The Belgian health care system has a few features that may havecontributed to the rising costs of health care: patients' freechoice of physicians, large clinical freedom of physicians, essentiallya fee-for-service remuneration for medical specialists in which the feesare agreed between insurance funds and physicians. The increased medicalconsumption and costs have prompted the state and insurance companies totake measures that limit the professional autonomy of the physicians.Access to medical education, free until 1997, is now restricted. Themedical profession is organized in the (...) Order of Physicians that hasestablished a code of professional ethics that has moral but not legalforce. So far, there is no special legislation for thepatient–physician relationship, though laws on specific issueslike organ transplantation contain duties for physicians. In recentyears a debate is taking place on patients' rights, of which informedconsent is central and gaining importance in medico-legal publications.An analysis of (ethical and legal) regulations concerning thewithholding or withdrawal of treatment by physicians demonstrate thatthe profession still enjoys a large clinical autonomy, though duediscussion with the patient has become more explicitly required. Therespect for professional autonomy is not primarily due to any formalpower that the Order of Physicians would have, but is rather grounded inthe generally high quality of the patient–physician relationshipthat in ethical terms is considered essentially as a confidencerelationship rather than a contractual relationship. (shrink)

Bioethics has been in existence now for more than twenty years. Much has changed, however, since Van Rensselaer Potter2 first used the term bioethics in 1971. For Potter, bioethics was an applied science with its roots in the biological sciences and its orientation towards the betterment of human life. Today the concept is used in a different context. It has become the name given to the ethical research that has become necessary in light of the new possibilities created by revolutionary (...) developments in medical science. Generally speaking, bioethics is concerned with the beginning and the end of life. In a certain sense, however, this is merely a de facto definition which does not possess a great deal of internal logical consistency.If we attempt to reconstruct the incredibly rapid evolution of bioethics we quickly realize how the times were truly ripe for this new discipline to begin to mature. In a very short space of time bioethics was taken seriously in just about every University and medical centre the world over. There is no part of the world which has not organised a colloquium or developed a study programme or created a Centre for Biomedical Ethics. Yet this advance is hardly surprising if we consider the fact that there have been revolutionary developments in themedical world in the 1960’s which have made it necessary to engage in serious ethical reflection on the borderline questions of human life.From the start, bioethicists have concerned themselves primarily with ethical problems related to reproductive technology such as in vitro fertilization, medically assisted fertilization with donor gametes, pregnancy termination, and the status of the embryo. More recently, however, questions concerning the end of life have entered the bioethicist’s field of interest, e.g. ethical questions related to euthanasia and the problems surrounding the artificial nutrition and hydration of persistently vegetative patients. In the meantime, of course, bioethics has broadened its field of interest beyond questions related to the beginning and end of life. Serious ethical and juridical reflection has resulted from the problems surrounding organ transplantation, transplantation of brain tissue, and the problem of AIDS.With the many recent developments in genetics, the first applications of gene therapy, and the world-wide human genome research project bioethics is assured an exciting future. It is clear that the issues which grab the bioethicist’s attention are rather disparate. Moreover, we are now beginning to realize that a whole gamut of specific questions cannot be addressed unless the broader context of the ethics of health care in general is taken into account. Such a realization has led to something of a new movement within the bioethical sphere which is interested in widening the notion of ‘medical ethics’ or ‘ethics of health’.The purpose of this article is to help familiarize the reader with the world of bioethics. Such a task is both simple and complex; bioethics has become a house with many rooms, a house, furthermore, which is being constantly renovated and rebuilt. By way of introduction, we shall take an investigative and evaluative stroll through the broad landscape bioethics has traced in the first twenty years of its existence. (shrink)

