The use of do not resuscitate (DNR) orders in Dutch hospitals was studied as part of a nationwide study on medical decisions concerning the end of life. DNR decisions are made in 6 per cent of all admissions, and 61 per cent of all in-hospital deaths were preceded by a DNR decision. We found that in only 14 per cent of the cases had the patients been involved in the DNR decision (32 per cent of competent patients). The concept of (...) futility is analysed as these findings are discussed. We conclude that determining the effectiveness of resuscitation is a medical judgement whereas determining the proportionality (burden/benefit ratio) of it requires a discussion between doctor and patient (or his or her surrogates). Since the respondents in the cases without patient involvement gave many reasons for their decision that went beyond determining effectiveness, we conclude that more patient involvement would have been desirable. (shrink)

This contribution consists of two parts. The first part identifies Augustine’s qualities as a mystagogue on the basis of the only poem he wrote that has been handed down: the Psalm against the Donatists. It shows that little is to be gained by studying Augustine as both poeta and mystagogue. Not his poetry itself, but his commentary on poetry as such reveals the transformative power that he ascribes to this genre. For this reason the second part examines Augustine’s Enarrationes in (...) psalmos. In this work, he makes explicit the transformative power that is contained in the 150 Psalms, which are both poetry and prayer. This part asks the question how Augustine articulates or heightens fear when the Psalmist in his dialogue with God ‘compels’ him to do this, as it were, by expressing fear of enemies or of the Last Judgement. He shows that he acknowledges that fear alone can lead to an unbalanced, and even a bad relationship with God. Fear should result in introspection and should be a guarantee against pride. That Augustine furthermore is not content to heighten the fear of God alone, but wants it to coincide with desire, joy, and hope, shows that he wishes to prevent any imbalance in the human who seeks a relationship with God. For Augustine, fear is necessary, but it is ‘only’ an ancilla of hope, joy, love, and desire. But as such, timor is indispensible. Fear causes attentiveness and carefulness: virtues that love presuppose and that also correlate with it. Nevertheless, love does not stand at the service of fear; for Augustine, it is the reverse. (shrink)

The American Academy of Pediatrics recently released a policy statement and technical report on circumcision, in both of which the organisation suggests that the health benefits conferred by the surgical removal of the foreskin in infancy definitively outweigh the risks and complications associated with the procedure. While these new documents do not positively recommend neonatal circumcision, they do paradoxically conclude that its purported benefits ‘justify access to this procedure for families who choose it,’ claiming that whenever and for whatever reason (...) it is performed, it should be covered by government health insurance. The policy statement and technical report suffer from several troubling deficiencies, ultimately undermining their credibility. These deficiencies include the exclusion of important topics and discussions, an incomplete and apparently partisan excursion through the medical literature, improper analysis of the available information, poorly documented and often inaccurate presentation of relevant findings, and conclusions that are not supported by the evidence given. (shrink)

Hereditary structural completeness is established for a range of substructural logics, mainly without the weakening rule, including fragments of various relevant or many-valued logics. Also, structural completeness is disproved for a range of systems, settling some previously open questions.

Slow euthanasia or a good palliative intervention?There are many ways in which doctors influence the circumstances and/or the timing of a patient’s death. Some of these are accepted as normal medical practice—for instance, when a disproportional treatment is forgone, others are considered tolerable only under strict conditions or even intolerable, such as non-voluntary active euthanasia. A relatively new phenomenon in the ethical discussion on end-of-life decisions is terminal sedation. Terminal sedation is used in patients with terminal illnesses where normal medical (...) treatments cannot relieve severe symptoms such as pain and agitation, and no option is left but to take away the perception of these symptoms. Often, the decision to start terminal sedation is accompanied by the decision to forgo the provision of artificial nutrition and hydration in these patients. In The Netherlands, terminal sedation was estimated to be applied in 4–10% of all deaths in 2001.1 The combination of these two decisions have made the moral status of terminal sedation the subject of fierce ethical debates. Is it slow euthanasia2,3 or is it a good palliative intervention that should be sharply distinguished from euthanasia?4,5 One of the characteristics of this debate is that it is a very confused one: people disagree about the meaning of the term, the appropriateness of it and, of course, about the conditions under which it would be morally justified. As a matter of fact, these three discussions are deeply connected: as is often the case, a discussion about terms is a discussion about norms in disguise.The first observation to be made is that many seemingly descriptive definitions of terminal sedation contain normative claims. Examples of this are definitions of terminal sedation in which only …. (shrink)

In April 2002 a new law regarding euthanasia came into effect in the Netherlands. This law holds that euthanasia remains a criminal offence unless it is performed by a physician who acts according to six specified rules of due care and reports the case to a review committee. The six rules of due care are similar to those of the previous regulation and are largely based on jurisprudence. Completely new, however, is the article concerning a competent patient who has written (...) an advance directive requesting euthanasia under certain circumstances. The law stipulates that a physician may act according to that written request, as long as he or she fulfils all other rules of due care. The author defends the view that these requests are neither feasible nor ethically justifiable, and presents both moral and practical arguments for this, claiming that for consistency reasons one cannot act on the basis of a written statement and fulfil the other rules of due care at the same time. The author also examines a difficult case of a demented, severely depressed woman who had written a living will requesting euthanasia before she became demented. (shrink)

