In Western countries a considerable number of older people move to a residential home when their health declines. Institutionalization often results in increased dependence, inactivity and loss of identity or self-worth (dignity). This raises the moral question as to how older, institutionalized people can remain autonomous as far as continuing to live in line with their own values is concerned. Following Walker's meta-ethical framework on the assignment of responsibilities, we suggest that instead of directing all older people towards more autonomy (...) in terms of independence, professional caregivers should listen to the life narrative of older people and attempt to find out how their personal identity, relations and values in life can be continued in the new setting. If mutual normative expectations between caregivers and older people are not carefully negotiated, it creates tension. This tension is illustrated by the narrative of Mr Powell, a retired successful public servant now living in a residential home. The narrative describes his current life, his need for help, his independent frame of mind, and his encounters with institutional and professional policies. Mr Powell sees himself as a man who has always cared for himself and others, and who still feels that he has to fulfil certain duties in life. Mr Powell's story shows that he is not always understood well by caregivers who respond from a one-sided view of autonomy as independence. This leads to misunderstanding and an underestimation of his need to be noticed and involved in the residential community. (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)

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily (...) routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes. (shrink)

This paper investigates what the source of time-asymmetry is in thermodynamics, and comments on the question whether a time-symmetric formulation of the Second Law is possible.

One of the founders of modern hermeneutics, German philosopher Wilhelm Dilthey (1833-1911) confronted the question of how modern, postmetaphysical human beings can cope with the ambivalence, contingency, and finitude that fundamentally characterize their lives. This book offers a reevaluation and fresh analysis of Dilthey's hermeneutics of life against the background of the development of philosophy during the past two centuries. Jos de Mul relates Dilthey's work to other philosophers who influenced or were influenced by him, including Kant, Schleiermacher, Hegel, Comte, (...) Mill, Nietzsche, Husserl, Heidegger, Gadamer, and Derrida. Weaving together systematic analysis and historical investigation, de Mul begins the book with an account of the horizon on which Dilthey developed his unfinished masterwork, Critique of Historical Reason. The author then elaborates a systematic reconstruction of Dilthey's ontology of life, relates the ontology to the work of other twentieth-century philosophers, and positions Dilthey's thought within current philosophical debate. (shrink)

The starting point of the present paper is Bell’s notion of local causality and his own sharpening of it so as to provide for mathematical formalisation. Starting with Norsen’s analysis of this formalisation, it is subjected to a critique that reveals two crucial aspects that have so far not been properly taken into account. These are the correct understanding of the notions of sufficiency, completeness and redundancy involved; and the fact that the apparatus settings and measurement outcomes have very different (...) theoretical roles in the candidate theories under study. Both aspects are not adequately incorporated in the standard formalisation, and we will therefore do so. The upshot of our analysis is a more detailed, sharp and clean mathematical expression of the condition of local causality. A preliminary analysis of the repercussions of our proposal shows that it is able to locate exactly where and how the notions of locality and causality are involved in formalising Bell’s condition of local causality. (shrink)

In this paper, it is argued that the most fruitful approach to developing normative models of argument quality is one that combines the argumentation scheme approach with Bayesian argumentation. Three sample argumentation schemes from the literature are discussed: the argument from sign, the argument from expert opinion, and the appeal to popular opinion. Limitations of the scheme-based treatment of these argument forms are identified and it is shown how a Bayesian perspective may help to overcome these. At the same time, (...) the contributions of the standard scheme-based approach are highlighted, and it is argued that only a combination of the insights of different traditions will yield a complete normative theory of argument quality. (shrink)

Brian Garrett has criticized my diagnosis of the paradox of self-consciousness. In reply, I focus on the classification of 'I'-thoughts, and show how the notion of immunity to error through misidentification can be used to characterize 'I'-thoughts, even though an important class of 'I'-thoughts are not themselves immune to error through misidentification. 'I'-thoughts which are susceptible to error through misidentification are dependent upon those which are not. The dependence here has to do with how a thinker understands what would defeat (...) such thoughts. (shrink)

