Clinical ethics support services are experiencing a phase of flourishing and of growing recognition. At the same time, however, the expectations regarding the acceptance and the integration of traditional CES services into clinical processes are not met. Ethics rounds as an additional instrument or as an alternative to traditional clinical ethics support strategies might have the potential to address both deficits. By implementing ethics rounds, we were able to better address the needs of the clinical sections and to develop a (...) more comprehensive account of ethics quality in our hospital, which covers the level of decisions and actions, and also the level of systems and processes and aspects of ethical leadership. (shrink)

Several psychosocial models have been proposed to explain the etiology of eating disorders and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study was to test an integrated comprehensive model consisting of a host of common risk and protective factors expected to explain both eating and weight disorders simultaneously in a large school-based sample of adolescents. Data were collected from 3,043 youth from 41 schools in the Ottawa region, Canada. (...) Working with interested school staff, validated self-report scales in the form of a questionnaire booklet were administered to participating students to assess several understood risk and protective factors common to both eating disorders and obesity. Anthropometric measurements of weight and height were taken at the end of the questionnaire administration period by trained research staff. Structural equation modeling with cross-validation was used to test the hypothesized model. Findings demonstrated that dysregulated eating was associated with both eating disorder and weight status with diet culture and emotion dysregulation directly associated with some of these disordered eating patterns. It equally pointed to how lifestyle made up of high sedentary behaviors, low vigorous exercise and varied eating patterns contributed to both emotion dysregulation and poor body image which subsequently affected eating issues and weight status simultaneously, signaling the complex interplay of psychosocial factors that underlie these concerns. This study provides evidence for an integrated psychosocial model consisting of socio-environmental, psychological, and behavioral factors may best explain the complex interplay of risk and protective factors influencing eating disorders and obesity. It equally highlights understanding the direct and indirect effects of some of the most salient risk factors involved in eating and weight-related concerns, including the strong effects of diet culture and stressors such as weight-based teasing, providing interventionalists evidence of important risk factors to consider targeting in eating disorder and weight-based prevention efforts. (shrink)

Nietzsche hat keine politische Theorie vorgelegt und dennoch ganz grundlegende, auch heute noch herausfordernde Fragen zu Wesen und Wert des Politischen gestellt. Unter den Gesichtspunkten von Psychologie und Moral, Kultursteigerung und Zukunftsgestaltung hat er das Politische umgedacht und umgewertet. Ziel des Bandes ist, diese Umwertungen neu zu durchdenken. Dabei steht zunächst das Verhältnis von Nietzsches Philosophie zu den wesentlichen Fragen der Politik – Herrschaft, Gewalt, Freiheit, Selbstbestimmung und Gerechtigkeit – im Vordergrund. Welche Regeln bzw. Normen und welche Arten von Gemeinschaft (...) sind aus seinem Denken ableitbar? Nietzsches Anti-Politik wird im Zeichen souveräner Individualität und als Gegen-Politik diskutiert, seine „große Politik" im Licht jüngerer Erfahrungen (Trump etc.) hinterfragt. Wie gehen wir mit Nietzsches polemischem Elitismus um, wie mit der Selbstermächtigung von Individuen, die in heutigen westlichen Gesellschaften (scheinbar) so wichtig sind? Die hier versammelten Beiträge erfassen Nietzsches politische Perspektiven in all ihrer Brisanz und Radikalität, aber auch mit der nötigen Sorgfalt und in textnaher Lektüre. (shrink)

The fracking debate is a product of the tension between the environmental degradation it may cause, on the one hand, and on the other the greater energy demands of a rapidly increasing South African population with expectations of an ever-increasing standard of living. Shale gas fracking in the Karoo of South Africa promises to make vast reserves of oil and gas available to help meet a significant percentage of the country’s energy needs for many years to come. This will aid (...) development and contribute to raising the standard of living of many. This article seeks to apprise the South African faith communities of the technology and risks involved. Christian theological guidelines are presented by which its benefits and dangers may be interrogated so that the community may be able come to an informed decision as to whether or not to support fracking. (shrink)

