Most models of patient-physician communication take decision-making as a central concept. However, we found that often the treatment course of metastatic cancer patients is not easy to describe in straightforward terms used in decision-making models but is instead frequently more erratic. Our aim was to analyse these processes as trajectories. We used a longitudinal case study of 13 patients with metastatic colorectal and pancreatic cancer for whom palliative chemotherapy was a treatment option, and analysed 65 semi-structured interviews. We analysed three (...) characteristics of the treatment course that contributed to the ‘erraticness’ of the course: (1) The treatment (with or without chemotherapy) contained many options; (2) these options were not stable entities to be decided upon, but changed identity over the course of treatment, and (3) contrary to the closure (option X means no option Y, Z, etc.) a decision implies, the treatment course was a continuous process in which options instead remained open. When the treatment course is characterised by these many and changeable options that do not result in closure, the shared decision-making model should take these into account. More attention needs to be paid to the erratic character of the process in which the doctor has to provide continuous information that is related to the changing situation of the patient; also, flexibility in dealing with protocols is warranted, as is vigilance about the overall direction of the process. (shrink)

From an interdisciplinary perspective the authors of this book, scholars in theology and religious studies, give an account of the problematic and promising aspects of biblically based monotheism, considered as a formative religious idea, belief, and practice in Western history and culture.

In diesem Fazit & Ausblick werden nun die in der Einleitung formulierten Themenfelder, in denen wir auch die Anschlüsse an Arbeiten und Forschungsgebiete der Historischen Anthropologie gegeben sahen, wieder aufgegriffen. Dies geschieht entlang von Aspekten, die durch die responses aufgeworfen wurden, und die wir hinsichtlich unserer Forschung zu Arenen transkultureller Bildung weiterdenken. Ein wichtiger Schwerpunkt liegt dabei auf den Transmissionseffekten, die sich im Forschungsprozess, auch unter Einbezug der responses, zwischen den Forschungsfeldern – den Arenen Theater und Schule – ergeben haben. (...) Daran anschließend formulieren wir die Implikationen, die sich daraus für die Weiterentwicklung unserer Methoden ergeben haben, sowie einen Ausblick, der sich den Möglichkeiten der Erweiterung der Forschung zu kultureller Bildung unter Einbezug postkolonialer und transkultueller Analyseperspektiven widmet. Wir haben in den drei Method Labs„Method Mixing: Methoden der Praxis in postmigrantischen Kontaktzonen“ (November 2017); „Towards new methodologies in transcultural education: Performativity of the digital, Material Feminism and transcultural analysis” (Juni 2018) und “Arenas of transcultural Education: artistic research, art based methods, New Materialism and Sensory Ethnography“ (Januar 2019). Praktiker*innen und Wissenschaftler*innen, die aus unterschiedlichen Disziplinen und Forschungsschwerpunkten kommen und in verschiedenen europäischen Universitäten und Institutionen forschen und arbeitenSound Studies, Historische und pädagogische Anthropologie; Allgemeine Erziehungswissenschaft, Anglistik und Postcolonial Studies, Global Childhood & Youth Studies, International Childhood Studies, Grundschulpädagogik, Theaterpädagogik und Dramaturgie sowie Lehrerbildung, künstlerische Forschung und kulturelle Bildung., eine Auswahl des über drei Jahre im Feld erhobenen Materials, das Method Mixing der beiden Arenen Schule und Theater, sowie unsere diffraktionellen Analysen, die entstandenen Interferenzen, und das sich daraus entwickelnde Method Mixing des Projekts vorgestellt. Nach intensiven, über zwei Tage andauernden Diskussionen über das unseren Gästen der Method Labs vorgestellte Material haben wir diese um eine Verschriftlichung ihrer responses gebeten. Die Wahl des Themas sowie des Umfangs und der Form wurden dabei freigestellt. Herausgekommen sind sehr unterschiedliche, und, wie wir finden, im Kern ebenfalls diffraktionell operierende Antworten, die in den vorangegangen Kapiteln vorgestellt wurden. (shrink)