The issue of the allocation of resources in health care is here to stay. The goal of this study was to explore the views of physicians on several topics that have arisen in the debate on the allocation of scarce resources and to compare these with the views of policy makers. We asked physicians and policy makers to participate in an interview about their practices and opinions concerning factors playing a role in decision making for patients in different age groups. (...) Both physicians and policy makers recognised allocation decisions as part of their reality. One of the strong general opinions of both physicians and policy makers was the rejection of age discrimination. Making allocation decisions as such seemed to be regarded as a foreign entity to the practice of medicine. In spite of the reluctance to make allocation decisions, physicians sometimes do. This would seem to be only acceptable if it is justified in terms of the best interests of the patient from whom treatment is withheld. (shrink)

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making.Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large (...) life-stance groups in each country.Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient’s death , physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics and Protestants reported ever having made such a decision.Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. (shrink)

Background: Caring for terminally ill patients is a meaningful task, however the patient’s suffering can be a considerable burden and cause of frustration.Objectives: The aim of this study is to describe the experiences of general practitioners in The Netherlands in dealing with a request for euthanasia from a terminally ill patient.Methods: The data, collected through in-depth interviews, were analysed according to the constant comparative method.Results: Having to face a request for euthanasia when attempting to relieve a patient’s suffering was described (...) as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient’s suffering without “intentionally hastening a patient’s death on his request”. The other GPs explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient’s request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient’s suffering through euthanasia and their personal values.Conclusion: Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient’s suffering and to promote a peaceful death. (shrink)

Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses’ attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better (...) not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units. (shrink)

We introduce the horizontal and vertical topologies on the product of topological spaces, and study their relationship with the standard product topology. We show that the modal logic of products of topological spaces with horizontal and vertical topologies is the fusion ${\bf S4}\oplus {\bf S4}$ . We axiomatize the modal logic of products of spaces with horizontal, vertical, and standard product topologies. We prove that both of these logics are complete for the product of rational numbers ${\Bbb Q}\times {\Bbb Q}$ (...) with the appropriate topologies. (shrink)

The transits of Venus in 1761 and 1769 appear to mark the starting point of instrumental science in the Dutch East Indies (now Indonesia). This essay examines the conditions that triggered and constituted instrumental and institutional science on Indonesian soil in the late eighteenth century. In 1765 the Reverend J. M. Mohr, whose wife had received a large inheritance, undertook to build a fully equipped private observatory in Batavia (now Jakarta). There he made several major astronomical and meteorological observations. Mohr’s (...) initiative inspired other Europeans living on Java around 1770 to start a scientific movement. Because of the lack of governmental and other support, it was not until 1778 that this offspring of the Dutch‐Indonesian Enlightenment became a reality. The Bataviaasch Genootschap van Kunsten en Wetenschappen tried from the beginning to put into effect the program Mohr had outlined. The members even bought his instruments from his widow, intending to continue his measurements. For a number of reasons, however, this instrumental program was more than the society could support. Around 1790 instrumental science in the former Dutch East Indies came to a standstill, not to be resumed for several decades. (shrink)

continent. 1.4 (2011): 242—252. Introduction The following two works were produced by visual artist Jonas Staal and writer Vincent W.J. van Gerven Oei during a visit as artists in residence at The Bag Factory, Johannesburg, South Africa during the summer of 2010. Both works were produced in situ and comprised in both cases a public intervention conceived by Staal and a textual work conceived by Van Gerven Oei. It was their aim, in both cases, to produce complementary works that could (...) be read “through each other,” in which the movement of artistic construction would be imitated by textual deconstruction and vice versa. Both works deal with the way in which capital, apartheid, and monumentality are interwoven in South-African society. The Missing Link addresses a monument for democracy, erected on the premises of a private corporation running both an amusement park and the Apartheid Museum franchise. The textual intervention accompanying this public intervention investigates the limits of the inclusiveness of the anti-discrimination section in the South-African constitution, itself a monumental work of democracy. The Monument for the Distribution of Wealth deals with the history and eventual dissolution of a monumental square, commemorating the Soweto Uprising, in one of the poorest townships of Johannesburg. The history accompanying this public dismemberment of memory is equally fragmented, which is expressed by the many voices recounting uncertain and perhaps even irrelevant “facts” about the genius loci, the way in which the memorial space has actually entered into the memory of the inhabitants surrounding it. Next to their individual practices, Staal and Van Gerven Oei have worked together on a number of projects ever since 2007, including several art residencies. Their work involves an investigation of the different interfaces between art, politics, and public space in media ranging from theater and public interventions, to video installations and (co-authored) textual works. The Missing Link Missing