Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Physics is the most fundamental of the sciences and its main purpose is to explain how the world works on the smallest as well as the largest scales. This book outlines the most important discoveries and technical development in the field of physics during the past two decades. The reader will learn the basics of the major theories that form the backbone of the current understanding of the universe through descriptions of the latest findings in particle physics, quantum optics, structure (...) of matter or astrophysics. The book also explains how devices such as lasers or particle accelerators work. (shrink)

In the debate surrounding the introduction of non-invasive prenatal testing in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: informed choice, freedom to choose and consequences for (...) people with a disability. Three of the strongest arguments raised under the flag of routinisation are assessed for their validity: the threat that NIPT poses to informed choice, the potential increase in uptake of first-trimester prenatal screening and its consequences for social pressure to participate in screening or terminate affected pregnancies, and the negative consequences for disabled people. These routinisation arguments lack empirical or normative ground. However, the results of this analysis do not imply that no attention should be paid to possible problems surrounding the introduction of NIPT. At least two problems remain and should be addressed: there should be an ongoing debate about the requirements of informed choice, particularly related to an expanded scope of prenatal screening. Also, reproductive autonomy can only be achieved when expecting parents’ options are variegated, real and valuable, so that they can continue to choose whether or not to screen or to terminate a pregnancy. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . This theoretical (...) framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This theoretical framework (...) prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Der Beitrag perspektiviert das Verhältnis von Werk und Wissenschaften auf zwei­ fache Weise: zum einen nimmt er das künstlerische Werk als ›Gegenstand‹ der Wissenschaften in den Blick. Ausgehend von Werkausgaben wird gezeigt, dass und inwiefern die Literaturwissenschaft im Rahmen der Editionspraxis maßgeblich an der Konstitution ihrer primären Forschungsgegenstände beteiligt ist. Zum anderen werden Werke als ›Medien‹ der Wissenschaften untersucht. Dabei wird nach den Implikationen des Werkstatus von Forschungsarbeiten für die wissenschaftliche Praxis gefragt. Neben der Kategorie des wissenschaftlichen Œuvres werden dazu (...) spezifische Werktypen (Standardwerke, Dissertations­ und Habilitationsschriften) untersucht und auch die medialen Rahmenbedingungen von wissenschaftlichen Werken reflektiert. Aus dieser Doppelperspektive erweist sich die Kategorie des Werks als aufschlussreicher Bezugspunkt für die Untersuchung von disziplinspezifischen und disziplinübergreifenden Wissenschaftspraktiken. (shrink)

Asking pregnant women to pay for non-invasive prenatal testing out of pocket leads to unequal access across socioeconomic strata. To avoid these social justice issues, first-trimester prenatal screening should be publicly funded in countries such as the Netherlands, with universal coverage healthcare systems that offer all other antenatal care services and screening programmes free of charge. In this reply, we offer three additional reasons for public funding of NIPT. First, NIPT may not primarily have medical utility for women and children, (...) but rather offers relevant information and reproductive options, and thus serves important autonomy interests of women. Second, public funding of NIPT can be justified because it results in a reduction of collectively borne costs associated with care and support for children with chromosomal abnormalities. It is important to note that this is not an argument for individual women to take part in screening or to terminate an affected pregnancy. However, it is a legitimate argument in policy making regarding funding arrangements for screening programmes. Finally, public funding would help to amend current misunderstandings among pregnant women, and thus to support informed consent for first-trimester prenatal screening. (shrink)

Edmund Gettier is Professor Emeritus at the University of Massachusetts, Amherst. This short piece, published in 1963, seemed to many decisively to refute an otherwise attractive analysis of knowledge. It stimulated a renewed effort, still ongoing, to clarify exactly what knowledge comprises.

This new edition of the classic Contemporary Theories of Knowledge has been significantly updated to include analyses of the recent literature in epistemology.