In general, there are two main approaches to settling the alleged conflict between religion and science. On the first approach, one argues that there is not even the possibility of such a conflict, since the uses of religious utterances are sufficiently different from those of scientific ones to constitute them a distinct logical type. Thus, if religion appears to conflict with science, either this is merely an appearance, or else one of them, at least, is also performing the function of (...) the other, in which case their conflict is really either a scientific conflict or a religious conflict. In no case, however, can the truth of a scientific utterance be any reason for inferring the falsity of a religious one, and much less can it be any reason for entertaining doubts about the religious utterance's logical propriety. (shrink)

Cowan assumes a unitary capacity-limited attentional focus. We argue that two main problems need to be solved before this assumption can complement theoretical knowledge about human cognition. First, it needs to be clarified what exactly the nature of the elements (chunks) within the attentional focus is. Second, an elaborated process model needs to be developed and testable assumptions about the proposed capacity limitation need to be formulated.

This book/CD package guides readers and listeners on a journey through Franz Schubert's Winterreise song cycle, in which the composer set the poetry of Wilhelm Muller to music. The complete text of the 24 poems is presented in both German and English, with 116 b&w photographs of winter scenes on the facing pages. An introductory essay by Susan Youens offers a critical examination of the song cycle. The music CD features a new recording of Winterreise, performed by baritone Paul (...) Rowe and pianist Martha Fischer. Oversize: 10.25x10.25". Annotation 2003 Book News, Inc., Portland, OR. (shrink)

The growth of knowledge and its effects on the practice of medicine have been issues of philosophical and ethical interest for several decades and will remain so for many years to come. The outline of the present volume was conceived nearly three years ago. In 1987, a conference on this theme was held in Maastricht, the Netherlands, on the occasion of the founding of the European Society for Philosophy of Medicine and Health Care (ESPMH). Most of the chapters of this (...) book are derived from papers presented at that meeting, and for the purpose of editing the book Stuart Spicker, Ph. D., joined two founding members of ESPMH, Henk ten Have and Gerrit Kimsma. The three of them successfully brought together a number of interesting contribu tions to the theme, and ESPMH is grateful and proud to have initiated the production of this volume. The Society intends that annual meetings be held in different European countries on a rotating basis and to publish volumes related to these meetings whenever feasible. In 1988, the second conference was held in Aarhus, Denmark on "Values in Medical Decision Making and Resource Allocation in Health Care". In 1989, a meeting was held in Czestochowa, Poland, on "European Traditions in Philosophy of Medicine. From Brentano to Bieganski". It is hoped that these conferences and the books to be derived from them, will initiate a new European tradition, lasting well into the 21 st century! P. J. (shrink)

This book offers an Arabic edition, English translation, study and glossaries of ʿUbaidallāh Ibn Buḫtīšūʿ’s important work on apparent death; an appendix moreover provides the Arabic and Hebrew recensions of ʿUbaidallāh’s lost Greek _Vorlage_.

The Einstein-Podolsky-Rosen (EPR) paradox and the correlated states it introduced comprise one of the central interpretive problems of quantum mechanics. Because of the apparent nonlocal character of this paradox, it should be given a relativistic treatment. The purpose of this paper is to provide such a treatment.

In pursuit of my ultimate objective of being in control of my self-deliverance at the time when my physical condition no longer warrants continuance, I have joined the Hemlock Society of Los Angeles. The Society urges its members to explore with their personal physicians this subject well in advance of the actual moment of necessity, and in particular the problem of acquiring a lethal dose of a drug that will provide a release consistent in quality with the degree of peace (...) and serenity sought in life. It is my hope that we can find a process commensurate with your moral and professional concerns which will allow us to collaborate. (shrink)

When do people say that they are moved, and does this experience constitute a unique emotion? We review theory and empirical research on being moved across psychology and philosophy. We examine feeling labels, elicitors, valence, bodily sensations, and motivations. We find that the English lexeme being moved typically (but not always) refers to a distinct and potent emotion that results in social bonding; often includes tears, piloerection, chills, or a warm feeling in the chest; and is often described as pleasurable, (...) though sometimes as a mixed emotion. While we conclude that it is a distinct emotion, we also recommend studying it in a more comprehensive emotion framework, instead of using the ambiguous vernacular term being moved as a scientific term. (shrink)

