Objectives: The objective of this study is to estimate the proportion of different types of end‐of‐life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium). The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practice. Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N=166) received an anonymous self‐administered mail questionnaire per death case (max. 5/doctor) Results: the response rate was 55% (...) (N=269). In 37.3% of all cases at least one ELD was made (16.5% non‐treatment decisions; 16% potential life‐shortening by intensifying the treatment of pain and symptoms; 4.8% administration, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristics were clearly related to the type of ELD. There was no influence of physician characteristics, except for commitment to life‐stance. In 71.3% of the cases the ELD was in no way discussed with the patient. 8.1% of the ELD‐cases were in response to a direct request from the patient Conclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviour of physicians at the end of their patients' life. The patient's and her family's entitlements to participation in the decision making process were rather poorly respected. (shrink)

Is GDP a good proxy for social welfare? Building on economic theory, this book confirms that it is not, but also that most alternatives to it share its basic flaw, i.e., a focus on specific aspects of people's lives without sufficiently taking account of people's values and goals. A better approach is possible.

In this paper a model for barrecursion is presented. It has as a novelty that it contains discontinuous functionals. The model is based on a concept called strong majorizability. This concept is a modification of Howard's majorizability notion; see [T, p. 456].

This paper explores the nature of the relationship between corporate social responsibility (CSR) and competitiveness. We start with the commonly held view that firm competitiveness is defined by the market. That is, the question of what are the critical competitiveness factors is answered by looking at how companies and financial analysts describe and evaluate a firm. To analyze this, we review the current state of the art on the relationship between CSR and competitiveness. Second, CSR criteria used by financial analysts (...) is identified and compared with company valuation methods. Third, the results of a multi-stakeholder dialogue on CSR and competitiveness of the European financial sector are presented. As a conclusion, we argue that CSR and competitiveness relate through a learning and innovation cycle, where corporate values, policies and practices are permanently defined and re-defined. Thus, we propose that learning takes place as CSR is embedded in business processes, and that once it has been integrated, in turn, it generates innovative practices, and finally, competitiveness. At the end of the paper, we propose that CSR in practice consists of managing inherent paradoxes generated by the tension between CSR and business policies. (shrink)

This thought-provoking collection sheds light on the plight of our nonhuman primate cousins--and what we can do to help.

Eine etablierte Unternehmensphilosophie gibt es noch nicht. Wenn man sich an verwandten Disziplinen orientiert, wie beispielsweise der politischen Philosophie, dann gehören dazu vier Forschungsbereiche: an erster Stelle eine ideengeschichtliche Verortung, zweitens die Klärung der Grundbegriffe, drittens eine wissenschaftstheoretische Auseinandersetzung mit der Wirtschaftswissenschaft und viertens eine Auseinandersetzung mit normativen Fragen. Diese vier Bereiche einer Unternehmensphilosophie sollen in diesem Artikel systematisch dargestellt werden.

The Food and Drug Administration authorizes the marketing of a drug only for uses that the manufacturer has demonstrated to be safe and effective, based on evidence from at least two clinical trials. However, the FDA does not regulate the practice of medicine, so physicians may prescribe drugs in any manner they choose. Prescribing drugs in ways that deviate from the uses specified in the FDA-approved drug label, package insert, and marketing authorization is referred to as off-label prescribing. This occurs (...) when physicians prescribe a drug for a therapeutic purpose other than the one approved by the FDA; treat patients in a different age cohort or gender than the population on which it was tested; or prescribe a different dose, for a different duration of use, or a different mode of administration than indicated on the label. (shrink)

The heart of the matter -- The evolution of the French medicine -- Coping with physicians' conflicts of interest in France -- The rise of a protected medical market : the United States before 1950 -- The commercial transformation : the United States, 1950-1980 -- The logic of medical markets : the United States, 1980 to the present -- Coping with physicians' conflicts of interest in the United States -- The evolution of Japanese medicine -- Coping with physicians' conflicts of (...) interest in Japan -- Reforms -- Professionalism reconsidered. (shrink)

