Much epistemological theorizing is the attempt to specify what makes for meritorious cognition, but epistemologists have not, despite meritorious effort, achieved unity when it comes to picking out the feature and principles that are distinctive of epistemic normativity. In this essay we explain why this is the inevitable outcome. We isolate important but overlooked variations in the link between epistemological theorizing and the idea of epistemic unification, and then argue that much epistemological theorizing is misguided because it aims toward complete (...) epistemic unification when only partial epistemic unification, at best, is possible. But our arguments — based on work in moral epistemology and philosophical psychology — stop short of epistemological eliminativism, and thus we stake out a middle ground between philosophers such as Descartes, the earlier Alston, Audi, and the earlier BonJour on one hand and Rorty, Fish, and Patricia Churchland on the other. (shrink)

Hesiod, um 700 vor Christus im armlichen Bootien lebend, ist nur wenig junger als Homer. Obwohl er von der hexametrischen Epik der "Ilias" und der "Odyssee" stark beeinflusst ist, bietet er in seinen beiden Werken "Vom Ursprung der Gotter" und "Werke und Tage" etwas vollig Neues: Zum ersten Mal in der europaischen Literaturgeschichte tritt uns ein Autor als Person entgegen. Er selbst erzahlt, wie die Musen ihm beim Schafehuten erschienen und den jungen Menschen zum Dichter beriefen.Ausserdem wird Hesiod zum Vater (...) einer eigenen literarischen Gattung: des Lehrgedichts. Er bringt die gottlichen Machte in verwandtschaftliche Beziehungen; so entsteht eine Deutung des Weltganzen, die bereits auf die philosophischen Entwurfe der vorsokratischen Denker vorausweist. Indem er die Erzahlungen uber die Gotter zusammenfasst und ordnet, wird Hesiod zur wichtigsten Quelle des griechischen Mythos. In den "Werken und Tagen," einer Art Bauernkalender, in den Bruchstucke einer ersten Autobiographie und einige beruhmte Sagen eingestreut sind, wirkt Hesiod mit seiner pessimistischen Beurteilung des eigenen Zeitalters erstaunlich aktuell. Mit Einfuhrung, Erlauterungen und Literaturhinweisen von E.G. Schmidt.". (shrink)

Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

In dit boek neemt de Tsjechisch-Nederlandse geleerde Jan Amos Comenius (1592-1670) een centrale plaats in. Met zijn filosofie en onderwijsleer wilde hij de menselijkheid in de samenleving bevorderen. Hij kwam ervoor op dat mensen met verschillende levensbeschouwelijke visies konden samenwerken om dit doel te helpen realiseren. Ook komen rozenkruisers en vrijmetselaars aan de orde, die reeds in de zestiende en zeventiende eeuw van zich lieten horen. Anders dan de kerken deden, manifesteerden zij een onafhankelijkheid van denken en een streven naar (...) meer menselijkheid in de cultuur.0In hun denken en spreken spelen ook de ideeën van Comenius een rol, direct of indirect, kritisch ondervragend of opbouwend, maar altijd inspirerend. (shrink)

Pursuant to the Doctrine of Consumer Sovereignty, we believe that tobacco companies should be compelled to disclose their ingredients so that the public health community can make more informed recommendations in order to protect consumer autonomy and sovereignty. However, a recent decision by the First Circuit precludes such a disclosure since it would be unduly burdensome to the industry, while granting only minimal gains to the public. We argue that many of the Court’s key claims rest on a misunderstanding of (...) the science and chemistry of tobacco products. In our view, a mandatory disclosure of ingredients would more effectively protect the public interest, whilst posing minimal burdens on the tobacco industry. (shrink)

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

The value of autonomy is generally stated to be of prime importance in relation to health care. Arising out of this, rights of the patient to and in health care have been extensively discussed and stated, and have found expression in law. There have been minimal statements of the rights of others involved in health care, such as caregivers, and minimal discussion of duties and responsibilities in relation to rights claimed and conferred. The author suggests that no claim to rights (...) in health care should now be accepted without consideration of related duties and responsibilities. (shrink)

Animal ethicists have recently debated the ethical questions raised by disenhancing animals to improve their welfare. Here, we focus on the particular case of breeding hens for commercial egg-laying systems to become blind, in order to benefit their welfare. Many people find breeding blind hens intuitively repellent, yet ‘welfare-only’ positions appear to be committed to endorsing this possibility if it produces welfare gains. We call this the ‘Blind Hens’ Challenge’. In this paper, we argue that there are both empirical and (...) theoretical reasons why even those adopting ‘welfare-only’ views should be concerned about breeding blind hens. But we also argue that alternative views, which (for example) claim that it is important to respect the telos or rights of an animal, do not offer a more convincing solution to questions raised by the possibility of disenhancing animals for their own benefit. (shrink)

