Personal appearance and physical beauty are becoming increasingly important in our societies and, as a consequence, enter into the realm of medicine and health care. Adequate and just health care policies call for an understanding of this trend. The core question to be addressed concerns the very idea of beauty. In the following, a conceptual clarification is given in terms of beauty's meaning, value and function (i.e. beauty that is used instrumentally, and beauty that is attained). Furthermore, some relevant distinctions (...) are drawn between physical and artistic beauty, and physical beauty in a human sense. The core idea for this is formed by a Kantian notion of the beauty concept. It is argued that beauty judgements should be understood as relative to persons and their contexts. Physical beauty should be taken seriously when it is understood in this deeper sense of being related to the shaping of a person's identity. (shrink)

Arguments against directed altruistic living organ donation are too weak to justify a ban. Potential donors who want to specify the non-related person or group of persons to receive their donated kidney should be accepted. The arguments against, based on considerations of motivation, fairness and (non-)anonymity (e.g. those recently cited by an advisory report of the Dutch Health Council), are presented and discussed, as well as the Dutch Governments response. Whereas the Government argues that individuals have authority with regard to (...) the allocation of their organs, partial considerations have not been sufficiently explored. In addition, it is argued that partial relationships govern human life, are significant and should be valued highly. These relationships are at the core of accepted living kidney donation between relatives (family members, partners, friends). Respecting the particular act of living donation goes beyond respect for autonomy; it touches upon our personal and social identity. Donation, e.g. of a kidney, is not undertaken strictly for the benefit of the recipient, but also to meet the moral standards we wish to set for ourselves. This consideration, rooted in a view of moral identity, provides the basis for many forms of directed donation that are both partial and justified. If the importance of this is not recognized, social policies can be neither adequate nor effective. (shrink)

Living kidney donation provides a promising opportunity in situations where the scarcity of cadaveric kidneys is widely acknowledged. While many patients and their relatives are willing to accept its benefits, others are concerned about living kidney programs; they appear to feel pressured into accepting living kidney transplantations as the only proper option for them. As we studied the attitudes and views of patients and their relatives, we considered just how actively health care professionals should encourage living donation. We argue that (...) active interference in peoples’ personal lives is justified - if not obligatory. First, we address the ambiguous ideals of non-directivity and value neutrality in counselling. We describe the main pitfalls implied in these concepts, and conclude that these concepts cannot account for the complex reality of living donation and transplantation. We depict what is required instead as truthful information and context-relative counselling. We then consider professional interference into personal belief systems. We argue that individual convictions are not necessarily strong, stable, or deep. They may be flawed in many ways. In order to justify interference in peoples’ personal lives, it is crucial to understand the structure of these convictions. Evidence suggests that both patients and their relatives have attitudes towards living kidney donation that are often open to change and, accordingly, can be influenced. We show how ethical theories can account for this reality and can help us to discern between justified and unjustified interference. We refer to Stephen Toulmin’s model of the structure of logical argument, the Rawlsian model of reflective equilibrium, and Thomas Nagel’s representation of the particularistic position. (shrink)

There is an increasing interest in the possibility of using nudges to promote people's health. Following the advances in developmental biology and epigenetics, it is clear that one's health is not always the result of one's own choices. In the period surrounding pregnancy, maternal choice behaviour has a significant influence on perinatal morbidity and mortality as well as the development of chronic diseases later in life. One's health is thus a matter of one's own as well as one's maternal choices. (...) Therefore, self-regarding and other-regarding nudges should be considered as viable strategies to promote health. In this article, we introduce the concept of other-regarding nudges. We use the harm principle and the principle of beneficence to justify these other-regarding nudges. We conclude by stressing the importance of a fair assessment of expectations towards the nudgee, when determining whether a nudge is aimed at preventing harm or promoting a good. (shrink)