Link (1) Missing Link (2) Missing Link (3) Intervention on the monument entitled The Seven Pillars of the Constitution , part of the Apartheid Museum in Johannesburg, South Africa. The Seven Pillars represent the constitutional values propagated in South Africa since the abolition of the apartheid regime. The monument and museum were built by the Gold Reef Resorts corporation, which is also responsible for the theme park and casino next to it. By placing the word “capitalism” on the wall surrounding the museum, the capitalist system and the constant social divisions that it implies are interpreted as sophistic continuations of apartheid politics. Through the capitalist system, apartheid is still operational within South African society. Whereas during the apartheid regime, the separation clearly ran along race divisions, in the current, “democratic” system, the same actual separation is sustained without it being an explicit element of the foundations of the country, i.e. the constitution. This intervention foregrounds the constant role of capitalism is both periods. At the same time the intervention acknowledges that contemporary Western artisthood is a mirror of the privileges that are offered by the capitalist system, and the type of artist that it produces. The intervention initiates a critical discourse concerning the capitalist system situated within the disaster of capitalism itself, in other words: through the desire to break with the presumption that art would be able to operate outside the capitalist system and to confirm that art—and the artist himself—is in fact modeled on this system. The public intervention by Staal was supplemented by a textual intervention by Van Gerven Oei: a proposition to alter the seventeenth amendment of the South African constitution. Even though the anti-discrimination legislation in South-Africa is one of the most stringent and inclusive in the world, one factor—wealth—remains outside its scope, thus continuing the schisms along racial lines produced during the apartheid regime: §9.3. The state may not unfairly discriminate directly or indirectly against anyone on one or more grounds, including race, gender, sex, pregnancy, marital status, ethnic or social origin, colour, sexual orientation, age, disability, religion, conscience, belief, culture, language, birth, and wealth. Monument for the Distribution of Wealth Intervention concerning the June 16 Memorial Acre in Central Western Jabavu, one of the poorest townships of Johannesburg. The monument comprises a park on which different are placed recalling an important protest the black population against the former apartheid regime. In 1976, from a school adjacent to the park, they started a massive protest against the introduction of Afrikaans in the school curriculum. The police reacted violently, and shot several hundreds of students. The construction of the June 16 Memorial Acre was started in 2005, and from the start was the paragon of corruption. Coordinated by local politicians, some family members of the protest leader from 1976 gained control of the realization of the monument, outside the regulation through external institutions. The available budget of 41 million rand (at that time well over 5 million euro) was largely embezzled. In the meantime, the monument has become fully dilapidated and defaced. The park has become overgrown with weeds and covered in a layer of dirt, and the local population is slowly plundering the square to use the material for the construction and decoration of their own houses. The Monument for the Distribution of Wealth develops the dynamics already existent around the June 16 Memorial Acre. Without obtaining official permission in advance, several local inhabitants were hired to break down the monument, sort the materials, and offer it to the neighborhood. Thus, the redistribution of wealth after the fall of the apartheid regime is finally taking place, albeit from the mere remains of the capital that was once invested in the community. The words “monument” and “for free” are spray-painted on the stacks of material, both in English and Zulu, as these are locally the most common languages. Van Gerven Oei supplemented Staal’s public intervention with an account of the history of the monument based on a series of interviews. The account clarifies how the different interests within the protest 1976 are reflected in the exceeding decay of the park, and how in the end those interests were represented by the June 16 Memorial Acre. Monument for the Distribution of Wealth 1: Removing stones Monument for the Distribution of Wealth 3: Pulling down statues Monument for the Distribution of Wealth 4: Offering the material Monument for the Distribution of Wealth 5: Offering the material Monument for the Distribution of Wealth 6 The next day A Fragmentary History of the Monument for the Distribution of Wealth, Formerly Known as the June 16 Memorial Acre in Central Western Jabavu, Soweto Vincent W.J. van Gerven Oei The following text, based on interviews and online research aims to provide parts of a history of the park in front of Morris Isaacson High School in Central Western Jabavu, Soweto. The idea for the transformation of the park into a memorial site has its source in the events of June 16, 1976: the start of the the student uprising in Soweto. The development of the park was started in the early 1980s, and the actual transformation into a memorial site, the June 16 Memorial Acre, was initiated in 2005. Over the last few years, several monumental additions have been made to the park: A marble monument with three pillars was revealed on June 16, 2006. A sculpture of a book and several billboards on June 16, 2008. A sculpture of student leader Tsietsi Mashinini on June 16, 2010. The park was transformed into the Monument for the Distribution of Wealth on August 3, 2010. According to the entry “Youth Struggle” on the website South African History Online, the Bantu Education Act was introduced in 1953 . In 1954 , Dr Verwoerd, Minister of Native Affairs, stated: “What is the use of teaching the Bantu child mathematics when it cannot use it in practice? That is quite absurd.” According to the entry “Soweto uprising” on Wikipedia, the Afrikaans Medium Decree was issued in 1974 , forcing all black schools to use Afrikaans and English in a 50-50 mix as languages of instruction. The Regional Director of Bantu Education (Northern Transvaal Region), J.G. Erasmus, told Circuit Inspectors and Principals of Schools that from January 1, 1975 , Afrikaans had to be used for mathematics, arithmetic, and social studies from standard five (7th grade). English would be the medium for general science and practical subjects. Indigenous languages would be used for religion instruction, music, and physical culture. According the entry “Soweto uprising” on Wikipedia, on April 30, 1976 , students from the Orlando West Junior School in Soweto went on strike, refusing to go to school. Their example was followed by other schools in Soweto. A student from Morris Isaacson High School, Toboho “Tsietsi” Mashinini, proposed a meeting on June 13, 1976 to discuss further action. According to Weizmann Hamilton’s article “The Soweto Uprising 1976,” which appeared in the September 1986 edition of Inqaba Ya Basebenzi (Fortress of the Revolution), on June 13, 1976 , the South African Students’ Movement called a meeting at the Donaldson Community Center in Orlando. 