Filosofische ponering van de subjectiviteit van elke interpretatie.

This article discusses Descartes’s preferred focus on morally and theologically neutral subjects and points out the impact of this focus on the scientific status of theology. It does so by linking Descartes’s method to his transformation of the notion of substance. Descartes’s _Meditations_ centred around epistemological questions rather than non-human intelligences or the life of the mind beyond this world. Likewise, in his early works, Descartes consistently avoided referring to causal operators. Finally, having first redefined the notion of substance in (...) the _Principia,_ Descartes would completely abandon making use of this notion in his later years. Indeed, in contrast to many authors before and after him, Descartes never showed any interest in the long-established metaphysical interpretation of substances as being causal factors of natural change. With God, nature, and mind commonly serving as instances of substantial causality, Descartes’s philosophy had a huge impact on the place of God in science and discreetl. (shrink)

In their 2007 paper, Swierstra and Rip identify characteristic tropes and patterns of moral argumentation in the debate about the ethics of new and emerging science and technologies (or “NEST-ethics”). Taking their NEST-ethics structure as a starting point, we considered the debate about tissue engineering (TE), and argue what aspects we think ought to be a part of a rich and high-quality debate of TE. The debate surrounding TE seems to be predominantly a debate among experts. When considering the NEST-ethics (...) arguments that deal directly with technology, we can generally conclude that consequentialist arguments are by far the most prominently featured in discussions of TE. In addition, many papers discuss principles, rights and duties relevant to aspects of TE, both in a positive and in a critical sense. Justice arguments are only sporadically made, some “good life” arguments are used, others less so (such as the explicit articulation of perceived limits, or the technology as a technological fix for a social problem). Missing topics in the discussion, at least from the perspective of NEST-ethics, are second “level” arguments—those referring to techno-moral change connected to tissue engineering. Currently, the discussion about tissue engineering mostly focuses on its so-called “hard impacts”—quantifiable risks and benefits of the technology. Its “soft impacts”—effects that cannot easily be quantified, such as changes to experience, habits and perceptions, should receive more attention. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.3 (2000) 381-395 [Access article in PDF] Minds, Forms, and Spirits: The Nature of Cartesian Disenchantment Han van Ruler What is Descartes's contribution to Enlightenment? Undoubtedly, Cartesian philosophy added to the conflict between philosophical and theological views which divided intellectual life in the Dutch Republic towards the end of its "Golden Age." 1 Although not everyone was as explicit as Lodewijk Meyer, who (...) said that his theological doubts were inspired by Descartes's philosophical method, Cartesianism along with Copernicanism, Socinianism, and Cocceianism played an important part in the growing skepticism towards the authority of Scripture. 2 Apart from Descartes's general method, however, specific Cartesian ideas encouraged a new view towards nature and towards God's role in governing it. In physics and physiology the new philosophy replaced the image of mind working on matter with the image of a self sufficient mechanism. This new causal metaphor led to a typically Cartesian form of "disenchantment." In this article I argue that on account of their approval of a Cartesian theory of causality, even authors with sincere religious motives came close to accepting radical and nearly Spinozistic ideas. I start with disenchantment in a very literal sense: Balthasar Bekker's denial of the activities of devils, angels, and other spirits. A comparison of Bekker's arguments with those of another Cartesian, Arnold Geulincx will, I hope, bring out the nature and importance of what I shall present as [End Page 381] Descartes's "mechanical reduction" in physics. Finally, I argue that the Cartesian separation of mind and body gave rise to a form of disenchantment that reached far beyond contemporary debates. Devils, Ghosts, and God's Omnipotence Balthasar Bekker's classic book The World Bewitched (1691-93) does not so much deal with the practice of sorcery as with its theory. Bekker offers a wide range of theological and philosophical arguments in order to combat the idea that ghosts, devils, and angels influence natural or historical events. In particular Bekker draws some important conclusions from the philosophy of Descartes. Yet it is immediately clear to the reader that the motives for his critique are religious rather than philosophical. 3 The World Bewitched is not written as a scientific assault on superstition. Bekker, at the time serving as a Calvinist minister in Amsterdam, presents his work as a new and perhaps final phase in the perfection of Christianity. For two centuries it had been a goal of the Protestant Reformation to accentuate God's majesty and to establish the idea of His absolute power over creation. Bekker's World again expresses this idea. His denial that ghosts and devils are active in the world is a logical consequence of the belief that there is no room for demigods in nature. Bekker thus adds a final touch to the project of the Reformation. The World Bewitched will testify to the fact "that I return as much of the honor of His Power and Wisdom to the Almighty, as they took from Him who gave it to the Devil. I ban [the Devil] from the World and I bind him in Hell." 4 Removing devils and spirits from nature, Bekker aims to distinguish superstition from true faith. The battle against superstitious beliefs had formed a characteristic element of Protestant tactics. Dutch Calvinists, for instance, took offense at the continuing practices of blessings and incantations. 5 Bekker wanted to go even further. The Protestantization of Christian dogma could only be completed by making everything in nature's course depend on God's unique power and providence. 6 "Science" in our sense of the word was a subsidiary matter. 7 Still, Bekker saw the new scientific theories of his day as useful allies. In particular it was the new philosophy of Descartes that attracted him. Following Descartes, Bekker reasons "that I think, that I will, [End Page 382] [and] that I understand something," without any part of my body being involved in this type of consciousness. Mind and body in fact have nothing in common: My... (shrink)