Bioethics has been in existence now for more than twenty years. Much has changed, however, since Van Rensselaer Potter2 first used the term bioethics in 1971. For Potter, bioethics was an applied science with its roots in the biological sciences and its orientation towards the betterment of human life. Today the concept is used in a different context. It has become the name given to the ethical research that has become necessary in light of the new possibilities created by revolutionary (...) developments in medical science. Generally speaking, bioethics is concerned with the beginning and the end of life. In a certain sense, however, this is merely a de facto definition which does not possess a great deal of internal logical consistency.If we attempt to reconstruct the incredibly rapid evolution of bioethics we quickly realize how the times were truly ripe for this new discipline to begin to mature. In a very short space of time bioethics was taken seriously in just about every University and medical centre the world over. There is no part of the world which has not organised a colloquium or developed a study programme or created a Centre for Biomedical Ethics. Yet this advance is hardly surprising if we consider the fact that there have been revolutionary developments in themedical world in the 1960’s which have made it necessary to engage in serious ethical reflection on the borderline questions of human life.From the start, bioethicists have concerned themselves primarily with ethical problems related to reproductive technology such as in vitro fertilization, medically assisted fertilization with donor gametes, pregnancy termination, and the status of the embryo. More recently, however, questions concerning the end of life have entered the bioethicist’s field of interest, e.g. ethical questions related to euthanasia and the problems surrounding the artificial nutrition and hydration of persistently vegetative patients. In the meantime, of course, bioethics has broadened its field of interest beyond questions related to the beginning and end of life. Serious ethical and juridical reflection has resulted from the problems surrounding organ transplantation, transplantation of brain tissue, and the problem of AIDS.With the many recent developments in genetics, the first applications of gene therapy, and the world-wide human genome research project bioethics is assured an exciting future. It is clear that the issues which grab the bioethicist’s attention are rather disparate. Moreover, we are now beginning to realize that a whole gamut of specific questions cannot be addressed unless the broader context of the ethics of health care in general is taken into account. Such a realization has led to something of a new movement within the bioethical sphere which is interested in widening the notion of ‘medical ethics’ or ‘ethics of health’.The purpose of this article is to help familiarize the reader with the world of bioethics. Such a task is both simple and complex; bioethics has become a house with many rooms, a house, furthermore, which is being constantly renovated and rebuilt. By way of introduction, we shall take an investigative and evaluative stroll through the broad landscape bioethics has traced in the first twenty years of its existence. (shrink)

World Health Organization [WHO] -- Australia -- Belgium -- Bulgaria -- Canada -- [People's Republic of] China -- Czech Republic -- France -- Hellas [Greece] -- Hungary -- Ireland -- Israel -- Malaysia -- The Netherlands -- Nigeria -- Peru -- Poland -- Singapore -- South Africa -- Spain -- Sweden -- United Kingdom -- United States of America -- Uruguay.

BackgroundBalancing the rights and obligations of custodians and applicants in relation to access to biobanks is of utmost importance to guarantee trust and confidence. This study aimed to reveal which issues divide different stakeholders in an attempt to determine the rights and/or obligations held on human biological materials and data.MethodsTwenty-eight informants in the Benelux and Scandinavia were interviewed in order to capture the perspectives of experts and stakeholders in relation to the rights and obligations held by custodians and applicants with (...) respect to access to HBM and data.ResultsThere was no consensus among the informants on whether the custodian of a biobank should decide upon the scientific merits and the utility of an access request. Nearly all informants agreed that a new request or an amendment to the initial request has to be submitted when an applicant wants to use leftover HBM in a new or follow-up project. Several informants felt that it might be justified to charge higher access fees to external or industrial applicants that did not contribute to the collection of HBM and data. Most informants agreed that a custodian of a biobank could request the sharing and return of research results. It was furthermore argued that some of the benefits of research projects should be fed back into biobanks.ConclusionsThe interviews revealed a rather complex web of rights and obligations allocated to the custodian and the applicant in relation to access to HBM and data stored in biobanks. Some rights and obligations are negotiated on a case-by-case basis, while others are stipulated in access arrangements. We did find a consensus on the attribution of certain general rights to the custodians and the applicant. (shrink)

Balancing the rights and obligations of custodians and applicants in relation to access to biobanks is of utmost importance to guarantee trust and confidence. This study aimed to reveal which issues divide dif..

