In recent years there has been a renewed interest in the design argument, which states that the seemingly purposeful features of the natural world point to the existence of a supernatural designer. The purpose of this article is to give a brief survey of the fine-tuning of the fundamental constants in physics and cosmology, and complexity in biology, and their potential implications for the design argument. Contingency in the history of the earth and the evolution of life on earth is (...) also discussed, and some of the problems associated with inferring design from scientific investigations of nature are evaluated. It is concluded that an unambiguous detection of design in nature is not possible, but that this does not eliminate the demand for an ultimate explanation of the existence of the universe and the life it harbours. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

I here defend historical entitlement theories of property rights against a popular charge. This is the objection that such theories fail because no convincing account of original appropriation exists. I argue that this argument assumes a certain reading of historical entitlement theory and I spell out an alternative reading against which it misfires. On this reading, the role of acts of original appropriation is not to justify but to individuate people’s holdings. I argue that we can identify which acts count (...) as original appropriation against the background of a general justification for a practice of property rights. On this view, what I will call ‘natural’ acts of original appropriation are acts by which a person begins to satisfy the general conditions for justified ownership. Finally, I offer an interpretation of John Locke's theory of appropriation along these lines and argue that it provides an attractive reading of his view. (shrink)

This chapter contains sections titled: References and Further Reading.

I analyze three forms of the slippery slope argument (two logical and one empirical) using two questions: 1) in the context of what kind of norms are we considering a first step on a possible slope: statute law, precedent law, positive morality, or critical morality? 2) What is meant by "If we allow this first step"? The conclusion is that the argument's greatest force is in a context of institutionalized norms, like law, whereas its importance in morality is only marginal.

The sense of agency has received much attention in the context of individual action but not in the context of joint action. We investigated how the sense of agency developed during individual and dyadic performance while people learned a haptic coordination task. The sense of agency increased with better performance in all groups. Individuals and dyads showed a differential sense of agency after initial task learning, with dyads showing a minimal increase. The sense of agency depended on the context in (...) which the task was first learnt, as transfer from joint to individual performance resulted in an illusory boost in the sense of agency. Whereas the quality of performance related to the sense of agency, the generated forces to achieve the task did not. Our findings are consistent with a predictive model account at the perceptual level, such that the sense of agency relies most strongly on sharable perceptual information. (shrink)

Although the change of beliefs in the face of new information has been widely studied with some success, the revision of other mental states has received little attention from the theoretical perspective. In particular, intentions are widely recognised as being a key attitude for rational agents, and while several formal theories of intention have been proposed in the literature, the logic of intention revision has been hardly considered. There are several reasons for this: perhaps most importantly, intentions are very closely (...) connected with other mental states—in particular, beliefs about the future and the abilities of the agent. So, we cannot study them in isolation. We must consider the interplay between intention revision and the revision of other mental states, which complicates the picture considerably. In this paper, we present some first steps towards a theory of intention revision. We develop a simple model of an agent’s mental states, and define intention revision operators. Using this model, we develop a logic of intention dynamics, and then investigate some of its properties. (shrink)

During the past decennium, one of the main issues discussed in research ethics has been focused on the care that should be provided to the control group in a clinical trial. This discussion is also called the standard of care debate . Current international research ethics guidelines contain a wide variety of standards for the standard of care—including the provision of the highest attainable, the best available, the best current, a proven , and an established effective treatment. In this article, (...) we systematically review the currently used standards and argue that none of the current standards is adequate to serve as a universal standard for the standard of care. Alex London has made a substantial proposal for a universal standard, but universally adopting his standard is problematic. In this article, we propose a revised version of London's standard. (shrink)

Public funding institutions are able to influence what aspects researchers take into account when they consider the future impacts of their research. On the basis of a description of the evaluation systems that public research funding institutes in the Netherlands (STW and SenterNovem) use to estimate the quality of engineering science, this article shows that researchers are now predominantly required to reflect on the intellectual merit of their research and on the usability and marketability of the technology it contributes to. (...) In addition, SenterNovem also mandates reflection on sustainability. Here it is argued that these requirements do not suffice. Funding institutions should also do more to enhance reflection during the research process on the “soft impacts” of technologies, which refer to the alterations that technologies may bring about in the quality of human life. To do this it is suggested that it is helpful to engage a specifically trained ethicist to monitor the research process and create a feedback loop from the ethicist to the funding institution. (shrink)