BackgroundOver the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.MethodsIn this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a (...) dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.ResultsWe first explore the gap between the ideal of personalized healthcare and the reality of today’s personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.ConclusionFinally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides. (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)

The emergence of the hominids, more than five million years ago, marked the start of the human odyssey through space and time. This book deals with the last stage of this fascinating journey: the exploration of cyberspace and cybertime. Through the rapid global implementation of information and communication technologies, a new realm for human experience and imagination has been disclosed. Reversely, these postgeographical and posthistorical technologies have started to colonize our bodies and minds. Taking Homer's Odyssey and Kubrick's 2001: A (...) Space Odyssey as his starting point, the author investigates the 'informatization of the worldview', focusing on its implications for our culture-arts, religion, and science-and, ultimately, our form of life. Moving across a wide range of disciplines, varying from philosophical anthropology and palaeontology to information theory, and from astrophysics to literary, film and new media studies, the author discusses our 'cyberspace odyssey' from a reflective position beyond euphoria and nostalgia. His analysis is as profound as nuanced and deals with issues that will be high on the agenda for many decades to come. In 2003 a Dutch Edition of Cyberspace Odyssey received the Socrates Prize for the best philosophy book published in Dutch. (shrink)

In this paper we examine some proposals to disprove the hypothesis that the interaction between mind and matter causes the collapse of the wave function, showing that such proposals are fundamentally flawed. We then describe a general experimental setup retaining the key features of the ones examined, and show that even a more general case is inadequate to disprove the mind-matter collapse hypothesis. Finally, we use our setup provided to argue that, under some reasonable assumptions about consciousness, such hypothesis is (...) unfalsifiable. (shrink)

Quantum mechanics is generally regarded as the physical theory that is our best candidate for a fundamental and universal description of the physical world. The conceptual framework employed by this theory differs drastically from that of classical physics. Indeed, the transition from classical to quantum physics marks a genuine revolution in our understanding of the physical world.

Increased pressures on agri-food systems have indicated the importance of intermediaries to facilitate sustainability transitions. While producer organizations are acknowledged as intermediaries between individual producers and other food system actors, their role as sustainability transition intermediaries remains understudied. This paper explores the potential of producer organizations as transition intermediaries to support producers in their needs to adopt sustainable production practices. Ten cases of producer organizations in conventional (regime) and organic (niche) vegetable systems in Uruguay were studied qualitatively. Findings show that (...) the classic intermediary roles that producer organizations fulfil in food systems also address the needs of producers in their transition to sustainable food systems. By providing organic inputs, organizing access to output markets, sharing knowledge, and facilitating sustainable production practices, producer organizations support producers within and across regime and niche. Producer organizations mostly function as implicit transition intermediaries, facilitated by their legitimacy among producers, their embeddedness in rural networks, and by refraining from taking a strong normative position. Producer organizations have the potential to be more explicit transition intermediaries, however this position comes with limitations. We provide policy recommendations to optimize the transition intermediary potential of producer organizations in their facilitation towards sustainable food systems. (shrink)

In this paper we will show you a part of a course “Clinical Psychology of Religion” that has been developed in the Netherlands for introducing mental health professionals in the field of clinical psychology of religion. Clinical psychology of religion applies insights from general psychology of religion to the field of the clinical psychologist. Clinical psychology of religion can be defined as that part of the psychology of religion dealing with the relation between religion, worldview and mental health. Like the (...) clinical psychologist, the clinical psychologist of religion deals with psychodiagnostics and psychotherapy, but concentrates on the role religion or worldview plays in mental health problems. The relation between religion and mental health has been a subject for study since the start of the psychology of religion at the end of the last century. A number of authors have elaborated on the ways in which religion can be beneficial or detrimental to psychological health. In recent research we have found that there is a great need among psychotherapists to become better equipped in this field. (shrink)