This edited volume represents a unique addition to the available literature on animal ethics, animal studies, and neuroethics. Its goal is to expand discussions on animal ethics and neuroethics by weaving together different threads: philosophy of mind and animal minds, neuroscientific study of animal minds, and animal ethics. Neuroethical questions concerning animals’ moral status, animal minds and consciousness, animal pain, and the adequacy of animal models for neuropsychiatric disease have long been topics of debate in philosophy and ethics, and more (...) recently also in neuroscientific research. The book presents a transdisciplinary blend of voices, underscoring different perspectives on the broad questions of how neuroscience can contribute to our understanding of nonhuman minds, and on debates over the moral status of nonhuman animals. All chapters were written by outstanding scholars in philosophy, neuroscience, animal behavior, biology, neuroethics, and bioethics, and cover a range of issues and species/taxa. Given its scope, the book will appeal to scientists and students interested in the debate on animal ethics, while also offering an important resource for future researchers. Chapter 13 of this book is available open access under a CC BY 4.0 license at link.springer.com. (shrink)

Excerpt from Der Echte: Und der Xenophontische Sokrates Der xen0phontische Sokrates selbst wieder zwang, die Fuh rung der Untersuchung weit mehr, als bisher geschehen, zu ver breitem. Die Memorabilien sind das Gegentheil eines selbst herrlichen Kunstwerks, weisen an allen Ecken und Enden uber sich hinaus, stehen als ein schwaches Glied in der Kette der sokratischen Literatur und zunachst in der der xenophontischen Schriften. Es galt, sie zunachst als solches zu begreifen und das volle Licht der Parallelen bei Xenophon auf sie (...) einwirken zu lassen. Dabei enthullten sich die Mem. Oft nur als durftiger Abklatsch anderer xenophontischen Schriften, von denen sie erst die farbige Beleuchtung, die Erklarung ihrer Motive, die Auf hellung ihrer Ordnung erhalten. So ward nun moglichst psycho logisch aus Xenophon erklart, was sich aus ihm erklaren liess. Indessen fur die Hauptsache, das Philosophische, stellte Xeno phon's notorische Unselbstandigkeit neue Fragen und Aufgaben, und hier ergab nun eine weitschichtige Vergleichung seine fast vollige philosophische Abhangigkeit im Ganzen wie im Einzelnen vom Kynismus, die in Grad und Art und plausiblen Motiven genau der Abhangigkeit der romischen Praktiker von den stoischen Nachfolgern der Kyniker_ entspricht. Nicht nur die Memorabilien, auch die andern Socratica Xenophon's, sowie vor Allem Cyropadie Hiero Agesilaus, de rep. Lac. Prolog und Epilog des Oynegeticus offenbarten sich mehr und mehr als durchaus kynisirende Schriften, und auch hier liegt dem Verf. 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)

First published in 1995. Routledge is an imprint of Taylor & Francis, an informa company.

Ingthorsson, McTaggart’s Paradox and the R-theory of Time L. Nathan Oaklander University of Michigan-Flint, USA [email protected] his provocative book, McTaggart’s Paradox, R.D. Ingthors- son argues that McTaggart’s argument for the unreality of time rests on the principle of temporal parity according to which all times or events in time exist equally or co-exist in a sense that is compatible with their being successive. Moreover, since temporal parity is also an essential tenet of the B-theory, McTaggart’s argument against the reality of (...) time can also be used to undermine the B-theory. Ingthorsson argues further that only by adopting an ontologically frugal presentist metaphysics can one avoid McTaggart’s paradox and account for identity through time and change. The aim of this paper is to clarify Russell’s authentic view of time in con- trast to the B-theory which is McTaggart’s misrepresentation of Russell and argue that temporal parity it is not a fundamental tenet of the Rus- sellian theory. For that reason, the R-theory is immune to objections that are based on temporal parity. I shall then offer my own interpretation of McTaggart’s paradox that renders Ingthorsson’s version of presentism subject to it. (shrink)

Zagadochnyĭ starik.--T︠S︡iolkovskiĭ v Peterburge.