I argue that there is a hitherto unrecognized connection between Henry of Ghent’s general theory of real relations and his Trinitarian theology, namely the notion of numerical sameness without identity. A real relation (relatio) is numerically the same thing (res) as its absolute (non-relative) foundation, without being identical to its foundation. This not only holds for creaturely real relations but also for the divine persons’ distinguishing real relations. A divine person who is constituted by a (...) class='Hi'>real relation (relatio) and the divine essence is numerically the same thing (res) as the divine essence without being identical to it. Further, I compare Mark Henninger’s and Jos Decorte’s interpretations of Henry’s general theory of real relations and show that Henninger’s is to be preferred and how it is consistent with my interpretation. I argue that the difficulty with Decorte’s interpretation stems, in part, from his misrepresentation of Henry’s Trinitarian theology. Subsequently, I fill in some missing pieces to Decorte’s presentation of Henry’s Trinitarian theology, and this in turn shows why Henninger’s interpretation in conjunction with mine is to be preferred. (shrink)
Tarski's theory of truth brings out the question of whether he intended his theory to be a correspondence theory of truth and whether, whatever his intentions, his theory is, in fact, a correspondence theory. The aim of this paper is to answer both questions. The answer to the first question depends on Tarski's relevant assertions on semantics and his conception of truth. In order to answer the second question Popper's and Davidson's interpretations of Tarski's truth theory are examined; to this (...) end both Tarski's definition of truth in terms of satisfaction and the T-sentences are taken into account. (shrink)
Scientists and 'anti-scientists' alike need a more realistic image of science. The traditional mode of research, academic science, is not just a 'method': it is a distinctive culture, whose members win esteem and employment by making public their findings. Fierce competition for credibility is strictly regulated by established practices such as peer review. Highly specialized international communities of independent experts form spontaneously and generate the type of knowledge we call 'scientific' - systematic, theoretical, empirically-tested, quantitative, and so on. Ziman shows (...) that these familiar 'philosophical' features of scientific knowledge are inseparable from the ordinary cognitive capabilities and peculiar social relationships of its producers. This wide-angled close-up of the natural and human sciences recognizes their unique value, whilst revealing the limits of their rationality, reliability, and universal applicability. It also shows how, for better or worse, the new 'post-academic' research culture of teamwork, accountability, etc. is changing these supposedly eternal philosophical characteristics. (shrink)
The legalization of euthanasia, both in the Netherlands and in other countries is usually justified in reference to the right to autonomy of patients. Utilizing recent Dutch jurisprudence, this article intends to show that the judicial proceedings on euthanasia in the Netherlands have not so much enhanced the autonomy of patients, as the autonomy of the medical profession. Keywords: allowing to die, criminal law, euthanasia, law enforcement, legal aspects, legislation, medical ethics, medical profession, self determination, the Netherlands, voluntary euthanasia, withholding (...) treatment CiteULike Connotea Del.icio.us What's this? (shrink)
In order to protect patients against medical paternalism, patients have been granted the right to respect of their autonomy. This right is operationalized first and foremost through the phenomenon of informed consent. If the patient withholds consent, medical treatment, including life-saving treatment, may not be provided. However, there is one proviso: The patient must be competent to realize his autonomy and reach a decision about his own care that reflects that autonomy. Since one of the most important patient rights hinges (...) on the patient's competence, it is crucially important that patient decision making incompetence is clearly defined and can be diagnosed with the greatest possible degree of sensitivity and, even more important, specificity. Unfortunately, the reality is quite different. There is little consensus in the scientific literature and even less among clinicians and in the law as to what competence exactly means, let alone how it can be diagnosed reliably. And yet, patients are deemed incompetent on a daily basis, losing the right to respect of their autonomy. In this article, we set out to fill that hiatus by beginning at the very beginning, the literal meaning of the term competence. We suggest a generic definition of competence and derive four necessary conditions of competence. We then transpose this definition to the health care context and discuss patient decision making competence. (shrink)
Increasingly, contemporary medical ethicists have become aware of the need to explicate a foundation for their various models of applied ethics. Many of these theories are inspired by the apparent incompatibility of patient autonomy and provider beneficence. The principle of patient autonomy derives its current primacy to a large extent from its legal origins. However, this principle seems at odds with the clinical reality. In the bioethical literature, the notion of authenticity has been proposed as an alternative foundational principle to (...) autonomy. This article examines this proposal in reference to various existentialist philosophers (Heidegger, Sartre, Camus and Marcel). It is concluded that the principle of autonomy fails to do what it is commonly supposed to do: provide a criterion of distinction that can be invoked to settle moral controversies between patients and providers. The existentialist concept of authenticity is more promising in at least one crucial respect: It acknowledges that the essence of human life disappears from sight if life's temporal character is reduced to a series of present decisions and actions. This also implies that the very quest for a criterion that allows physicians to distinguish between sudden, unexpected decisions of their patients to be or not to be respected, without recourse to the patient's past or future, is erroneous. (shrink)
This paper seeks to define and delimit the scope of the social responsibilities of health professionals in reference to the concept of a social contract. While drawing on both historical data and current empirical information, this paper will primarily proceed analytically and examine the theoretical feasibility of deriving social responsibilities from the phenomenon of professionalism via the concept of a social contract.
