Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

In the debate surrounding the introduction of non-invasive prenatal testing in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: informed choice, freedom to choose and consequences for (...) people with a disability. Three of the strongest arguments raised under the flag of routinisation are assessed for their validity: the threat that NIPT poses to informed choice, the potential increase in uptake of first-trimester prenatal screening and its consequences for social pressure to participate in screening or terminate affected pregnancies, and the negative consequences for disabled people. These routinisation arguments lack empirical or normative ground. However, the results of this analysis do not imply that no attention should be paid to possible problems surrounding the introduction of NIPT. At least two problems remain and should be addressed: there should be an ongoing debate about the requirements of informed choice, particularly related to an expanded scope of prenatal screening. Also, reproductive autonomy can only be achieved when expecting parents’ options are variegated, real and valuable, so that they can continue to choose whether or not to screen or to terminate a pregnancy. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Asking pregnant women to (co)pay for non-invasive prenatal testing (NIPT) out of pocket leads to unequal access across socioeconomic strata. To avoid these social justice issues, first-trimester prenatal screening should be publicly funded in countries such as the Netherlands, with universal coverage healthcare systems that offer all other antenatal care services and screening programmes free of charge. In this reply, we offer three additional reasons for public funding of NIPT. First, NIPT may not primarily have medical utility for women and (...) children, but rather offers relevant information and reproductive options, and thus serves important autonomy interests of women. Second, public funding of NIPT can be justified because it results in a reduction of collectively borne costs associated with care and support for children with chromosomal abnormalities. It is important to note that this isnotan argument for individual women to take part in screening or to terminate an affected pregnancy. However, itisa legitimate argument in policy making regarding funding arrangements for screening programmes. Finally, public funding would help to amend current misunderstandings among pregnant women (eg, that they are not at risk), and thus to support informed consent for first-trimester prenatal screening. (shrink)

This monograph presents new ideas in nomic truth approximation. It features original and revised papers from a philosopher of science who has studied the concept for more than 35 years. Over the course of time, the author's initial ideas evolved. He discovered a way to generalize his first theory of nomic truth approximation, viz. by dropping an unnecessarily strong assumption. In particular, he first believed to have to assume that theories were maximally specific in the sense that they did not (...) only exclude certain conceptual possibilities, but also that all non-excluded possibilities were in fact claimed to be nomically possible. Now, he argues that the exclusion claim alone, or for that matter the inclusion claim alone, is sufficient to motivate the formal definition of being closer to the nomic truth. The papers collected here detail this generalized view of nomic truthlikeness or verisimilitude. Besides this, the book presents, in adapted form, the relation with several other topics, such as, domain revision, aesthetic progress, abduction, inference to the best explanation, pragmatic aspects, probabilistic methods, belief revision and epistemological positions, notably constructive realism. Overall, the volume presents profound insight into nomic truth approximation. This idea seeks to determine how one theory can be closer to, or more similar to, the truth about what is nomically, e.g. physically, chemically, biologically, possible than another theory. As a result, it represents the ultimate goal of theory oriented empirical science. Theo Kuipers is the author of Studies in Inductive Probability and Rational Expectation, From Instrumentalism to Constructive Realism and Structures in Science. He is the volume-editor of the Handbook on General Philosophy of Science. In 2005 there appeared two volumes of Essays in Debate with Theo Kuipers, entitled Confirmation, Empirical Progress, and Truth Approximation and Cognitive Structures in Scientific Inquiry. (shrink)

This pathbreaking work pursues two interwoven themes. Firstly, it engages in a deconstruction of Ancient philosopher's texts--mainly from Plato, but also from Homer and Parmenides--in order to free four Greek female figures from the patriarchal discourse which for centuries had imprisoned them in a particular role. Secondly, it attempts to construct a symbolic female order, reinterpreting these figures from a new perspective. Building on the theory of sexual difference, Cavarero shows that death is the central category on which the whole (...) edifice of traditional philosophy is based. By contrast, the category of birth provides the thread with which new concepts of feminist criticism can be woven together to establish a fresh way of thinking. Cavarero develops a philosophical narrative which, by re-interpreting each of the four figures of ancient thought, uncovers several images of the female desire for self-representation. Plato himself had not forseen that one day female subjectivity would assert its autonomy, plundering and throwing into confusion the patriarchal text in order to tell another story. (shrink)

Adriana Novoa and Alex Levine offer here a history and interpretation of the reception of Darwinism in Argentina, illuminating the ways culture shapes ...

