When attempting to predict future events, people commonly rely on historical data. One psychological characteristic of judgmental forecasting of time series, established by research, is that when people make forecasts from series, they tend to underestimate future values for upward trends and overestimate them for downward ones, so-called trend-damping. Events in a time series can be experienced sequentially, or they can also be retrospectively viewed simultaneously, not experienced individually in real time. In one experiment, we studied the influence of presentation (...) mode on two sorts of judgment: predictions of the next event and estimation of the average value of all the events in the presented series. Participants' responses in dynamic mode were anchored on more recent events than in static mode for all types of judgment but with different consequences; hence, dynamic presentation improved prediction accuracy, but not estimation. These results are not anticipated by existing theoretical accounts; we develop and present an agent-based model—the adaptive anchoring model —to account for the difference between processing sequences of dynamically and statically presented stimuli. ADAM captures how variation in presentation mode produces variation in responses in both forecasting and judgment tasks. ADAM's model predictions for the forecasting and judgment tasks fit better with the response data than a linear-regression time series model. Moreover, ADAM outperformed autoregressive-integrated-moving-average and exponential-smoothing models, while neither of these models accounts for people's responses on the average estimation task. (shrink)

According to the foundations of economic theory, agents have stable and coherent preferences that guide their choices among alternatives. However, people are constrained by information-processing and memory limitations and hence have a propensity to avoid cognitive load. We propose that this in turn will encourage them to respond to preferences and goals influenced by context and memory representations.

In the last decade, a number of studies in the behavioural sciences, particularly in psychology and economics, have explored the complexity of individual risk behaviour and its underlying factors. Most previous studies have examined the influences of various socio-economic, cognitive, biological and psychological factors on human decision-making however, the relationship between the decision-makers’ risk preferences and occupational background has not received much empirical attention. Accordingly, in the current study, we investigated how occupational background, together with decision-making framing (e.g., variations in (...) decision domain, context, presentation of risk and utility ratios), influence participants’ risk preferences for decision options with equivalent expected utility. Our novel findings indicate that risk preferences may vary among individuals from different occupational backgrounds. As such, when the task was framed in gain terms, participants who mostly deal with health/safety-related risks on a day-to-day basis (high-risk occupations) were predominantly risk-averse (avoiding risky options), while participants who mostly deal with financial/social risks (white-collar occupations) were prone to risk-seeking behaviour (avoiding certain options). Specifically, in “high-risk” occupations, participants’ pattern of choices changed from risk-averse in gain scenarios to risk-seeking in loss scenarios. However, the opposite pattern of risk preferences was found in participants with “white-collar” occupations. Our findings indicate that decision-makers’ occupational backgrounds influence risk preferences under some circumstances. (shrink)

A groundbreaking study of the lost tradition of Tibetan Zen containing the first translations of key texts from one thousand years ago. Banned in Tibet, forgotten in China, the Tibetan tradition of Zen was almost completely lost to us. According to Tibetan histories, Zen teachers were invited to Tibet from China in the 8th century, at the height of the Tibetan Empire. When doctrinal disagreements developed between Indian and Chinese Buddhists at the Tibetan court, the Tibetan emperor called for a (...) formal debate. When the debate resulted in a decisive win by the Indian side, the Zen teachers were sent back to China, and Zen was gradually forgotten in Tibet. This picture changed at the beginning of the 20th century with the discovery in Dunhuang (in Chinese Central Asia) of a sealed cave full of manuscripts in various languages dating from the first millennium CE. The Tibetan manuscripts, dating from the 9th and 10th centuries, are the earliest surviving examples of Tibetan Buddhism. Among them are around 40 manuscripts containing original Tibetan Zen teachings. This book translates the key texts of Tibetan Zen preserved in Dunhuang. The book is divided into ten sections, each containing a translation of a Zen text illuminating a different aspect of the tradition, with brief introductions discussing the roles of ritual, debate, lineage, and meditation in the early Zen tradition. Van Schaik not only presents the texts but also explains how they were embedded in actual practices by those who used them. (shrink)

The Gathering of Intentions: A History of Tibetan Buddhist Tantra, by Jacob P. Dalton. Columbia University Press, 2016. 272pp. Hb. $60.00, ISBN-13: 9780231176002.