Retractions solicited by authors following the discovery of an unintentional error—what we henceforth call a “self-retraction”—are a new phenomenon of growing importance, about which very little is known. Here we present results of a small qualitative study aimed at gaining preliminary insights about circumstances, motivations and beliefs that accompanied the experience of a self-retraction. We identified retraction notes that unambiguously reported an honest error and that had been published between the years 2010 and 2015. We limited our sample to retractions (...) with at least one co-author based in the Netherlands, Belgium, United Kingdom, Germany or a Scandinavian country, and we invited these authors to a semi-structured interview. Fourteen authors accepted our invitation. Contrary to our initial assumptions, most of our interviewees had not originally intended to retract their paper. They had contacted the journal to request a correction and the decision to retract had been made by journal editors. All interviewees reported that having to retract their own publication made them concerned for their scientific reputation and career, often causing considerable stress and anxiety. Interviewees also encountered difficulties in communicating with the journal and recalled other procedural issues that had unnecessarily slowed down the process of self-retraction. Intriguingly, however, all interviewees reported how, contrary to their own expectations, the self-retraction had brought no damage to their reputation and in some cases had actually improved it. We also examined the ethical motivations that interviewees ascribed, retrospectively, to their actions and found that such motivations included a combination of moral and prudential considerations. These preliminary results suggest that scientists would welcome innovations to facilitate the process of self-retraction. (shrink)

Cadaveric transplantation and living transplantation exist side by side. Both practices help to alleviate organ need. They provide us with two separate moral schemes. Is it rational to keep them apart? The cadaveric system is organised along strict, impartial lines, while the living system is inherently partial and local. The ethical justification for this partial scheme seems to be that it merely supplements the cadaveric scheme: partial transplants do not come at the expense of cadaveric impartiality, but in fact significantly (...) reduce the waiting time for patients on the list for a cadaveric transplant.This seemingly peaceful coexistence is challenged by new initiatives, among them living donation list exchange, and also the LifeSharers initiative, leading to practices that undermine cadaveric impartiality. Should we bemoan this fact, or should we move on towards a new balance in the relationship between cadaveric and living transplantation practices, towards a new moral weighing of impartial and partial values? I argue, against the background of a rapid growth of living donations, that we have good, ethical reasons—not only utilitarian ones—for giving the value of partiality a more prominent place in our policies. (shrink)

It is within the context of a person’s lifestory, we argue, that the idea of wearing aprosthesis assumes place and meaning. Todevelop this argument, a brightly colored hookprosthesis for children is taken as a startingpoint for reflection. The prosthesis can beseen as fitting this person perfectly, when thebodily difference is understood as positivelyadding to this person’s identity. The choicefor the prosthesis is normative in a moralsense, in that it is grounded in a person’sfundamental convictions with respect to hisbeing and living. (...) This understanding of ‘howto live’ can best be grasped – as is suggested– in contrastive terms of ‘sameness’ and‘otherness’. Striving for conformity andsimilarity would do no justice to theexperiences and ideals of unique persons, andwould come at great cost. Moreover, society isnot benefited by persons who merely conform,who copy and imitate others, but by those whowillfully live up to their own unique standards. (shrink)

Cadaveric transplantation and living transplantation exist side by side. Both practices help to alleviate organ need. They provide us with two separate moral schemes. Is it rational to keep them apart? The cadaveric system is organised along strict, impartial lines, while the living system is inherently partial and local. The ethical justification for this partial scheme seems to be that it merely supplements the cadaveric scheme: partial transplants do not come at the expense of cadaveric impartiality, but in fact significantly (...) reduce the waiting time for patients on the list for a cadaveric transplant.This seemingly peaceful coexistence is challenged by new initiatives, among them living donation list exchange, and also the LifeSharers initiative, leading to practices that undermine cadaveric impartiality. Should we bemoan this fact, or should we move on towards a new balance in the relationship between cadaveric and living transplantation practices, towards a new moral weighing of impartial and partial values? I argue, against the background of a rapid growth of living donations, that we have good, ethical reasons—not only utilitarian ones—for giving the value of partiality a more prominent place in our policies. (shrink)

To explore whether market reforms in a health care system affect medical professional ethics of hospital-based specialists on the one hand and physicians in independent practices on the other. Qualitative interviews with 27 surgeons and 28 general practitioners in The Netherlands, held 2–3 years after a major overhaul of the Dutch health care system involving several market reforms. Surgeons now regularly advertise their work (while this was forbidden in the past) and pay more attention to patients with relatively minor afflictions, (...) thus deviating from codes of ethics that oblige physicians to treat each other as brothers and to treat patients according to medical need. Dutch GPs have abandoned their traditional reticence and their fear of medicalization. They now seem to treat more in accordance with patients’ preferences and less in accordance with medical need. Market reforms do affect medical professional principles, and it is doubtful whether these changes were intended when Dutch policy makers decided to introduce market elements in the health care system. Policy makers in other countries considering similar reforms should pay attention to these results. (shrink)

