Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

The failure to maintain a canonical Christian understanding of the family as a microcosm of the church oriented toward deification instead of a microcosm of society aimed at social ends has opened Christians up to an uncritical adoption of non-Christian approaches in medical decision making. This article begins by identifying the Christian family crisis not as a liberal versus conservative debate centered on the form and function of the family, but more fundamentally as an ecclesial versus sociological understanding of the (...) Christian family. The article presents a historical sketch of the circumstances that have led to this contemporary crisis in the Western Christian family, followed by an analysis that provides a canonical account of the Christian family as exemplified in the thought of Gregory the Theologian. This article concludes by looking at the specific issue of labor and delivery in the United States, and the implications for a canonical Christian understanding of labor and delivery in light of contemporary medical practices. (shrink)

The growth in the direct-to-consumer genetic testing industry poses a number of challenges for healthcare practice, among a number of other areas of concern. Several companies providing this service send their customers reports including information variously referred to as genetic ethnicity, genetic heritage, biogeographic ancestry, and genetic ancestry. In this article, we argue that such information should not be used in healthcare consultations or to assess health risks. Far from representing a move toward personalized medicine, use of this information poses (...) risks both to patients as individuals and to racialized ethnic groups because of the way it misrepresents human genetic diversity. (shrink)

The aim of this paper is to investigate the flow of MHD mixed convection nanofluid flow under nonlinear heated due to an extending surface. The transfer of heat in nanofluid subject to a magnetic field and boundary conditions of convective is studied to obtain the physical meaning of the convection phenomenon. The governing partial differential equations of the boundary layer are reduced to ordinary differential equations considering a technique of the transformation of similarity. The transformed equations are solved numerically considering (...) the technique of an efficient numerical shooting applying the Runge–Kutta technique scheme from the fourth-fifth order. The results corresponding to the dimensionless speed, temperature, concentration profiles, and the Nusselt number reduced, and the Sherwood numbers are presented by figures to display the physical meaning of the phenomena. A comparison has been made between the obtained results with the previous results obtained by others and agrees with them if the new parameters vanish. The results obtained indicate the impacts of the nondimensional governing parameters, namely, magnetic field parameter M, Soret number Sr, heat source λ, thermal buoyancy parameter λ T, and solutal buoyancy parameter λ C on the flow, temperature, and concentration profiles being discussed and presented graphically. (shrink)

An interesting question, in both the moral and the legal context, is whether babies born of an infertility treatment-induced supernumerary pregnancy are properly considered to have been harmed. One might wonder how such a question could even arise in the face of data that clearly demonstrate that ITISP leaves an unduly large number of babies blind, deaf, and palsied, and facing lifelong disabilities. In fact, however, a number of arguments, based on the problem of collective form and two forms of (...) the so-called “nonidentity problem,” challenge the claim of harm in the ITISP context. The purpose of the present paper is to establish, as against these arguments, that harm has been imposed on the ITISP-damaged offspring. (shrink)

Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affect influenza vaccination rates and to answer the question whether deviating from standard informed consent procedures could be morally justified. Design: A survey among nursing home physicians. Setting & Participants: We sent a questionnaire to all (356) nursing (...) homes in the Netherlands, to be completed by one of the physicians. Results: We received 245 completed questionnaires. As 21 institutions appeared to be closed or merged into other institutions, the response was 73.1% (245/335). Of all respondents 81.9% reported a vaccination rate above 80%. Almost 50% reported a vaccination rate above 90%. Most respondents considered herd immunity to be an important consideration for institutional policy. Freedom of choice for residents was considered important by almost all. Nevertheless, 106 out of 245 respondents follow a tacit consent procedure, according to which vaccination will be administered unless the resident or her proxy refuses. These institutions show significantly higher vaccination rates (p < 0.03). Conclusions: In our discussion we focus on the question whether tacit consent procedures can be morally justifiable. Such procedures assume that vaccination is good for residents either as individuals or as a group. Even though this assumption may be true for most residents, there are good reasons for preferring express consent procedures. (shrink)

Name der Zeitschrift: Das Mittelalter Jahrgang: 19 Heft: 2 Seiten: 253-301.