The discriminatory effects of categorizing psychiatric patients into competent and incompetent, have urged lawyers, philosophers and health care professionals to seek a functional approach to capacity assessment. Dutch and English law have produced some guidelines concerning this issue. So far, most legal systems under investigation have concentrated on alternatives for informed consent by the patient in case of mental incapacity, notably substitute decision-making, intervention of a judge and advance directives. It is hard to judge the way in which the law (...) may further adapt to a more functional assessment of capacity, because the nature of law shows that legal reforms usually take place only when new methods have been accepted by the field. This is not yet the case today. (shrink)

The combination of the issue of return of individual genetic results/incidental findings and paediatric biobanks is not much discussed in ethical literature. The traditional arguments pro and con return of such findings focus on principles such as respect for persons, autonomy and solidarity. Two dimensions have been distilled from the discussion on return of individual results in a genetic research context: the respect for a participant’s autonomy and the duty of the researcher. Concepts such as autonomy and solidarity do not (...) fit easily in the discussion when paediatric biobanks are concerned. Although parents may be allowed to enrol children in minimal risk genetic research on stored tissue samples, they should not be given the option to opt out of receiving important health information. Also, children have a right to an open future: parents do not have the right to access any genetic data that a biobank holds on their children. In this respect, the guidelines on genetic testing of minors are applicable. With regard to the duty of the researcher the question of whether researchers have a more stringent duty to return important health information when their research subjects are children is more difficult to answer. A researcher’s primary duty is to perform useful research, a policy to return individual results must not hamper this task. The fact that vulnerable children are concerned, is an additional factor that should be considered when a policy of returning results is laid down for a specific collection or research project. (shrink)

The participation of minors in clinical trials is essential to provide safe and effective medical care to children. Because few drugs have been tested in children, pediatricians are forced to prescribe medications off-label with uncertain efficacy and safety. In this article, we analyze how the enrollment of minors in clinical trials is negotiated within relationships of mutual trust between clinicians, minors, and their parents. After a brief description of the problems associated with involving minors in clinical research, we consider how (...) existing “relationships of trust” can be used as a place where the concerns of research subjects can be more fully discussed and addressed. Building on the tacit recognition of trust found in The European Clinical Trials Directive we make policy recommendations that allow for clearer, more ethically informed guidelines for enrolling minors in clinical research. (shrink)

The Database on Ethics Related Legislation and Guidelines was launched in March 2007 as the fourth database of the UNESCO Global Ethics Observatory system of databases in ethics of science and technology. The database offers a collection of legal instruments searchable by region, country, bioethical themes, legal categories and applicability to specific articles of the UNESCO Universal Declaration on Bioethics and Human Rights and International Declaration on Human Genetic Data. This paper discusses the background and rationale for the database and (...) its role as a consultative and comparative resource hub for the study of ethics related legal instruments across the world, with the purpose of informing and inspiring relevant stakeholders on the implementation of the principles contained within the UNESCO declarations on bioethics. (shrink)

This paper discusses the legal implications of setting up two new biobanks in Belgium. The first is hospital-based and will archive tissue from patients with haematologic cancer, whereas the second is linked to a general practice based morbidity registry and will involve storage of blood samples. To date, Belgium has no specific legislation that regulates storage of human tissue and related databases. Several issues concerning the protection of individuals with regard to the processing of personal medical data are discussed from (...) the existing privacy legislation. We will address the principle of consent (broad versus specific) and the type of data recorded (anonymous, encoded and identifiable) for both biobanks. (shrink)

This is the most comprehensive book ever published on philosophical methodology. A team of thirty-eight of the world's leading philosophers present original essays on various aspects of how philosophy should be and is done. The first part is devoted to broad traditions and approaches to philosophical methodology. The entries in the second part address topics in philosophical methodology, such as intuitions, conceptual analysis, and transcendental arguments. The third part of the book is devoted to essays about the interconnections between philosophy (...) and neighbouring fields, including those of mathematics, psychology, literature and film, and neuroscience. (shrink)