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

Climate dynamics and trends have significant environmental and socioeconomic impacts; however, in the Benin Republic, they are generally studied with diverse statistical methods ignoring the nonstationarity, nonlinearity, and self-similarity characteristics contained in precipitation time series. This can lead to erroneous conclusions and an unclear understanding of climatic dynamics. Based on daily precipitation data observed in the six synoptic stations of Benin Republic, in the period from 1951 to 2010, we have proposed determining the local trends of precipitations, investigating precipitation nonlinear (...) dynamics, and assessing climatic shift in the study period by Ensemble Empirical Mode Decomposition and Multifractal Detrended Fluctuation Analysis method. To overcome the detrending issue in the standard MFDFA method, the EEMD algorithm is embedded into the MFDFA. The study period is subdivided into three subperiods: 1951–1970, 1971–1990, and 1991–2010. Intrinsic Mode Functions are obtained according to the climatic region in which the stations are located. Results show that precipitation variation is significantly governed by the five first IMFs, in which oscillation periods vary from 1 to 25 days. The trend curves decrease at all the synoptic stations, and their slope values vary accordingly to the subperiods. Referring to the values of the multifractal spectrum parameters, α 0, and the width of the spectrum w, consistent changes are observed regardless of the subperiods and the concerned stations. The spatial and temporal variability of precipitation indicates that the multifractal properties are good indicators for assessing changes in precipitation dynamics, and the changes in their features could be explained by the global change than by the local climate variation. Despite the observed differences in multifractal spectra properties from the three subperiods, it is not possible to verify the subdivision of 1951–2010 in three subperiods as it is done by previous studies in West Africa. Our findings can be used in the validation of global and regional climate models since a valid model should explain empirically detected scaling properties in observed data. (shrink)

There are barriers of perception between Sudanese Muslims for whom the sharia is a source of authority and identity and others who see it as an oppressive means of dominating Sudan's minority populations. I make a distinction between process and substance in law, and show that a flawed process has contributed to a perception of international law as an instrument of powerful states, which has obscured its legislative and procedural usefulness to the Sudan as a member of the United Nations. (...) Similarly a distortion of due process in Sudan's sharia has created a substance derived from the legacy of medieval Arabia rather than applied legal methodology. One consequence of this is that Sudan's Civil Wars have been given the attributes of offensive jihad against its diverse non-Muslim populations. I argue that offensive jihad was a legal construction designed to meet the challenges of medieval Arab society, with little basis in the fundamental sources of Islamic law or in contemporary legal methodology. I advocate a return to due process as a partial solution to the impasse between Muslim and non-Muslim identities in the Sudan, and show how international law can be improved by accommodating other legal traditions. (shrink)

Society in the 21st century is in many ways different from society in the 1950s, the 1960s or the 1970s. Two of the most important changes relate to the level of education in the population and the balance between work and private life. These days a large percentage of people are highly educated. Partly as a result of economic progress in the 1950s and the 1960s and partly due to the fact that many women entered the labour force, people started (...) searching for ways to combine their career with family obligations and a private life (including hobbies, outings and holidays). Medical professional ethics, more specifically: professional attitudes towards patients and colleagues, is influenced by developments such as these, but how much and in what way? It was assumed that surgery ethics would be more robust, resistant to change and that general practitioner (GP) ethics would change more readily in response to a changing society, because surgeons perform technical work in operating theatres in hospitals whereas GPs have their offices in the midst of society. The journals of Dutch surgeons and GPs from the 1950s onwards were studied so as to detect traces of change in medical professional ethics in The Netherlands. GP ethics turned out to be malleable compared with surgery ethics. In fact, GP medicine proved to be an agent of change rather than merely responding to it, both with regard to the changing role of patients and with regard to the changing work life balance. (shrink)

Some philosophers have thought that life could only be meaningful if there is no God. For Sartre and Nagel, for example, a God of the traditional classical theistic sort would constrain our powers of self-creative autonomy in ways that would severely detract from the meaning of our lives, possibly even evacuate our lives of all meaning. Some philosophers, by contrast, have thought that life could only be meaningful if there is a God. God and the Meanings of Life is interested (...) in exploring the truth in both these schools of thought, seeking to discover what God could and couldn't do to make life meaningful (as well as what he would and wouldn't do). Mawson espouses a version of the 'amalgam' or 'pluralism' thesis about the issue of life's meaning – in essence, that there are a number of different legitimate meanings of 'meaning' (and indeed 'life') in the question of life's meaning. According to Mawson, God, were he to exist, would help make life meaningful in some of these senses and hinder in some others. He argues that whilst there could be meaning in a Godless universe, there could be other sorts of meaning in a Godly one and that these would be deeper. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and argues (...) that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