300-400 Students representing 55 schools decided to hold a mass demonstration on June 16. According to Brian Mokhele, member of the Joint Community Safety Forum, Dr Edelstein was the first victim of the Soweto uprising and killed the day before the march on June 15, 1976 . Edelstein was an administrator at the pass office in Jabavu and gave golf courses to the local community. Edelstein was put in a garbage bin and pierced by pickaxes. The garbage bin was left at the very spot of the murder for many years. A few years ago, a child was beheaded at the same spot, and the basketball court next to it has been abandoned since. According to Marcus Neustetter, founder of the Trinity Session, this story is untrue. According the entry “Soweto uprising” on Wikipedia, on June 16 , Tsietsi Mashinini led students from Morris Isaacson High School to join up with others who walked from Naledi High School. A crowd of between 3,000 and 10,000 eventually ended up near Orlando High School. According to Raymond Marlowe, a local photographer, Tsietsi Mashinini was heading the march. According to the entry “Hector Pieterson” on Wikipedia, Dr Edelstein died on June 16, 1976 , stoned to death by mob and left with a sign around his neck proclaiming “Beware Afrikaaners.” The first child to die that day was called Hastings Ndlovu. According to Pat Motsiri, Orlando West is claiming struggle heritage through the Hector Pieterson Museum, while Hector Pieterson was from Jabavu. According to Pat Motsiri, his generation effectively struggled between 1980 and 1991, forcing the release of Nelson Mandela and negotiations with the apartheid regime while the 1976-generation was safely in exile. Nevertheless, this has not been recognized in any monument. After the abolition of apartheid, the generation from 1976 returned from exile, occupied important government and ANC positions, creating an abundance of 1976 memorials and refusing to acknowledge that this was only possible because of the younger generation’s struggle. He calls this a generational conflict. According to Archibald Dlamini, the park officer responsible for the Memorial Acre, he started working for the municipality in 1978. In 1981/82 , Isaac Makhele from Pimville, who used to work in the cemetery business, was the first developer of the park. It used to be just a normal park until City Parks decided to develop the Memorial Acre in 2006. In 2007 the work was stopped by the community. According to Brian Mokhele, he left the country in 1989 after he participated in the riots of 1986. But when he returned in 1999 he found that nothing had changed. He says that they were promised to be protected by the Constitution, but that reality is different. The police uses fear to suppress them so that they don’t come out to talk openly. He has been arrested twice, both times harassed and tortured by the police, but in the end always released without indictment. He says that this is their way to threaten communities to back off from politics. According to Moses, who is sitting outside rolling a joint, Brian knows everything. He tells Brian to tell me everything he knows. According to Brian Mokhele, Tsietsi Mashinini was possibly murdered in 1990 during his exile in New York. Two weeks before he was supposed to return to South Africa, his papers in order, he was found dead under mysterious circumstances. His coffin was sealed when he was buried. According to Pat Motsiri, he came up with the idea for the Memorial Acre in 2003 . He submitted the documents for the proposal to the council, which sidelined him as soon as the budget came out in 2005 . According to Brian Mokhele, there was on estimation R 41,000,000 spent to redesign the park and turn it into the Memorial Acre. The millions were divided by Amos Masondo, the mayor of Soweto, the local councilor Bongani D. Zondi, and the director of the city of Johannesburg, Pat Lephunya. They were dividing the money between several contractors: Tsietsi Mashinini’s brothers were involved in the development of the park, they got the tender to do the green areas, the landscaping. Construction was done by other companies, some did the paving, the toilets, etc. EMBA, a private company appointed by the municipality was in control of the money flow, but the money was quickly gone. According to Raymond Marlowe, the contractor bought a BMW with the money. According to Archibald Dlamini, the Mashinini brothers got the tender, so the space would look more like the other places around in Soweto. It was agreed that after they were done, they would return the property to the municipality. They did whatever they could do. According to Mafaisa, a member of the Jabavu business community, he was one of the contractors for the landscaping and the pavement under Mpho Mashinini, one of the brothers. He says that I should contact Mavi for information on Mpho. According to Poi Stuurman, a local youth worker, Mafaisa is one of the guys who ran away with the money. According to Mavi, Mpho Mashinini was never a contractor. The contracts were organized by Sbu Butelezi, the former head of the Gauteng Department for Public Works. The June 16 Foundation and the Mashinini brothers will be the beneficiaries of the park when it is finished. According to Brian Mokhele, City Parks did not accept the Memorial Acre because it was not finished. The rest of the year, the unfinished park is not maintained, as should have happened. This was done deliberately so that in the end they can just clean the whole thing up and have a reason to redo the whole park. According to Brian Mokhele, the Mashinini brothers now work for the government. People that manipulate for money purposes always come from the government’s side. Because the park was left unfinished, the people from the neighborhood are taking away the stones to decorate their own homes with. According to Archibald Dlamini, because City Parks doesn’t accept responsibility of the park, he officially has nothing