This interdisciplinary study of commitment draws on the disciplines of theology, philosophy, and psychology to demonstrate the importance of trust in midlife adulthood. It gives particular attention to the place of trust in resolving tensions surrounding commitments. Taking a relational perspective, this text addresses the various aspects of commitment as they affect the self, the community, and God. Several midlife people serve as test cases to illustrate the crucial role of trust for those who are called to reassess interpersonal commitments (...) at midlife. Contents: An Ethics of Trust; Marcel on Philosophy of Trust; Theology of Trust; Psychology of Trust; and An Ethics of Trust; Trust and Commitment in Adulthood. (shrink)

Grounded in human experience, this accessible introduction to principles in Catholic morality focuses on moral development, not simply the acquisition of learning. The book begins with a historical overview of moral theology and goes on to examine such issues as conscience, freedom, fundamental option, authority, law, sin, and conversion.

This intervention study examined the effects of a career crafting training on physicians' perceptions of their job crafting behaviors, career self-management, and employability. A total of 154 physicians working in two hospitals in a large Dutch city were randomly assigned to a waitlist control group or an intervention group. Physicians in the intervention group received an accredited training on career crafting, including a mix of theory, self-reflection, and exercises. Participants developed four career crafting goals during the training, to work on (...) in the subsequent weeks, after which a coaching conversation took place over the phone. Physicians in the control group received no intervention. A pre- and post-test 8 weeks later measured changes in job crafting and career self-management and employability of 103 physicians that completed the pre- and post-test. RM ANOVAs showed that the intervention enhanced perceptions of career self-management and job crafting behavior to decrease hindering job demands. No support was found for the effect of the intervention on other types of job crafting and employability. This study offers novel insights into how career crafting can be enhanced through training, as this is the first empirical study to examine a career crafting intervention. HR managers can use the outcomes to develop tailored career policies and career development practices. (shrink)

According to an influential view by Elizabeth Harman, moral ignorance, as opposed to factual ignorance, never excuses one from blame. In defense of this view, Harman appeals to the following considerations: that moral ignorance always implies a lack of good will, and that moral truth is always accessible. In this paper, I clearly distinguish these considerations, and present challenges to both. If my arguments are successful, sometimes moral ignorance excuses.

Physicians are increasingly confronted with the consequences of allocation policies. In several countries, physicians have been assigned a gatekeeper role for secondary health care. Many ethicists oppose this assignment for several reasons, concentrating on the harm the intrusion of societal arguments would inflict on doctor-patient relations. It is argued that these arguments rest on a distinction of spheres of values and of rationality, without taking into account the mixing of values and rationalities that takes place in everyday medical practice. If (...) medical practice, then, does not follow a single, pure rationality, can it also incorporate the societal rationality of the gatekeeper role?Using a case from general practice, I try to show how physicians may integrate societal arguments into their practice in a morally acceptable way. A version of the model of reflective equilibrium and especially Beauchamp and Childress's safeguards, may be helpful both to analyse and teach such balancing of values and rationalities. (shrink)

The objective of this study was to explore the participants’ processing strategies on the mere exposure effect, object decision priming and explicit recognition. In Experiments 1, we observed that recognition and the mere exposure effect for unfamiliar three-dimensional objects were not dissociated by plane rotations in the same way as recognition and object decision priming. However, we showed that, under identical conditions, prompting analytic processing at testing produced a large plane rotation effect on recognition and the mere exposure effect similar (...) to that observed for object decision priming . Furthermore, inducing a non-analytic processing strategy at testing produced a reduced plane rotation effect on recognition and object decision , similar to that observed for the mere exposure effect. These findings suggest that participants’ processing strategies influence performance on the three tasks. (shrink)