The qualitative theory of nomic truth approximation, presented in Kuipers in his, in which ‘the truth’ concerns the distinction between nomic, e.g. physical, possibilities and impossibilities, rests on a very restrictive assumption, viz. that theories always claim to characterize the boundary between nomic possibilities and impossibilities. Fully recognizing two different functions of theories, viz. excluding and representing, this paper drops this assumption by conceiving theories in development as tuples of postulates and models, where the postulates claim to exclude nomic impossibilities (...) and the models claim to represent nomic possibilities. Revising theories becomes then a matter of adding or revising models and/or postulates in the light of increasing evidence, captured by a special kind of theories, viz. ‘data-theories’. Under the assumption that the data-theory is true, achieving empirical progress in this way provides good reasons for the abductive conclusion that truth approximation has been achieved as well. Here, the notions of truth approximation and empirical progress are formally direct generalizations of the earlier ones. However, truth approximation is now explicitly defined in terms of increasing truth-content and decreasing falsity-content of theories, whereas empirical progress is defined in terms of lasting increased accepted and decreased rejected content in the light of increasing evidence. These definitions are strongly inspired by a paper of Gustavo Cevolani, Vincenzo Crupi and Roberto Festa, viz., “Verisimilitude and belief change for conjunctive theories” :183–222, 2011). (shrink)

3 in philosophy, and therefore in metaphilosophy, cannot be based on rules that avoid spending time on pseudo-problems. Of course, this implies that, if one succeeds in demonstrating convincingly the pseudo-character of a problem by giving its 'solution', the time spent on it need not be seen as wasted. We conclude this section with a brief statement of the criteria for concept explication as they have been formulated in several places by Carnap, Hempel and Stegmiiller. Hempel's account is still very (...) adequate for a detailed introduction. The process of explication starts with the identification of one or more vague and, perhaps, ambiguous concepts, the so-called explicanda. Next, one tries to disentangle the ambiguities. This, however, need not be possible at once. Ultimately the explicanda are to be replaced by certain counterparts, the so-called explicata, which have to conform to four requirements. They have to be as precise as possible and as simple as possible. In addition, they have to be useful in the sense that they give rise to the formulation of theories and the solution of problems. The three requirements of preciseness, simplicity and usefulness. have of course to be pursued in all concept formation. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . This theoretical (...) framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

The paper focuses on the ethical teachings of Classical Antiquity philosophers in the poetry of Saint Gregory of Nazianzus, especially on the parallels between the author’s work and the Cynics and the Stoics. The syncretic nature of Gregory’s work, reflected in the assimilation of the teachings of ancient philosophical schools and the then expanding Christianity creates conditions for the explanation and highlighting of basic human virtues. Gregory of Nazianzus’ legacy also draws on the teachings of such philosophers as Plato and (...) Aristotle, but he always approaches them from the perspective of a strictly Christian worldview. He understands philosophy as a moral underlying basis from which one can draw inspiration for a virtuous and happy life. Gregory thinks that philosophy cannot harm Christians in the pursuit of a virtuous life. Nevertheless, Christian teachings and God are the highest authority. They stand above all philosophical schools or ideas advanced by specific philosophers. Gregory’s moral poetry thus directs his readers, if they are to deserve eternal life, to follow the commandments, which is possible only if one lives a practical and virtuous life. (shrink)

An interesting consequence of the structuralist theory of truth approximation, as developed in my From Instrumentalism to Constructive Realism, henceforth ICR, concerns so-called ‘inference to the best explanation’. It will be argued that this popular rule among scientific realists can better be replaced by, various kinds of, ‘inference to the best theory’.