This paper explores semi‐formal interactions between SRI‐investors that take the governance route rather than deploy a best‐in‐class logic or exclusionary screening. On the basis of a stakeholder typology of the investor and of the chosen topic of interaction, namely compliance with the core ILO labour conventions, the paper formulates 10 expectations about management reactions to the concerns raised by investors. These expectations cover responsiveness, acknowledgment of positions and general attitude. The expectations are then related to the factual discourse by management (...) responding to such concerns raised by investors. Based on data obtained from the Portfolio21‐correspondence, which is a joint initiative of European investors, it is found that management is very willing to discuss cases but at the same time denies the truth‐value of the allegations. Here, the problem of information asymmetry comes to the fore. (shrink)

Part of being a good professional is, so we contend, to have ideals. Ideals essentially complement the deontic considerations that are usually taken as the main components of professional moral deliberation. Yet the notion of professional ideals is problematic. As professional ideals they refer to a profession collectively, while as professional ideals they are first of all strong personal commitments of individual professionals. As collective aspirations, professional ideals have a kind of external normative thrust on individual professionals, but people cannot (...) be forced to identify with ideals on demand. Endorsing ideals can only come from within. On the basis of an analysis of ?professional ideals? and ?professional identity?, we conclude that professional ideals are necessary constituents of the personal identity of professionals. This explains the dual character of professional ideals: they are pursued by a collective and constitute the group professional identity but they also need to be endorsed by individual professionals in order to be able to say that the ideals are their own. We end with a short and tentative description of some practical implications for the fostering and education of professional ideals. (shrink)

This is the first book in healthcare ethics addressing the moral issues regarding ownership of the human body. Modern medicine increasingly transforms the body and makes use of body parts for diagnostic, therapeutic and preventive purposes. The book analyzes the concept of body ownership. It also reviews the ownership issues arising in clinical care (for example, donation policies, autopsy) and biomedical research. Societies and legal systems also have to deal with issues of body ownership. A comparison is made between specific (...) legal arrangements in The Netherlands and France, as examples of legal approaches. In the final section of the book, different theoretical perspectives on the human body are analyzed: libertarian, personalist, deontological and utilitarian theories of body ownership. (shrink)

Helmuth Plessner’s Levels of Organic Life and the Human [Die Stufen des Organischen und der Mensch, 1928] is one of the founding texts of twentieth century philosophical anthropology. It is argued that Plessner’s work demonstrates the fundamental indispensability of the qualitative humanities vis-à-vis the natural-scientific study of man. Plessner’s non-reductionist, emergentist naturalism allots complementary roles to the causal and functional investigations of the life sciences and the phenomenological and hermeneutic interpretation of the phenomenon of life in its successive levels and (...) stages. Within this context, human agency can be understood as a higher-order property of organic life, which act by the selective activation of lower-level psychophysical powers. Plessner’s three ‘anthropological laws’ are used to situate the notion of practical self-understanding in between two extremes: deterministic views that deny human freedom and responsibility and views that ascribe an unrealistic amount of autonomy to human beings. (shrink)

The 2008 UN Convention on the Rights of Persons with Disabilities (CRPD) provides a landmark articulation of the universality of human rights. It affirms in strong terms that all human beings have a claim to full inclusion and equal participation in society, something denied to many because of disability. The CRPD is an ambitious document with far-reaching and fundamental implications. This interdisciplinary collection of essays takes up pressing philosophical, legal, and practical issues raised by the CRPD and the ongoing process (...) of its implementation. Combining clear legal and philosophical overviews with ground-breaking conceptual analyses, the collection aims to advance the academic debate about human rights and disability and to serve as a useful resource for policymakers, ethicists, disability activists, jurists, and all those interested in the human rights of persons with disabilities. With contributions by Jackie Leach Scully, Marcus Düwell, Jenny Goldschmidt, Sigrid Graumann, Caroline Harnacke, Jan Vorstenbosch, Esther van Weele, Joel Anderson, Jos Philips. (shrink)