In the literature three mechanisms are commonly distinguished to make decisions about the care of incompetent patients: A living will, a substituted judgment by a surrogate (who may or may not hold the power of attorney ), and a best interest judgment. Almost universally, the third mechanism is deemed the worst possible of the three, to be invoked only when the former two are unavailable. In this article, I argue in favor of best interest judgments. The evermore common aversion of (...) best interest judgments entails a risk that health care providers withdraw from the decision-making process, abandoning patients (or their family members) to these most difficult of decisions about life and death. My approach in this article is primarily negative, that is, I criticize the alleged superiority of the living will and substituted judgment. The latter two mechanisms gain their alleged superiority because they are supposedly morally neutral, whereas the best interest judgment entails a value judgment on behalf of the patient. I argue that on closer inspection living wills and substituted judgments are not morally neutral; indeed, they generally rely on best interest judgments, even if those are not made explicit. (shrink)
This article provides a summary overview of the ideas on medical anthropology and anthropological medicine of the German philosopher-psychiatrist Viktor Emil von Gebsattel (1883–1974), and discusses in more detail his views on the doctor-patient relationship. It is argued that Von Gebsattel''s warning against a dehumanization of medicine when the person of both patient and physician are not explicitly present in their relationship remains valid notwithstanding the modern emphasis on respect for patient (and provider) autonomy.
In this paper we discuss the epistemological positions of evolution theories. A sharp distinction is made between the theory that species evolved from common ancestors along specified lines of descent (here called the theory of common descent), and the theories intended as causal explanations of evolution (e.g. Lamarck's and Darwin's theory). The theory of common descent permits a large number of predictions of new results that would be improbable without evolution. For instance, (a) phylogenetic trees have been validated now; (b) (...) the observed order in fossils of new species discovered since Darwin's time could be predicted from the theory of common descent; (c) owing to the theory of common descent, the degrees of similarity and difference in newly discovered properties of more or less related species could be predicted. Such observations can be regarded as attempts to falsify the theory of common descent. We conclude that the theory of common descent is an easily-falsifiable & often-tested & still-not-falsified theory, which is the strongest predicate a theory in an empirical science can obtain. Theories intended as causal explanations of evolution can be falsified essentially, and Lamarck's theory has been falsified actually. Several elements of Darwin's theory have been modified or falsified: new versions of a theory of evolution by natural selection are now the leading scientific theories on evolution. We have argued that the theory of common descent and Darwinism are ordinary, falsifiable scientific theories. (shrink)
This paper examines the complexity and fluidity of maternal identity through an examination of narratives about "real motherhood" found in children's literature. Focusing on the multiplicity of mothers in adoption, I question standard views of maternity in which gestational, genetic and social mothering all coincide in a single person. The shortcomings of traditional notions of motherhood are overcome by developing a fluid and inclusive conception of maternal reality as authored by a child's own perceptions.
Beginning with the well-knowncyber-rape in LambdaMOO, I argue that it ispossible to have real moral wrongs in virtualcommunities. I then generalize the account toshow how it applies to interactions in gamingand discussion communities. My account issupported by a view of moral realism thatacknowledges entities like intentions andcausal properties of actions. Austin's speechact theory is used to show that real people canact in virtual communities in ways that bothestablish practices and moral expectations, andwarrant strong identifications betweenthemselves and their online (...) identities. Rawls'conception of a social practice is used toanalyze the nature of the wrong and thestage-setting aspect of engaging in a practice. (shrink)
This article examines whether cosmetic interventions by dentists and plastic surgeons are medically indicated and, hence, qualify as medical interventions proper. Cosmetic interventions (and the business strategies used to market them) are often frowned upon by dentists and physicians. However, if those interventions do not qualify as medical interventions proper, they should not be evaluated using medical-ethical norms. On the other hand, if they are to be considered medical practice proper, the medical-ethical principles of nonmaleficence, beneficence, justice and others hold (...) true for cosmetic interventions as much as they do for other medical and dental interventions. It is concluded that most cosmetic interventions do not qualify as medical interventions proper because they do not restore or maintain the patient's health (defined as the patient's integrity) by any objective standards. Rather, cosmetic interventions are intended to enhance a person's physical appearance; more specifically, they intend to fulfill the client's subjective perception of an enhanced appearance. (shrink)
In this article, I argue that the relationship between patients and their health care providers need not be construed as a contract between moral strangers. Contrary to the (American) legal presumption that health care providers are not obligated to assist others in need unless the latter are already contracted patients of record, I submit that the presence of a suffering human being constitutes an immediate moral commandment to try to relieve such suffering. This thesis is developed in reference to the (...) French philosopher Levinas and the Dutch theologian Schillebeeckx. An expanded version of the biblical parable of the Good Samaritan serves as test case. (shrink)
Let us call an integer part of an ordered field any subring such that every element of the field lies at distance less than 1 from a unique element of the ring. We show that every real closed field has an integer part.