Understanding a sentence and integrating it into the discourse depends upon the identification of its focus, which, in spoken German, is marked by accentuation. In the case of written language, which lacks explicit cues to accent, readers have to draw on other kinds of information to determine the focus. We study the joint or interactive effects of two kinds of information that have no direct representation in print but have each been shown to be influential in the reader’s text comprehension: (...) i. the (low-level) rhythmic-prosodic structure that is based on the distribution of lexically stressed syllables, and ii. the (high-level) discourse context that is grounded in the memory of previous linguistic content. Systematically manipulating these factors, we examine the way readers resolve a syntactic ambiguity involving the scopally ambiguous focus operator auch (engl. `too') in both oral (Experiment 1) and silent reading (Experiment 2). The results of both experiments attest that discourse context and local linguistic rhythm conspire to guide the syntactic and, concomitantly, the focus-structural analysis of ambiguous sentences. We argue that reading comprehension requires the (implicit) assignment of accents according to the focus structure and that, by establishing a prominence profile, the implicit prosodic rhythm directly affects accent assignment. (shrink)

A measure of coherence is said to be reliability conducive if and only if a higher degree of coherence (as measured) results in a higher likelihood that the witnesses are reliable. Recently, it has been proved that several coherence measures proposed in the literature are reliability conducive in a restricted scenario (Olsson and Schubert 2007, Synthese 157:297–308). My aim is to investigate which coherence measures turn out to be reliability conducive in the more general scenario where it is any (...) finite number of witnesses that give equivalent reports. It is shown that only the so-called Shogenji measure is reliability conducive in this scenario. I take that to be an argument for the Shogenji measure being a fruitful explication of coherence. (shrink)

Philosophical issues with respect to anxiety and its pathological variants arise at the border between everyday and clinical understanding of anxiety, between clinical and scientific approaches and between scientific concepts and the philosophical frameworks they refer to. These four ways of understanding can be seen as epistemic levels that point at different aspects and qualities of anxiety. After a brief historical introduction the three interfaces will be discussed. Philosophical questions at the interface between the first two levels relate to the (...) issue of where to draw the boundary between normal and pathological manifestations of anxiety and of how to balance the medical view with everyday understandings of anxiety. At the interface between clinical and scientific approaches, the question arises whether scientific theories and models are adequate, more particularly, which aspects of the clinical picture can be explained by scientific theories and concepts. The third interface, between scientific concepts and the philosophical frameworks they presuppose, is the origin of debates about what belongs to science and what should be regarded as meta-theoretical or paradigmatic. To what extent does a particular scientific concept stand on its own and to what extent does it borrow from pre-theoretical and/or philosophical views? (shrink)

This chapter appeared in: G. J. van Nes et al. (eds.), Relational Anthropology for Contemporary Economics. Dordrecht: Springer, 121-132. -/- Abstract: This chapter is a comment on the contribution of Rebecca Klein in this volume, preceded by a conceptual analysis of the argument that is developed in the Homo Amans position paper. The main question that is raised is twofold and concerns the relation between science and worldview on the one hand, and between science and economic life on the other. (...) With respect to the science – worldview relationship, it is doubted that science can play the role the authors of the Homo Amans project expect it can have. What they have in mind is that science helps in validating and legitimizing a biblically informed concept of love. This author disagrees, to a large extent. Science can indeed orient itself on ideas and intuitions that are based on one’s worldview. But it cannot prove the truth of these intuitions and ideas. To think so, is to commit a naturalistic fallacy. With respect to the relationship between science and economic life, the author is also not convinced that science and philosophy as academic disciplines will by themselves be able (and should be expected to be able) to transform deeply ingrained, institutionally anchored economic practices. New theories, concepts, and paradigms are a precondition for change, but they do not bring about change by themselves. What is needed is a change in the practices themselves, a change that is both personal and comprehensive. What is needed is a clear, succinct, and encompassing view on the intrinsic normativity of economic interactions between relevant stakeholders in what we call ‘the’ economy. This is a huge undertaking, that requires painstaking ‘phenomenological’ analyses of a wide variety of economic practices. The chapter agrees with most of Klein’s observations and concerns with respect to the position paper. These observations and concerns gain even more depth and relief given the conceptual distinctions that are made in the chapter. (shrink)