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

The explorer Albert Grünwedel’s Tibetan maps of Shambhala are a controversial and contested part of the history of the exploration of the Silk Routes. In the early 1900s Albert Grünwedel collected material related to archaeological sites at Kucha and Turfan including several Tibetan maps of the region, which he published in 1920 in the book Alt-Kutscha. Soon after publication, doubts were raised about the authenticity of the maps, which presented Kucha and Qocho in terms of the mythical realm of Shambhala, (...) and they are still widely considered to be either fabrications or delusions. Judging from internal references to historical figures of the late twelfth century, the maps may derive from sources as early as the thirteenth century, and can be linked to an increasing interest in the Kālacakra tantra and the realm of Shambhala described therein. I conclude that the Alt-Kutscha maps should not be regarded as fakes, nor as historically descriptive maps, but as guides for pilgrims that reimagined these sites in terms of the sacred geography of tantric Buddhism, with particular reference to the mythology of Shambhala. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

"First published in this translation 1955; second edition (revised) 1974; reprinted with additional revisions 1987; reissued with new Further Reading 2003; reissued with new introduction 2007"--T.p. verso.

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

Dieses historische Buch kann zahlreiche Tippfehler und fehlende Textpassagen aufweisen. Kaufer konnen in der Regel eine kostenlose eingescannte Kopie des originalen Buches vom Verleger herunterladen (ohne Tippfehler). Ohne Indizes. Nicht dargestellt. 1910 edition. Auszug:...endliche als durch sie erzeugt; oder diese in jener involviert und aus ihr sich evolvierend. Der wahre Erzeuger der endlichen Grosse ist nicht die unendlichkleine" Grosse (das Unendlichkleine ware dem Grossenwert nach vielmehr Null), sondern es ist das Gesetz der Grosse (als Veranderlicher), das man sich nun wie (...) in einen Punkt zusammengezogen, d. h. fur den einzelnen Punkt ausgedruckt, oder an einer endlichen Erstreckung sich darstellend denken kann, das aber dem letzten Sachgehalt nach dasselbe ist fur den Punkt und die endliche Erstreckung, wenn es auch in Bezug auf beide verschiedene, im allgemeinen auseinander ableitbare Ausdrucke erhalten muss. Da aber die endliche Grosse uberhaupt von Punkt zu Punkt entstehend (d. h. veranderlich) gedacht wird, so ist insofern der punktuelle, d. h. infinitesimale Ausdruck der fundamentale, aus dem der extensionale gleichsam erst hervorwachst. Die Differenz entsteht eben von der Null an; nicht aus ihr; aus Null wird keine extensive Grosse; wohl aber von der Null, d. h. dem Nichtsein dessen, was werden soll, oder ganz schlicht1) vom Ausgangs wert an; woraus? Aus dem Gesetz; eine andere Antwort ist nicht zu geben und nicht zu verlangen. Durch dies Gesetz aber ist die Grosse als Eines, Identisches, im Unterschied von den sukzessiven Grossenwerten, also in ihrem Gattungsausdruck definiert. i) Vgl. oben S. 122. Fragt man also: wie soll aus der Null gewordenen, verschwundenen" Grosse die endliche Grosse wiederentstehen? so ist zu antworten: die Grosse zwar (yuantitas). (shrink)

JOURNAL OF THE HISTORY OF PHILOSOPHY PRIZE for the best published book in the history of philosophy [Awarded in 2010] _______________ -/- Although it is widely recognized that David Hume's A Treatise of Human Nature (1739-40) belongs among the greatest works of philosophy, there is little agreement about the correct way to interpret his fundamental intentions. It is an established orthodoxy among almost all commentators that skepticism and naturalism are the two dominant themes in this work. The difficulty has been, (...) however, that Hume's skeptical arguments and commitments appear to undermine and discredit his naturalistic ambition to contribute to "the science of man". This schism appears to leave his entire project broken-backed. The solution to this riddle depends on challenging another, closely related, point of orthodoxy: namely, that before Hume published the Treatise he removed almost all material concerned with problems of religion. Russell argues, contrary to this view, that irreligious aims and objectives are fundamental to the Treatise and account for its underlying unity and coherence. It is Hume's basic anti-Christian aims and objectives that serve to shape and direct both his skeptical and naturalistic commitments. When Hume's arguments are viewed from this perspective we can solve, not only puzzles arising from his discussion of various specific issues, we can also explain the intimate and intricate connections that hold his entire project together. This "irreligious" interpretation provides a comprehensive fresh account of the nature of Hume's fundamental aims and ambitions in the Treatise. It also presents a radically different picture of the way in which Hume's project was rooted in the debates and controversies of his own time, placing the Treatise in an irreligious or anti-Chrisitan philosophical tradition that includes Hobbes, Spinoza and freethinking followers. Considered in these terms, Hume's Treatise constitutes the crowning achievement of the Radical Enlightenment. (shrink)