Happiness studies have rekindled interest in the measurement of subjective well-being, and often claim to track faithfully ‘what people care about’ in their lives. It is argued in this article that seeking to respect individuals’ preferences in the context of making intrapersonal and interpersonal comparisons for social evaluation has important and somewhat surprising implications, which shed light, in particular, on subjective measures and their objective alternatives, such as Sen’s capability approach. Four points are made. First, raw subjective well-being scores are (...) problematic because they involve different calibration norms for different individuals or for the same individuals at different times. Money-metric and similar measures appear more attractive in this perspective. Second, if individuals genuinely care about their relative positions, incorporating such relative aspects in the evaluation of individual situations does not necessarily lead to rewarding the selfish and malevolent. Third, in the context of risk, relying on ex ante preferences may clash with a concern for ex post preferences, which are better informed. Fourth, focusing on opportunities or capabilities may fail to respect preferences. (shrink)

Two variables are usually recognised as determinants of human causal learning: the contingency between a candidate cause and effect, and the temporal and/or spatial contiguity between them. A common finding is that reductions in temporal contiguity produce concomitant decrements in causal judgement. This finding had previously (Shanks & Dickinson, 1987) been interpreted as evidence that causal induction is based on associative learning processes. Buehner and May (2002, 2003, 2004) have challenged this notion by demonstrating that the impact of temporal delay (...) depends on expectations about the timeframe between cause and effect. A corollary of this knowledge-mediation account is that in certain situations longer delays could facilitate, while shorter delays should impair, causal learning. Here we present two experiments involving a physical apparatus that demonstrate a detrimental effect of contiguity under certain conditions. In contrast to all previous studies, delays universally promoted causal learning. This evidence is clearly at variance with the notion of a bottom-up contiguity bias in causal induction. A new, more general timeframe bias is discussed. (shrink)

Introduction L’analyse des temporalités de l’action constitue une entrée pertinente pour aborder les rapports sociaux de domination. À sa manière, la revue Temporalités a perpétué cette tradition des sciences sociales qui observent les inégalités et les différenciations sociales, analysent leurs logiques, en insistant sur les relations étroites entre temporalités et pouvoir. Mais les articles de Temporalités, à l’exception d’un dossier sur les temps sexués de l’activité (Bess..

In this article we present a new experimental paradigm: comparative visual search. Each half of a display contains simple geometrical objects of three different colors and forms. The two display halves are identical except for one object mismatched in either color or form. The subject's task is to find this mismatch. We illustrate the potential of this paradigm for investigating the underlying complex processes of perception and cognition by means of an eye‐tracking study. Three possible search strategies are outlined, discussed, (...) and reexamined on the basis of experimental results. Each strategy is characterized by the way it partitions the field of objects into “chunks.” These strategies are: (i) Stimulus‐wise scanning with minimization of total scan path length (a “traveling salesman” strategy), (ii) scanning of the objects in fixed‐size areas (a “searchlight” strategy), and (iii) scanning of object sets based on variably sized clusters defined by object density and heterogeneity (a “clustering” strategy). To elucidate the processes underlying comparative visual search, we introduce besides object density a new entropy‐based measure for object heterogeneity. The effects of local density and entropy on several basic and derived eye‐movement variables clearly rule out the traveling salesman strategy, but are most compatible with the clustering strategy. (shrink)

Der Mensch als „homo viator“ ist ein Topos, der sich in der Literatur und Philosophie, aber auch in diversen religiösen Traditionen unterschiedlicher Epochen finden lässt. Der vorliegende Sammelband konzentriert sich auf die Thematisierung dieses Bildes vom Menschen, der auf dem Wege ist, durch das moderne Existenzdenken.