In his book A secular age, Charles Taylor rejects the view that modernity must lead to a steady decline of religion and argues that although the conditions of belief changed, causing a destabilization and recomposition of religious forms, our modern world still can and should be open to the transcendent. I attempt to give a general overview of A secular age by describing shifts in worldview with respect to nature, self, society and God. Finally, I discuss how Taylor’s message relates (...) to that of Reformational thinking. Taylor’s description of motivations to regard the world as closed to the transcendent corresponds well with the Reformational analysis of the humanistic ground motives of freedom and nature. Taylor, however, seems to consider our current worldview as a neutral basis and religion as an optional add-on. (shrink)

The article investigates the concept of self-illness ambiguity (SIA), which was recently re-introduced in the philosophy of psychiatry literature. SIA refers to situations in which patients are uncertain about whether features (symptoms, signs) of their illness should be attributed to their illness or to their ‘selves’. Identification of these features belongs to a more encompassing process of self- definition and -interpretation. The paper introduces a distinction between the notions of self-relatedness, self-referentiality (or: implicit self-signification), self-awareness and self-interpretation. Each of these (...) notions offers a different perspective on SIA, but these perspectives do not exclude one another. A further distinction will be developed between primary, secondary and tertiary forms of self-referentiality. The practical and conceptual relevance of these distinctions will be illustrated with case vignettes. Throughout the paper our findings will placed in the context of other philosophical work on the self, especially in the field of narrative theory (Ricoeur), phenomenology (Ratcliffe) and philosophy of mind. The article closes with a brief discussion about the appropriateness of the term ambiguity and the potential of SIA as concept in the context of clinical psychiatry. Directions for future work will be indicated. (shrink)

Moshe ben Maimon, or Moses Maimonides, remains one of the most celebrated rabbis in this history of Judaism; his numerous writings include philosophical and medical treatises in Arabic, two of history's most important works on Jewish law, and, most notably, efforts to reconcile Aristotelian philosophy with biblical teaching. The _Complete Medical Works_, edited by Gerrit Bos of the Martin-Buber-Institut fur Judaistik at the University of Cologne, collects the entirety of Maimonides's medical writings. Notwithstanding its title, _On Asthma_ is in (...) fact a complete regimen of health, designed for the needs of a high-ranking patient whose identity is not stated. In true Galenic fashion, Maimonides stresses that a healthy lifestyle and diet are the most important preventative measures against chronic illness such as asthma. Good and bad foods are described in detail, and many recipes for beneficial dishes and drugs are included, with Maimonides adapting Galenic regimens to the needs of his Muslim patient. (shrink)

We thank Sanneke de Haan for her thoughtful response. We agree with what she says and consider it as a further specification of our intentions. We particularly endorse the two main points she raises, that is, that dealing with self-illness ambiguity requires a relational perspective; and that relying on reflection solely is problematic since it plays an only modest role in the resolution of self-illness ambiguity. We discuss both points in reverse order.With respect to the role of reflection, we have, (...) as a matter of fact, been very explicit: “we should not overemphasize the importance of reflection”; and “self-ambiguity is more likely to be a diachronic process”, with a “back and forth between narrative... (shrink)

Foucault's theory of power and subjectification challenges common concepts of freedom in social philosophy and expands them through the concept of 'freedom as critique': Freedom can be defined as the capability to critically reflect one's own subjectification, and the conditions of possibility for this critical capacity lie in political and social institutions. The article develops this concept through a critical discussion of the standard response by Foucault interpreters to the standard objection that Foucault's thinking obscures freedom. The standard response interprets (...) Fou-cault's later works, especially The Subject and Power, as a solution to the problem of freedom. It is mistaken, because it conflates different concepts of freedom that are present in Foucault's work. By differentiating these concepts, this paper proposes a new institutionalist approach to solve the problem of freedom that breaks with the partly anarchist underpinnings of Foucault scholarship: As freedom as critique is not given, but itself a result of subjectification, it entails a demand for 'modal robustness' and must therefore be institutionalized. This approach helps to draw out the consequences of Foucault's thinking on freedom for postfoundationalist democratic theory and the general social-philosophical discussion on freedom. (shrink)