the guard, except for his cottage, which is municipal property. The thieves come at night and destroy the park, but he cannot do anything because he is sleeping. According to the website of the Thanda Foundation on June 16, 2006 a bronze statue of Hector Pieterson, the first child to die in the 1976 protests, made by Kobus Hattingh and Jacob Maponyane was unveiled in the Maponya Mall in Soweto. The statue is sculpted after the famous image shot by Sam Nzima of Mbuyisa Makhubo carrying the dead body of the boy. The sculpture was sponsored by the Thanda Foundation, founded by the Swedish entrepreneur Dan Olofsson and South-African entrepreneur Matthews Phosa. According to the official website of the City of Johannesburg, the Memorial Acre and Artwork were unveiled in 2006. According to a blog post on sowetouprisings.com, the Memorial Acre was still under development on July 24, 2006. According to Archibald Dlamini, City Parks only cleans up the park once a year just before the June 16 celebrations. Everybody is waiting for the Mashinini brothers to finish their job. The last time he talked with them was in 2007 . According to a sign on the school grounds of the Morris Isaacson High School, the June 16 Trail will be finished in 2008 . According to a blog post on sowetouprisings.com, the Memorial Acre contains another monument erected in Tsietsi’s honor. The monument was created as part of the Sunday Times Heritage Public Art program. Its physical form resembles a giant book which symbolizes the crisis in education experienced in 1976. On the face of the book is the map of the route taken by the students from Morris Isaacson High School in Central Western Jabavu to Phefeni Junior Secondary in Orlando West (currently the site of the Hector Pieterson Museum), while the back cover of the ‘book’ is inscribed with a tribute to Tsietsi Mashinini. The monument was revealed on June 16, 2008 . According to Marcus Neustetter, the billboards on the Memorial Acre were part of a school project realized in 2008. Following several workshops, the students from different high schools along the June 16 Trail were invited to work with artists on the billboards, while the neighborhood community was invited to watch the process during the festivities on June 15 and 16, 2008 . The billboards were supposed to be removed because of construction works on the Memorial Acre, which never ended up happening. According to Brian Mokhele, the former toilet facilities were converted into a house for the park officer. This park officer has been working for city parks for more than 12-15 years, but does nothing here, because the park, including the new toilet buildings, is not finished. The government is now moving around looking for people to take this job because they stopped it. They confronted everybody who was going in and chased them away. According to John, in 2009 , some girls, around 16 or 17 years old, were raped by four men who had been drinking in a local shebeen. When the bar quit they said that they would go home by car, but instead raped the girls on the Memorial Acre nearby. This happened in the unfinished toilets, because the doors couldn’t be closed. According to Brian Mokhele, there used to be some fences around the park because of the construction work that was eventually stopped, but these were also stolen. According to Archibald Dlamini, people from the neighborhood started about two and a half years ago, and the last piece was stolen near the end of 2009 . Sometimes he would catch someone with a roll of fence, and then use it for his own cottage. According to the official website of the City of Johannesburg, a statue of Tsietsi Mashinini by Johannes Pokhela was revealed on June 16, 2010 , “Youth Day.” According to Shirley Makutoane, deputy principal of Isaac Morrison High School, the statue of Tsietsi Mashinini, funded by the June 16 Foundation, has temporarily been placed within the school perimeter. The statue will be moved to the Memorial Acre when it will be finished, in 2011 . According to Brian Mokhele, beside the June 16 Foundation, there is also a June 16 Memorial Acre Foundation. Both foundations are quarreling about the money involved in the Memorial Acre project. Nobody knows who’s involved in them. According to Marcus Neustetter, the June 16 Foundation consists of people that were part of 1976 protest movement, local government officials, representatives of the Hector Pieterson Museum, and the council. According to students from the Isaac Morrison High School, the statue of Tsietsi Mashinini is on the school ground because on the Memorial Acre it would be vandalized by youths from White City, an adjacent neighborhood. Accorcing to Brian Mokhele, the statue of Tsietsi should eventually be mounted on the Memorial Acre. It is wrong that the statue is in the school at the moment, because it is not a public school. He wants the statues to depict the massiveness of the force that was coming into Soweto after the protests. According to Brian Mokhele, City Parks, City of Jo’burg, City Lights, and SAPS are making some sort of plan to take the plan back. They want to remove the trees from the Memorial Acre, and redesign the Memorial Acre into a relaxing park, without political content. They want to depoliticize the square. In doing so,they will have their own employment and not use local workforces. According to Brian Mokhele, the community wants to remove the monuments, amphitheater, and sculptures from the Memorial Acre because they do not resemble anything. The sculptures should be depicting the truth of what happened, because the Memorial Acre is a political heritage site. He wants to involve the people that actually participated in the struggle to make the monument so that everyone can enjoy it and get a better understanding of the struggle heritage. Therefore, he proposes collective ideology in which everyone has a say. This would prevent future vandalization of the monument. According to Pat Motsiri, the sculptures must depict the event around June 16, 1976. Like the story of Dr Edelstein, who was pierced by pickaxes, forced into a garbage bin and burned alive. According to Jonas Staal, the Memorial Acre should be destroyed, its elements stacked on pallets, thus forming the Monument for the Distribution of Wealth . According to Mafaisa, his men can do the work quickly. He has about twenty men working under him. (shrink)