The meaning of a declarative sentence and that of an interrogative sentence differ in their aspect of mood. A semantics of mood has to account for the differences in meaning between these sentences, and it also has to explain that sentences in different moods may have a common core. The meaning of the declarative mood is to be explained not in terms of actual force (contra Dummett), but in terms of potential force. The meaning of the declarative sentence (including its (...) mood) is called the assertion-candidate, which is explained by what one must know in order to be entitled to utter the declarative with assertive force. Both a cognitive notion (knowledge) and a pragmatic notion (assertive force) are thus part of the explanation of the assertion-candidate. Davidson’s criticism that such a theory is in need of an account of the distinction between standard and non-standard uses of the declarative is answered: without counter-indications an utterance of a declarative sentence is understood as having assertive force. The meaning of an interrogative sentence, the question-candidate, and that of the other sentence types can ultimately be explained in terms of their specific relations to the assertion-candidate. Martin-Löf’s constructive type theory is used to show the philosophical relevance of a semantics of mood. The constructivist notion of proposition needs to be embedded in a theory of the assertion-candidate, which fulfils the offices of being the meaning of the declarative sentence, the content of judgement and assertion and the bearer of epistemic truth. (shrink)

Contextualist moral philosophers criticise hands-off liberal theories of justice for abstracting from the cultural context in which people make choices. Will Kymlicka and Joseph Carens, for example, demonstrate that these theories are disadvantageous to cultural minorities who want to pursue their own way of life. I argue that Pierre Bourdieu's critique of moral reason radicalises contextualist moral philosophy by giving it a sociological turn. In Bourdieu's view it is not enough to provide marginalised groups or subgroups with equal access to (...) public institutions and specific cultural rights—in some cases this may in fact be detrimental. He contends that scientists, politicians and other intellectuals have a duty to take seriously the social presuppositions of free deliberate choice and public opinion and to support cultural minorities with instruments to liberate themselves from their often precarious situation. (shrink)

Although normative systems, or social laws, have proved to be a highly influential approach to coordination in multi-agent systems, the issue of compliance to such normative systems remains problematic. In all real systems, it is possible that some members of an agent population will not comply with the rules of a normative system, even if it is in their interests to do so. It is therefore important to consider the extent to which a normative system is robust, i.e., the extent (...) to which it remains effective even if some agents do not comply with it. We formalise and investigate three different notions of robustness and related decision problems. We begin by considering sets of agents whose compliance is necessary and/or sufficient to guarantee the effectiveness of a normative system; we then consider quantitative approaches to robustness, where we try to identify the proportion of an agent population that must comply in order to ensure success; and finally, we consider a more general approach, where we characterise the compliance conditions required for success as a logical formula. We furthermore introduce a logic for specifying properties of norm compliance in general and norm robustness in particular. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This program enables (...) students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

The philosophical aspects of Greek medicine are now more widely appreciated, not only by historians of science and medicine but also by students of philosophy in a more narrow sense. There has also been a greater appreciation of the fact that Greek medical writers not only reflect a derivative awareness of developments in philosophy but that they also actively contributed to the formation of philosophical thought more strictly defined, for instance by developing concepts and methodologies for the acquisition of knowledge (...) and understanding. Yet the consequences of this for a renewed study of the formation of Greek philosophy have yet to be drawn; and disciplinary boundaries between historians of medicine on the one hand and philosophers and historians of philosophy on the other still pose obstacles to an integrated account of Greek thought that takes on board the contributions by the medical writers. Some preliminary remarks may therefore be in order. (shrink)

