Moral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics...

BackgroundMoral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate.The objective of this pilot study is to investigate: 1) the current way of dealing with (...) moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and needs regarding clinical ethics support for dealing with moral questions at the IGZ.MethodsWe performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation.ResultsProfessionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate.ConclusionWe conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation. (shrink)

There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors’ ethical challenges. The objective of this paper (...) is to give an overview of the ethical challenges which health care inspectors encounter in their daily work. A thematic qualitative analysis was performed on cases that were collected from health care inspectors in a moral case deliberation pilot study. Eight themes were identified in health care regulation. These can be divided in two categories: work content and internal collaboration. The work of the health care inspectorate is morally loaded and our recommendation is that some form of ethics support is provided for health care inspectors. (shrink)

This is the first extensive study of ecological virtue ethics and the new rhetoric of environmentalists. Based on a wide-ranging survey of environmental literature, Louke van Wensveen offers an overview of current "green" virtue language and proposes the basic elements of a matching ecological virtue theory, dubbed "dirty virtues" by ecological philosophers.Environmental ethics is not exhausted by debates about the need to preserve rivers, our duties to bioregions, and the intrinsic value of nonhuman nature; rather, ecoliterature also contains a rich (...) virtue language. Highlighting the integrity, diversity, internal tensions, dynamism, and visionary character of this ecological virtue language, the author shows both its historical roots and innovative features. Van Wensveen illustrates a widespread awareness of attitudes and habits that help or harm our relations with the nonhuman world. She includes a unique catalog of 189 virtues and 174 vices that mark the vision and praxis of people committed to ecological flourishing.The second part of Dirty Virtues presents carefully crafted criteria to help discern genuine virtue and vice in an ecological age. Her arguments are distinguished by a critical balance of moral sources, including Aristotelian virtue theory, Christian tradition, women's experiences, psychological theory, and metaphorical representations of nonhuman nature.Methodologically innovative and boldly interdisciplinary, Dirty Virtues will challenge and inspire virtue theorists, as well as environmental ethicists and theologians. (shrink)

Sound and complete axiomatizations are provided for a number of different logics involving modalities for the knowledge of multiple agents and operators for branching time, extending previous work of Halpern, van der Meyden and Vardi [to appear, SIAM Journal on Computing] for logics of knowledge and linear time. The paper considers the system constraints of synchrony, perfect recall and unique initial states, which give rise to interaction axioms. The language is based on the temporal logic CTL*, interpreted with respect to (...) a version of the bundle semantics. (shrink)

In recent years, there has been a heated debate about how to interpret findings that seem to show that humans rapidly and automatically calculate the visual perspectives of others. In the current study, we investigated the question of whether automatic interference effects found in the dot-perspective task (Samson, Apperly, Braithwaite, Andrews, & Bodley Scott, 2010) are the product of domain-specific perspective-taking processes or of domain-general “submentalizing” processes (Heyes, 2014). Previous attempts to address this question have done so by implementing inanimate (...) controls, such as arrows, as stimuli. The rationale for this is that submentalizing processes that respond to directionality should be engaged by such stimuli, whereas domain-specific perspective-taking mechanisms, if they exist, should not. These previous attempts have been limited, however, by the implied intentionality of the stimuli they have used (e.g. arrows), which may have invited participants to imbue them with perspectival agency. Drawing inspiration from “novel entity” paradigms from infant gaze-following research, we designed a version of the dot-perspective task that allowed us to precisely control whether a central stimulus was viewed as animate or inanimate. Across four experiments, we found no evidence that automatic “perspective-taking” effects in the dot-perspective task are modulated by beliefs about the animacy of the central stimulus. Our results also suggest that these effects may be due to the task-switching elements of the dot-perspective paradigm, rather than automatic directional orienting. Together, these results indicate that neither the perspective-taking nor the standard submentalizing interpretations of the dot-perspective task are fully correct. (shrink)