In 2001 hield Johan J. Graafland zijn oratie Maatschappelijk ondernemen: analyse, verantwoording en fundering. Hiermee aanvaardde hij het ambt van bijzonder hoogleraar Economie, Onderneming en Ethiek aan de Universiteit van Tilburg. Graag wil ik Johan Graafland van harte feliciteren met zijn benoeming. Ik ervaar het toch steeds weer als een bijzondere zegen als christenen zo’n positie mogen bezetten. Ik wens hem veel vruchten toe op zijn arbeid. Op de nieuwjaarsconferentie 2002 van de Vereniging voor Reformatorische Wijsbegeerte heeft Graafland een lezing (...) gegeven waarin hij enkele momenten uit zijn oratie toelichtte. Op die conferentie mocht ik als co-referent optreden. De week voorafgaande aan de conferentie was ik voor een zakenreis in Taiwan. Ik kwam vrijdagsavonds weer in Nederland terug. Door een ongelukkige samenloop van omstandigheden kreeg ik ook toen pas de tekst van de oratie van Graafland in handen. De tijd was voor mij te kort — en de onvermijdelijke jet-lag werkt dan ook niet mee — om de oratie goed te bestuderen en op vruchtbare wijze te kunnen reageren. Ik had geen andere mogelijkheid dan een ‘eigen’ verhaal te houden . Graag wil ik nu van de gelegenheid gebruik maken om inhoudelijk op de oratie van Graafland in te gaan. (shrink)

Is het nog de moeite waard om het op te nemen voor de transcendentale kritiek van Dooyeweerd? Deze vraag suggereert dat de transcendentale kritiek wanneer zij aan zichzelf overgelaten zou worden, niet meer te redden is. Dat is misschien wat overdreven, maar één ding is duidelijk: de transcendentale kritiek is niet onomstreden, zelfs niet onder de meest trouwe volgelingen van Dooyeweerd. En daarin zit iets paradoxaals: het was hem er immers om te doen met zijn transcendentale kritiek ‘de denkgemeenschap in (...) het avondland’ te herstellen, maar het lukt hem niet eens om de denkgemeenschap onder gelijkgezinden op dit punt te bewaren. Intentie en werkelijkheid lopen hier dus ver uiteen. Daar zijn verschillende redenen voor. In de eerste plaats lijkt de transcendentale kritiek geplaagd te worden door een tweetal tegenstrijdige uitgangspunten. Kort gezegd komen deze uitgangspunten hierop neer: 1) de transcendentale kritiek poogt aan te tonen dat ieder theoretisch denken uitgaat van religieuze uitgangspunten; het theoretische denken is dus niet neutraal, zelfgenoegzaam of autonoom; 2) het onder punt 1 genoemde kan worden aangetoond door een stringente analyse van de aard van het theoretische denken zelf, zoals het door ieder die zich bezighoudt met wetenschap en wijsbegeerte beoefend wordt. De vraag is nu of het eerste punt niet impliceert, dat het tweede onmogelijk is. (shrink)

Deze korte studie biedt niet de zoveelste inleiding in het denken van Spinoza, maar doet verslag van de persoonlijke, vijfentwintig jaar durende zoektocht om de vaak moeilijke thema's van Spinoza onder de knie te krijgen. Om via Spinoza's filosofie meer te begrijpen van de wereld en van het eigen leven. Om de vreugde te ervaren die dit verbeterde inzicht, in oorzaken en gevolgen, en ook in de eigen beperktheid, ons biedt. Elk hoofdstuk gaat over een onderwerp dat de auteur bijzonder (...) aanspreekt. Bestaat er een levenswil, Spinoza's conatus, die mensen voort doet leven ook onder de meest bittere omstandigheden? Is kennis en inzicht gradueel van aard? Wat is het verschil tussen adequate en inadequate kennis van de oorzaken van ons handelen? Hoe ontwikkelt een machtsstaat zich tot een rechtsstaat? (shrink)

De drie korte verhandelingen over de positie van hooggeplaatsten moeten gezien worden als een schakel in de lange keten van de literair-filosofische traditie van de Vorstenspiegels, die met name in de Italiaanse Renaissance zeer geliefd waren. Pascal volt echter deze voorbeelden maar gedeeltelijk, omdat hij een nieuwe macht introduceert, waaraan ook de groten der aarde onderworpen zijn, nl. de macht van het geloof. Zijn bespiegelingen over macht, morele plicht en verantwoordelijkheid zijn nog steeds actueel.

Den filosofiske position konsekventialisme er ofte genstand for debat i filosofikredse, men alt for hyppigt opstår der misforståelser blandt de involverede, fordi de ikke er eksplicitte, hvad grundantagelser og væsentlige distinktioner angår. Denne korte artikel vil give en approksimation af, hvad der forstås ved konsekventialisme på et generisk niveau. Målet med artiklen er at klargøre nogle af de grundantagelser og distinktioner, som konsekventialister ofte benytter i deres teoridannelse, og som bør holdes for øje i ønsket om en frugtbar debat.