Post-industrial societies confront common problems in pharmaceutical industry-physician relations. In order to promote sales, drug firms create financial relationships that influence physicians' prescriptions and sometimes even reward physicians for prescribing drugs. Three main types exist: kickbacks, gifts, and financial support for professional activities. The prevalence of these practices has evolved over time in response to changes in professional codes, law, and markets. There are certainly differences among these types of ties, but all of them can compromise physicians' independent judgment and (...) rational prescribing.Drug firms have paid kickbacks for prescribing drugs, purchasing drugs, switching brands prescribed, adding a drug to a hospital formulary, enrolling patients in post-marketing clinical trials, and writing practice guidelines that encourage the use of certain drugs. (shrink)

The present essay on the being of the sensible investigates the individuation of intensity differentials. This is Deleuze's theme in the fifth chapter of Difference and Repetition, where he places individuation in the context of his ‘transcendental empiricism’. The mechanisms of subjectivation are conceived as spatially-temporally determined actualisations (of the virtual) whose implicit intensity relations are neither accessible empirically nor are they governed by transcendental conditions (in the conventional sense). Central to the discussion is the distinction, stemming from Kant, between (...) intensive and extensive magnitudes. (shrink)

This paper argues that Hutto and Satne’s three-pronged attempt to solve the problem of intentionality – or, at least, to provide an outline of how this problem should be approached – suffers from two shortcomings. First, the idea of Ur-intentionality is problematic. Second, Hutto and Satne have not provided us with a way of getting from Ur-intentionality to content intentionality.

It has become accepted that social choice is impossible in the absence of interpersonal comparisons of well-being. This view is challenged here. Arrow obtained an impossibility theorem only by making unreasonable demands on social choice functions. With reasonable requirements, one can get very attractive possibilities and derive social preferences on the basis of non-comparable individual preferences. This new approach makes it possible to design optimal second-best institutions inspired by principles of fairness, while traditionally the analysis of optimal second-best institutions was (...) thought to require interpersonal comparisons of well-being. In particular, this approach turns out to be especially suitable for the application of recent philosophical theories of justice formulated in terms of fairness, such as equality of resources. (shrink)

This article explores a training need common to every stage of a teacher’s career : the need to be accompanied. It takes an integrative perspective on the process of the situated learning of teaching, throughout the career, from the pre-service practicums to the period of entrance in the profession then to the in-service training. Providing a reflexive accompaniment of the teachers’ practical experiences is here presented as a central factor for linking the training and the work environments. The first part (...) of the article exposes our conception of a reflexive accompaniment and justifies its importance for the evolution of the teaching practices. Then, we describe how we were convinced of that importance through our role as directors of two teacher training devices, one in Switzerland, one in Quebec. Finally, the third part of the article is devoted to the training of the persons that practice such an accompaniment. (shrink)

Empathy is likely more widely distributed among animals than many researchers realize or perhaps are willing to admit. Studies of social carnivores, other group-living animals, and communication via different modalities will help us learn more about the evolutionary roots and behavioral, sensory, and cognitive underpinnings of empathy, including what it means to have a sense of self. There are also important implications for debates about animal well-being.

The occurrence of poor patient care is emerging as one of the most significant, challenging, and critical issues confronting contemporary nursing and those responsible for the provision of health care more generally. Indeed, as a consequence of the increased recognition of the manner in which nurses can be implicated in the occurrence of poor patient care, there has been sustained critical debate that seeks to understand how such healthcare failings can occur and, in particular, why nurses seemingly fail to intervene, (...) raise concerns, and effectively respond to prevent the occurrence and continuation of such poor patient care. In seeking to contribute to this critical discussion, and in contrast to those “situational explanations” that maintain that the failure to raise concerns is a consequence of the contextual factors and challenging conditions to which nurses can be subject in the clinical setting, this paper will provide a resolutely philosophical analysis of that failure. In particular, it will draw upon the work of Jean‐Paul Sartre—the French philosopher generally regarded as one of the most influential thinkers of the twentieth century—in order to propose that his work can be productively recontextualized to provide a detailed, challenging, and provocative critical analysis of the occurrence and continuation of poor patient care and the role of individual nurse practitioners in such healthcare failings. (shrink)