This chapter describes how philosophical theorizing about justice can be connected with empirical research in the social sciences. We begin by drawing on some received distinctions between ideal and non-ideal approaches to theorizing justice along several different dimensions, showing how non-ideal approaches are needed to address normative aspects of real-world problems and to provide practical guidance. We argue that there are advantages to a transitional approach to justice focusing on manifest injustices, including the fact that it enables us to set (...) aside some reasonable disagreements about justice. The ‘bottom-up’ approach we advocate, for which we borrow Wolff’s term ‘real-world political philosophy’, is an empirically-informed normative analysis that attends to specific, identifiable injustices, and thus is partial, though not isolationist. We illustrate our approach by considering how different models of the nature of disability suggest different kinds of remedy for injustices faced by persons living with disabilities. We reflect on the nature and significance of vulnerabilities, and we assess the role of public opinion in normative theorizing, suggesting a particular significance for the opinions and experiences of marginalized groups. We finally reflect on the relevance of European legal and institutional frameworks for theorizing justice in Europe. (shrink)

In dit artikel wordt de dominante metafysische oriëntatie in de hedendaagse meta-ethiek kritisch onder de loep genomen. Het hedendaagse debat, dat zich voornamelijk richt op de vraag hoe moraliteit metafysisch gezien 'in de werkelijkheid past', wordt gekenmerkt door een reeks complexe en soms esoterische discussies die, zo wordt betoogd, weinig bijdragen aan ons filosofische begrip van ethiek. Deze focus op metafysische grondslagen heeft geleid tot een tunnelvisie, waarin het debat gevangen zit tussen steeds ingewikkeldere vormen van non-cognitivisme, herconceptualisaties van 'objectiviteit' (...) en metafysische acrobatiek. Als alternatief wordt voorgesteld de aandacht in de meta-ethiek te verleggen naar het domein van praktisch redeneren. Door ons te concentreren op de patronen van geldige praktische argumentatie en het soort overwegingen dat mensen daadwerkelijk overtuigt, kunnen we wellicht een beter inzicht krijgen in de aard van ethische normativiteit en de rol ervan in ons leven. Het artikel pleit voor een meer pragmatische en minder metafysisch beladen benadering van de meta-ethiek, die zich richt op de daadwerkelijke praktijken van moreel redeneren en argumenteren. (shrink)

Ludwig Feuerbach is traditionally regarded as a significant but transitional figure in the development of nineteenth-century German thought. Readings of Feuerbach's The Essence of Christianity tend to focus on those features which made it seem liberating to the Young Hegelians: namely, its criticism of reification as abstraction, and its interpretation of religion as alienation. In this book, Van Harvey claims that this is a limited and inadequate view of Feuerbach's work, especially of his critique of religion. The author argues that (...) Feuerbach's philosophical development led him to a much more complex and interesting theory of religion which he expounded in works which have been virtually ignored hitherto. By exploring these works, Harvey gives them a significant contemporary re-statement, and brings Feuerbach into conversation with a number of modern theorists of religion. (shrink)

Certain organoid subtypes are particularly sensitive. We explore whether moral intuitions about the heartbeat warrant unique moral consideration for newly advanced contracting cardiac organoids. Despite the heartbeat’s moral significance in organ procurement and abortion discussions, we argue that this significance should not translate into moral implications for cardiac organoids.

Contemporary internalists typically idealize the conditions for motivation, claiming for example that motivation must be present in rational persons under certain conditions. Robert Johnson, in The Philosophical Quarterly, 49, convincingly argues that these versions of internalism overlook ways in which the conditions in the antecedent of the conditional expressing the analysis are incompatible with the claim under analysis. However, avoiding the fallacy decouples internalism from its use to explain and justify moral action. I use Johnson’s argument as the basis of (...) a new proposal for defining central internalist claims, modifying the conditions in which motivation must be manifest so that it is less idealized. We can specify conditions which are ideal enough to ensure motivation, but which are not so ideal as to be incompatible with the grounds of an agent’s reasons. (shrink)

Michael Smith's recent defence of the theory shows promise, in that it captures the most common reasons for accepting a Humean view. But, as I will argue, it falls short of vindicating the view. Smith's argument fails, because it ignores the role of rationality conditions on the ascription of motivating reason explanations. Because of these conditions, we must have a theory of rationality before we choose a theory of motivation. Thus, we cannot use Humean restrictions on motivation to argue for (...) a particular conception of rationality. I will not directly criticize using a Humean conception of rationality to defend a Humean theory of motivation. For my argument implies that such criticism must come more directly, as argument over the substantive content of rationality. (shrink)