In two celebrated and widely-anthologized articles, as well as several books, the biologist Garrett Hardin claims (a) that the world population problem has a certain structure – it is a tragedy of the commons - and, (b) that, given this structure, the only tenable solutions involve either coercion or immense human suffering. In this paper, I shall argue for two claims. First, Hardin’s arguments are deeply flawed. The population problem as he conceives it does not have the structure of a (...) commons; and even if it did, this would not necessitate the extreme responses he canvasses. Second, nevertheless, much of Hardin’s pessimism is justified. Some environmental problems associated with population do have tragic structures, though these are of a different form than Hardin envisions. For example, the problem of global climate change has an intergenerational aspect that makes it importantly worse than Hardin’s commons, and for this reason (as opposed to Hardin’s) extreme responses may be needed to avert environmental catastrophe. (shrink)
On one side of his sign board, a nineteenth century surgeon depicted a physician operating on a patient's leg; the other side showed the Good Samaritan taking care of the victim's wounds. Christ's parable has often been quoted and depicted as a primary example of human compassion, to be followed by all persons and, a fortiori, by so-called professionals such as physicians and nurses. If we grant that the parable has not lost its narrative power for 20th century “postmodern” readers (...) living in a “pluralistic” society, it merits a closer analysis. (shrink)
Naturalism about the mind is often taken to be equivalent to some form of physicalism: the existence of mental properties must be shown not to compromise the autonomy of the physical realm. It is argued that this leads to a choice between reductionism, eliminativism, epiphenomenalism or interactionism. The central aim of the paper is to outline an Aristotelian alternative to the physicalist conception of natural bodies. It is argued that the distinction between form and matter, and an ontology which treats (...) individual natural bodies as real, unified things, rather than as complexes, enables us to achieve the non-reductionist, non-epiphenomenalist and non-interactionist position which eludes the post-Cartesian. (shrink)
Aesthetics has typically been regarded as an arena where claims about truth cannot be made as questions about art seem to involve more matters of taste than knowledge. In _Real Beauty_, however, Eddy Zemach maintains that beauty, ugliness, gracefulness, gaudiness, and similar aesthetic properties are real features of public things and argues that whether these features are present is a matter of fact that can be empirically investigated. By examining the opposing nonrealistic views of Subjectivism, Noncognitivism, and Relativism, Zemach (...) attempts to show how antirealistic interpretations of art generate absurd results and leave the realistic reading as the only cogent semantic interpretation of aesthetic statements. By discussing what inclines most people to hold nonrealistic views in aesthetics, such as the fluctuations of taste in fashion, Zemach argues that Realism can account for these fluctuations. He proposes that the aesthetic value of some things is due to their relations to other things and that relation may be temporal, resulting in the need for a temporal point for the correct temporal angle from which to view things. Zemach concludes that great art reveals significant truths about reality and that significantly true statements are aesthetically valuable, hence truth is an aesthetic merit. (shrink)
Quantifiers, unlike proper names or definite descriptions, cannot be given the semantics of referring expressions. This fact has triggered a long-standing debate in formal semantics and syntax as to the combinatorial means by which quantifiers are integrated into a sentence. The present paper contributes to this debate through an investigation of quantifier comprehension during real-time sentence processing. We present evidence showing that two potentially independent processes—the integration of a quantifier in object position and the resolution of antecedent-contained deletion (ACD)—are (...) linked. Our data show, more specifically, that the resolution of a downstream ACD site is facilitated during real-time sentence processing if the upstream DP hosting the ACD site is quantificational but not if it is definite. We discuss these findings in the context of a QUANTIFIER RAISING-based approach and a type-shifting-based approach to quantifier integration. We argue that facilitation of ACD resolution by an upstream quantifier is only expected by theories, such as the QUANTIFIER RAISING approach, which employ the same mechanism for both processes. We then compare the QUANTIFIER RAISING-based account with a non-grammatical experience-based approach to our data, which attempts to explain the findings in terms of corpus frequencies. Although we cannot rule out such an alternative at this stage, we offer reasons to believe that an account that exploits QUANTIFIER RAISING has an explanatory advantage. (shrink)
Frege's theory of real numbers has undeservedly received almost no attention, in part because what we have is only a fragment. Yet his theory is interesting for the light it throws on logicism, and it is quite different from standard modern approaches. Frege polemicizes vigorously against his contemporaries, sketches the main features of his own radical alternative, and begins the formal development. This paper summarizes and expounds what he has to say, and goes on to reconstruct the most important (...) steps which he is likely to have subsequently taken. The various difficulties facing his theory in this reconstruction are outlined, and some surprising consequences drawn about the nature of his logicism. (shrink)
Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...) Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)
The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)