To understand how compliance develops both in everyday and corporate environments, it is crucial to understand how different mechanisms work together to shape individuals’ (non)compliant behavior. Existing compliance studies typically focus on a subset of theories (i.e., rational choice theories, social theories, legitimacy theories, capacity theories, and opportunity theories) to understand how key variables from one or several of these theories shape individual compliance. The present study provides a first integrated understanding of compliance, rooted in complexity science, in which key (...) elements from these theories are considered simultaneously, and their relations to compliance and each other are explored using network analysis. This approach is developed by analyzing online survey data (_N_ = 562) about compliance with COVID-19 mitigation measures. Traditional regression analysis shows that elements from nearly all major compliance theories (except for social theories) are associated with compliance. The network analysis revealed groupings and interconnections of variables that did not track the existing compliance theories and point to a complexity overlooked in existing compliance research. These findings demonstrate a fundamentally different perspective on compliance, which moves away from traditional narrow, non-network approaches. Instead, they showcase a complexity science understanding of compliance, in which compliance is understood as a network of interacting variables derived from different theories that interact with compliance. This points to a new research agenda that is oriented on mapping compliance networks, and testing and modelling how regulatory and management interventions interact with each other and compliance within such networks. (shrink)

Examples of hypotheses about the number of planets are frequently used to introduce the topic of (actual) truthlikeness but never analyzed in detail. In this paper we first deal with the truthlikeness of singular quantity hypotheses, with reference to several ‘the number of planets’ examples, such as ‘The number of planets is 10 _versus_ 10 billion (instead of 8).’ For the relevant ratio scale of quantities we will propose two, strongly related, normalized metrics, the proportional metric and the (simplest and (...) hence favorite) fractional metric, to express e.g. the distance from a hypothetical number to the true number of planets, i.e. the distance between quantities. We argue that they are, in view of the examples and plausible conditions of adequacy, much more appropriate, than the standardly suggested, normalized absolute difference, metric. Next we deal with disjunctive hypotheses, such as ‘The number of planets is between 7 and 10 inclusive is much more truthlike than between 1 and 10 billion inclusive.’ We compare three (clusters of) general ways of dealing with such hypotheses, one from Ilkka Niiniluoto, one from Pavel Tichý and Graham Oddie, and a trio of ways from Theo Kuipers. Using primarily the fractional metric, we conclude that all five measures can be used for expressing the distance of disjunctive hypotheses from the actual truth, that all of them have their strong and weak points, but that (the combined) one of the trio is, in view of principle and practical considerations, the most plausible measure. (shrink)

Relating Narratives is a major new work by the philosopher and feminist thinker Adriana Cavarero. First published in Italian to widespread acclaim, Relating Narratives is a fascinating and challenging new account of the relationship between selfhood and narration. Drawing a diverse array of thinkers from both the philosophical and the literary tradition, from Sophocles and Homer to Hannah Arendt, Karen Blixen, Walter Benjamin and Borges, Adriana Cadarero's theory of the `narratable self' shows how narrative models in philosophy and (...) literature can open new ways of thinking about formation of human identities. By showing how each human being has a unique story that can be told about them, Adriana Cavarero inaugurates an important shift in thinking about subjectivity and identity which relies not upon categorical or discursive norms, but rather seeks to account for `who' each one of us uniquely is. (shrink)

INTRODUCTION When Karl Popper published in' his definition of closer-to-the- truth this was an important intellectual event, but not a shocking one. ...

