The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

In this paper, we explore the conceptual problems arising when using network analysis in person- centered care (PCC) in psychiatry. Personalized network models are potentially helpful tools for PCC, but we argue that using them in psychiatric practice raises boundary problems, i.e., problems in demarcating what should and should not be included in the model, which may limit their ability to provide clinically-relevant knowledge. Models can have explanatory and representational boundaries, among others. We argue that we can make more explicit (...) what kind of questions personalized network models can address in PCC, given their representational and explanatory boundaries, using perspectival reasoning. (shrink)

Syltern et al. (2022) propose a new approach to decision-making at the limit of viability: by default, intensive care will be initiated for every infant born in “the gray zone” of viability. This w...

This paper articulates a formal theory of belief incorporating three key theses: (1) belief is a dyadic relation between an agent and a property; (2) this property is not the belief's truth condition (i.e., the intuitively self-ascribed property which the agent must exemplify for the belief to be true) but is instead a certain abstract property (a "thought-content") which contains a way of thinking of that truth condition; (3) for an agent a to have a belief "about" such-and-such items it (...) is necessary that a possesses a language of thought, $M_{a}$ , and that a (is disposed as one who) inwardly affirms a sentence of $M_{a}$ in which there are terms that denote those objects. Employing an extended version of E. Zalta's system ILAO, the proffered theory locates thought-contents within a typed hierarchy of "senses" and their "modes of presentation", the provisional definitions of which (suppressing complications added later to accommodate the contents of beliefs about beliefs) are as follows. A mode of presentation of e is a ternary relation of the sort [λxyz z is a name in $M_{y}$ that denotes x, and $D_{e}yz$ ] in which $D_{e}$ is an e-determiner - a relation between agents and their mental expressions imposing a syntactico-semantic condition sufficient for such an expression to denote e therein. A sense of an entity e is an abstract property that "contains" a mode of presentation $R_{e}$ of e by dint of encoding its property-reduct [λx(∃y)(∃z) $R_{e}xyz$ ]. In particular, a thought-content is a sense T of an ordinary first-order property P containing a mode of presentation whose P-determiner $D_{P}$ is such that, for any y and z, $D_{P}yz$ entails that z is a λ-abstract [λv S] of $M_{y}$ in which S is a sentence whose non-logical parts stand in appropriate semantic relations to the constituents of T's (some of which may themselves be senses). Where $I_{a}$ is agent a's dedicated self-demonstrative and |T| is the mode of presentation contained in a thought-content T, the belief relation itself is then characterized as obtaining between a and T iff a( is disposed as one who) inwardly affirms the substitution instance $S(I_{a}/v)$ of a sentence S in $M_{a}$ such that |T|(P, a, [λv S]). The aforementioned "constituents" and "appropriate semantic relations" are formally characterized so as to permit a system of canonical descriptions for thought-contents of arbitrary complexity. These canonical descriptions are then employed to chart the nature and interrelations of belief de re, de dicto and de se and to identify the source of opacity in belief ascription. (shrink)

ZusammenfassungWährend eines Abendessens in einem amerikanischen Restaurant wurde eine Gruppe von christlichen Ethikern, von denen einige Lutheraner waren, von einer jungen Frau angesprochen. Als sie hörte, welchen Beruf die Gruppe ausübte, antwortete sie: »Ich bin eine Lutheranerin – daher habe ich zu christlicher Ethik nichts zu sagen.« Dieser Artikel versucht herauszufinden, in welcher Hinsicht die Frau Recht gehabt haben könnte. Ich argumentiere dafür, dass zu dem Bereich des »Ethischen« zumindest drei Charakteristika gehören: Universalität, Normativität, und ein Verweis auf einen Begriff (...) des höchsten Gutes . Anschließend wird dafür argumentiert, dass eine der Konsequenzen aus Luthers Verweis auf Gott als höchstes Gut darin besteht, dass der sogenannte politische Gebrauch des Gesetzes zugleich ausgeprägt ethisch und christlich ist. Sein christliches Element besteht jedoch weniger in der Bestimmung derjenigen Werte, deren Realisierung angestrebt werden sollen, also im Feld der normativen Ethik, da das Gesetz in seiner politischen Interpretation allen Menschen, Gläubigen und Nicht-Gläubigen gleichermaßen, bekannt ist und auf alle angewandet werden kann. Der Beitrag des Christentums für die Ethik liegt vielmehr auf zwei anderen Ebenen: zum einen auf einer metaethischen Ebene ; und zum zweiten, aufgrund von Luthers Betonung der menschlichen Freiheit als Konsequenz der Versöhnung, auf der Ebene der Realisation des Guten. Abschließend wird argumentiert, dass Luthers theologischer Gebrauch des Gesetzes ebenso wie seine Lehre von der menschlichen Freiheit kaum als Ethik begriffen werden können, da die Charakteristika der Universalität und der Normativität fehlen. Einige mögen dies als eine Schwäche ansehen, aber die Kritik könnte auch in die entgegengesetzte Richtung gewendet werden: denn für Luther gehört mehr zum guten Leben als Normativität und Universalität allein.SummaryWhile having dinner in an American restaurant, a group of Christian ethicists, some of whom were Lutherans, were addressed by a woman. Upon hearing the profession of the group, she replied, “Well, I'm a Lutheran, so I don't know anything about Christian Ethics.” This article intends to explore in what sense the woman might have been correct. In order to do this, I argue that the realm of “the ethical” comprises at least three characteristics: universalisability, prescriptivity, and a reference to a conception of the highest good . After this, it is argued that, as a consequence of Luther's reference to God as the highest good, the so-called political use of the law can be seen as strongly ethical and Christian at the same time. The Christian element lies, however, not so much in the designation of what values ought to be pursued, i. e., in the field of normative ethics, since the law in its political interpretation may be known by, and is applicable, to all people, believers and nonbelievers alike. Rather, the contribution of Christianity to ethics lies on two other levels of ethics: first, on the level of metaethics ; and, second, because of Luther's stress on human freedom as a consequence of salvation, on the level of the realisation of the good. Finally, it is argued that Luther's theological use of the law as well as his doctrine of human freedom can hardly be conceived as ethics, due to the absence of the characteristics of universalisability and prescriptivity. By some, this may be considered as a flaw, but the criticism might also go in the other direction: to Luther, there is more to the good life than prescriptivity and universalisability alone. (shrink)