Many of our most important goals require months or even years of effort to achieve, and some never get achieved at all. As social psychologists have lately emphasized, success in pursuing such goals requires the capacity for perseverance, or "grit." Philosophers have had little to say about grit, however, insofar as it differs from more familiar notions of willpower or continence. This leaves us ill-equipped to assess the social and moral implications of promoting grit. We propose that grit has an (...) important epistemic component, in that failures of perseverance are often caused by a significant loss of confidence that one will succeed if one continues to try. Correspondingly, successful exercises of grit often involve a kind of epistemic resilience in the face of failure, injury, rejection, and other setbacks that constitute genuine evidence that success is not forthcoming. Given this, we discuss whether and to what extent displays of grit can be epistemically as well as practically rational. We conclude that they can be (although many are not), and that the rationality of grit will depend partly on features of the context the agent normally finds herself in. In particular, grit-friendly norms of deliberation might be irrational to use in contexts of severe material scarcity or oppression. (shrink)

A study of how syntax relates to meaning by a leader of the new generation of philosopher-linguists.

We make three points. First, even if Finlay et al.'s proposed developmental mechanisms hold, there remains great scope for selection on specific brain structures. Second, the positive covariance among the size of brain structures provides far less support for the proposed developmental mechanisms than Finlay et al. acknowledge. Third, even if the proposed mechanisms are the primary size determinants for most brain structures, these structures should not be considered.

For over twenty years, Paul Weithman has explored the thought of John Rawls to ask how liberalism can secure the principled allegiance of those people whom Rawls called 'citizens of faith'. This volume brings together ten of his major essays, which reflect on the task and political character of political philosophy, the ways in which liberalism does and does not privatize religion, the role of liberal legitimacy in Rawls's theory, and the requirements of public reason. The essays reveal Rawls (...) as a thinker deeply engaged with political and existential questions that trouble citizens of faith, and explore how - in firm opposition to political realism - he tries to show that the possibility of liberal democracy and the natural goodness of humanity are objects of reasonable faith. The volume will be of interest to political philosophers, political theorists, moral theologians, and religious ethicists. (shrink)

_An engaging introduction to Zen Buddhism, featuring a new English translation of one of the earliest Zen texts_ Leading Buddhist scholar Sam van Schaik explores the history and essence of Zen, based on a new translation of one of the earliest surviving collections of teachings by Zen masters. These teachings, titled _The Masters and Students of the Lanka_, were discovered in a sealed cave on the old Silk Road, in modern Gansu, China, in the early twentieth century. All more (...) than a thousand years old, the manuscripts have sometimes been called the Buddhist Dead Sea Scrolls, and their translation has opened a new window onto the history of Buddhism. Both accessible and illuminating, this book explores the continuities between the ways in which Zen was practiced in ancient times, and how it is practiced today in East Asian countries such as Japan, China, Korea, and Vietnam, as well as in the emerging Western Zen tradition. (shrink)

In this chapter, we analyze the relationships between the Internet and its users in terms of situated cognition theory. We first argue that the Internet is a new kind of cognitive ecology, providing almost constant access to a vast amount of digital information that is increasingly more integrated into our cognitive routines. We then briefly introduce situated cognition theory and its species of embedded, embodied, extended, distributed and collective cognition. Having thus set the stage, we begin by taking an embedded (...) cognition view and analyze how the Internet aids certain cognitive tasks. After that, we conceptualize how the Internet enables new kinds of embodied interaction, extends certain aspects of our embodiment, and examine how wearable technologies that monitor physiological, behavioral and contextual states transform the embodied self. On the basis of the degree of cognitive integration between a user and Internet resource, we then look at how and when the Internet extends our cognitive processes. We end this chapter with a discussion of distributed and collective cognition as facilitated by the Internet. (shrink)

The first study of this ancient text in over 70 years, Rituals of the Way explores how the Xunzi influenced Confucianism and other Chinese philosophies through its emphasis on "the Way.".