The ethical issues around decision making on behalf of infants have been illuminated by two empirical research studies carried out in Scotland. In-depth interviews with 176 medical and nursing staff and with 108 parents of babies for whom there was discussion of treatment withholding/withdrawal, generated a wealth of data on both the decision making process and the management of cases. Both staff and parents believe that parents should be involved in treatment limitation decisions on behalf of their babies. However, whilst (...) many doctors and nurses consider the ultimate responsibility too great for families to carry, the majority of parents wish to be the final arbiters. We offer explanations for the differences in perception found in the two groups. The results of these empirical studies provide both aids to ethical reflection and guidance for clinicians dealing with these vulnerable families. They demonstrate the value of empirical data in the philosophical debate. (shrink)

In the language of secular bioethics, autonomy is always accorded first place in the hierarchy of values that has come to be referred to as the “Georgetown mantra” A dictionary definition of mantra is “a verbal spell, ritualistic incantation, or mystic formula used devotionally,” and the value placed upon autonomy is largely of this nature: uncritical and uncriticised. That there should be and are limits to autonomy is obvious, but these boundaries are undefined, little discussed, and mostly unexplored. To use (...) another metaphor, our emphasis on autonomy is an index of how far the pendulum has swung in an understandable and partly justifiable reaction from, earlier paternalism; has this swing approached its proper limit, and should we be seeking a less extreme and more balanced assessment of autonomy as a bioethical value? (shrink)

Nach der Problemumgrenzung werden im zweiten Abschnitt die Möglichkeiten der aktualistischen Methode behandelt. Zuerst werden Beispiele für die Anwendung der Methode auf vorwiegend geologischem Gebiet gebracht, gegliedert in exogene und endogene Vorgänge. Wegen der gleichzeitigen Bedeutung für Geologie und Paläontologie und Biologie schliesst sich eine Besprechung der Biostratonomie an. Der letzte Teil dieses Abschnittes behandelt ausgewählte Beispiele aus der Paläontologie. Der dritte Abschnitt schliesslich behandelt die Grenzen aktualistischer Betrachtungsmethode an Hand typischer Beispiele.The theory of actualism is the most important in (...) geological and palaeontological thinking. In this paper the historical development of this theory, its possibilities and boundaries are described and elucidated by geological and palaeontological examples. (shrink)

Ideologues of the American Dream doctrine assume that state intervention aimed at providing social safety nets for citizens and reducing economic inequality, restricts freedom and undermines individual opportunity. This assumption is the result of empirical misinformation and, more fundamentally, a conceptual mistake. Robust empirical data indicate that economic equality, far from stifling initiative or undermining opportunity, is conducive to social mobility.

This collection of previously unpublished essays addresses a number of issues arising out of philosophical controversies over the possibility of genuine moral dilemmas. Issues addressed include the form of a moral dilemma; the paradoxes a moral dilemma is said to entail; the question of whether a moral dilemma must exhibit inconsistency; the role of intractable circumstances in occasioning moral dilemmas; and the plausibility of supposing that there might be rational ways of addressing moral dilemmas in practice. The contributors, writing from (...) a number of widely differing points of view, include Simon Blackburn, Ruth Barcan Marcus, Alan Donagan, Terrance McConnell, Walter Sinnott-Armstrong, Mary Mothersill, Norman Dahl, David Brink, Peter Railton, Thomas E. Hill, Jr., Christopher Gowans, and H.E. Mason. (shrink)

Most contemporary societies are ethnically and culturally diverse. Responding to diversity is a challenge--for the United States, a 'nation of immigrants', for post-colonial states of the global south, cobbled together from diverse ethnic groups, and for European nations experiencing mass immigration.

Preferentism is the doctrine that "in deciding what is good and what is bad for a given individual, the ultimate criterion can only be his own wants and his own preferences." If preferentism is true then it would seem to follow that modifying a person's preferences so that they are satisfied by what is on offer should be as good as improving the circumstances of her life to satisfy her preferences. Our intuitive response to stories of life-adjustment through brainwashing, psychosurgery (...) and the like suggests otherwise. I sketch a broadly preferentist account drawing upon Sen's (non-preferentist) capability approach that resists such putative counterexamples. (shrink)