Objectives Access to healthcare in most western societies is based on equality. Rapidly rising costs have fuelled debates about differentiation in access to healthcare. We assessed the public's perceptions and attitudes about differentiation in healthcare according to lifestyle behaviour. Methods A vignette study was undertaken in participants in a colorectal cancer screening pilot programme in the Netherlands. Screenees with a negative test result received a questionnaire in which nine hypothetical situations were described: three different healthcare settings (screening, lung cancer, chronic (...) obstructive pulmonary disease) combined with three forms of differentiation each: a difference in premium, waiting list ordering or copayment according to lifestyle. We evaluated the responses using a general hierarchical linear model. Results The percentage of participants in agreement with differentiation varied from 20% to 58% (overall mean of 40%). Significantly more participants were in favour of giving a premium discount to those who do not engage in unhealthy behaviour compared with supporters for higher payments for those who do. More differentiation was supported for non-smoking versus smoking cessation than for participation versus non-participation in screening. We observed in-group favouritism in smokers, but no significant effects of age or disease. There was no support for waiting list ordering based on lifestyle. Conclusions Results of this study show that Dutch citizens eligible for colorectal cancer screening are in favour of some form of financial differentiation in the distribution of healthcare, but that significant differences exist between type of setting and the type of behaviour. Our study can be used in the ongoing discussion about solidarity and behaviour in healthcare. (shrink)

BackgroundConsent for data research in acute and critical care is complex as patients become at least temporarily incapacitated or die. Existing guidelines and regulations in the European Union are of limited help and there is a lack of literature about the use of data from this vulnerable group. To aid the creation of a patient-centred framework for responsible data research in the acute setting, we explored views of patients and next-of-kin about the collection, storage, sharing and use of genetic and (...) health-related data for observational research.MethodsWe conducted qualitative interviews (n = 19) with Dutch sudden cardiac arrest survivors who donated clinical and socio-economic data and genetic samples to research. We also interviewed their next-of-kin. Topics were informed by ethics literature and we used scenario-sketches to aid discussion of complex issues.ResultsSudden cardiac arrest survivors displayed limited awareness of their involvement in health data research and of the content of their given consent. We found that preferences regarding disclosure of clinically actionable genetic findings could change over time. When data collection and use were limited to the medical realm, patients trusted researchers to handle data responsibly without concern for privacy or other risks. There was no consensus as to whether deferred consent should be explicitly asked from survivors. If consent is asked, this would ideally be done a few months after the event when cognitive capacities have been regained. Views were divided about the need to obtain proxy consent for research with deceased patients’ data. However, there was general support for the disclosure of potentially relevant post-mortem genetic findings to relatives.ConclusionsSudden cardiac arrest patients’ donation of data for research was grounded in trust in medicine overall, blurring the boundary between research and care. Our findings also highlight questions about the acceptability of a one-time consent and about responsibilities of patients, researchers and ethics committees. Finally, further normative investigation is needed regarding the (continued) use of participants’ data after death, which is of particular importance in this setting. Our findings are thought to be of relevance for other acute and life-threatening illnesses as well. (shrink)

Disability is primarily a social phenomenon -- a way of being a minority, a way of facing social oppression, but not a way of being inherently or intrinsically worse off. This is how disability is understood in the Disability Rights and Disability Pride movements; but there is a massive disconnect with the way disability is typically viewed within analytic philosophy. The idea that disability is not inherently bad or sub-optimal is one that many philosophers treat with open skepticism, and sometimes (...) even with scorn. The goal of this book is to articulate and defend a version of the view of disability that is common in the Disability Rights movement. To be physically disabled is not to have a defective body, but simply to have a minority body. (shrink)

This book focuses on the idea of a modus vivendi as a way of governing political life and addressing problems characterized by pluralism or deep-rooted diversity. The individual essays illustrate both the merits and the limitations of a political theory of modus vivendi; how it might be interpreted and developed; specific challenges entailed by articulating it in a convincing form; what its institutional implications might be; and how it relates to other seminal issues and concepts in political theory; such as (...) legitimacy, toleration, the social contract, etc. The book makes a significant contribution to the discussion on the scope and limits of liberal political theory, and on how to deal politically with deep-rooted diversity. (shrink)