Asylbarns status og rettigheter i Norge er i kritisk søkelys. En særlig utsatt gruppe er barn av papirløse foreldre som fødes på norske sykehus. Med bakgrunn i Kirkens Bymisjons arbeid med denne gruppen, argumenterer jeg i denne artikkelen for at slike eksempler viser at norsk offentlig politikk overfor disse barna tenderer mot å gradere og dermed underminere deres grunnleggende menneskeverd, slik dette blant annet kommer til uttrykk i barnekonvensjonens krav om hensynet til barnets beste. Ved hjelp av Judith Butlers tenkning (...) om sårbarhet og «framing» samt Giorgio Agambens tenkning om «nakent liv» og unntakstilstanden, analyserer jeg hvordan denne graderingen av asylbarnas menneskeverd skjer. Til slutt viser jeg kort hvordan Helsesenteret uttrykker motstand mot disse mekanismene som bidrar til å underminere asylbarnas og de papirløses menneskeverd.Nøkkelord: menneskeverd, asylbarn, papirløse i Norge, Kirkens Bymisjon, helsesenter, etikk, flyktninger, Judith Butler, Giorgio Agamben, diakonalt arbeidEnglish summary: Children of asylum seekers and human dignity: Ethical reflections based on the experiences of the Health Care Centre for Undocumented MigrantsThe human rights and dignity of children of asylum seekers and undocumented migrants is much debated in Norway. A group that is particularly at risk is children born in Norwegian hospitals whose parents do not possess a legal residence permit. On the basis of the diaconal work of the Church City Mission in Oslo that aims at providing care and defending the rights of these groups through the Health Care Centre for Undocumented Migrants, the purpose of this article is to argue that the inherent human dignity of these children is being undermined in contemporary Norwegian politics. By relating to Judith Butler's thoughts on vulnerability and «framing» and Giorgio Agamben's theory of the «bare life» and the state of exception, the article aims at showing mechanisms that contribute to the undermining of the human dignity and rights of this group. The last part shows how the work of the health care center with its ethical and theological basis can be seen as offering resistance to these mechanisms and tendencies. (shrink)

From an interdisciplinary perspective the authors of this book, scholars in theology and religious studies, give an account of the problematic and promising aspects of biblically based monotheism, considered as a formative religious idea, belief, and practice in Western history and culture.

After having defined the KARO logic for specifying intelligent agents in earlier work we now turn to the question how to realise agents specified in the KARO framework. To this end we look at agent programming languages that we have defined, and investigate how programs in these languages can be linked to the KARO logic.

For some of us, the defeasibility theory of knowledge remains the most plausible approach to the Gettier Problem. Epistemological fashion and faded memories notwithstanding, persuasive objections to the theory are very hard to find. The most impressive of those objections to the theory that have hitherto gone unanswered are examined and rejected here. These are objections put forward by Richard Feldman, Richard Foley, and John Turri. While these are all interesting, the objection recently put forward by Turri is, we think, (...) by far, the most serious threat to the theory that we have seen in a long time. A successful reply to it requires a surprising amount of care, as it turns out. If tenable, Turri's objection deals a devastating blow to the theory developed by Roderick Chisholm, Keith Lehrer, Peter Klein, Marshall Swain, Risto Hilpinen, John Pollock, and Paul Moser, among others. Under scrutiny, however, the threat proves illusory. It results from inattention to a crucial, but relatively subtle, aspect of.. (shrink)

One of the main limitations of natural language‐based approaches to meaning is that they do not incorporate multimodal representations the way humans do. In this study, we evaluate how well different kinds of models account for people's representations of both concrete and abstract concepts. The models we compare include unimodal distributional linguistic models as well as multimodal models which combine linguistic with perceptual or affective information. There are two types of linguistic models: those based on text corpora and those derived (...) from word association data. We present two new studies and a reanalysis of a series of previous studies. The studies demonstrate that both visual and affective multimodal models better capture behavior that reflects human representations than unimodal linguistic models. The size of the multimodal advantage depends on the nature of semantic representations involved, and it is especially pronounced for basic‐level concepts that belong to the same superordinate category. Additional visual and affective features improve the accuracy of linguistic models based on text corpora more than those based on word associations; this suggests systematic qualitative differences between what information is encoded in natural language versus what information is reflected in word associations. Altogether, our work presents new evidence that multimodal information is important for capturing both abstract and concrete words and that fully representing word meaning requires more than purely linguistic information. Implications for both embodied and distributional views of semantic representation are discussed. (shrink)

Albert and De Ruiter provide an introduction to the Conversation Analytic approach to ‘repair’: the ways in which people detect and deal with troubles in speaking, hearing and understanding in conversation. They explain the basic turn‐taking structures involved, provide examples, explain recent developments in the field and highlight some important points of contact and contrast with work in the Cognitive Sciences.