Over the last years, self-management has become a central value in the practice of mental health care. Patients are positioned as expertclients who are actively involved in the management of their disease. Some of the ideas that are implied in the concept of self-management may raise important and intriguing questions. For instance, in the context of psychiatry impaired agency and altered self-experience are often part of the psychopathological process itself. The capacity to manage oneself may be impeded by the very (...) problem that needs to be managed. Therefore, how should self-management be conceived in... (shrink)

The approach to AIDS as a disease and a threat for social discrimination is used as an example to illustrate a conceptual thesis. This thesis is a claim that concerns what we call a medical issue or not, what is medicalised or needs to be demedicalised. In the friction between medicalisation and demedicalisation as discursive strategies the latter approach can only be effected through the employment of discourses or discursive strategies other than medicine, such as those of the law and (...) of economics. These discourses each realise different values, promote a different subject, and have a different concept of man. The concept of discourse is briefly outlined against concepts such as the linear growth concept of science and the growth model of science as changes in paradigm. The issue of testing for AIDS shows a conflict between the medical and the legal discourse and illustrates the title of our contribution: the human body as field of conflict between discourses. (shrink)

Many methods are used in research on complexity. One of these is qualitative comparative analysis. Although many authors allude to the relationships between complexity and QCA, these links are rarely made explicit. We propose that one way of doing so is by using critical realism as a meta-framework. This article discusses the viability of this approach by examining the extent to which QCA is a complexity-informed method. This question is answered in three steps. First, we discuss the nature of complexity (...) and its epistemological implications. Second, we focus on Bhaskar’s perspective on critical realism and show how it can be used as a framework for understanding social complexity. Third, we examine the ontological and epistemological assumptions underlying QCA and synthesize these with our critical realist approach to complexity. We argue that complex reality is non-decomposable, contingent, non-compressible and time-asymmetric. We conclude that, although QCA is inevitably reductive and partial, its core premises are built upon the notions of contingency and time-asymmetry. Therefore, it is not only a powerful method for doing complexity-informed research, but is also a complexity-informed method by itself. (shrink)

Enactive approaches to emotion are rare and to anxiety and anxiety disorder even more. This article aims to show how an enactive paradigm might be helpful in solving some problems in the clinical and scientific understanding of anxiety and anxiety disorder. I begin by pointing at a number of relevant clinical features of anxiety and anxiety disorder and by sketching how and why anxiety theories have difficulties with doing justice to these features. I specifically focus on two themes: a) how (...) to conceptualize anxiety as the expression of a dynamical interaction with the environment instead of as just a reaction to the environment (or to... (shrink)

Name der Zeitschrift: Klio Jahrgang: 99 Heft: 2 Seiten: 676-679.

This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practised only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated and helped regulate it. Some of them have themselves (...) practised euthanasia. The book will contribute to the world literature on physician-assisted death by providing a comprehensive examination of how euthanasia has been practised and how it has evolved in one specific national and cultural context. It will greatly advance the understanding of euthanasia among both advocates and opponents of the practice. (shrink)

This book focuses on two important, interlinked themes in psychiatry, i.e., the relation between self (or: person), context and psychopathology; and the intrinsic value-ladenness of psychiatry as a practice. -/- Written against the background of scientistic tendencies in today’s psychiatry, it is argued in Part I that psychiatry needs a clinical conception of psychopathology alongside more traditional scientific conceptions; that this clinical conception of psychopathology must be based on a fundamental rethinking of the interaction between illness manifestations, contextual influences and (...) the patient as person, such that psychopathology is conceived as the product of this interaction rather than as the outward manifestation of a broken mechanism within the patient. -/- In Part II, it is shown that self- and context-related factors have a large impact on who one is as a professional. I argue that an analysis is needed of the normative aspects of the relations that sustain and frame professional role-fulfilment. This analysis culminates into a so-called normative practice model (NPM) which distinguishes between qualifying, conditioning and foundational principles (or: rules, norms). The normative practice model helps to locate and resist scientistic defenses of the legitimacy of psychiatry and to replace them by a positive account that provides clinicians (and scientists) the conceptual tools they need to justify what they do in broader contexts. The main thrust of the argument is to show that psychiatry needs a value-sensitive account of its legitimacy, in which other normative dimensions are recognized than those that sustain the expert role. Psychiatrists should in other words not defend the legitimacy of their profession by referring to the expert role solely but provide a broader account in which justice is done to the broader social, legal, and economic contexts of professional activity. The analysis of this inherent normativity begins within clinical practice, it extends to the concept of disease as well as to wider domains of psychiatric care and the sociology of professions, and, finally, amounts into an analysis of the value-ladenness of interactions between healthcare institutions, the government, professional organizations and patient groups. (shrink)