Iris Murdoch claims that “clear vision is a result of moral imagination and moral effort.” Our experience of the world can be blurred by egoism, inattentiveness, and other failings. I ask how we distinguish clear vision from distorted vision. Murdoch’s texts appeal to four factors: (A) attention; (B) unselfing; (C) a form of conceptual articulacy; and (D) love. I ask three questions about these standards: - Are these standards directed at the same goal? (For example, are they all geared toward (...) securing purely epistemic goals?) - Are these standards criterial for improvements in vision? (That is, does the presence of some combination of (A)-(D) constitute or guarantee better vision?) - Does Murdoch think that there’s a single best form of vision? (Such as the one attained by the person who manifests (A)-(D)?) In the secondary literature, the typical answers to these questions are: yes, yes, yes. But I give different answers: no, no, no. (shrink)

In this book, Livingston develops the political implications of formal results obtained over the course of the twentieth century in set theory, metalogic, and computational theory. He argues that the results achieved by thinkers such as Cantor, Russell, Godel, Turing, and Cohen, even when they suggest inherent paradoxes and limitations to the structuring capacities of language or symbolic thought, have far-reaching implications for understanding the nature of political communities and their development and transformation. Alain Badiou's analysis of logical-mathematical structures forms (...) the backbone of his comprehensive and provocative theory of ontology, politics, and the possibilities of radical change. Through interpretive readings of Badiou's work as well as the texts of Giorgio Agamben, Jacques Lacan, Jacques Derrida, Gilles Deleuze, and Ludwig Wittgenstein, Livingston develops a formally based taxonomy of critical positions on the nature and structure of political communities. These readings, along with readings of Parmenides and Plato, show how the formal results can transfigure two interrelated and ancient problems of the One and the Many: the problem of the relationship of a Form or Idea to the many of its participants, and the problem of the relationship of a social whole to its many constituents. (shrink)

Although thinkers of the past might have started from presumptions of fundamental difference and inequality between (say) the genders, or people of different races, this is no longer the case. At least in mainstream political philosophy, we are all now presumed to be, in some fundamental sense, basic equals. Of course, what follows from this putative fact of basic equality remains enormously controversial: liberals, libertarians, conservatives, Marxists, republicans, and so on, continue to disagree vigorously with each other, despite all presupposing (...) some kind of basic equality. They may argue about who gets what, how much, and why, but the starting point - that all people are in some sense deserving of prima facie equal consideration - has become an axiom of our moral and political thinking. But why? Why are we basic equals? The trouble is that as soon as one asks for an explanation of this foundational premise, it begins to look shaky. After all, on any conceivable metric human beings are notably unequal, and often to striking degrees. Philosophers in this area tend to talk of equal worth, but often without trying to specify what exactly that means. Philosophically, basic equality is neither acceptable nor rejectable. It is not rejectable because we appear to be, as a matter of fact, profoundly committed to the truth of the claim that we are all one another's basic equals. But to the extent that there appear to be no philosophical arguments for believing in the truth of basic equality, it is not acceptable either. The aim of this book is to try and show why basic equality is acceptable. To do so, however, it will also contend that we need to approach the question rather differently to how it has mostly been handled so far. What's required is an exercise in what Bernard Williams called 'impure philosophy': it must include insights from other areas of human intellectual endeavour, whether psychology and history or even what we learn from how we go about practicing basic equality in our collective lives. (shrink)

