In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the (...) experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia. We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Eleven general practitioners and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration. (shrink)

Research has shown the importance of engaging in networking behaviors for employees’ career success. Networking behaviors can be seen as a proactive way of creating access to career-related social resources and we argue that this type of proactive career behaviors might be particularly relevant for freelancers who cannot depend on an organizational career system supporting their further development, yet whose careers are characterized by high levels of uncertainty and unpredictability. To date, however, our understanding of how freelancers, being a category (...) of workers that are deprived of an organizational context of support for career development, can safeguard their employability, is limited. Therefore, this study addresses this gap and investigates whether freelancers’ networking behaviors are positively associated with career outcomes, through the mediating role of the need for relatedness fulfillment and employability-enhancing competencies. Hypotheses are tested via Structural Equation Modelling using a sample of 1,874 freelancers from Belgium, France, Germany, the Netherlands and the United Kingdom. The results generally support our hypotheses, providing evidence for a significant association between networking behaviors and need for relatedness fulfillment, and between networking behaviors and employability-enhancing competencies. Moreover, we found a significant association between need for relatedness fulfillment and employability-enhancing competencies, being the mediators in our research model and the outcomes of career satisfaction and future career opportunities. Implications for career development in the contemporary workplace are discussed, with particular attention for need for relatedness fulfillment, employability, and sustainable careers of freelance workers. (shrink)

This essay is an introduction to the cluster on Latina feminism published in Hypatia (Spring 2016), Vo. 31 (2), which features essays on various areas of Latina feminisms as well as discussions on the intersection of Latina feminisms and the work of thinkers such as Mikhail Bakhtin, Simone de Beauvoir, Enrique Dussell, Immanuel Kant, Édouard Glissant, Walter Mignolo, and Friedrich Nietzsche. Contributors to the cluster include Stephanie Rivera Berruz, Cynthia M. Paccacerqua, Andrea J. Pitts, Monique Roelofs, Susan C. Méndez, (...) Gabriela Veronelli, and Elena Flores Ruiz. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

Signed utterances are densely packed with pointing signs, reaching a frequency of one in six signs in spontaneous conversations . These pointing signs attain a wide range of functions and are formally highly diversified. Based on corpus analysis of spontaneous pointing signs in Kata Kolok, a rural signing variety of Bali, this paper argues that the full meaning potentials of pointing signs come about through the integration of a varied set of linguistic and extralinguistic cues. Taking this hybrid nature of (...) pointing phenomena into account, it is argued that pointing signs may become an intrinsic aspect of sign language grammars through two mechanisms: morphemization and syntactic integration. Although not entailed in this research, this approach could implicate that some highly systematized pointing systems of speaking communities may to a degree be grammatical as well. (shrink)

Design research programs attempt to bring together the properties of available materials and the demands derived from intended applications. The logic of problem states and state transitions in such programs, including assessment criteria and heuristic principles, is described in settheoretic terms, starting with a naive model comprising an intended profile and the operational profile of a prototype. In a first concretization the useful distinction between structural and functional properties is built into the model. In two further concretizations the inclusion of (...) potential applications is motivated and described for the case of drug research as well as the inclusion of potential realizations for the case of complex products. Next, another line of concretization of the naive model, the incorporation of potentially relevant properties, is sketched. Then the partial analogy between product- and truth-approximation is indicated. We conclude with some remarks about the usefulness of our models for products reaching the market in comparison to the the so-called social construction of technology approach. (shrink)

In reference to the different approaches in philosophy(of medicine) of the nature of (medical) technology,this article introduces the topic of this specialissue of Theoretical Medicine and Bioethics, that is,the way the different forms of medical technologyfunction in everyday medical practice. The authorselaborate on the active role technology plays inshaping our views on disease, illness, and the body,whence in shaping our world.

There has long been interest in identifying and studying ‘‘successful psychopaths.” This study sampled psychologists with an interest in law, attorneys, and clinical psychology professors to obtain descriptions of individuals considered to be psychopaths who were also successful in their endeavors. The results showed a consistent description across professions and convergence with descriptions of traditional psychopathy, though the successful psychopathy profile had higher scores on conscientiousness, as measured within the five-factor model (FFM). These results are useful in documenting the existence (...) of successful psychopathy, demonstrating the potential benefit of informant methodology, and providing an FFM description that distinguishes successful psychopaths from unsuccessful psychopaths studied more routinely within prison settings. (shrink)

Non-governmental organizations are increasingly important drivers for businesses’ self-regulation to operate in a sustainable way. We shift the perspective on NGOs from focusing on their advocacy role to focusing on their accountability for having sustainable internal operations. In a multiple case analysis, we explore the question ‘What are the drivers and barriers to sustainable conduct of NGOs that are sustainability advocates?’ Drawing on institutional theory, we obtain novel insights into the legitimacy-seeking motivations for sustainable conduct in the specific context of (...) advocacy NGOs. We found that, affected by its mission, the cultural-cognitive drive is particularly high, with sustainable conduct as an internally ‘taken-for-granted’ behavior, followed by the normative drivers, with the balance between perceived vulnerability of needing to ‘walk the talk’ and the sense of immunity due to lack of external scrutiny, and there are hardly any regulative drivers. Furthermore, these organizations face idiosyncratic trade-offs when balancing investments in their advocacy missions with investments in sustainable operations, reflecting ethical dilemmas. In a broader sense, this research elucidates the way advocates cope in situations of institutional complexity, with conflicting institutional demands between their mission and role-model function. (shrink)

Studie over het theologische en filosofische gedachtengoed van de franciscaanse scholasticus (ca. 1265-1308).

