To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

Using as a springboard a three-way debate between theoretical physicist Lee Smolin, philosopher of science Nancy Cartwright and myself, I address in layman’s terms the issues of why we need a unified theory of the fundamental interactions and why, in my opinion, string and M-theory currently offer the best hope. The focus will be on responding more generally to the various criticisms. I also describe the diverse application of string/M-theory techniques to other branches of physics and mathematics which render the (...) whole enterprise worthwhile whether or not “a theory of everything” is forthcoming. (shrink)

Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)

Moral theories which, like those of Plato, Aristotle and Aquinas, give a central place to the virtues, tend to assume that as traits of character the virtues are mutually compatible so that it is possible for one and the same person to possess them all. This assumption—let us call it the compatibility thesis—does not deny the existence of painful moral dilemmas: it allows that the virtues may conflict in particular situations when considerations associated with different virtues favour incompatible courses of (...) action, but holds that these conflicts occur only at the level of individual actions. Thus while it may not always be possible to do both what would be just and what would be kind or to act both loyally and honestly, it is possible to be both a kind and a just person and to have both the virtue of loyalty and the virtue of honesty. (shrink)

Ronald Dworkin argues on the basis of a theory of well-being that critical paternalism is self-defeating. People must endorse their lives if they are to benefit. This is the endorsement constraint and this paper rejects it. For certain kinds of important mistakes that people can make in their lives, the endorsement constraint is either incredible or too narrow to rule out as much paternalism as Dworkin wants. The endorsement constraint cannot be interpreted to give sensible judgements when people change their (...) minds about the value of their lives. And the main argument for the endorsement constraint, which is based on the value of integrity, does not support Dworkin's anti-paternalism. (shrink)

In the intellectual autobiography that opens this book, Chisholm divides philosophers into “drones” and “commentators,” placing himself in the first group. As a drone, Chisholm proposed solutions to philosophical problems and asked his students and colleagues to try to refute him. He reports that they often did, sending him back to the drawing board. Chisholm’s wry self-description says much about his manner as well as his method. A more pretentious philosopher might have spoken of his dogged search for philosophical truth (...) in an age when many have come to disparage that quest. (shrink)

Twentieth century philosophers introduced the distinction between “objective rightness” and “subjective rightness” to achieve two primary goals. The first goal is to reduce the paradoxical tension between our judgments of what is best for an agent to do in light of the actual circumstances in which she acts and what is wisest for her to do in light of her mistaken or uncertain beliefs about her circumstances. The second goal is to provide moral guidance to an agent who may be (...) uncertain about the circumstances in which she acts, and hence is unable to use her standard moral principle directly in deciding what to do. This paper distinguishes two important senses of “moral guidance”; proposes criteria of adequacy for accounts of subjective rightness; canvasses existing definitions for “subjective rightness”; finds them all deficient; and proposes a new and more successful account. It argues that each comprehensive moral theory must include multiple principles of subjective rightness to address the epistemic situations of the full range of moral decision-makers, and shows that accounts of subjective rightness formulated in terms of what it would reasonable for the agent to believe cannot provide that guidance. (shrink)

Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)

A large body of literature agrees that persons with schizophrenia suffer from a Theory of Mind deficit. However, most empirical studies have focused on third-person, egocentric ToM, underestimating other facets of this complex cognitive skill. Aim of this research is to examine the ToM of schizophrenic persons considering its various aspects, to determine whether some components are more impaired than others. We developed a Theory of Mind Assessment Scale and administered it to 22 persons with a DSM-IV diagnosis of schizophrenia (...) and a matching control group. Th.o.m.a.s. is a semi-structured interview which allows a multi-component measurement of ToM. Both groups were also administered a few existing ToM tasks and the schizophrenic subjects were administered the Positive and Negative Symptoms Scale and the WAIS-R. The schizophrenic persons performed worse than control at all the ToM measurements; however, these deficits appeared to be differently distributed among different components of ToM. Our conclusion is that ToM deficits are not unitary in schizophrenia, which also testifies to the importance of a complete and articulated investigation of ToM. (shrink)

We argue that thoughts are structures of concepts, and that concepts should be individuated by their origins, rather than in terms of their semantic or epistemic properties. Many features of cognition turn on the vehicles of content, thoughts, rather than on the nature of the contents they express. Originalism makes concepts available to explain, with no threat of circularity, puzzling cases concerning thought. In this paper, we mention Hesperus/Phosphorus puzzles, the Evans-Perry example of the ship seen through different windows, and (...) Mates cases, and we believe that there are many additional applications. (shrink)

The environment has often been thought to consist of resources that are unowned, and hence subject to the well-known tragedy of the commons. But in recent years, property ideas have been increasingly recruited for environmental protection, in a manner that appears to vindicate the view that property rights evolve along with the needs for resource management. Nevertheless, property regimes have some pitfalls for environmental resources: the relevant parties may not be able to come to agreement; property regimes may be weak (...) or ineffective; they may be aimed at purposes inconsistent with environmental protection; property rights definitions may not work well for environmental resources; modern property regimes may promote monoculture rather than diverse environments. This essay describes these problems and asks to what degree they apply to a new effort to use property rights approaches, namely cap-and-trade programs to control greenhouse gases. It concludes that property rights, while imperfect and something of a retreat from a regime of complete liberty, may offer gains for environmental protection. But success will depend on close attention to the accountability and effectiveness of the governmental institutions necessary to support environmental property regimes. (shrink)

The popular television series House M.D. is drawn upon to provide a critical examination of medical paternalism and how it is presented in the show. Dr Gregory House, the character named in the title of the series, is a paradigm of a paternalistic physician. He believes that he knows what is best for his patients, and he repeatedly disregards their wishes in order to diagnose and treat their illnesses. This paper examines several examples of medical paternalism and the means used (...) to portray it favourably in the series. It is argued that the positive depiction of medical paternalism in the fictional world of the series does not apply in the real world. The paper also considers why a show that features a paternalistic physician who so blatantly flouts mainstream medical ethics might appeal to health professionals and members of the general public. (shrink)