Ricoeur’s theory of productive imagination in previously unpublished lectures. The eminent philosopher Paul Ricoeur was devoted to the imagination. These previously unpublished lectures offer Ricoeur’s most significant and sustained reflections on creativity as he builds a new theory of imagination through close examination, moving from Aristotle, Pascal, Spinoza, Hume, and Kant to Ryle, Price, Wittgenstein, Husserl, and Sartre. These thinkers, he contends, underestimate humanity’s creative capacity. While the Western tradition generally views imagination as derived from the reproductive example of (...) the image, Ricoeur develops a theory about the mind’s power to produce new realities. Modeled most clearly in fiction, this productive imagination, Ricoeur argues, is available across conceptual domains. His theory provocatively suggests that we are not constrained by existing political, social, and scientific structures. Rather, our imaginations have the power to break through our conceptual horizons and remake the world. (shrink)

Free Will & The Tragic Predicament : Making Sense of Williams -/- The discussion in this paper aims to make better sense of free will and moral responsibility by way of making sense of Bernard Williams’ significant and substantial contribution to this subject. Williams’ fundamental objective is to vindicate moral responsibility by way of freeing it from the distortions and misrepresentations imposed on it by “the morality system”. What Williams rejects, in particular, are the efforts of “morality” to further “deepen” (...) or “refine” the notion of the voluntary, with a view to securing “ultimate justice”. It is these aims and aspirations, he argues, that take us to the precipice of scepticism. In Shame and Necessity (1993) Williams advances a vindicatory genealogy that unmasks the “illusions” and “fantasies” of our current ethical ideas as they relate to agency and responsibility. What we are then left with is the task of “recasting our ethical conceptions” . It is here that Williams is especially insistent on the importance and value of historical consciousness and reflection. The role of our reflections about the Greeks and tragedy is precisely to show that in order to move forward, into the future, we need to first look back at where we have come from. The value of these “untimely” observations is that they provide us with alternatives and options that we might otherwise lack. What we discover, when we consider the Greeks, is their commitment to a “pessimism of strength” that rests on rejecting scepticism. It is this two-sided perspective on our ethical predicament that delivers a more truthful account of our human situation, one that will help us discard those illusions and fantasies of "morality" that we are “better off” without. An account of this kind refuses to accept an optimism that insists that any form of responsible ethical life must be one that is immune to the influence of luck and fate. This is the fundamental lesson that we can learn from the ancient Greeks and that Williams seeks to “recover” for us. (shrink)

This Special Issue addresses a range of educational issues linked to main themes from our 2019 book The Emergence of Complexity: Rethinking Education as a Social Science. This book elaborated two major theses that raise fundamental questions for philosophy of education. First, that learning by groups is typically a distinctive kind of learning that is not reducible to learning by individuals. Second, that a degree of holism, as against a focus on individuals, is essential for achieving a convincing understanding of (...) this distinctive type of group learning. These two theses are of direct interest to philosophy of education since they challenges the resources of received theories of learning. Yet this kind of group learning characterises the vast bulk of human learning situations that occur outside of formal education systems. In this Special Issue introductory article we, firstly, introduce some basic principles of complexity theory, and demonstrate that, together with the concept of a ‘co-present group’ (between 2 and about 12 individuals), these ideas offer develop novel understandings of the distinctive learning that occurs within such groups. Secondly, we outline and illustrate with further examples the main features of co-present groups. Thirdly, we consolidate our conceptual work by showing five ways in which our account of group learning serves to refurbish the concept of ‘learning’. (shrink)

Vorrede | In diesem charakteristischerweise hervorragend recherchierten Beitrag erörtern Kappeler und Fichtel die Konsequenzen sozialer und einkommensbedingter Ungleichheit für die individuelle Gesundheit und die empfundene Einsamkeit aus einer evolutionären Perspektive. Das zentrale Argument der Autoren ist, dass sich die modernen Großgesellschaften, in denen fast alle Menschen heutzutage leben, grundsätzlich von den egalitären Kleingesellschaften unterscheiden, in denen wir evolviert sind und in denen wir bis vor lediglich 20.000 Jahren alle gelebt haben. Diese Zeitspanne war gemäß den meisten Schätzungen viel zu kurz, (...) als dass sich durch die Evolution notwendige Anpassungen in der menschlichen Natur an das Leben in modernen Großgesellschaften hätten etablieren können. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)