The clinical introduction of medical devices often occurs with relatively little oversight, regulation and (long-term) follow-up. Some recent controversies underscore the weaknesses of the current regime, such as the complications surrounding the metal-on-metal hip implants and the scandal surrounding the global breast implant scare of silicone implants made by France's Poly Implant Prothese (PIP) Company. The absence of national registries hampered the collection of reliable information on the risks and harms of the PIP breast implants. To warrant long-term safety, a (...) case can be made for mandatory post-marketing surveillance by means of the establishment of compulsory registries. In this edition of Public Health Ethics, Schofield calls for debate on how such a registry system should be initiated and maintained and how it would relate to the ethical requirement of consent. Here we use breast implant registries as a case to discuss whether and when a so-called ‘thick opt-out’ would be an appropriate method to include people in medical device registries. We conclude that a thick opt-out procedure for medical device registries is only justifiable in cases where inclusion does not involve burdens (or very low), when it does not involve a sensitive subject and when the data are stored anonymously (or at least not directly linked to the medical record). Otherwise, inclusion should be sought by means of an opt-in. (shrink)

In this paper, we examine how organizations’ impression management evolves in response to rising stakeholder pressures regarding organizations’ corporate responsibility initiatives. We conducted a comparative case study analysis over a period of 13 years for two organizations—Exxon and BP—that took extreme initial stances on climate change. We found that as stakeholder pressures rose, their IM tactics unfolded in four phases: advocating the initial stance, sensegiving to clarify the initial stance, image repairing, and adjusting the stance. Taken together, our analysis of (...) IM over these four phases provides three key insights about the evolution of IM in the face of rising pressures. First, when faced with stakeholder pressures, it seems that organizations do not immediately resort to conforming but tend to give in gradually when pressures increase and start to come from relatively powerful stakeholders. Second, evolution of IM seems to be characterized by path dependence, i.e., even as organizations’ positions evolve, they continue to show their conviction in their initial positions and try to convey that their subsequent positions flow logically from the previous ones. Finally, IM involves navigation between symbolism and substance, and companies tend to strive toward harmonizing their symbolic and substantive actions as stakeholder pressure increases. (shrink)

Arnold Geulincx Arnold Geulincx was an early-modern Flemish philosopher who initially taught at Leuven University, but fled the Catholic Low Countries when he was fired there in 1658. He settled at Leiden, in the Protestant North, where he worked under the patronage of the Cartesian Calvinist theologian Abraham Heidanus, and … Continue reading Geulincx, Arnold →.

The primary aim of this study was to investigate the relation between self-perceived executive functions and the school achievement of young adolescents, while controlling for parental education and sex. We specifically focused on executive aspects of daily life behavior and the higher-order EFs, as measured with self-report, rather than on the more basic EFs which have been the primary focus of prior investigations. In two independent samples of sixth graders, students evaluated their EFs on a self-report questionnaire, the Amsterdam Executive (...) Functioning Inventory. School achievement in the domains of mathematics and reading comprehension were evaluated with nationally used, norm-based achievement tests. Results revealed that the self-perceived EFs of young adolescents were significantly correlated with their school achievement in both study samples. School achievement was also correlated with the level of parental education, but the factor sex did not have such influence. In study 1, self-perceived EFs explained additional variance in school achievement, while controlling for parental education and sex. In study 2, this was only the case for the most robust measure of school achievement, i.e., the end-of-primary-school final achievement test. Furthermore, besides the relation with achievement tests, we also found a relation between self-perceived EFs and teacher ratings behavioral problems in the classroom. Together, our findings imply that young students can properly reflect on the effectiveness and appropriateness of their EFs in a way that is relevant to their academic achievement and classroom behavior. The findings underscore the importance of considering the development of EFs and parental education in the evaluation of academic achievements in early adolescence. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

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)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

A diagnosis of dementia often comes with difficulties in understanding a conversational context and expressing how one feels. So far, research on how to facilitate advance care planning for people with dementia focused on defining relevant themes and topics for conversations, or on how to formalize decisions made by surrogate decision makers, e.g., family members. The aim of this review is to provide a better scope of the existing research on practical communication aspects related to dementia in ACP conversations. In (...) November 2020, seven databases were searched to select papers for inclusion. This search was updated in December 2021. The search strategy consisted of three tiers, intersected by using the Boolean term “AND,” and resulted in 787 studies. Two researchers followed explicit criteria for two sequential levels of screening, based on titles and abstracts and full papers. A total of 22 studies were included for data analysis. Seven topics emerged clustered around two themes. This scoping review provides practical suggestions for healthcare professionals to improve ACP communication and uncovered gaps in research on communication aspects related to dementia in ACP conversations, such as non-verbal behavior, timing and implementation, and personal preferences. (shrink)