This article examines the methodology of a core branch of contemporary political theory or philosophy: “analytic” political theory. After distinguishing political theory from related fields, such as political science, moral philosophy, and legal theory, the article discusses the analysis of political concepts. It then turns to the notions of principles and theories, as distinct from concepts, and reviews the methods of assessing such principles and theories (e.g., the reflective-equilibrium method), for the purpose of justifying or criticizing them. Finally, it looks (...) at a recent debate on how abstract and idealized political theory should be, and assesses the significance of disagreement in political theory. The discussion is carried out from an angle inspired by the philosophy of science. (shrink)

This is an open access title available under the terms of a CC BY-NC-ND 4.0 International licence. It is free to read on Oxford Academic and offered as a free PDF download from OUP and selected open access locations. If we don't know what the words 'democracy' and 'democratic' mean, then we don't know what democracy is. This book defends a radical view: these words mean nothing and should be abandoned. The argument for Abolitionism is simple: those terms are defective (...) and we can easily do better, so let's get rid of them. According to the abolitionist, the switch to alternative devices would be a significant communicative, cognitive, and political advance. The first part of the book presents a general theory of abandonment: the conditions under which language should be abandoned. The rest of the book applies this general theory to the case of 'democracy' and 'democratic'. Cappelen shows that 'democracy' and 'democratic' are semantically, pragmatically, and communicatively defective. Abolitionism is not all gloom and doom. It also contains a message of good cheer: we have easy access to conceptual devices that are more effective than 'democracy'. We can do better. These alternative linguistic devices will enable us to ask better questions, provide genuinely fruitful answers, and have more rational discussions. Moreover, those questions and answers better articulate the communicative and cognitive aims of those who use empty terms like 'democracy' and 'democratic'. (shrink)

Herman Cappelen investigates how language and other representational devices can go wrong, and how to fix them. We use language to understand and talk about the world, but what if our language has deficiencies that prevent it from playing that role? How can we revise our concepts, and what are the limits on revision?

La vie, la mort, le sexe : ces trois thèmes n'ont cessé de hanter l'homme, cet étrange animal pensant. Peu de civilisations anciennes cependant ont développé, comme l'ont fait les Grecs 500 ans avant notre ère, des réflexions et des pratiques sociales aussi voisines des nôtres encore aujourd'hui. Ils ont été plus loin que quiconque dans l'élaboration d'une pensée qui s'interroge sur la place et le rôle de l'homme au sein de l'univers. Certes, les dieux sont omniprésents. Mais ce sont (...) des humains divinisés qui ne différent guère des mortels que par leur privilège de l'immortalité. Les Grecs ont anticipé comme personne nos questionnements, nos angoisses, nos passions, nos interrogations, nos rapports avec la vie, la nature, le temps, l'amour, la mort. Nous divergeons parfois, nous convergeons souvent, mais le plus fascinant est le dialogue qui ne cesse de s'établir avec eux depuis 2500 ans.--Page 4 of cover. (shrink)

Barbara Herman argues for a radical shift in the way we perceive Kant's ethics. She convincingly reinterprets the key texts, at once allowing Kant to mean what he says while showing that what Kant says makes good moral sense. She urges us to abandon the tradition that describes Kantian ethics as a deontology, a moral system of rules of duty. She finds the central idea of Kantian ethics not in duty but in practical rationality as a norm of unconditioned (...) goodness. This book both clarifies Kant's own theory and adds programmatic vitality to modern moral philosophy. (shrink)

This chapter contains sections titled: Introduction Nietzsche's Socio‐Physiology and the Question of Sovereignty Nietzsche versus Liberalism on Freedom and Resistance Freedom and Resistance in Nietzsche's Later Thought On the Necessity of Conflict for Freedom: Nietzsche's Critique of the Subject.