continent. 1.2 (2011): 129-135. Introduction Vincent W.J. van Gerven Oei Successions of words are so agreeable. It is about this. —Gertrude Stein Nachoem Wijnberg (1961) is a Dutch poet and novelist. He also a professor of cultural entrepreneurship and management at the Business School of the University of Amsterdam. Since 1989, he has published thirteen volumes of poetry and four novels, which, in my opinion mark a high point in Dutch contemporary literature. His novels even more than his poetry are (...) criticized for being inaccessible, which I generally take to be a compliment. It would be like saying that Fernando Pessoa is inaccessible, which he is not. Neither is Wijnberg. When we think of the combination economist-poet we are immediately reminded of the American poet Wallace Stevens, who, as the story goes, had two stacks of paper on his desk, one for contracts, one for poems. We also know that Stevens wrote on the economy and that questions of economy and insurance surface at multiple points in his poems. The following text is a very preliminary attempt to point at the intersections between poems, novels, business, and poetry in Wijnberg’s work. On the back cover of his novel De opvolging ( The Succession , 2005), Wijnberg states the following: “[This is] a novel for whomever is interested in the workings of a company as much as in the workings of a poem.” Wijnberg thus claims that the way in which a company “works” may be similar to the way in which a poem “works.” The question is the obvious one, what does this similarity consist in? De opvolging tells the story of company in which bosses and company doctors, secretaries, children, clowns, and beggars have tons of meetings, recite poems, perform plays, tell jokes, and succeed each other, climbing up and down in the company’s hierarchy. De opvolging is a novel in which the career of people follows the career of words. It resonates with Gertrude Stein's sentences, "Grammar. What is it. Who was it" (1975, 50). The words in Wijnberg's poems are like he characters in his novel. And if we keep in mind this allegorical reading of De opvolging , which is obviously only one of the possible readings, we may be able to understand some aspects of Wijnberg’s poetry. A repetition is already a pun. Look, that word is trying it again, as if it is afraid that by not doing it it would give up the hope that it will ever be able to do something. A pun is the opposite of the first word coming to the mind of someone who shouts it when he suddenly discovers something. (104) The repetition, the succession of the same word, is already a pun, a joke. The succession of the father by the son after the revolution is a joke. "Look he's trying it again!" The essence of a joke is a repetition. Archimedes’ “Eureka!” is its opposite. Poems can easily become jokes, depending on the way the words follow and repeat each other. In De opvolging , the careers of the bosses, good and bad secretaries, and company doctors easily become jokes, as they are “afraid that by not doing it [they] would give up the hope that [they] will ever be able to do something.” Not only the repetition, but also the distance and difference between the words in a poem, their cause and effect relations can be read as company relations. This becomes clear when we, for example, read the first lines of the poem “Cause, sign” from Het leven van ( The Life Of , 2009). A sign lets know what is going to happen, a cause lets it happen. If the sign also lets happen there is no reason to isolate it, because then I would isolate some- thing only because it’s different for me. If I didn’t have to write this myself, but would have secretaries to whom I could dictate it, I would be able to say more about it. (49) Upon reading the first two lines we can already conclude that any word may be cause or sign or both. If a sign is also a cause there is no reason to discriminate it, yet to the poet they are still different. This difference only becomes expressible the moment he would have a secretary. Just like in De opvolging , the secretary introduces a distance; not in a company but in a poem. Hence the difference between “good” and “bad” secretaries in a company, where the good secretary of one boss may be the bad secretary of another one. The more we can say about the bosses of the company, or signifiers of the poem, the greater the distance we introduce between them and us. We should take serious the relation between Wijnberg’s novels and poems. Although they operate on different scales, they explain and converse with each other. Another example may be the novel Politiek en liefde ( Politics and Love , 2002), which deals with the relation, precisely, between politics and love. In the novel, Nicolai, a lieutenant in the Dutch army, is sent to Africa on a military mission. Upon leaving a receives a letter from his father. Dear son, Don’t do anything stupid before your father has advised you to do so. Your mother asked me to write a wise letter. I have been looking for wisdom for half a day and haven’t found much. If you borrow a small amount from a bank you become the bank’s slave, but if you borrow a couple of millions and spend them as quickly as possible the bank becomes your slave. What I want to say is that you have to return from Africa in good health, and before you know it the world will be your slave [....] Signed with a kiss from your father. (88) The line, “If you borrow a small amount from a bank you become the bank’s slave, but if you borrow a couple of millions and spend them as quickly as possible the bank becomes your slave,” returns as the title of poem in Het leven van: “If I borrow enough money the bank becomes my slave” (12-3), which elaborates this theme. So both in the way that these poems are structured and in their subject matter, they refer to the structures of our economy, to the ever-continuing line of CEOs succeeding each other like words, to the distance between them introduced by bureaucracy, and giving and receiving as economical and poetical acts. Poem and economy map onto each other, as in another episode from De opvolging : Edward reads two of the beggar’s poems about presents. Of a holiday nothing remains, except for memories, and if some of them are bad I’d rather forget them all; if I get a present I’d rather get something that’s useful to me for a long time. If I may choose, I choose what I can use longest, long enough to partially forget that this was the present, because it feels bad when nothing is left of it. […] Giving away becomes destruction in the stock destruction economy [ voorraadvernie -tigings-economie ], that is a gift economy [ geschenkeneconomie ], encountering for the first time an economy in which there’s selling and buying on markets. Instead of destroying supplies someone can also quickly say that they aren’t worth anything anymore; if someone wants to take them I’d gladly give him something extra. In a stock destruction economy he is someone who each day wants