Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)
Background Studies describing physicians’ experiences with sedation at the end of life are indispensible for informed palliative care practice, but they are scarce. We describe the accounts of physicians from the USA and the Netherlands, two countries with different regulations on end-of-life decisions regarding their use of sedation.Methods Qualitative face-to-face interviews were held in 2007–2008 with 36 physicians , including primary care physicians and specialists. We applied purposive sampling and conducted constant comparative analyses.Results In both countries, the use of sedation (...) was described in diverse terms, especially in the USA, and was often experienced as emotionally challenging. Respondents stated different and sometimes multiple intentions for their use of sedation. Besides alleviating severe suffering, most Dutch respondents justified its use by stating that it does not hasten death, while most American respondents indicated that it might hasten death but that this was justifiable as long as that was not their primary intention. While many Dutch respondents indicated that they initiated open discussions about sedation proactively to inform patients about their options and to allow planning, the accounts of American respondents showed fewer and less-open discussions, mostly late in the dying process and with the patient's relatives.Conclusions The justification for sedation and the openness with which it is discussed were found to differ in the accounts of respondents from the USA and the Netherlands. Further clarification of practices and research into the effect and effectiveness of the use of sedation is recommended to enhance informed reflection and policy making. (shrink)
We suggest that morbid jealousy falls on the extreme end of a jealousy continuum. Thus, many features associated with normal jealousy will be present in individuals diagnosed with morbid jealousy. We apply Boyer & Lienard's (B&L's) prediction one (P1; target article, sect. 7.1) to morbid jealousy, suggesting that fitness-related life-cycle dimensions predict sensitivity to cues, and frequency, intensity, and content of intrusive thoughts of partner infidelity. (Published Online February 8 2007).
Moral theory -- Abortion -- Genetic engineering, cloning, and stem cell research -- Euthanasia and assisted suicide -- The death penalty -- Drug and alcohol use -- Sexual intimacy and marriage -- Feminism, motherhood, and the workplace -- Freedom of speech -- Racial discrimination and global justice.
Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)
This paper discusses the significance of gender-based conflicts for thefailure of Gambian irrigated rice projects. In particular, it illustrateshow resource control of a gendered crop, rice, shifts from females to maleswith the development of pump-irrigated rice projects. Irrigation imposes aradically different labor regime on household producers, demanding thatthey intensify labor for year-round cultivation. Yet, the Gambian farmingsystem evolved for a five month agricultural calendar, in which women wereaccorded specific land and labor rights. The need to restructure familylabor, specifically skilled female (...) labor, to meet the cultivation demandsof pump irrigation is crucial for understanding the pattern of gender-basedconflicts in Gambian rice schemes. The case study illustrates thatirrigation involves more than technology transfer. Appropriate irrigationdemands sensitivity to the social structure of household production systems. The paper concludes by emphasizing the centrality of gender issuesfor improving food security in sub-Saharan Africa. (shrink)
The Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control is based on a two-part conceptual framework composed of public health and legal perspectives. The public health perspective comprises the six target areas and intervention settings that are the focus of the obesity prevention and control efforts of the Centers for Disease Control and Prevention.This paper presents the legal perspective. Legal preparedness in public health is the underpinning of the framework for the four “assessment” papers and (...) the four “action” papers that are integral to the application of public health law to any particular health issue. In addition, this paper gives real-world grounding to the legal framework through examples that illustrate the four core elements of legal preparedness in public health that are at work in obesity prevention and control. (shrink)
The Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control is based on a two-part conceptual framework composed of public health and legal perspectives. The public health perspective comprises the six target areas and intervention settings that are the focus of the obesity prevention and control efforts of the Centers for Disease Control and Prevention.This paper presents the legal perspective. Legal preparedness in public health is the underpinning of the framework for the four “assessment” papers and (...) the four “action” papers that are integral to the application of public health law to any particular health issue. In addition, this paper gives real-world grounding to the legal framework through examples that illustrate the four core elements of legal preparedness in public health that are at work in obesity prevention and control. (shrink)
This important and provocative book on the work of Alfred North Whitehead (1861-1947) explores how his avowed atomism is consistent with his equally essential commitment to a view of reality as a thoroughly interconnected sphere of relations. Judith Jones challenges Whitehead's readers to reconsider certain prevailing interpretations of his organic philosophy.
