value external environmental costs and include those into decisions about human welfare. The ecological economic response, heavily influenced by systems ecology, brought the concept of ecological scale or carrying capacity, as a limit to human choice. The divisions between these two theories are not merely cosmetic as illustrated by the highpolitical stakes in recent economic and environmental debates. This article concerns itself specifically with the question (...) how Christian economists position themselves towards the unfolding ecological and economic crises. It is shown that the main positions taken in the policy debates on economy and ecology are closely mirrored in the broader Christian economic community, raising the question whether the Christian economic tradition does have anything particular to offer in response to the ecological and economic crises. We approach this question from two angles, first, reviewing the literature on an earlier debate by the Association of Christian Economists on what Christian economists should be doing and, second, reviewing the literature on the relationships between Christianity and environmental beliefs and behaviour. With reference to eco-theological literature on the varying theological views on the relationship between humanity and the rest of creation, and on different expectations of the eschaton, it is shown why such diverging positions are taken among Christian economists. Nevertheless, the objective reality of Jesus Christ demands a particular Christian ethics and behaviour, which in turn, kindles fertile questions for Christian economists in their practical engagement withthe economic and ecological sciences and with broader culture. (shrink)

The proposal that there is an illusion of conscious will has been supported by findings that priming of stimulus location in a task requiring judgements of action-authorship can enhance participants’ experience of agency. We attempted to replicate findings from the ‘Wheel of Fortune’ task [Aarts, H., Custers, R., & Wegner, D. M. . On the inference of personal authorship: enhancing experienced agency by priming effect information. Consciousness and Cognition, 14, 439–458]. We also examined participants’ performance on this task in relation (...) to self-reported passivity experiences and hallucination-proneness. We found a significant effect of priming, with primes being found to increase the experience of agency. An interaction between gender and priming was also found, with priming enhancing feelings of agency in women but not in men. There were no significant correlations between levels of self-reported passivity experiences or hallucination-proneness and participants’ susceptibility to the priming effect on ratings of agency. Implications of these findings are discussed with regard to a prominent model of passivity experiences. (shrink)

The challenges raised in this article are not with information theory per se, but the assumptions surrounding it. Neuroscience isn't sufficiently critical about the appropriate ‘receiver’ or ‘channel’, focuses on decoding ‘parts’, and often relies on a flawed ‘veridicality’ assumption. If these problematic assumptions were questioned, information theory could be better directed to help us understand how the brain works.

Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse events. (...) We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate (...) work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)