to work more hours than his colleagues. If around a company there is a gift economy in which someone’s rank is determined and made visible by the gifts someone can give someone else, a company will be more often character- ized by an invisible or unclear system of ranks. (152) Two poems about gifts present two different economical models, described by Wijnberg with the terms “stock destruction economy” and “gift economy.” Here we immediately recall the opposition introduced by George Bataille’s work on the concept of expenditure in The Accursed Share , where a “general economy” would surpass the stock destruction economy based on scarcity (capitalism) and become a gift economy (potlatch) and an egalitarian (communist) society. These claims are made both on the level of the poems and in their discursive explanation. They follow each other and on each other. I would like to finish this introduction to Wijnberg’s writing with a translation from his novel De joden ( The Jews , 1999), which develops the story of Hitler abdicating as chancellor of the Third Reich, appointing philosopher Martin Heidegger as his successor. In a conversation with two Russian actor-spies, sent by Stalin to figure out the situation, philosopher Walter Benjamin describes the abdication scene. Maimon: You were there when Hitler resigned? Benjamin: In the room we’re right now. The desk and the chairs are new. After his resignation Hitler would like to take his furniture to his new house. Martin naturally agrees. It is a sunny day. Martin is very nervous and complains about the heat. Martin is wearing his best dark blue suit, not his professor’s robe. Hitler is wearing his uniform. We enter the room and Hitler gets up and embraces Martin. Martin is not very good at embracing. Hitler shakes his hand. Hitler’s cap is on the desk. The cap has a metal lining. Hitler has strong neck muscles. Hitler says: A man is unclean. He takes a bath. Does he make the bath water unclean? I say: a man is unclean. He steps into a river. A little further a man steps into the river; does he become unclean? Hitler nods. I say: a man is standing in music. Another man hears the music but also sees the first man moving on the beat of the music in a way that he is certain that the music would excite different feelings in him if he wouldn’t to see the first man. Hitler says: a man is clean, listens to music, is suddenly touched and he doesn’t know by what. The conversation ends in the way you know it ends. Hitler picks up his cap from the desk and puts it on Martin’s head. (73-4) Aware of the never ending debate on the question of Heidegger’s involvement in the Nazi regime, Wijnberg has the audacity to present the arguments of complicity in the religious terminology of cleanliness and uncleanliness, while at the same time recalling overtones of Hitler’s supposed love for Wagner, suggesting a relation between Benjamin and Hitler, and so on. The space of this introduction is to small to treat a novel like De joden , a reading of which together with passages from Philippe Lacoue-Labarthe's Heidegger, Art, and Politics: The Fiction of the Political , Jacques Derrida's Of Spirit , Christopher Fynsk's Heidegger: Thought and Historicity , and Avital Ronell's The Telephone Book would be extremely elucidating and potentially open new avenues in thinking Heidegger's emphasis on poetry after the fall of the Nazi empire. But at this point we will have to curb our curiosity and follow the poet himself. The themes of the relation between business and poetry, but also Chinese landscape painting, love, Indian and Japanese poetry, and Western philosophy are analyzed and assimilated in Wijnberg’s work without ever losing the clarity of expression. It may be that, according to Alain Badiou, the “Age of the Poets” is over, but its end (Paul Celan) has exactly brought a new balance between philosophy and poetry, and it is this playful, but nonetheless serious balance that makes one hope that one day Wijnberg’s complete oeuvre might become available to readers across the planet. Tiranë, Albania February 15, 2011 English translations (all of them translated by David Colmer, who is preparing an English collection of Wijnberg’s poems entitled Advanced Payment ): Poetry International Words Without Borders Green Integer Review from Het leven van ( The Life of ) THE LIFE OF KANT, OF HEGEL As if every day he takes a decision that is as good as when he’d been able to think about it all his life. The life of Kant, of Hegel, the days of the life of, select three or four of them. Tell what he has discovered during those days as if he were the last one who knew so little. Give me something that I can cancel against then I can prepare myself for it. The reward is that I may continue with what I’m doing, it doesn’t matter how long it takes. This has nothing to do with everything remaining the same if I say that I no longer want anything else. I wouldn’t be able to say in which one and the other occur in a way that I if I knew something to cancel that one against it wouldn’t be possible now. The stars above my head and being able to say what belongs to what if I’ve let them in. FOLLOWING MY HEART WITHOUT BREAKING THE RULES Observing the rules without observing the rules by going where the rules no longer apply. I could also observe the rules there by applying them to what at great distance may resemble what the rules are about. But why would I do that, not to confuse someone who is seeing me from a great distance? Behind this morning the morning prepares itself when the rules are everything I have. IF I BORROW ENOUGH MONEY THE BANK BECOMES MY SLAVE A bank lends me money, if I don’t pay it back they tell my boss that he has to pay them my salary. But they have to leave me enough to eat and sleep and an umbrella when it’s raining. They can also empty my house, the furniture isn’t worth a lot, but every little helps. Each morning I leave for work, if I don’t start early they’ll soon get someone else, no bank will lend me money when the sun is shining. My boss has given me a cat to raise as a dog. Of course I know that it won’t work out, but I’ve asked for a week—maybe the cat gets lucky, maybe I get lucky. My hands around a cup of coffee, before I leave for work, warm-empty, cold-empty, as if hidden in the mist over a lawn. What I make when there’s no work left for me, I’m ashamed to say how little it is. Once I’m outside I check it, if they watch out of the window they can see me doing it. Suppose it is so much that I’d stay counting for hours, it’s getting dark and I’m still there. They stay watching for a while once they’ve finished their work, but have to go home, I get that, sure, I could also go home