O escopo central do artigo converge na análise e problematização das relações entre colonialismo e masculinidade na produção literário-intelectual do romancista H. Rider Haggard, com destaque para seu romance Marie. A narrativa literária cinge elementos da ficção e realidade ao narrar eventos do passado sul-africano, em especial o Great Trek, período de migrações e deslocamentos de colonos bôeres na década de 1830. No cerne de um contexto imaginado com as marcas da violência e do martírio, Haggard retrata a formação de (...) seu protagonista, o caçador Allan Quatermain, de modo a promover figurações de virilidade e heroísmo que atuam como respostas ao que muitos de seus contemporâneos sentem e ressentem como crises da masculinidade no fin-de-siècle.The South African Question: Literature, Colonialism and Masculinities in H. Rider Haggard’s Marie The central scope of the article converges in the analysis and problematization of relations between colonialism and masculinity in H. Rider Haggard’s literary and intellectual production, with emphasis in his romance Marie. The literary narrative deals with elements of fiction and reality by narrating events from South African past, especially the Great Trek, a period of migrations and displacements of Boer colonists during the 1830s. At the heart of a context imagined with violence and martyrdom, Haggard depicts the formation of his protagonist, the hunter Allan Quatermain, in order to promote virility and heroism, which act as answers to what many of his contemporaries feel and resent as crises of masculinity in the fin-de-siècle. Resumen La cuestión sudafricana: literatura, colonialismo y masculinidades en Marie, de H. Rider Haggard La meta central del artículo converge en la análisis y problematización de las relaciones entre colonialismo y masculinidad en la producción literario-intelectual del novelista H. Rider Haggard, con destaque para su romance Marie. La narrativa literaria establece una relación entre elementos de ficción y realidad al narrar eventos del pasado sudafricano, en especial el Great Trek, período de migraciones y desplazamientos de colonos bôeres en la década de 1830. En el corazón de un contexto imaginado con las marcas de la violencia y el el martirio, Haggard retrata la formación de su protagonista, el cazador Allan Quatermain, para promover imágenes de virilidad y heroísmo que actúan como respuestas a lo que muchos de sus contemporáneos sienten y resienten como crisis de la masculinidad en el fin-de-siècle. (shrink)

This is a collection of essays in ethics and the philosophy of religion contributed by former students and colleagues of Professor W. Harry Jellema to honor his 70th birthday and his retirement from Calvin College. The essays are quite diverse but uniformly worthwhile. They are nicely balanced between such traditional approaches as in Veatch's "For a Renewal of an Old Departure in Ethics" and Parker's "Traditional Reason and Modern Reason," contemporary analytic approaches as in Plantinga's "Necessary Being" and Brouwer's "A (...) Restricted Motive Theory of Ethics," and historical studies such as Stob's "The Ethics of Jonathan Edwards" and De Boer's "First Steps in Mysticism." The quality and seriousness of the collection as a whole appropriately honors a man who has been one of the most devoted and effective teachers in the American philosophic community for the past fifty years.—W. G. E. (shrink)

INTRODUCTION. 1. THE THEATRE. 1. In olden time the Arabian desert was, as it is at this da)7, the roaming-ground of independent Bedouin tribes. ...