The standard view of philosophical methodology is that philosophers rely on intuitions as evidence. Herman Cappelen argues that this claim is false: it is not true that philosophers rely extensively on intuitions as evidence. At worst, analytic philosophers are guilty of engaging in somewhat irresponsible use of 'intuition'-vocabulary. While this irresponsibility has had little effect on first order philosophy, it has fundamentally misled meta-philosophers: it has encouraged meta-philosophical pseudo-problems and misleading pictures of what philosophy is.

Contemporary society needs the recognition of a moral middle ground, where human behavior can be evaluated as permissible, understandable, or even valuable. As a counterforce to polarization and divisive politics, an identity model is proposed in which individual and group identities are transcended by a human and ecological identity.

Excerpt from La Notion d'Espace Le probleme de l'espace que nous nous proposons de traiter forme une partie integrante de la cosmologie. Il a sa place tout indiquee dans cette etude cosmologique, intitulee: les causes constitutives du monde mineral. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format (...) whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

In our book The Inessential Indexical we argue that the various theses of essential indexicality all fail. Indexicals are not essential, we conclude. One essentiality thesis we target in the third chapter is the claim that indexical attitudes are essential for action. Our strategy is to give examples of what we call impersonal action rationalizations , which explain actions without citing indexical attitudes. To defeat the claim that indexical attitudes are essential for action, it suffices that there could be even (...) one successful impersonal action rationalization. In what follows we bolster our case against an essential connection between action and the de se (or indexicality), first by developing a range of new action models and secondly by responding to challenges from Dilip Ninan, Stephan Torre, and José Luis Bermúdez . (shrink)

This text contains contributions from two Kant conferences which took place in Leuven and Cerisy-la-Salle in 1993.

Cappelen and Hawthorne present a powerful critique of fashionable relativist accounts of truth, and the foundational ideas in semantics on which the new relativism draws. They argue compellingly that the contents of thought and talk are propositions that instantiate the fundamental monadic properties of truth and falsity.

_Insensitive Semantics_ is an overview of and contribution to the debates about how to accommodate context sensitivity within a theory of human communication, investigating the effects of context on communicative interaction and, as a corollary, what a context of utterance is and what it is to be in one. Provides detailed and wide-ranging overviews of the central positions and arguments surrounding contextualism Addresses broad and varied aspects of the distinction between the semantic and non-semantic content of language Defends a distinctive (...) and explanatorily powerful combination of semantic minimalism and speech act pluralism Confronts core problems which not only run to the heart of philosophy of language and linguistics, but which arise in epistemology, metaphysics, and moral philosophy as well. (shrink)

An introduction to the field of historical theory, incorporating examples from novels, paintings, music, and political debates and using text boxes to provide focus on key topics.

Includes chapters that address the selection of disciplines and thinkers that are grouped into: religious thought; individual thinkers in the narrative tradition, and two noteworthy themes in the area of business thought (specifically, management and organizational behaviour).

Nietzsche's strengths as a critic are widely acknowledged, but his peculiar style of critique is usually ignored as rhetoric, or dismissed as violent or simply incoherent. In this book, Nietzsche's concept of the agon or Wettkampf, a measured and productive form of conflict inspired by ancient Greek culture, is advanced as the dynamic and organising principle of his philosophical practice, enabling us to make sense of his critical confrontations and the much disputed concept of transvaluation or Umwertung. Agonal perspectives are (...) cast on a number of key problems in his thought across a broad range of texts. Topics and problems treated include: critical history and the need for a limit in the negation of the past; Nietzsche contra Socrates and the problem of closure; Nietzsche contra humanism and the problem of humanity; Nietzsche contra Kant on genius and legislation; the problem of self-legislation in relation to life and temporality; Nietzsche's sense of community in its articulation with law, and the normativity of taste; ressentiment and the question of therapy in Nietzsche and Freud; and the problem of total affirmation in relation to critique. (shrink)