So far, the most prominent measure for actual truthlikeness, i.e. the likeness of a theory to the actual truth, is Ilkka Niiniluoto’s minsum definition, which is purely based on distances. A competing definition is the average distance measure proposed by Pavel Tichy and Graham Oddie. We will define three related, distance and size based, measures for actual truthlikeness and compare them with the two well-known options. However, we will start, Sect. 2, from a trio of such measures for nomic truthlikeness. (...) The nomic truth, or the true theory, here refers to what is nomically, e.g. physically, possible. In a nomic (and factual) context there are two basic kinds of theories, viz. either based on an exclusion claim or on an inclusion claim. Two-sided theories combine these claims, with the maximal claim as extreme special case. We will base truthlikeness measures for exclusion, inclusion, two-sided, and hence maximal, nomic theories on two similarity measures, one in terms of distances between conceptual possibilities and the other in terms of sizes of sets of such possibilities. In Sect. 3 we will treat actual truthlikeness as extreme special case of nomic truthlikeness, viz. assuming that there is just one nomic possibility, the actual one. Next we will compare the resulting measures mutually and with the above mentioned measures of Niiniluoto and Tichy & Oddie. Finally, in Sect. 4, we will sum up the results and explore five questions for further research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fault LinesLaura A. KatersI first meet Shawn in person on the 46th day of his most recent hospitalization. We sit outside of a community hospital on a wooden bench dedicated as a place to “sit, pause, and reflect.” It’s a biting cold November afternoon and I try to keep my shivering at bay by thinking of warm things. Shawn is wearing only a thin hospital gown and socks, but (...) the cold doesn’t seem to bother him. I’m his self-appointed chaperone so he can sit outside and vape.“I hope you don’t think you’re doing me a favor,” he says. “I should be able to do this in my room.”What Shawn doesn’t realize is that I’ve turned my day upside down for him and this vape. He is off balance and at high risk for falls and so he can’t leave his room without someone watching him. I yearned to do something human for Shawn and so I spent hours chasing for permission from his primary medical team. We etch out an agreement that just because I am offering to take Shawn outside, he shouldn’t expect the same from others.Shawn is gaunt and toxic appearing, and visitors stare at us as they enter the hospital with one patron mouthing to me, “Are you alright?” as if I’m there against my will, but I see what they see. I watch as a stringy mess of brown hair falls away from his upturned face; his eyes are closed against the sunlight. I’m overwhelmed by the odor of urine and feces and staleness because he refuses to let anyone help him bathe. We sit in an awkward silence initially, but nothing about Shawn is straightforward. After yet another prolonged hospital admission, he’s already made the clearest decision of his life. He’s 32 years old.I learn that Shawn was diagnosed with Crohn’s disease, an inflammatory bowel disease (IBD), only two years prior. Such were the ravages of his illness and its lack of response to conventional medications and treatment modalities that he lost sight of himself, literally. His body morphed from strong and athletic to cachectic, his skin turned translucent. The first surgery after his diagnosis was an emergent one for a perforated bowel that nearly killed him and was rife with complications. Afterward, Shawn was frequently admitted to various hospitals with complex abdominal pain, followed by more surgeries.This admission is different, however, because Shawn also has an abdominal infection so severe that it limits his ability to eat or drink. The nurses placed a peripherally inserted central catheter, or PICC line, which allows for intravenous delivery of nutrition and fluids, and he is made terminally NPO. Nothing by mouth.Shawn’s abdominal infection also coincides with terrific pain that is never adequately alleviated. One night, out of a desperate attempt to momentarily escape his illness and reality, Shawn crushed the opioids he is given every few hours, mixed them with tap water, and injected them directly into his PICC line. He later admitted to doing this for years every time he had a PICC or IV access outside the hospital, which was often. Unbeknownst to him was that the nondigestible parts of the pills such as talc and cellulose—the bits that hold the pills together—end up in the veins as wells. These fragments travel to the lungs where they lodge in the alveoli and create an irreversible condition called “excipient lung disease,” leading to pulmonary hypertension, inflammation, and early mortality. Shawn had experienced increasing shortness of breath over the last year, and ground glass opacities on his chest [End Page 26] CT-imaging could reflect this rare phenomenon. Most notable, however, was how upset he became that no one warned him that injecting crushed pills into his PICC line could result in such damage.“You see how desperate I’ve become,” he earnestly told his medical team. “Why wouldn’t you help me protect myself?”From what I know, it’s evident that Shawn needs a PICC line to survive outside the hospital, yet because of his misuse of the... (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Richard Rorty is one of the most oft-cited yet least understood philosophers of the twentieth century. This book offers an overview and introduction to Rorty's ideas, key writings and contributions to the various fields of philosophy. Chronologically organized, the book traces the development of Rorty's thought and examines all the key topics, and controversies, central to his work. Ronald A. Kuipers introduces Rorty's complex thought through the exploration of three Rortyan personas: The Philosophical Therapist, The Liberal Ironist, and the Anticlerical (...) Prophet. This exploration of Rorty's multivalent yet deeply coherent intellectual identity is set against the background of Rorty's personal motivations for studying philosophy, and for pursuing the controversial questions he did. The book portrays how, in conversation with the traditions of American Pragmatism, Analytic Philosophy, and Continental Thought, Rorty weaves his own unique and original philosophy. Rorty's originality resides in his fresh approach to interrelated social and political problems, revealing a thinker who has important reasons for wading into controversial intellectual waters. This is the ideal companion to study of this hugely influential thinker. (shrink)

