In this article the author shows that we must distinguish between criterion as a characteristic in a definition and as a norm for truth and ethical values. He shows that we must accept a hierarchy of such criteria, But that this hierarchy is not absolute. He also discusses and solves the 'paradox of the publican'.

In this article the author investigates the scientific (wetenschappelijk) character of moral statements. First he gives an analysis of the verb ‘to know’ and its equivalents in Dutch. His conclusion is that the verb to know may be, depending on its context, (i) an epistemic qualificator, (ii) a dispositional verb or (iii) a relational verb. Then he deals with the criteria of a scientific system : evidence, relevance, possibility of prediction, of formalisation and finally the criterion of simplicity. The author (...) shows that the latter criterion is the most fundamental. Various formalized ethical systems are developed in this article. The author shows that ethics fulfills all the criteria of science, except the criterion of the possibility of prediction. In ethics one cannot predict without committing the naturalistic fallacy. The author sees scientific systems as logical empirical ones. He demonstrates that ethics can be considered a scientific system, provided that the logic permitted in the system is strong enough (i.e. that it includes deontic logic) and the experience permitted in the system is wide enough (i.e. that it includes ethical intuition). (shrink)

no abstract. Book review in Dutch about a book written in Dutch.

Vakfilosofische opstellen over de hedendaagse vraagstukken binnen de ethiek.

Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients (...) and render the process less transparent. Other solutions focus on preferences expressed when patients are not ill, but this information is often not available. The reason for such difficulties with assessing decision-making capacity is that the underlying psychological processes of normal decision-making are not well known and one cannot differentiate between unwise decisions caused by an illness or other factors. The proposed alternative, set out in this paper, is to allow compulsory treatment of patients with decision-making capacity in cases of an emergency, if the refusal is potentially life threatening, but only for a time-limited period. The argument is also made for investigating hindsight agreement, in particular after compulsory measures. -/- . (shrink)

This is a response to the response by Robyn Bluhm to my paper, and I am again arguing for a limited role of capacities in psychiatry, given the current scientific uncertainties.

Crisis resolution and home treatment (CRHT) teams have been introduced into mental health care in the UK because, in general, patients do not want to be admitted to hospital, treatment at home is cheaper and in the only randomized controlled trial conducted so far there was no difference in symptomatic outcome. However, because of compulsory gate-keeping by CRHT teams, some patients no longer have the option of going to hospital if they want to. This aspect of the introduction of CRHT (...) teams has not been discussed so far, but it certainly warrants further examination. Intervention through CRHT teams may in fact increase compulsory admissions and serious and untoward incidents, although this is not certain. Sufferers from psychosis are the patient group most likely to be compulsorily admitted to hospital and they are generally considered less responsible for serious and untoward incidents. Therefore, a possible solution could be to offer a choice to some patients, namely those with a psychotic disorder, on whether they want to be admitted or not. At least one should investigate what the consequences of this policy would be, if it were to be adopted in a test region. This example shows that in developing policies for rationing health care, it can be important to look at subgroups and not just at average results when determining the best course of action. (shrink)

In this article the author shows Harthorne's important contribution to the revival of modern interest in the proofs of God's existence. He gives a short exposition of Harthorne's philosophy as far as that is relevant to our understanding of the superiority of the neo-classical concept of God (in comparison with classical theories) to face critical questions as to the validity of the ontological argument. The author analyses Harthorne's ontological argument and examines the following points of critique : (i) Existence is (...) not a predicate. (ii) The concept of a perfect being as well as the concept of a greatest number is meaningless. (iii) In the ontological argument the logical type fallacy is committed : Just as the universal ‘humanity’ is not human so ‘perfection’ is not perfect. (iv) In the ontological argument the paradox of the abstractness of the necessary is present. (v) The ontological argument forces us to accept an objectionable Aristotelian essentialism. (vi) The ontological argument jumps incorrectly from a de dicto modality to a de re modality. The author shows that these objections can be answered satisfactorily in Harthorne's neo-classical metaphysics. He discusses further a modal reconstruction of the cosmological argument (of his own) and shows that this establishes an argument for Harthorne's God conception. Finally he asks two critical questions. Hartshorne does not sufficiently acknowledges the fact that there are more than one logical system so that a choice must be made, which brings in an ‘existential’ moment in philosophy. Further he wonders as to whether Harthorne's temporal interpretation of modalities is correct. In an appendix written in English the author discusses modern reconstructions of the ontological and cosmological argument with the help of modern symbolic logic. (shrink)

This paper addresses the concept of moral luck. Moral luck is discussed in the context of medical error, especially an error of omission that occurs frequently, but only rarely has adverse consequences. As an example, a failure to compare the label on a syringe with the drug chart results in the wrong medication being administered and the patient dies. However, this error may have previously occurred many times with no tragic consequences. Discussions on moral luck can highlight conflicting intuitions. Should (...) perpetrators receive a harsher punishment because of an adverse outcome, or should they be dealt with in the same way as colleagues who have acted similarly, but with no adverse effects? An additional element to the discussion, specifically with medical errors, is that according to the evidence currently available, punishing individual practitioners does not seem to be effective in preventing future errors. The following discussion, using relevant philosophical and empirical evidence, posits a possible solution for the moral luck conundrum in the context of medical error: namely, making a distinction between the duty to make amends and assigning blame. Blame should be assigned on the basis of actual behavior, while the duty to make amends is dependent on the outcome. (shrink)