Thepresentwork is arevisedand enlarged English versionofa book originally writtenin Spanish and published in late 1996, La rejlexion de DavidHume en lorno a /a religion. SinceDavidHume is arguablynot only the most important philosopherwhohaseverwrittenintheEnglishlanguage,butthemoststudiedand influential,itisonlynaturalthatsoonerthanlaterIwouldfeelthe urgencyto bring totheattentionofamuchwiderpublicaworkwhoseoutlook is, I think, signifi cantlydifferentfrom that ofother books which deal with the Scottish thinker's worksonreligionandnaturaltheology.Thisdesirewassostrongastoallowmeto overcome the all-too-natural fear that my wavering and uncertain command of English wouldmakethe few valuableinsights theworkmight containappearun clear,andmyphilosophicalerrors,evenmoreastonishing. This book is addressednot only to scholarswhomay beinterested in modem philosophy in (...) generalorHume'sphilosophyofreligion in particular,but also to themoreextensivecompassofreaderseitherintriguedortroubledby religion and themyriadofissuesandproblemsitposes,whichare, as it were, the primematter forphilosophicalanalysisandtheorizing.Inspiteofitsphilosophicaland linguistic limitations,forwhichIamentirelyresponsible,Iferventlyhopethatthisworkmay befoundtocontainsomethingofthatelusivetruthafterwhichHumestrove, andto whichheremainedconstantto theend, particularlyatatime whenthe priceto be paidforthepublicationofcontroversialphilosophicalandreligious views wascon siderablyhigherthanthatofbecominganeasytargetforuniversalridicule. Thecompletionofthisworkhasbeenmadepossible principally by asabbatical leavethattheUniversityofPuertoRico grantedme fortheyear 1999. This leave gavemethenecessarytimeto readandstudy thepertinentliterature,aswell asto writemostoftheEnglish manuscript.Italsoallowedmeto visit Edinburgh and spendmostofJuly andAugust 1999 attheNationalLibraryofScotlandand the EdinburghUniversityLibrary.Although Ihaveincorporatedinto thepresentwork onlyasmallpartofmyresearchatthose libraries,ifthis bookshows agreaterap preciation of the immediate social and religious context of Hume's thought than its Spanish predecessor, it is in no small measure due to the books, articles, and xi xii Preface manuscritsIwasabletoconsultatthe time. Inthis respect, Iwouldliketo thank Professor Peter Jones, Director of the Institute for Advanced Studies in the HumanitiesattheUniversityofEdinburgh, who was very instrumental in making myvisittoEdinburghareality,andgenerouslyputthefacilitiesoftheInstitute at mydisposal. Manythoughts andlinesofargumentcontained in this bookdatebackto my doctoraldissertation,andsomeearlierversionsofanumberofchaptersorsections ofchaptershavebeenpublished in differentphilosophyjournalsor anthologies. I oftheminthebibliographyundermy name. But sincemy previousworks listall onthe subjecthavebeenrevisedandmodifiedsomanytimes in the lightofnew fmdingsortomeetactualorpossiblecriticism,Ican saythatthey havebeeneffec tivelysupersededbythepresentwriting. (shrink)

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I (...) adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non‐naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. (shrink)

Many contemporary logicians acknowledge a plurality of logical theories and accept that theory choice is in part motivated by logical evidence. However, just as there is no agreement on logical theories, there is also no consensus on what constitutes logical evidence. In this paper, I outline Jean Piaget’s psychological theory of reasoning and show how he used it to diagnose and solve one of the paradoxes of material implication. I assess Piaget’s use of psychology as a source of evidence for (...) logical theory in light of reservations raised by psychologism, and I highlight some ramifications for exceptionalism and anti-exceptionalism about logic by considering his use of psychology as logical evidence in the framework of genetic epistemology, Piaget’s research programme. I conclude that Piaget’s psychological theory of reasoning not only plausibly serves as a source of evidence for logical theory but also makes a strong case for anti-exceptionalism about logic. (shrink)

This text explores how human beings construe experience: experience as a resource, as a potential for understanding, representing and acting on reality.

There is a theistic argument which is discussed at least twice in the Hume corpus, both times rather perfunctorily. This perfunctoriness has carried over to some of his commentators, who are not always clear as to what the argument is or about the force of Hume’s comments on it. On page 23 of A Letter from a Gentleman to his Friend in Edinburgh Hume calls it “the metaphysical Argument a priori” and in Part 9 of Dialogues concerning Natural Religion simply (...) “the argument a priori”.1 It is the argument of Demea. (shrink)

In Chinese scholarship, Xunzi is often regarded as an eclectic Confucian master who accepted some form of utilitarian thoughts (e.g. Fung Yu-lan, Mou Zongsan and Xu Fuguan). This characteristic was also observed by some western scholars such as Benjamin I. Schwartz. In a recent study, I argued that the basic character of Xunzi’s philosophy is utilitarianism in a broad sense based on an examination on his intellectual criticism and political criticism. Xunzi asserts that humans are innately driven by self-interested desires, (...) and he evaluates all intellectual works and political behaviours by their utility. However, he does not limit utility to only basic animal desires such as food and sex. In Xunzi’s view, humans also have innate emotions; hence, these emotions should also be accounted for in their utility. This is similar to John Stuart Mill’s redefinition of Bentham’s concept of utility. Are Xunzi’s and Mill’s concepts of utility exactly the same? This question has yet to be examined. This article is a comparative study between utilitarianism and Xunzi’s philosophy which especially explores the compatibility of these two philosophies. (shrink)