Information is a recognized fundamental notion across the sciences and humanities, which is crucial to understanding physical computation, communication, and human cognition. The Philosophy of Information brings together the most important perspectives on information. It includes major technical approaches, while also setting out the historical backgrounds of information as well as its contemporary role in many academic fields. Also, special unifying topics are high-lighted that play across many fields, while we also aim at identifying relevant themes for philosophical reflection. There (...) is no established area yet of Philosophy of Information, and this Handbook can help shape one, making sure it is well grounded in scientific expertise. As a side benefit, a book like this can facilitate contacts and collaboration among diverse academic milieus sharing a common interest in information. . First overview of the formal and technical issues involved in the philosophy of information . Integrated presentation of major mathematical approaches to information, form computer science, information theory, and logic . Interdisciplinary themes across the traditional boundaries of natural sciences, social sciences, and humanities. (shrink)

Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project “support and consultation in euthanasia in Amsterdam” which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity. Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the (...) general practitioners who were going to use the protocol. Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia. Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants. Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere. (shrink)

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

The technological advances in medicine, including prolongation of life, have constituted several dilemmas at the end of life. In the context of the Belgian debates on end-of-life care, the views of Muslim women remain understudied. The aim of this article is fourfold. First, we seek to describe the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward withholding and withdrawing life-sustaining treatments. Second, we aim to identify whether differences are observable among middle-aged and elderly women’s attitudes toward withholding (...) and withdrawing life-sustaining treatments. Third, we aim to explore the role of religion in their attitudes. Fourth, we seek to document how our results are related to normative Islamic literature. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women living in Antwerp and with experts in the field. We found an unconditional belief in God’s sovereign power over the domain of life and death and in God’s almightiness. However, we also found a tolerant attitude, mainly among our middle-aged participants, toward withholding and withdrawing based on theological, eschatological, financial and quality of life arguments. Our study reveals that religious beliefs and worldviews have a great impact on the ethical attitudes toward end-of-life issues. We found divergent positions toward withholding and withdrawing life-sustaining treatments, reflecting the lines of reasoning found in normative Islamic literature. In our interviews, theological and eschatological notions emerged as well as financial and quality of life arguments. (shrink)

Criticizing Gallagher’s view on direct perception, I develop a basic model of social perception. According to the Cartesians another person’s intentions are not directly accessible to an observer. According to the cognitivist Cartesians conscious processes are necessary for social understanding. According to the Anti-Cartesians social perception is direct. Since both of these latter approaches face serious problems, I will argue in favor of an alternative: anti-cognitivist Cartesianism. Distinguishing between an active- and a passive part of the perceptual system we can (...) describe the situation as follows: Some functionally individuated parts of our nervous system generate percepts that correspond to the properties that causally trigger the system, whilst others form percepts of properties that do not causally trigger the system. The model is basic in that it merely helps clarifying some of the fundamental concepts we need in order to describe empirical findings. (shrink)

An important Belgian avant-garde poet, Daive's investigations alternate between poetry, narration and reflective prose. In addition to translations of Daive's poetry, van Gerven Oei offers a lush presentation of Daive's poetry and its relationship to the production-analysis of signification.

Although pain is widely recognized by clinicians and researchers as an experience, pain is always felt in a patient-specific way rather than experienced for what it objectively is, making perceived meaning important in the study of pain. The book contributors explain why meaning is important in the way that pain is felt and promote the integration of quantitative and qualitative methods to study meanings of pain. For the first time in a book, the study of the meanings of pain is (...) given the attention it deserves. All pain research and medicine inevitably have to negotiate how pain is perceived, how meanings of pain can be described within the fabric of a person’s life and neurophysiology, what factors mediate them, how they interact and change over time, and how the relationship between patient, researcher, and clinician might be understood in terms of meaning. Though meanings of pain are not intensively studied in contemporary pain research or thoroughly described as part of clinical assessment, no pain researcher or clinician can avoid asking questions about how pain is perceived or the types of data and scientific methods relevant in discovering the answers. (shrink)

Partial proceedings of the 17th World Congress, International Association for Philosophy of Law and Social Philosophy, Bologna, 1995.