Previous studies show that medical students in clinical training face ethical problems that are not often discussed in the literature. In order to make teaching timely and relevant for them, it is important to understand what medical students perceive as ethical problems, as various factors may influence their perception, including cultural differences and working environment. The purpose of this qualitative study was to explore students’ perceptions of what an ethical problem is, during their clinical training in the hospital, and compare (...) the results from two different countries. We observed a total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools, in Indonesia and the Netherlands. Data were interpreted and analyzed using content analysis. We found that students in both settings encounter problems which are closer to their daily work and responsibilities as medical students and perceive these problems as ethical problems. Indonesian students perceived substandard care and inequity in healthcare as ethical problems, while Dutch students perceived that cases which are not matters of life and death are less worthy to discuss. Our study suggests that there might be a gap between ethical problems that are discussed in class with teachers, and problems that students actually encounter in practice. Teachers should be aware of the everyday situations in clinical training which may be perceived by students as ethically problematic and should acknowledge and discuss these ethical problems with students as part of the learning processes in ethics education. (shrink)

Metaphysical orthodoxy maintains that the relation of ontological dependence is irreflexive, asymmetric, and transitive. The goal of this paper is to challenge that orthodoxy by arguing that ontological dependence should be understood as non- symmetric, rather than asymmetric. If we give up the asymmetry of dependence, interesting things follow for what we can say about metaphysical explanation— particularly for the prospects of explanatory holism.

Climate Change and the Moral Agent examines the moral foundations of climate change and makes a case for collective action on climate change by appealing to moralized collective self-interest, collective ability to aid, and an expanded understanding of collective responsibility for harm.

Neural Geographies draws together recent feminist and deconstructive theories, early Freudian neurology and contemporary connectionist theories of cognition. In this original work, Elizabeth A. Wilson explores the convergence between Derrida, Freud and recent cognitive theory to pursue two important issues: the nature of cognition and neurology, and the politics of feminist and critical interventions into contemporary scientific psychology. This book seeks to reorient the usual presumptions of critical studies of the sciences by addressing the divisions between the static and (...) the changeable; the natural and the political; the neuro-cognitive and the cultural that have been traditional to both scientific and critical accounts of neurology and cognition. (shrink)

Introduction: Depression, biology, aggression -- Underbelly -- The biological unconscious -- Bitter melancholy -- Chemical transference -- The bastard placebo -- The pharmakology of depression.

As current events around the world have illustrated, epistemological issues are at the center of our political lives. It has become increasingly difficult to discern legitimate sources of evidence, misinformation spreads faster than ever, and the role of truth in politics has allegedly decayed in recent years. It is therefore no coincidence that political discourse is currently saturated with epistemic notions like ‘post-truth,’ ‘fake news,’ ‘truth decay,’ ‘echo chambers,’ and ‘alternative facts.’ This book brings together leading philosophers to explore ways (...) in which the analytic and conceptual tools of epistemology bear on political philosophy, and vice versa. It is organized around three broad themes: truth and knowledge in politics; epistemic problems for democracy; and disagreement and polarization. The authors provide new and rich insights on topics such as: propaganda, fake news, weaponized skepticism, belief polarization, political disagreement, the epistemic value of democracy, voter ignorance, irrationality in politics, political bullshit, and identity politics. (shrink)

Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)

When Georg von der Gabelentz’s book Die Sprachwissenschaft was published, the historical-comparative paradigm was the dominant perspective in empirical linguistic enquiry, and the then current theory of language was fijirmly rooted in language psychology. While itself based in this tradition, Gabelentz’s Sprachwissenschaft nevertheless strikes another chord, which sets it apart from contemporary sources. This chapter argues that the book is particularly noteworthy for its wide-ranging bottom-up approach to linguistic phenomena and its propensity to conceive of language both as object and (...) instrument of enquiry in a sense akin to the ‘reflexive’ stance that later would become a hallmark of Edmund Husserl’s phenomenology. The ‘phenomenological mindset’ can in particular be retraced in the way a diffferent philosophy of the language sciences and theory of meaning take shape in Die Sprachwissenschaft. (shrink)

philosophy of language, the study of the essence of language and its importance to mankind and culture, is concerned with the relationship between linguistic signs and thought, knowledge , consciousness, logic, communication, truth, reference, and reality.