This paper critically evaluates the transition from crisis to development in northern Uganda from the perspective of agricultural service provision. It contributes to debates on how efforts to link relief to rehabilitation and development may bypass the underlying challenges in linking humanitarian aid to prevailing national development policies and structures. This paper is based on research into agricultural services undertaken in Pader district, northern Uganda, between 2010 and 2012. It studied the interplay between humanitarian interventions and the parallel development of (...) the government’s agricultural departments and services in northern Uganda. The article brings out how Ugandan agricultural policies do not suit the post-conflict realities of northern Uganda. The evolving policies affect power relations and processes of inclusion and exclusion in northern Uganda. As a result, at the time that the government is ready to integrate northern Uganda into the mainstream development of agricultural policy, the gap between addressing humanitarian needs and development has become larger. (shrink)

How do we think about animals? How do we decide what they deserve and how we ought to treat them? Subhuman takes an interdisciplinary approach to these questions, drawing from research in philosophy, neuroscience, psychology, law, history, sociology, economics, and anthropology. Subhuman argues that our attitudes to nonhuman animals, both positive and negative, largely arise from our need to compare ourselves to them.

Exegesis, with text, on the Nyāyasūtra of Gautama, basic aphoristic text of Nyāya.

Kit Fine (2000) breaks with tradition, arguing that, pace Russell (e.g., 1903: 228), relations have neither directions nor converses. He considers two ways to conceive of these new "neutral" relations, positionalism and anti-positionalism, and argues that the latter should be preferred to the former. Cody Gilmore (2013) argues for a generalization of positionalism, slot theory, the view that a property or relation is n-adic if and only if there are exactly n slots in it, and (very roughly) that each slot (...) may be occupied by at most one entity. Slot theory (and with it, positionalism) bears the full brunt of Fine's (2000) symmetric completions and conflicting adicities problems. I fully develop an alternative, plural slot theory (or pocket theory), which avoids these problems, key elements of which are first considered by Yi (1999: 168 ff.). Like the slot theorist, the pocket theorist posits entities (pockets) in properties and relations that can be occupied. But unlike the slot theorist, the pocket theorist denies that at most one entity can occupy any one of them. As a result, she must also deny that the adicity of a property or relation is equal to the number of occupiable entities in it. By abandoning these theses, however, the pocket theorist is able to avoid Fine's problems, resulting in a stronger theory about the internal structure of properties and relations. Pocket theory also avoids a serious drawback of anti-positionalism. (shrink)

_Purpose._ This paper aims to investigate the phenomenon of a human being within the Confucian tradition as well as its interpretations from intercultural perspective. _Theoretical basis._ One of the ways to understand the deepest level of the intercultural dialogue is to reveal the interpretations of a human being in philosophical traditions, since they refer to the formation of personality and identity within a given culture including interpersonal, intergroup, and intercultural relations. Humanism based on the unity of Human and Heaven runs (...) like a red thread through the philosophical teachings of Confucius, Mencius, Xunzi, Zhu Xi, Wang Yangming defining the ideas of human nature, his/her duties, his/her place and roles in society that shaped the Chinese mentality. _Originality._ Quite often, Chinese concepts (for example, human dignity beyond the ideas of democracy and mass political participation, guanxi, mianzi) are incomprehensible to the representatives of the Western civilization, which leads to the challenges in intercultural communication. The interpretation of these ideas in the context of Confucianism allows to understand them from the perspective of Others and expand the set of patterns of cultural perception. This ultimately leads to the awareness that there are many social, political, cultural realities, which we perceive through the lens of our own concepts and attitudes. The participants of an intercultural dialogue realize that each of them has a unique experience, own way of posing a problem and resolving it, and no one is better or worse. _Conclusions._ Confucian philosophy shaped the worldview of Chinese people, defined values, goals, meanings, attitudes, communication models, which affected all spheres of Chinese life and culture. The study of the philosophical heritage of the great Chinese civilization enhances the cultural competence of the intercultural communicators and expands the field of dialogue to the level of global communication. (shrink)