Written by an emigrant French aristocrat turned farmer, the Letters from an American Farmer posed the famous question `What, then, is the American, this new man?', as the new nation took shape before the eyes of the world. Addressing some of American literature's most pressing concerns and issues of identity, the Letters celebrates personal determination, freedom from institutional oppression and the largeness and fertility of the land, and also raises darker and more symbolic elements, particularly slavery. This is the only (...) critical edition available of what is regarded as the first ever work of American literature. (shrink)

A kind of “ruthless reductionism” characterized the experimental practices of the first two decades of molecular and cellular cognition. More recently, new research tools have expanded experimental practices in this field, enabling researchers to image and manipulate individual molecular mechanisms in behaving organisms with an unprecedented temporal, sub-cellular, cellular, and even circuit-wide specificity. These tools dramatically expand the range and reach of experiments in MCC, and in doing so they may help us transcend the worn-out and counterproductive debates about “reductionism” (...) and “emergence” that divide neuroscientists and philosophers alike. We describe examples of these new tools and illustrate their practical power by presenting an exemplary recent case of MCC research using them. From these tools and results, we provide an initial sketch of a new image of the behaving organism in its full causal-interactive complexity, with its molecules, cells, and circuits combined within the single system that it is. This new image stands in opposition to the traditional “levels” image of the behaving organism, and even the initial sketch we provide of it here offers hope for avoiding the dreary metaphysical debates about “emergence” and “downward causation,” and even the reduction vs. anti-reduction dispute, all dependent upon the familiar “levels” image. (shrink)

Núñez and colleagues (2019) question whether cognitive science still exists “as a coherent academic field with a well‐defined and cohesive interdisciplinary research program.” This worry may be premature on two grounds. First, we are not convinced that the Lakatosian criterion of coalescence around a core framework is the best standard for judging whether a field is well‐defined and productive. Second, although we acknowledge that cognitive science is not as visible as we would like, we doubt that this low profile accurately (...) reflects the state of actual research and teaching programs based on the cognitive science approach. (shrink)

Artifacts are probably our most obvious everyday encounter with technology. Therefore, a good understanding of the nature of technical artifacts is a relevant part of technological literacy. In this article we draw from the philosophy of technology to develop a conceptualization of technical artifacts that can be used for educational purposes. Furthermore we report a small exploratory empirical study to see to what extent teachers’ intuitive ideas about artifacts match with the way philosophers write about the nature of artifacts. Finally, (...) we suggest a teaching and learning strategy for improving teachers’ concepts of technical artifacts through practical activities. (shrink)

Is there ever any reason for a doctor to lie to a patient? In this paper, we critically review the literature on lying to patients and challenge the common notion that while lying is unacceptable, a related entity--'benevolent deception' is defensible. Further, we outline a rare circumstance when treating psychotic patients where lying to the patient is justified. This circumstance is illustrated by a clinical vignette.

We develop a framework for assessing security market quality, relating five elements of market design to three metrics of market integrity and two metrics of market efficiency. We empirically implement this integrity–efficiency MQ framework by testing a hypothesis that trade-based ramping manipulation at the close raises execution costs on 24 security markets worldwide. Estimating a simultaneous equations model of ramping incidence, spreads, and the probability of deploying real-time surveillance, we show that quoted bid-ask spreads are positively related to the incidence (...) of MTC across seven liquidity deciles. The magnitude is economically significant; improving market integrity by cutting MTC in half reduces spreads 6–11 %. Allowing direct market access in conjunction with RTS, conducting auctions at the close, and developing regulations that require surveillance, all reduce MTC and thereby lower spreads, assuring better market integrity and enhancing market efficiency. Introducing circuit breakers or prohibiting shorts poses integrity–efficiency tradeoffs. (shrink)

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)