This article presents standards for setting up and educating institutional ethics committees (IECs). These standards are based on experiences in the Netherlands, where IECs have been established in a large number of health care institutions. Though the IEC has become a generally accepted institution within Dutch health care, there are concerns over its effectiveness regarding the improving of the moral quality of clinical decision making. Health care practitioners and members of IECs too, experience a gap between the IEC and the (...) reality of the clinical environment. At this moment, there is interest in developing programmes which educate practitioners in moral issues and how to deal with them, using the method of a structured debate on the ward. The IEC will not be made obsolete by this development, but can play a guiding role in the implementation of such programmes. Current concerns are the lack of patient representation in the Dutch IEC, and the loss of contact with the local community of health care practitioners because of the merger of hospitals into bodies similar to UK National Health Service (NHS) trusts. (shrink)

A.G. van Aarde and historical Jesus research. A.G. van Aarde’s contribution to historical Jesus research is mainly expressed in his book Fatherless in Galilee: Jesus as Child of God. The book was the result of five years of Jesus research. Van Aarde is an ordained minister of the Netherdutch Reformed Church of Africa. Since the book’s publication in 2001, the NRCA has experienced an immense dispute regarding the book in particular but also regarding the subject of historical Jesus research in (...) general. This dispute has publicly escalated since 2010. It has often centred on Van Aarde’s notion of Jesus’ fatherlessness. This article will focus on said book in order to ascertain what is meant by the concept ‘the fatherless Jesus’. This is done to illustrate that Van Aarde’s research, as it converges in the scrutinised publication, remains of relevance to the NRCA. (shrink)

Onderzoekers die kritiek willen leveren op de institutionele eisen die doorgaans aan hun werk worden gesteld, nemen meestal een visie op de zin en noodzaak van onderzoek als uitgangspunt. Ze laten zien dat een onderzoeker die ‘goed scoort’ volgens de maatstaven van publieke onderzoeksfinanciers, zoals in Nederland nwo, nog geen goed onderzoekswerk levert. En ze geven redenen om te betwijfelen dat een instituut dat zich een ‘topinstituut’ mag noemen niet per se mensen opleidt die in staat zijn om zelfstandig hoogwaardig (...) en vernieuwend onderzoek te doen. (shrink)

Die voortgesette proses van implementering van nuwe materiaal wat gebruik word vir katkisasie in die Nederduitsch Hervormde Kerk van Afrika vertoon 'n besondere trajek. Die proses het, in terme van geloof, begin met die formalisering van sowel die geloofsbegrip as die beskrywing van die inhoud van geloof. Dit is voortgesit deur 'n proses van die objektivering van die inhoud van geloof tot feite wat geleer kan word en is uiteindelik voltrek deur die implementering van 'n pragmatiese opvoedkundige doelwit waarin geloof (...) bloot 'n middel tot 'n doel geword het. Die trajek kan kortliks soos volg beskryf word: • Die Heidelbergse Kategismus Geloof is die aanneming van die beloftes van God wat vertroue in die lewende God skep. • 'Kortbegrip': Geloof is sekere kennis van God en sy beloftes en 'n hartlike vertroue dat al my sondes om Christus ontwil vergewe is. • Die belydenis van die Hervormers: Ek glo in God beteken dat ek al my vertroue op God stel en Hom op sy woord neem. • Geloofsleer: Geloof is kennis van die Woord van God en vertroue in die God van die Woord. • Geloof en Lewe 11: Geloof is die toe-eiening van kenbare geloofoorleweringe wat in die Bybel opgeneem is. Die kerk kan daarom kinders deur 'n proses van kategese begelei tot geloofsvolwassenheid. Vandag is die uitgangspunt van katkisasie en die motivering daarvoor in die Nederduitsch Hervormde Kerk van Afrika die oortuiging dat die kerk kinders deur 'n proses van kategese tot godsdienstige volwassenheid kan lei. Van Selms se kategismus pas nie in die trajek wat hier beskryf word nie. Die Nederduitsch Hervormde Kerk van Afrika sou vandag heeltemal anders gelyk het as meer as een generasie van die lidmate van die Kerk aan hierdie kategeseboek blootgestel was. (shrink)