Does preaching bring God on stage? Protestants assume an intimate relationship between the ‘Word of God’ and preaching. However, the principle that ‘preaching of the Word of God is the Word of God’ caused intense debates about the status of God language. The author highlights the classic disputes of the 19th and 20th centuries and argues that the old dilemma must be overcome. Sermons address the subjective-contextual conditions of the listeners, and this in no way precludes the attention for divine (...) disclosure. On the contrary, there is a true reciprocity between personal spirituality and the sense of God as really other. The author defends the thesis that the renewed attention for the human condition in the theological debates of the last decades should also include a positive stand towards the believer’s spiritual awareness of God’s real existence and presence. (shrink)

This study sets out to investigate the ¿poetry of grammar¿, more specifically the role of the body in figurative speech, in African languages mainly belonging to Nilotic and Bantu. Apprehending the semantics and pragmatics of metaphorical and metonymic expressions in these languages presupposes an interaction between a number of cognitive processes, as argued below. Interestingly, these languages seem to use these strategies involving figurative speech in tandem with alternative strategies involving on-record statements. This multivocality only makes sense if we place (...) language and language structure more in the social world in which it is used. (shrink)

previous theories and the relevance of those criticisms to the new accounts. Additionally, we have included a new section at the end, which gives some directions to literature outside of formal semantics in which the notion of mass has been employed. We looked at work on mass expressions in psycholinguistics and computational linguistics here, and we discussed some research in the history of philosophy and in metaphysics that makes use of the notion of mass.

What is the purpose of Friesen’s 95 theses and what is the audience he has in mind? The title refers to a major church historical event and suggests that — like in 1517 — we are dealing with a concise statement of a new and radical doctrine that is unfolded in opposition to an established canon. But who is the opponent in this case? What is the established canon that is rejected? And what is new or radical in the summary? (...) Dooyeweerd’s philosophy was definitely new and radical at the time of its conception. It still has an enormous potential for the special sciences. It offers important resources for any critique of ‘immanence’ philosophies. However, on first reading and without knowledge of the context, Friesen does not seem to aim at offering a new or radical interpretation of Dooyeweerd’s philosophy. I read the 95 theses as an attempt to wipe off the dust, to provide the overall picture, doing justice to aspects that were neglected or were wrongly understood in the reformational tradition. However, the audience he has in mind seems to be one that is already familiar with the basic concepts and the thrust of Dooyeweerdian thinking; not an audience that is opposed to reformational philosophical thinking, but one that might be helped by a succinct summary in order to encourage further study and discussion. (shrink)

The concepts of adaptation and fitness have such an appeal that they have been used in other scientific domains, including the social sciences. One particular aspect of this theory transfer concerns the so-called fitness landscape models. At first sight, fitness landscapes visualize how an agent, of any kind, relates to its environment, how its position is conditional because of the mutual interaction with other agents, and the potential routes towards improved fitness. The allure of fitness landscapes is first and foremost (...) that it represents a complex story about adaptation and fitness in one coherent image. Different accounts of fitness landscapes in different domains in the social sciences suggest that the properties and functions of fitness landscapes are attributed rather freely. These differences are testimony of the model’s versatility. At the same time, one will notice that the different approaches can also create ambiguity about the exact meaning and role of fitness landscapes in the social sciences. This article presents an extensive literature survey of the diverging interpretations and uses of fitness landscapes in the social sciences and discusses the implications in terms of how these models inform scientific inquiry. (shrink)

Schubert squarely addresses the question of whether there is a single standard of certainty that can be applied to such disparate areas as logic, mathematics, politics, religion, familial/tribal commitments, and science. The result is a new “philosophy in a grand manner” and a powerful ethical proposal for our time.