Lower levels of news use are generally understood to be associated with less political engagement among citizens. But while some people simply have a low preference for news, others avoid the news intentionally. So far little is known about the relationship between active news avoidance and civic engagement in society, a void this study has set out to fill. Based on a four-wave general population panel survey in the Netherlands, conducted between April and July 2020 (N = 1,084) during a (...) crisis situation, this research-in-brief investigates the development of news avoidance and pro-social civic engagement over time. Results suggest that higher news topic avoidance results in higher levels of civic engagement. The study discusses different explanations for why less news can mean more engagement. (shrink)

Whether any non-human animal can attribute mental states to others remains the subject of extensive debate. This despite the fact that several species have behaved as if they have a ‘theory of mind’ in various behavioral tasks. In this paper, we review the reasons of skeptics for their doubts: That existing experimental setups cannot distinguish between ‘mind readers’ and ‘behavior readers’, that results that seem to indicate ‘theory of mind’ may come from studies that are insufficiently controlled, and that our (...) own intuitive biases may lead us to interpret behavior more ‘cognitively’ than is necessary. The merits of each claim and suggested solution are weighed. The conclusion is that while it is true that existing setups cannot conclusively demonstrate ‘theory of mind’ in non-human animals, focusing on this fact is unlikely to be productive. Instead, the more interesting question is how sophisticated their social reasoning can be, whether it is about ‘unobservable inner experiences’ or not. Therefore, it is important to address concerns about the setup and interpretation of specific experiments. To alleviate the impact of intuitive biases, various strategies have been proposed in the literature. These include a deeper understanding of associative learning, a better knowledge of the limited ‘theory of mind’ humans actually use, and thinking of animal cognition in an embodied, embedded way; that is, being aware that constraints outside of the brain, and outside of the body, may naturally predispose individuals to produce behavior that looks smart without requiring complex cognition. To enable this kind of thinking, a powerful methodological tool is advocated: Computational modeling, namely agent-based modeling and, particularly, cognitive modeling. By explicitly simulating the rules and representations that underlie animal performance on specific tasks, it becomes much easier to look past one’s own biases and to see what cognitive processes might actually be occurring. (shrink)

Health technology assessment consists of thesystematic study of the consequences of theintroduction or continued use of the technology in aparticular context, with the explicit objective toarrive at a judgment of the value or merit of thetechnology. Ideally, it is aimed at assessing allaspects of a given technology or group oftechnologies, including non-technical, e.g.socio-ethical, aspects. However, methods for assessingsocio-ethical implications of health technology arerelatively undeveloped and few mechanisms exist totake action based on the results of such evaluations.Still, the examples of cochlear (...) inplants and other cases illustratethat HTA is not a matter of merely collecting thefacts about a technology. The facts must beplausible and relevant from a particular framework,which is not always shared by different groups. It ishere that socio-ethical aspects are encountered. Ifhealth technology assessment aims to enhance theaccountability of the decision making processregarding funding and use of health technology, it isa major challenge to assessors of health technologiesto deal adequately with existing value pluralism. Inthis respect interactive evaluation may have somethingto offer. (shrink)

Exploring Practical Knowledge investigates professional practices from a hermeneutic perspective. The book presents, discusses and applies notions such as practical knowledge, practical wisdom, tacit knowledge, and normativity to the professional lifeworld. These contributions focus on both specific practices and more general questions concerning theories and investigations of practice. This volume comes as the result of a cooperation of three research centres: The two Centres for Practical Knowledge in Bodø, Norway and in Södertörn, Sweden, as well as the Research Group Value-Oriented (...) Professionalisation at the University of Applied Sciences in Utrecht, the Netherlands. It offers empirical studies of professionals as well as discussing the underlying theories, approaches and methods of exploring practical knowledge - including the limits to any articulation of these aspects of professional action. In contrast to the objectivist paradigm that otherwise dominates professional studies, each chapter presents central perspectives and possibilities drawing from humanistic and interdiscipkinary research traditions. The book explores professions in a style accessible to scholars and practitioners alike. It is interesting for those studying practices within these professions and for vocational studies in education, social work, health care, police work, journalism, etc. (shrink)