This collection of 17 articles offers an overview of the philosophical activities of a group of philosophers (who have been) working at the Groningen University. The meta-methodological assumption which unifies the research of this group, holds that there is a way to do philosophy which is a middle course between abstract normative philosophy of science and descriptive social studies of science. On the one hand it is argued with social studies of science that philosophy should take notice of what scientists (...) actually do. On the other hand, however, it is claimed that philosophy can and should aim to reveal cognitive patterns in the processes and products of scientific and common sense knowledge. Since it is thought that those patterns can function as guidelines in new research and/or in research in other disciplines, philosophy can nevertheless hold on to the normative aim which is characteristic of 'classical' philosophy of science. Compared to this common assumption, there is a diversity of subjects. Some papers deal with general problems of science, knowledge, cognition and argumentation, others with topics relating to foundational problems of particular sciences. Therefore this volume is of interest to philosophers of science, to philosophers of knowledge and argumentation in general, to philosophers of mind, as well as for scientists working in the physical and applied sciences, biology, psychology and economy who are interested in the foundations of their disciplines. After a foreword by Leszek Nowak and a general introduction by the editors, the book is divided into four parts, with special introductions. - I: Conceptual Analysis in Service of Various Research Programmes (Henk Zandvoort, Rein Vos, Rick Looijen, Gerben Stavenga, Renée Dalitz); - II: The Logic of the Evaluation of Arguments, Hypotheses, Default Rules, and Interesting Theorems (Erik Krabbe, Theo Kuipers, Alfons Keupink, Maarten Janssen/Yao-Hua Tan, Bert Hamminga); - III: Three Challenges to the Truth Approximation Programme (Sjoerd Zwart, Hinne Hettema/Theo Kuipers, Roberto Festa); - IV: Explicating Psychological Intuitions (Anne-Ruth Mackor, Jeanne Peijnenburg, Lex Guichard, Michel ter Hark). The Groningen research group was recently qualified, by an official international assessment committee, as one of the best philosophy research groups in the Netherlands. (shrink)

Three related intuitions are explicated in this paper. The first is the idea that there must be some kind of probabilistic version of the HD-method, a 'Hypothetico-Probabilistic method', in terms of something like probabilistic consequences, instead of deductive consequences. According to the second intuition, the comparative application of this method should also be functional for some probabilistic kind of empirical progress, and according to the third intuition this should be functional for something like probabilistic truth approximation. In all three cases, (...) the guiding idea is to explicate these intuitions by explicating the crucial notions as appropriate 'concretizations' of their deductive analogs, being 'idealizations'. It turns out that the comparative version of the proposed HP-method amounts to the likelihood comparison method applied to the cumulated evidence. This method turns out to be not only functional for probabilistic empirical progress but also for probabilistic truth approximation. The latter is based on a probabilistic threshold theorem constituting for this reason the analog of the deductive success theorem. (shrink)

The philosophy of science has lost its self-confidence, witness the lack of advanced textbooks in contrast to the abundance of elementary textbooks. Structures in Science is an advanced textbook that explicates, updates, accommodates, and integrates the best insights of logical-empiricism and its main critics. This `neo-classical approach' aims at providing heuristic patterns for research. The book introduces four ideal types of research programs and reanimates the distinction between observational laws and proper theories. It explicates various patterns of explanation by subsumption (...) and specification as well as structures in reductive and other types of interlevel research. Its analysis of theory evaluation leads to new characterizations of confirmation, empirical progress, and pseudoscience. Partial analogies between progress in nomological research and progress in explicative and design research emerge. Finally, special chapters are devoted to design research programs, computational philosophy of science, the structuralist approach to theories, and research ethics. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This theoretical framework (...) prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)