In the middle of the 18th century, a new fad found its way into the gardens of England's well-to-do: building fake Gothic ruins. Newly constructed castle towers and walls looked like they were already falling apart, even on the first day of their creation. Made of stone, plaster, or even canvas, these "sham ruins" are often considered an embarrassing blip in English architectural history. However, Sham Ruins: A User's Guide expands the specific example of the sham ruin into a general (...) principle to examine the way purposely broken objects can be used both to uncover old truths and invent new ones. Along with architecture, work by Ivan Vladislavić, Tom Stoppard, Alain Mabanckou, Aleksei Fedorchenko, Michael Haneke, and Sturtevant is used to develop this thesis, as well as artifacts such as pre-torn jeans, fake histories, and broken screen apps. Using these examples, one of the key questions the book raises is: What is it that sham ruins ruin? In other words, if real ruins are ruins of what they actually are, then sham ruins should be considered ruins of what they are not. Thus sham ruins are about imposing new meaning where such meaning does not and should not exist. They also can show how things we think are functioning well are actually already broken. Sham ruins do this, and much more, by being lies, ruses, and embarrassments. This is what gives them the power with which we can think about objects in new, unintended ways. (shrink)

In the _Nichomachean Ethics_, Aristotle defines three kinds of friendship: utility, pleasure, and virtue. The characters in the films of Sean Baker fit into none of these categories. Friendship is central to all of Baker’s films, but it takes the non-Aristotelian form of “friends, no matter what,” which I interpret as a description of the aporia of friendship, of an impossible friend, or a friend in the realm of fantasy. In other words, friends are only friends when they resist everything (...) friends are supposed to do. Betrayal, lies, and complications sit at the heart of this new definition. One mechanism for this kind of friendship is _mourning_. Friends are only friends when friendship is mourned, or when it is part of a crypt, or a vault for losses that are too traumatic to confront fully, as set out in the work of Sigmund Freud, Jacques Derrida, Nicolas Abraham and Mária Török, and developed by Laurence Rickels. This reading of mourning puts a particular spin on fantasy, for if fantasy is generally assumed to be about wish-fulfillment, then when fantasy reaches into the crypt for inspiration, it is retooled into a vehicle for confronting what is too hard to face. This is the function of friendship in Baker’s films: his friends are Judas figures going against their friends in order to keep their friendship alive. In _Tangerine_ (2015), two transgender sex workers in West Hollywood develop their friendship around a fight over a man. In _Starlet_ (2012), a young woman hides a secret from her elderly female friend, and this friendship is only saved when another actress betrays this secret. In these films, friendship is paradoxically formed by attempting to ruin friendship. Thought on fantasy and mourning will help in defining this type of non-Aristotelian friendship, as well as Freud’s work on the “ambivalence of feeling” from his writing on the First World War. (shrink)

This chapter contains section titled: “One Must Die to Know the Truth” “Prayer to the Cloud of Unknowing” Bored, as in Really Bored The Boxing of D'Anna Biers Notes.

To Aristotle, spoken words are symbols, not of objects in the world, but of our mental experiences related to these objects. Presently there are two major strands of interpretation of Aristotle’s concept of the linguistic sign. First, there is the structuralist account offered by Coseriu (Geschichte der Sprachphilosophie. Von den Anfängen bis Rousseau, 2003 [1969], pp. 65–108) whose interpretation is reminiscent of the Saussurean sign concept. A second interpretation, offered by Lieb (in: Geckeler (Ed.) Logos Semantikos: Studia Linguistica in Honorem (...) Eugenio Coseriu 1921–1981, 1981) and Weidemann (in: Schmitter (Ed.) Geschichte der Sprachtheorie 2. Sprachtheorien der abendländischen Antike, 1991), says that Aristotle’s concept of the linguistic sign is similar to the one presented in Ogden and Richard’s (The meaning of meaning: A study of the influence of language upon thought and of the science of symbolism, 1970 [1923]) semiotic triangle. This paper starts off with an introductory outline of the so-called phýsei-thései discussion which started during presocratic times and culminated in Plato’s Cratylus. Aristotle’s concept of the linguistic sign is to be regarded as a solution to the stalemate position reached in the Cratylus. Next, a discussion is offered of both Coseriu’s and Lieb’s analysis. We submit that Aristotle’s concept of the linguistic sign shows features of both Saussure’s and Ogden and Richards’s sign concept but that it does not exclusively predict one of the two. We argue that Aristotle’s concept of the linguistic sign is based on three different relations which together evince his teleological as well empiricist point of view: one internal (symbolic) relation and two external relations, i.e. a likeness relation and a relation katà synthéken. (shrink)

Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health-related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks.Aim: to explore the (...) ways in which clinicians distinguish important from unimportant health risks.Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in-depth interviews on their interpretation of what makes a health risk important.Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance.Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)

During his long and continuing scholarly career, Patrick Suppes contributed significantly both to the sciences and to their philosophies. The volume consists of papers by an international group of Suppes colleagues, collaborators, and students in many of the areas of his expertise, building on or adding to his insights. Michael Friedman offers an overview of Suppes accomplishments and of his unique perspective on the relation between science and philosophy. Paul Humphreys, Stephen Hartmann, and Tom Ryckman present essays in the philosophy (...) of physics. Jens-Erik Fenstad, Harvey Friedman, and Jaako Hintikka consider problems in the foundations of mathematics, while the late Duncan Luce, Jean-Claude Falmagne, Brian Skyrms, and Hannes Leitgeb have contributed essays in theory of measurement, decision theory and probability. Foundations of economics and political theory are addressed by Adolfo Garcia de la Sienra, Russell Hardin, and Kenneth Arrow. Psychology, language, and philosophy of language are addressed by Elizabeth Loftus, Anne Fagot-Largeault, Willem Levelt, Dagfinn Follesdal, and Marcos Perreau-Guimares and some of Suppes most recent research in neurobiology is addressed in essays by Colleen Crangle, Acadio de Barros and Claudio Carvalhes. Finally Nancy Cartwright and Alexandre Marcelles consider the alignment (or misalignment) of method and policy. Each of the essays is accompanied by a response from Suppes.". (shrink)

A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the (...) advent of uterus transplantation, and the anticipated development of artificial placentas.In this paper, I highlight the pertinent conceptual differences between technologies assisting conception and those assisting gestation to demonstrate that distinct issues arise when assisted gestative technologies are used. I argue that there is utility in considering AGTs as a genus of technologies. These technologies perform the same function from the perspective of putative parents and might exist on a spectrum of alternatives when they become more available. Moreover, since many of the same or very similar ethical, social and legal issues are raised by surrogacy, UTx and ectogestation, analysis of these issues will be better contextualised by considering these technologies together. Many of the matters currently being highlighted for reform in the context of surrogacy will inevitably impact on how other forms of assisted gestation are governed. The conversation should be broadened; we should consider how far other emerging technologies might be accommodated in revised regulatory schemes. (shrink)

Background Since the enactment of the euthanasia law in the Netherlands, there has been a lively public debate on assisted dying that may influence the way patients talk about euthanasia and physician-assisted suicide with their physicians and the way physicians experience the practice of EAS. Aim To show what developments physicians see in practice and how they perceive the influence of the public debate on the practice of EAS. Methods We conducted a secondary analysis of in-depth interviews with 28 Dutch (...) physicians who had experience with a complex case of EAS. Respondents were recruited both by the network of physicians working for SCEN as well as via a national questionnaire, wherein participating physicians could indicate their willingness to be interviewed. Results Three themes came up in analysing the interviews. First, the interviewed physicians experienced a change in what patients would expect from them: from a role as an involved caregiver to being the mere performer of EAS. Second, interviewees said that requests for EAS based on non-medical reasons came up more frequently and wondered if EAS was the right solution for these requests. Last, respondents had the impression that the standards of EAS are shifting and that the boundaries of the EAS regulation were stretched. Conclusions The perceived developments could make physicians less willing to consider a request for EAS. Our results also raise questions about the role of physicians and of EAS in society. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract for health (...) research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

ABSTRACT Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health‐related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks. Aim: to (...) explore the ways in which clinicians distinguish important from unimportant health risks. Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in‐depth interviews on their interpretation of what makes a health risk important. Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance. Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)