The International Committee of Medical Journal Editors is a working group of editors of selected medical journals that meets annually. Founded in Vancouver, Canada, in 1978, it currently consists of 11 member journals and a representative of the US National Library of Medicine. The major purpose of the Committee is to address and provide guidance for the conduct and publishing of biomedical research and the ethical tenets underpinning these activities. This advice is detailed in the Committee's Uniform Requirements for Manuscripts (...) Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication . Recently, the ICMJE has adopted an interventionist role to ensure transparency of conflict of interest revelations in the conduct and publication of industry supported research. It also pursues a policy for the lodgement with trial registries of specified details of Phase III clinical trials. Failure to comply would jeopardise publication of trial outcomes in ICMJE member journals. This policy has resulted in the coming on stream of trial registries, international agreement on trial minimal datasets and compliance with trial registration requirements. (shrink)

This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

Whether its title, ύπέρ τοῦ μ γεννᾶν is authentic or not, the work transmitted as ‘Book X’ of Aristotle's History of Animals deals with a wide range of possible causes for failure to conceive and generate offspring. It sets out by saying that these causes may lie in both partners or in either of them, but in the sequel the author devotes most of his attention to problems of the female body. Thus he discusses the state of the uterus, the (...) occurrence and modalities of menstruation, the condition and position of the mouth of the uterus, the emission of fluid during sleep , physical weakness or vigour on awakening after this nocturnal emission, the occurrence of flatulence in the uterus and the ability to discharge this, moistness or dryness of the uterus, wind-pregnancy, and spasms in the uterus. Then he briefly considers the possibility that the cause of infertility lies with the male, but this is disposed of in one sentence: if you want to find out whether the man is to blame, the author says, just let him have intercourse with another woman and see whether that produces a satisfactory result . The writer also acknowledges that the problem may lie in a failure of two otherwise healthy partners to match sexually, or as he puts it, to ‘run at the same pace’ ἲσοδρομῆσαι during intercourse, but he does not go into this possibility at great length , and he proceeds to discuss further particulars on the female side. (shrink)

In this article, I argue that law has two oftenneglected functions: the expressive and thecommunicative functions. They are especially importantfor legislation on moral issues, such as biomedicalethics and anti-discrimination law. The communicativefunction of law is a complex one: law may create anormative framework, a vocabulary to structurenormative discussions, as well as institutions andprocedures that promote further discussion. Theexpressive function of law is at stake when itexpresses which fundamental standards, which valuesare regarded as important. The recognition of thesefunctions is not only (...) important for descriptivepurposes; it is also fruitful for normative theory. (shrink)

This paper deals with transnational Hindu and Muslim movements. It rejects the common assertion that migrant communities are conservative in religious and social matters by arguing that ‘traditionalism’ requires considerable ideological creativity that transforms previous practices and discourses considerably. It suggests instead that religious movements, active among migrants, develop cosmopolitan projects that can be viewed as alternatives to the cosmopolitanism of the European Enlightenment. This raises a number of challenges concerning citizenship, integration and political loyalty for governmentality in the nation-states (...) in which these cosmopolitan projects are carried out. The paper suggests that instead of looking at religious migrants as at best conservative and at worst terrorist one should perhaps pay some attention to the creative moments in human responses to new challenges and new environments. (shrink)

Qualitative Coalitional Games are a variant of coalitional games in which an agent's desires are represented as goals that are either satisfied or unsatisfied, and each choice available to a coalition is a set of goals, which would be jointly satisfied if the coalition made that choice. A coalition in a QCG will typically form in order to bring about a set of goals that will satisfy all members of the coalition. Our goal in this paper is to develop and (...) study logics for reasoning about QCGs. We begin by introducing a logic for reasoning about “static” QCGs, where participants play a single game, and we then introduce and study Temporal QCGs , i.e., games in which a sequence of QCGs is played. In order to represent and reason about such games, we introduce a linear time temporal logic of QCGs, called ℒ. We give a complete axiomatisation of ℒ, use it to investigate the properties of TQCGs, identify its expressive power, establish its complexity, characterise classes of TQGCs with formulas from our logical language, and use it to formulate several solution concepts for TQCGs. (shrink)