We describe delusional disorder–jealous type (“morbid jealousy”) with the adaptationist perspective used by Darwinian psychiatrists and evolutionary psychologists to explain the relatively common existence and continued prevalence of mental disorders. We then apply the “harmful dysfunction” analysis to morbid jealousy, including a discussion of this disorder as (1) an end on a continuum of normal jealousy or (2) a discrete entity. (Published Online November 9 2006).
When philosophers speak of the inconclusiveness of arguments for the existence of God, they often do so as if they were talking about a matter of principle—as if it were in principle impossible to prove God's existence, that every proof was in principle inconclusive. Of course, rebutals of the cosmological, ontological, and teleological arguments are usually designed to show that these types of arguments are in principle inconclusive. But one supposes that religious experience arguments are not all in such difficulties. (...) That is, one supposes, for example, that an encounter with the deity would provide a proof of his existence which is at least as conclusive as proofs for the existence of an ‘external world’. And thus it would be false to maintain in an unqualified way that ‘Reason cannot prove the existence of God’. The most one would be able to say would be that at present , or in terms of the currently available evidence, no one can prove God's existence. Further, whether or not sufficient evidence has ever been available in the past would be seen as an historical question— a matter of contingencies, not logical possibilities. (shrink)
This study provides a comparison of thinking style and ethical decision-making patterns between 386 U.S. students and 506 students from the People’s Republic of China enrolled in undergraduate business education in their respective countries. Contrary to our expectations, the Chinese students demonstrated a significantly greater linear thinking style compared to American students. As hypothesized, both Chinese and U.S. students possessing a balanced linear and nonlinear thinking style profile demonstrated greater ethical intent across a series of ethics vignettes. Chinese students also (...) were more likely to adopt an act utilitarian rationale, an ethical philosophy that in practice may violate government regulations or social rules to benefit one’s family instead of society for explaining their decisions across the vignettes. We conclude with a discussion of important theoretical as well as practical and potential future implications based on this comparative study. (shrink)
A philosophical essay under this title faces severe rhetorical challenges. New accounts of the good life regularly and rapidly turn out to be variations of old ones, subject to a predictable range of decisive objections. Attempts to meet those objections with improved accounts regularly and rapidly lead to a familiar impasse — that while a life of contemplation, or epicurean contentment, or stoic indifference, or religious ecstasy, or creative rebellion, or self-actualization, or many another thing might count as a good (...) life, none of them can plausibly be identified with the good life, or the best life. Given the long history of that impasse, it seems futile to offer yet another candidate for the genus “good life” as if that candidate might be new, or philosophically defensible. And given the weariness, irony, and self-deprecation expected of a philosopher in such an impasse, it is difficult for any substantive proposal on this topic to avoid seeming pretentious. (shrink)
Service and education organizations such as the ASPCA claim a connection between family violence against children and companion animals, but to what extent does the general public share this perception? Sixty-three undergraduates rated their certainty about perceiving family violence using 60 pictures with differing potential targets of family violence. Participants showed stronger certainty when the target was a child than when the target was a companion animal, but ratings for companion animals averaged above the midpoint of the scale used. Interview (...) questions were used to obtain information about childhood recollections of joint discipline situations in which children received punishment for what companion animals did, or vice versa. Thirty-four participants recalled such situations, some of which resulted in the death or discarding of a family's companion animal. The majority of participants affirmed a connection between violence against children and companion animals in the family, with some giving credit for that insight to their taking part in the study. (shrink)
This qualitative study examines the moral courage of leaders working for democracy and human rights in Burma. As Burma transitions to democracy moralcourage will be essential for leaders of civil society organizations as they face corruption, cronyism, and resistance to change. From interview data with nineteen leaders in Burma and Thailand, and a review of the literature we developed a conceptual model of moral courage that suggests that the relationship between moral motivation and the demonstration of moral courage was mediated (...) by political, social, and individual level factors including the activists’ knowledge and experiences. In addition to applications for leadership in civil society organizations in emerging democracies, results suggest individuals in private, public, or non-governmental organizations, when confronted with coercion, corruption, exploitation, or denial of due process can act with moral courage by engaging their moral principles, commitment, compassion, and sense of urgency while recognizing risks and potential hardship. (shrink)