This excellent work defends the radical nature of Husserl’s transcendental phenomenology from those who want to turn it into a kind of realism. The influence of such "revisionists" "is so strong at present that the historical Husserl threatens to vanish from sight completely". Husserl, de Boer insists, eventually defined consciousness as absolute being which constitutes the world within itself. "Husserl’s entire development becomes incomprehensible when this idealism is denied". According to de Boer, Franz Brentano convinced the young Husserl (...) that the aim of philosophy was to find a way of anchoring norms in the face of relativism and historicism. Brentano sought to use scientific methodology to found a descriptive psychology which could in turn form the basis for normative sciences. Like Brentano, Husserl was taken with the idea of developing a "rigorous science" of consciousness which would help provide rational a priori values in the face of the irrational world-views so prevalent in the first part of the century. Husserl’s turn away from his early empiricism and naturalism and his eventual adoption of transcendental idealism follows from his attempt to solve three problems in Brentano’s work: 1) the relation between things in themselves and the immanent intentional object; 2) the method for founding a priori truths; 3) the naturalistic attitude inherent in Brentano’s view that positivistic-genetic psychology and phenomenological psychology have equal value in the study of consciousness. Husserl solved the second problem with the notion of the intuition of essences. He solved the first and third problems with the discovery of transcendental idealism in 1908. De Boer maintains that the denial of the thing in itself, which is still presupposed in the naturalistic standpoint operating in Logische Untersuchungen, "is the most important step of all in Husserl’s development". The notion of the thing in itself is common to the naturalistic-dogmatic belief that on the one hand there is a realm of objects independent of consciousness and that on the other hand there is consciousness which has some experience of those objects. In LU, Husserl simply suspended the question of the relation of the thing in itself to consciousness because he still regarded the latter as a kind of island within the "real" world, to which natural science alone has direct access. Despite the fact that LU rejected the naturalizing of ideas, LU continued to regard consciousness in a naturalistic way. Only the "Copernican revolution" of transcendental idealism enabled Husserl to see that the foundation of all being is absolute mind or consciousness. Because consciousness "constitutes" reality in a creative and productive sense, there is no point in speaking of a "thing in itself." Husserl’s transcendental reduction does not deny "reality," but merely rejects the naturalistic tendency to absolutize it. (shrink)

INTRODUCTION In the first part of this study I will deal with the publications of Husserl's first period, ie Ueber den Begriff der Zahl (his "Habilita- ...

Does philosophical critique have a future? What are its possibilities, limits, and presuppositions? Bringing together outstanding scholars from various traditions, this collection of essays is the first to examine the forms of critique that have shaped modern and contemporary continental thought. Through critical analyses of key texts by, among others, Spinoza, Kant, Hegel, Marx, Adorno, Habermas, Foucault, and Rancière, it traces the way critique has time and again geared itself towards new cultural, social, and political problems, shedding those of its (...) assumptions no longer deemed tenable. It is our hope that the many voices of critique that arise from the present volume will produce effects – new doubts, new insights, new challenges, or new resources – that none could have achieved on their own. (shrink)

RésuméBien que Hegel soit parfaitement conscient du fait que l'activité de penser nepuisse devenir ce qu'elle est que dans etpar le langage, on peut dire qu'ila préservé une distinction hiérarchisée entre la pensée et le langage dans lequel elle s'exprime. Dans le but de clarifier ce qu'il veut dire exactement lorsqu'il distingue entre, d'un côté, la totalité des concepts purs et, de l'autre, le langage, la première partie du présent article—qui en est aussi la plus longue—fournit une interprétation deplusieurs textes (...) de Hegel sur le rapport entre la pensée pure et le langage, et montre pourquoi la conception qu'il se fait de cette relation est plus difficile à critiquer qu'on ne l'a souvent cru. L'article part de la conception hégélienne du concept absolu et, après avoir briévement esquissé la relation entre la Logique et la philosophic de la nature et de l'esprit, examine divers passages sur le langage, tirés, entre autres, des leçons sur la philosophic de l'histoire mondiale. La deuxième partie de l'article propose—dans une veine heideggérienne—une perspective à partir de laquelle une déconstruction des présupposés de base de cette conception pourrait avoir quelque chance de succès. (shrink)

although mostly known to specialists nowadays, Kenelm Digby was a remarkable figure on the intellectual scene of the early seventeenth century. He has been described as “one of the most influential natural philosophers” of his time,1 and corresponded with many of the great scholars of his days, including Descartes, and the French pioneer of atomism, Pierre Gassendi. In the later years of his life, Digby, alongside men like Robert Boyle, became one of the founding members of the Royal Society.2Digby authored (...) one major work of philosophy: the Two Treatises of 1644. This work consisted of a long First Treatise on bodies, and a shorter, Second Treatise on the human soul. In the First Treatise, Digby argued... (shrink)

Scholarly debates on the Critique of Pure Reason have largely been shaped by epistemological questions. Challenging this prevailing trend, Kant's Reform of Metaphysics is the first book-length study to interpret Kant's Critique in view of his efforts to turn Christian Wolff's highly influential metaphysics into a science. Karin de Boer situates Kant's pivotal work in the context of eighteenth-century German philosophy, traces the development of Kant's conception of critique, and offers fresh and in-depth analyses of key parts of the (...) Critique of Pure Reason, including the Transcendental Deduction, the Schematism Chapter, the Appendix to the Transcendental Analytic, and the Architectonic. The book not only brings out the coherence of Kant's project, but also reconstructs the outline of the 'system of pure reason' for which the Critique was to pave the way, but that never saw the light. (shrink)