We investigated how the perception of being dissimilar to others at work relates to employees’ felt inclusion, distinguishing between surface-level and deep-level dissimilarity. In addition, we tested the indirect relationships between surface-level and deep-level dissimilarity and work-related outcomes, through social inclusion. Furthermore, we tested the moderating role of a climate for inclusion in the relationship between perceived dissimilarity and felt inclusion. We collected survey data from 891 employees of a public service organization. An ANOVA showed that felt inclusion was lower (...) for individuals who perceived themselves as deep-level dissimilar compared to individuals who perceived themselves as similar, while felt inclusion did not differ among individuals who perceived themselves as surface-level similar or dissimilar. Furthermore, a moderated mediation analysis showed a negative conditional indirect relationship between deep-level dissimilarity and work-related outcomes through felt inclusion. Interestingly, while the moderation analysis showed that a positive climate for inclusion buffered the negative relationship between deep-level dissimilarity and felt inclusion, it also positively related to feelings of inclusion among all employees, regardless of their (dis)similarity. This research significantly improves our understanding of how perceived dissimilarity affects employees by distinguishing between surface-level and deep-level dissimilarity and by demonstrating the importance of a climate for inclusion. (shrink)

This paper sketches the ambitious outlines of an assessment of the place of Russian philosophy in philosophical history ‘at large’, i.e. on a global and world-historical scale. At the same time, it indicates, rather modestly, a number of elements and aspects of such a project. A retrospective reflection and reconstruction is not only a recurrent phenomenon in philosophical culture (which, the author assumes, has become global), it also is, by virtue of its being a philosophical reflection, one among many possible (...) perspectives. The central claim of the paper is that the key to an assessment of the world-historical place of Russian philosophy is to be found in the Soviet period, not only because it was, through its isolation policy and its subordination of philosophy to political and ideological goals, a determining factor for a large part of the 20th century, but also, and more importantly, because it has systematically distorted the perception of Russia’s philosophical history, including of the Soviet episode itself. The very undoing of these distortions, however, risks becoming a distortion because of, on the one hand, a demonization of the Soviet factor and, on the other hand, a disregard for its philosophical and meta-philosophical relevance. (shrink)

The development of gene expression profiling and next-generation sequencing technologies have steered oncogenomics to the forefront of precision medicine. This created a need for harmonious cooperation between clinicians and researchers to increase access to precision oncology, despite multiple implementation challenges being encountered. The aim is to apply personalised treatment strategies early in cancer management, targeting tumour subtypes and actionable gene variants within the individual’s broader clinical risk profile and wellbeing. A knowledge-generating database linked to the South African Medical Research Council’s (...) Genomic Centre has been created for the application of personalised medicine, using an integrated service and research approach. Insights gained from patient experiences related to tumour heterogeneity, access to targeted therapies and incidental findings of pathogenic germline variants in tumour DNA, provided practice-changing evidence for the implementation of a cost-minimisation pathology-supported genetic testing strategy. Integrating clinical care with genomic research through data sharing advances personalised medicine and maximises precision oncology benefits. (shrink)

Despite its uniform appearance, the cerebellar cortex is highly heterogeneous in terms of structure, genetics and physiology. Purkinje cells (PCs), the principal and sole output neurons of the cerebellar cortex, can be categorized into multiple populations that differentially express molecular markers and display distinctive physiological features. Such features include action potential rate, but also their propensity for synaptic and intrinsic plasticity. However, the precise molecular and genetic factors that correlate with the differential physiological properties of PCs remain elusive. In this (...) article, we provide a detailed overview of the cellular mechanisms that regulate PC activity and plasticity. We further perform a pathway analysis to highlight how molecular characteristics of specific PC populations may influence their physiology and plasticity mechanisms. (shrink)

In this paper I respond to Bernd Krehoff’s article ‘Legitimate Political Authority and Sovereignty: Why States Cannot Be the Whole Story’. I criticize Krehoff’s use of Raz’s theory of authority to evaluate the legitimacy of our political institutions. Krehoff argues that states cannot (always) claim exclusive authority and therefore cannot possess exclusive legitimacy. Although I agree with his conclusion, I argue that the questions of legitimacy and (Razian) authority are distinct and that we need to focus more on the former (...) in order to really support and defend Krehoff’s conclusions. (shrink)