Johannes Duns Scotus (1266-1308) was one of the greatest medieval theologians. He joined the Franciscan order and soon stood out because of his acumen. The ideas he developed about the non-necessity of reality became very influential, also in Reformed theology. The life of Duns Scotus is difficult to reconstruct. This biography provides an overview of the state of research and therefore of the life of Duns in his native Scotland, England, where he was educated, France, where he taught, and Germany, (...) where he died. (shrink)

In today’s society, religion as adherence to ‘the law of God’ is often considered inherently violent and a threat to civilization. This volume contains theological and philosophical explorations of clashes as well as disclosures of God and civilization.

Argues that Americans must improve their understanding of probability and logic.

It is important and urgent to question therelationship between evidence-based medicineand power shifts in health care systems.Although definitions of EBM are phrased as ascientific approach to medicine, EBM is anormative concept: it aims to improve medicineand health care. Both proponents and opponentsuse a normative concept. More particularly,they provide particular views on positions,responsibilities, possibilities, norms andrelationships between professionals, patientgroups, governments and other parties in healthcare and society. From this perspective, wewant to analyse the role of EBM in modernwestern societies. By using (...) citizenshiptheory, we will argue that the role of EBM isnot fixed but depends on the relation betweenstate and society. We will first analyse thefundamental change in western societies duringthe past decades, from modern to post-modernsocieties. Then, we will elaborate a fourfoldmodel of possible relationships between stateand society, and discuss the issue of how EBM mayfit in, by giving some examples of the practiceof EBM in different European countries. On thisbasis, we conclude to consider EBM as a publicforum where proponents and opponents of EBMdiscuss diverse and possibly conflicting waysof changing medicine, health care, and healthpolicy. This requires the incorporation of theperspective of citizens and their socialnetworks, professionals with practical andtacit knowledge, and diverse public views onwhat is regarded as `a good life'. Inasmuch asEBM is expected to be practically relevant, itought to be tied to rather than separated fromthe normative world of emancipated patients anddiverse health care practices. Proponents andopponents of EBM should be prepared to defendthe normative claims and power effects that areinherently tied to any presentation ofevidence. (shrink)

Humanitarian aid’s psycho-therapeutic turn in the 1990s was mirrored by the increasing emotionalization and subjectivation of fund-raising campaigns. In order to grasp the depth of this interconnectedness, this article argues that in both cases what we see is the post-Fordist production paradigm at work; namely, as Hardt and Negri put it, the direct production of subjectivity and social relations. To explore this, the therapeutic and mental health approach in humanitarian aid is juxtaposed with the more general phenomenon of psychologization. This (...) allows us to see that the psychologized production of subjectivity has a problematic waste-product as it reduces the human to Homo sacer, to use Giorgi Agamben’s term. Drawing out a double matrix of a de-psychologizing psychologization connected to a politicizing de-politicization, it will further become possible to understand psycho-therapeutic humanitarianism as a case of how, in these times of globalization, psychology, subjectivity and money are all interrelated. (shrink)

Since virtue and the virtues have been important in Reformed theology for most of its history, this essay is devoted to the question of how this tradition may contribute to and interact with contemporary virtue ethics. Reformed concepts of sanctification as open to moral growth, covenant as a narrative context of divine commandments, and unio cum Christo as defining human teleology and virtuousness provide valuable contributions to the development of such an ethics. On the other hand, Reformed conceptions of reform, (...) natural law, common grace and christological eschatology offer theological arguments for overcoming Hauerwas’s problematic overemphasis on the distinctiveness of the church’s ethic. (shrink)

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

Surrogates’ decisions to withhold or withdraw life-sustaining treatments (LSTs) are pervasive. However, the factors influencing surrogates’ decisions to initiate LSTs are relatively unknown. We present evidence from two experiments indicating that some surrogates’ decisions about when to initiate LSTs can be predictably manipulated. Factors that influence surrogate decisions about LSTs include the patient’s cognitive state, the patient’s age, the percentage of doctors not recommending the initiation of LSTs, the percentage of patients in similar situations not wanting LSTs, and default treatment (...) settings. These results suggest that some people may use heuristics when making these important life-and-death decisions. These findings may have important moral implications for improving surrogate decisions about LSTs and reconsidering paternalism. (shrink)

This article contributes to the contemporary debate on land and water grabbing through a detailed, qualitative case study of horticultural agribusinesses which have settled in Tanzania, disrupting patterns of land and water use. In this paper we analyse how capitalist settler farms and their upstream and downstream peasant neighbours along the Nduruma river, Tanzania, expand and defend their water use. The paper is based on 3 months of qualitative field work in Tanzania. We use the echelons of rights analysis framework (...) combined with the concept of institutional bricolage to show how this contestation takes place over the full spectrum of actual abstractions, governance and discourses. We emphasise the role different national development narratives play in shaping day-to-day contestations over water shares and rule-making. Ultimately, we emphasise that water grabbing is not a one-time event, but rather an on-going struggle over different water resources. In addition, we show how a perceived beneficial development of agribusinesses switching to groundwater allows them to avoid peasant-controlled institutions, avoiding further negotiation between the different actors and improving their image among neighbouring communities. This development illustrates how complex and obscured processes of water re-allocation can be without becoming illegal per se. (shrink)

This article proposes a new acrostic (SAPI) and telestic (SOIS) at Laus Pisonis 227–30. Their position opposite one another is an indication that they are to be read as a single sentence and an admonition to both dedicatee and reader that poet and patron need each other to gain eternal fame. The telestic allows us to reconstruct the poet's usus scribendi of the reflexive possessive pronoun suus.