Coping with death in the classroom. A trajectory for beginning primary school teachers To support beginning teachers in primary education to deal with death in the classroom, a community of practice developed a trajectory for a pedagogy of death. Negative pedagogy, a movement within humanities pedagogy, was chosen for the theoretical foundation of this trajectory. Negative pedagogy is about the beginning of formative processes and their development. Gadamer’s hermeneutics is an important source of inspiration. Buck adopts from Gadamer that negative (...) experiences are at the beginning of formative processes and that the course of these processes has a circular structure. Koller criticizes Gadamer and Buck, because they assume that there is continuity between the old and the new horizon. This makes it impossible to learn something completely new. To solve that problem, Koller follows Waldenfels who developed a phenomenology of the radical strange. When confronted with the radical strange, the old horizon is set aside and a new horizon emerges. According to Koller, this involves crisis situations, including the loss of a significant other. Furthermore, Buck and Koller adopt Gadamer’s idea that the humanities are about historical knowledge. That means, we cannot give recipes for the pedagogical action because each child is unique and each situation is different. However, we can practice judgment by reflecting with teachers on cases.. In this way, we offer them an action orientation for future situations in the classroom. (shrink)

Helmut Plessner was one of the founders of philosophical anthropology, and his book _The Stages of the Organic and Man_, first published in 1928, has inspired generations of philosophers, biologists, social scientists, and humanities scholars. This volume offers the first substantial introduction to Plessner’s philosophical anthropology in English, not only setting it in context with such familiar figures as Bergson, Cassirer, and Merleau-Ponty, but also showing Plessner’s relevance to contemporary discussions in a wide variety of fields in the humanities and (...) sciences. (shrink)

The concept of Integrative Bioethics is the idea of an equal discussion between different ethical concepts from different backgrounds. This concept is not only suitable for the specific situation in Southeast Europe. It can also be a basis to affect the ethical discourse in other parts of the world, either with a homogeneous historical background or within a very diverse ethical setting. With this essay I will try to point out the possibilities for the discussion of ethical problems in other (...) parts of the world if the core idea of Integrative Bioethics is added to bioethical discussions. It seems to be a chance to find a way to deal with the differences between traditional and modern concepts of ethics. Der Entwurf der integrativen Bioethik steht für die Idee einer gleichgestellten Auseinandersetzung zwischen verschiedenerlei ethischen Konzepten aus differenten Hintergründen. Dieses Schema ist nicht lediglich am außerordentlichen Beispiel des Südosteuropas verwendungsfähig. Es könnte gleichermaßen als Basis zur Einflussnahme auf den ethischen Diskurs in den restlichen Regionen der Welt fungieren, entweder jenen mit einem homogenen historischen Hintergrund oder denjenigen mit einer mannigfaltigen ethischen Färbung. Innerhalb dieses Essays wage ich den Versuch, auf die Möglichkeiten zur Debatte über ethische Angelegenheiten in anderen Teilen der Welt zu verweisen, sollte die Kernidee der integrativen Bioethik den bioethischen Erörterungen hinzugefügt werden. Sie nimmt sich aus als die Chance, einen Weg ausfindig zu machen, die Differenzen zwischen den traditionellen und zeitgenössischen Konzepten der Bioethik in Angriff zu nehmen. (shrink)

The author argues that the reductionist illusions of the Modern Synthesis, which Noble criticizes in his target article, are to a large extent resulting from a mere syntactical notion of biological information, neglecting the pragmatic and semantic dimension of information. Although the syntactical notion, introduced by Shannon, has been applied with much success in information theory and computer technologies, it is too narrow to understand biological reality. Biosemiotics can help to clarify the problems identified by Noble, and offers a more (...) adequate biological information concept, which not only may help to overcome these problems in the life sciences, but may also serve to integrate natural-scientific and humanities approaches to life. (shrink)

The concepts of uncertainty in prediction and inference are introduced and illustrated using the diffraction of light as an example. The close relationship between the concepts of uncertainty in inference and resolving power is noted. A general quantitative measure of uncertainty in inference can be obtained by means of the so-called statistical distance between probability distributions. When applied to quantum mechanics, this distance leads to a measure of the distinguishability of quantum states, which essentially is the absolute value of the (...) matrix element between the states. The importance of this result to the quantum mechanical uncertainty principle is noted. The second part of the paper provides a derivation of the statistical distance on the basis of the so-called method of support. (shrink)