and continue counting there. If it’s too little running back immediately won’t help, because nobody’s there anymore, and if I come back tomorrow I may have spent what’s missing tonight. Going somewhere where it’s warm enough to walk around without clothes during daytime, it helps me to know that something’s more there than here. For someone like me there’s work anywhere, it shouldn’t take a week to find work for me there. Three times work and a home close to work, I may choose one and try for a week whether I want to stay there. If at the end of the week I don’t want to stay I’m back on the next day, then it was a week’s holiday. RULES If that’s against a rule, it’s yet another one that I cannot observe, or only so briefly that I cannot re- member it later. Anyways the rules are only there to help me remember what I need in order to do better what I do. In that respect there’s no difference between the rules that I find in a book and the rules that I think of early in the morning. I know that because I’ve made a rule just now nothing has yet to observe it. CAUSE, SIGN A sign lets know what is going to happen, a cause lets it happen. If the sign also lets happen there is no reason to isolate it, because then I would isolate something only because it’s different for me. If I didn’t have to write this down myself, but would have secretaries to whom I could dictate it, I could to say more about it. If something is taken away from me I consider how it would be if the opposite had been taken from me. That is what causes or signifies what is farthest away from what is caused or signified by what has been taken away from me. note: For the translations of “The life of Kant, of Hegel” and “If I borrow enough money the bank becomes my slave” I was able to consult David Colmer’s wonderful translations. (shrink)

This paper elaborates on conceptual, empirical and practical arguments why corporations need to focus on their social dimensions, in order to further enhance organizational performance. The paper starts with an introduction on the general trend towards inclusiveness and connectedness. It then elaborates on the phase-wise development of cultures and organizational structures. Managing corporate improvement by building cultures of trust is the central focus of this contribution. By showing the cultural dimensions of Great Places to Work and their workplace practices, worthwhile (...) experiences leading to organizational improvement and superior financial performance are demonstrated. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.3 (2000) 381-395 [Access article in PDF] Minds, Forms, and Spirits: The Nature of Cartesian Disenchantment Han van Ruler What is Descartes's contribution to Enlightenment? Undoubtedly, Cartesian philosophy added to the conflict between philosophical and theological views which divided intellectual life in the Dutch Republic towards the end of its "Golden Age." 1 Although not everyone was as explicit as Lodewijk Meyer, who (...) said that his theological doubts were inspired by Descartes's philosophical method, Cartesianism along with Copernicanism, Socinianism, and Cocceianism played an important part in the growing skepticism towards the authority of Scripture. 2 Apart from Descartes's general method, however, specific Cartesian ideas encouraged a new view towards nature and towards God's role in governing it. In physics and physiology the new philosophy replaced the image of mind working on matter with the image of a self sufficient mechanism. This new causal metaphor led to a typically Cartesian form of "disenchantment." In this article I argue that on account of their approval of a Cartesian theory of causality, even authors with sincere religious motives came close to accepting radical and nearly Spinozistic ideas. I start with disenchantment in a very literal sense: Balthasar Bekker's denial of the activities of devils, angels, and other spirits. A comparison of Bekker's arguments with those of another Cartesian, Arnold Geulincx will, I hope, bring out the nature and importance of what I shall present as [End Page 381] Descartes's "mechanical reduction" in physics. Finally, I argue that the Cartesian separation of mind and body gave rise to a form of disenchantment that reached far beyond contemporary debates. Devils, Ghosts, and God's Omnipotence Balthasar Bekker's classic book The World Bewitched (1691-93) does not so much deal with the practice of sorcery as with its theory. Bekker offers a wide range of theological and philosophical arguments in order to combat the idea that ghosts, devils, and angels influence natural or historical events. In particular Bekker draws some important conclusions from the philosophy of Descartes. Yet it is immediately clear to the reader that the motives for his critique are religious rather than philosophical. 3 The World Bewitched is not written as a scientific assault on superstition. Bekker, at the time serving as a Calvinist minister in Amsterdam, presents his work as a new and perhaps final phase in the perfection of Christianity. For two centuries it had been a goal of the Protestant Reformation to accentuate God's majesty and to establish the idea of His absolute power over creation. Bekker's World again expresses this idea. His denial that ghosts and devils are active in the world is a logical consequence of the belief that there is no room for demigods in nature. Bekker thus adds a final touch to the project of the Reformation. The World Bewitched will testify to the fact "that I return as much of the honor of His Power and Wisdom to the Almighty, as they took from Him who gave it to the Devil. I ban [the Devil] from the World and I bind him in Hell." 4 Removing devils and spirits from nature, Bekker aims to distinguish superstition from true faith. The battle against superstitious beliefs had formed a characteristic element of Protestant tactics. Dutch Calvinists, for instance, took offense at the continuing practices of blessings and incantations. 5 Bekker wanted to go even further. The Protestantization of Christian dogma could only be completed by making everything in nature's course depend on God's unique power and providence. 6 "Science" in our sense of the word was a subsidiary matter. 7 Still, Bekker saw the new scientific theories of his day as useful allies. In particular it was the new philosophy of Descartes that attracted him. Following Descartes, Bekker reasons "that I think, that I will, [End Page 382] [and] that I understand something," without any part of my body being involved in this type of consciousness. Mind and body in fact have nothing in common: My... (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)