Next SectionObjective The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. Methods This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Findings Most respondents see a (...) need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. Conclusion There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice. (shrink)

In previous literature, ethicists mention several goals of Clinical Ethics Support (CES). It is unknown what key persons in healthcare institutions see as main–—and sub-goals of CES. This article presents the goals of CES as perceived by board members and members of ethics support staff. This is part of a Dutch national research using a mixed methods design with questionnaires, focus groups and interviews. Quantitative and qualitative data were analyzed and combined in an iterative process. Four main clusters of goals (...) were found: 1) encouraging an ethical climate, 2) fostering an accountable and transparent organization, 3) developing professionalism and a final goal, overarching the previous three, 4) good care. Most important sub-goals of CES were: attention for ethical issues, raising awareness of ethical issues, fostering ethical reflection and supporting employees. The article ends with a discussion on the desirability to further operationalize the general goal of good care, the context-boundedness of our findings and the need to relate goals of CES to the features of organizational cultures to further improve the integration of CES in healthcare institutions. (shrink)

The attention for Moral case deliberation has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this paper is to provide an overview of the state of the art concerning MCD in the Netherlands. As part of a larger national study on clinical ethics support in the (...) Netherlands, we will focus on the prevalence and characteristics of MCD in Dutch health. A mixed methods design was used in which we combined two survey questionnaires, two focus groups and 17 individual interviews with top managers or ethics support staff. The findings demonstrate that the prevalence of MCD is relatively high in Dutch health care, especially in mental health care. Institutions with MCD differ from institutions without MCD concerning size, kind of problems and importance of ideological background. Characteristic of MCD is that it often exists for 3 years or more, has a high participation of health professionals and middle managers and is both organized scheduled as unscheduled. As well integration in existing policy as key persons emerge as important issues in relation to the positioning of MCD. We conclude that MCD is a part of an integrated ethics policy and serves as a catalyst for such an integrated ethics policy. (shrink)

Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support (...) are less appropriate as they are removed from practice. Ethics support should be tailored to the often mundane and easily overlooked moral issues that arise in long-term care. Attention should also be given to the learning styles of nurses who favour experiential learning. Raising awareness and developing a climate of openness and dialogue are the most suitable ways to deal with the mundane moral issues in elderly care. (shrink)

Internationally, the prevalence of clinical ethics support (CES) in health care has increased over the years. Previous research on CES focused primarily on ethics committees and ethics consultation, mostly within the context of hospital care. The purpose of this article is to investigate the prevalence of different kinds of CES in various Dutch health care domains, including hospital care, mental health care, elderly care and care for people with an intellectual disability. A mixed methods design was used including two survey (...) questionnaires, sent to all health care institutions, two focus groups and 17 interviews with managing directors or ethics support staff. The findings demonstrate that the presence of ethics committees is relatively high, especially in hospitals. Moral case deliberation (MCD) is available in about half of all Dutch health care institutions, and in two-thirds of the mental health care institutions. Ethics consultants are not very prominent. A distinction is made between explicit CES forms, in which the ethical dimension of care is structurally and professionally addressed and implicit CES forms, in which ethical issues are handled indirectly and in an organic way. Explicit CES forms often go together with implicit forms of CES. MCD might function as a bridge between the two. We conclude that explicit and implicit CES are both relevant for clinical ethics in health care. We recommend research regarding how to combine them in an appropriate way. (shrink)

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...) aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

Within psychiatry, patients, family, and professionals are involved and interrelated. Yet it is not easy for healthcare professionals to involve family actively in patient care. Taking a feminist perspective, we investigate why health-care professionals experience ambivalence in involving family in attempts to reduce seclusion, suggesting how they can improve family involvement by adopting a relational view on autonomy. Professionals should view patients not only in terms of individual autonomy and rights, but also in terms of relations and dependencies that need (...) to be considered in fostering patient care. (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.

Recently, there has been increased interest in the involvement of family members in treating psychiatric patients who are involuntarily admitted into mental hospitals (Goodwin and Happel 2006; Wilkinson and McAndrew 2008). Family is, for instance, expected to be of use in preventing escalations and aggression on the wards by giving information about patient needs and providing support to the patient. Yet, in practice, family is not routinely involved in the treatment process, and is not even regularly informed about situations (Marshall (...) and Solomon 2003). Professionals mention privacy and confidentiality as issues that constrain collaboration with family (Goodwin and Happel 2006; Wynaden and Orb 2005). .. (shrink)

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)

Le philosophe Jean Baudrillard (1929-2007) a-t-il vraiment existé? Que reste-t-il de lui? "Une élégance certaine de la pensée", affirme l'un de ses meilleurs interprètes, François L'Yvonnet. Le philosophe de La Société de consommation, des Stratégies fatales et des Cool Memories s'attachait à l'idée du fragment comme mode de pensée : car dans le détail, tout est parfait, c'est dans sa reproduction que tout se complique. François L'Yvonnet explore cinq fragments de la philosophie de Jean Baudrillard et de sa biographie pour (...) mieux saisir l'éclat et la jubilation d'une pensée toujours vivante et contemporaine. (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.

Keine ausführliche Beschreibung für "Die Natur und Entstehung der Träume" verfügbar.

Two things become one thing, something having parts, and something becoming something else, are cases of many things being identical with one thing. This apparent contradiction introduces others concerning transitivity of identity, discernibility of identicals, existence, and vague existence. I resolve the contradictions with a theory that identity, number, and existence are relative to standards for counting. What are many on some standard are one and the same on another. The theory gives an account of the discernibility of identicals using (...) phrases like “insofar as”. And it holds that standards for counting remain or shift depending on our purposes. (shrink)

En une petite centaine de pages, l'auteur éclaire l'œuvre de Simone Weil avec des facettes emblématiques de sa biographie : une cartographie des lieux et des influences, la question du déracinement, son rapport à la judaïté.

Although Plotinus’ two treatises on beauty could be taken to reflect an evolution in his thought, a careful examination shows that he consistently argues for a conception of beauty as the illuminated unity in multiplicity of the Intellect.