Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)
Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)
Among the various appropriations and discussions of M.M. Bakhtin’s work, his ‘philosophy of the everday’ has received increasing recognition in Western scholarship that has complemented his reputation as a literary theorist, aesthetician, and linguist. For example, some critics have suggested that Bakhtin’s work on literature springs from his understanding of the novel as a ‘transcendental metaphor’ for life. Others have attempted to adapt Bakhtin’s work on literature and its emancipatory practical orientation to critical social theory. Such interpretive endeavors might be (...) valid in their respective contexts. However, they in effect obscure the fact that Bakhtin starts his intellectual career as a phenomenologist intent on giving a non-aesthetic explanation of the world, i.e., as human beings experience it through cognition and practical action prior to the mediation of art. In one of his earliest pieces, Toward a Philosophy of the Act, Bakhtin sets out to advance the foundations of a prima philosophia, a philosophical ontology that would explain human existence through categories of being rather than through those of representation. No matter how much of Bakhtin’s early work draws on the legacy of other thinkers, such an intention, unequivocally expressed, testifies to his investment in the philosophy of the real, the practical, and the everyday. In Bakhtin’s early essays, the human being—the figure around which his whole philosophy of the 1920’s revolves—is explicitly portrayed as a living, breathing individual and is carefully distinguished from a literary ‘hero’. (shrink)
Among the various appropriations and discussions of M.M. Bakhtin’s work, his ‘philosophy of the everday’ has received increasing recognition in Western scholarship that has complemented his reputation as a literary theorist, aesthetician, and linguist. For example, some critics have suggested that Bakhtin’s work on literature springs from his understanding of the novel as a ‘transcendental metaphor’ for life. Others have attempted to adapt Bakhtin’s work on literature and its emancipatory practical orientation to critical social theory. Such interpretive endeavors might be (...) valid in their respective contexts. However, they in effect obscure the fact that Bakhtin starts his intellectual career as a phenomenologist intent on giving a non-aesthetic explanation of the world, i.e., as human beings experience it through cognition and practical action prior to the mediation of art. In one of his earliest pieces, Toward a Philosophy of the Act, Bakhtin sets out to advance the foundations of a prima philosophia, a philosophical ontology that would explain human existence through categories of being rather than through those of representation. No matter how much of Bakhtin’s early work draws on the legacy of other thinkers, such an intention, unequivocally expressed, testifies to his investment in the philosophy of the real, the practical, and the everyday. In Bakhtin’s early essays, the human being—the figure around which his whole philosophy of the 1920’s revolves—is explicitly portrayed as a living, breathing individual and is carefully distinguished from a literary ‘hero’. (shrink)