Despite widespread and worldwide efforts to eradicate vector-borne diseases such as malaria, these diseases continue to have an enormous negative impact on public health. For this reason, scientists are working on novel control strategies, such as gene drive technologies (GDTs). As GDT research advances, researchers are contemplating the potential next step of conducting field trials. An important point of discussion regarding these field trials relates to who should be informed, consulted, and involved in decision-making about their design and launch. It (...) is generally argued that community members have a particularly strong claim to be engaged, and yet, disagreement and lack of clarity exist about how this “community” should be defined and delineated. In this paper, we shed light on this “boundary problem”: the problem of determining how boundaries of inclusion and exclusion in (GDT) community engagement should be drawn. As our analysis demonstrates, the process of defining and delineating a community is itself normative. First, we explicate why it is important to define and delineate the community. Second, we demonstrate that different definitions of community are used and intermingled in the debate on GDTs, and argue in favor of distinguishing geographical, affected, cultural, and political communities. Finally, we propose initial guidance for deciding who should (not) be engaged in decision-making about GDT field trials, by arguing that the definition and delineation of the community should depend on the rationale for engagement and that the characteristics of the community itself can guide the effective design of community engagement strategies. (shrink)

Prof. W.A. Dreyer played an important role in the continuous reformation of the Nederduitsch Hervormde Kerk van Afrika (NHKA). This contribution to his Festschrift is not about him. He would not want that. It is about the church and how his understanding of reformed ecclesiology became the basis on which the transformation from ‘ Volkskerk ’ to missional church took place. According to himself, that was his calling and his life’s work. The importance of his contribution cannot be understood without (...) the historical background in which it played out. Neither is it possible to envisage what really happened without acknowledging the theologians who played an important part in his life. This article therefore starts with a short overview of the history of the NHKA. It then proceeds with an overview of how important theologians in the NHKA influenced his ecclesiology. It concludes with three specific contributions that Prof. W.A. Dreyer made which makes him a key role player which led the NHKA on the way of Ecclesia reformata semper reformanda. Contribution: Prof. W.A. Dreyer became an important church leader in the Netherdutch Reformed Church. His leadership resulted in important changes in the church and especially in the ecclesiology of the church. This article, which is part of his Festschrift, gives an overview of his theological contribution through the lens of semper reformanda. By doing so, it indicates how important is the role of church leaders. All the research is based on his scholarly work. (shrink)

Norman's reconciliation of the two theories of perception is challenged because it directly leads to the nature-nurture dichotomy in the development of the two visual systems. In contrast, the proposition of a separate development of the two visual systems may be better understood as involving different types of information that follow a distinct temporal sequence.

Introduction Families of patients with dementia may need support in difficult end-of-life decision making. Such guidance may be culturally sensitive. Methods To support families in Canada, a booklet was developed to aid decision making on palliative care issues. For reasons of cost effectiveness and promising effects, we prepared for its implementation in Italy, the Netherlands and Japan. Local teams translated and adapted the booklet to local ethical, legal and medical standards where needed, retaining guidance on palliative care. Using qualitative content (...) analyses, we grouped and compared adaptations to understand culturally sensitive aspects. Results Three themes emerged: (1) relationships among patient, physician and other professionals—the authority of the physician was more explicit in adapted versions; (2) patient rights and family position—adding detail about local regulations; and (3) typology of treatments and decisions. Considerations underlying palliative care decisions were detailed (Dutch and Italian versions), and the Japanese version frequently referred to professional and legal standards, and life-prolongation was a competing goal. Text on artificial feeding or fluids and euthanasia was revised extensively. Conclusions Providing artificial feeding and fluids and discussing euthanasia may be particularly sensitive topics, and guidance on these subjects needs careful consideration of ethical aspects and possible adaptations to local standards and practice. The findings may promote cross-national debate on sensitive, core issues regarding end-of-life care in dementia. (shrink)