Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

The Remmelink Committee published its report on medical decisions at the end of life in the Netherlands in September 1991. As a result, the Dutch debate about physician aid‐in‐dying has been broadened to include life‐terminating acts that have not been explicitly requested by the patient.

The Remmelink Committee published its report on medical decisions at the end of life in the Netherlands in September 1991. As a result, the Dutch debate about physician aid‐in‐dying has been broadened to include life‐terminating acts that have not been explicitly requested by the patient.

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

This collection of papers makes a step towards increased dialogue among philosophical liberals and their theological, sociological and legal critics. The text should be significant for those concerned with the place of religion within a liberal society.

In Religion and the Obligations of Citizenship Paul J. Weithman asks whether citizens in a liberal democracy may base their votes and their public political arguments on their religious beliefs. Drawing on empirical studies of how religion actually functions in politics, he challenges the standard view that citizens who rely on religious reasons must be prepared to make good their arguments by appealing to reasons that are 'accessible' to others. He contends that churches contribute to democracy by enriching political (...) debate and by facilitating political participation, especially among the poor and minorities, and as a consequence, citizens acquire religiously based political views and diverse views of their own citizenship. He concludes that the philosophical view which most defensibly accommodates this diversity is one that allows ordinary citizens to draw on the views their churches have formed when voting and offering public arguments for their political positions. (shrink)

This study examined the historical perspectives of eleven emergent bilingual and bilingual students at two middle schools. Data analysis revealed that the participants’ perspectives on U.S. history reflected three schematic narrative templates focused on nation-building, equality, and discrimination. The participants primarily employed the (in)equality narratives when discussing aspects of U.S. history directly linked to their identities. The findings add to the extant research on student historical perspectives and use of schematic narrative templates. The findings further suggest that engaging (emergent) bilingual (...) students in examining multiple perspectives and conducting critical history inquiry can contribute to notions of culturally and linguistically responsive social studies instruction. (shrink)

ARCHIVES INTERNATIONALES D'HISTOIRE DES IDEES INTERNATIONAL ARCHIVES OF THE HISTORY OF IDEAS 33 PAUL J. OLSCAMP The Moral Philosophy of George Berkeley ..

Like nature itself, modern economic life is driven by relentless competition and unbridled selfishness. Or is it? Drawing on converging evidence from neuroscience, social science, biology, law, and philosophy, Moral Markets makes the case that modern market exchange works only because most people, most of the time, act virtuously. Competition and greed are certainly part of economics, but Moral Markets shows how the rules of market exchange have evolved to promote moral behavior and how exchange itself may make us more (...) virtuous. Examining the biological basis of economic morality, tracing the connections between morality and markets, and exploring the profound implications of both, Moral Markets provides a surprising and fundamentally new view of economics--one that also reconnects the field to Adam Smith's position that morality has a biological basis. Moral Markets, the result of an extensive collaboration between leading social and natural scientists, includes contributions by neuroeconomist Paul Zak; economists Robert H. Frank, Herbert Gintis, Vernon Smith, and Bart Wilson; law professors Oliver Goodenough, Erin O'Hara, and Lynn Stout; philosophers William Casebeer and Robert Solomon; primatologists Sarah Brosnan and Frans de Waal; biologists Carl Bergstrom, Ben Kerr, and Peter Richerson; anthropologists Robert Boyd and Michael Lachmann; political scientists Elinor Ostrom and David Schwab; management professor Rakesh Khurana; computational science and informatics doctoral candidate Erik Kimbrough; and business writer Charles Handy. (shrink)

Because Paul has proven difficult to understand, the interpreter must pay careful attention to the language, the rhetorical structure, and the context if unnecessary difficulties are to be avoided.

How does personality influence the relationship between appraisals and emotions? Recent research suggests individual differences in appraisal structures: people may differ in an emotion's appraisal pattern. We explored individual differences in interest's appraisal structure, assessed as the within-person covariance of appraisals with interest. People viewed images of abstract visual art and provided ratings of interest and of interest's appraisals (novelty–complexity and coping potential) for each picture. A multilevel mixture model found two between-person classes that reflected distinct within-person appraisal styles. For (...) people in the larger class (68%), the novelty–complexity appraisal had a stronger effect on interest; for people in the smaller class (32%), the coping potential appraisal had a stronger effect. People in the larger class were significantly higher in appetitive traits related to novelty seeking (e.g., sensation seeking, openness to experience, and trait curiosity), suggesting that the appraisal classes have substantive meaning. We conclude by discussing the value of within-person mixture models for the study of personality and appraisal. (shrink)

This paper examines the strengths and weaknesses of one of science's most pervasive and flexible metaprinciples;optimalityis used to explain utility maximization in economics, least effort principles in physics, entropy in chemistry, and survival of the fittest in biology. Fermat's principle of least time involves both teleological and causal considerations, two distinct modes of explanation resting on poorly understood psychological primitives. The rationality heuristic in economics provides an example from social science of the potential biases arising from the extreme flexibility of (...) optimality considerations, including selective search for confirming vidence, ex post rationalization, and the confusion of prediction with explanation. Commentators are asked to reflect on the extent to which optimality is an organizing principle of nature, a set of relatively unconnected techniques of science, a normative principle for rational choice and social organization, a metaphysical way of looking at the world, or something else still. (shrink)

A framework is presented for studying ethical conduct in public accounting practice. Four levels of analysis are distinguished: individual, local office, multi-office firm and professional institute. Several propositions are derived from the framework and discussed: (1) The effects of ethical vs. unethical behavior on an accountant's prospects for advancement are asymmetrical in nature; (2) the way individuals perceive or frame the decision problem at hand will make an ethical response more or less likely; (3) the economic incentives present in competitive (...) markets influence the work goals of firms and offices, and lead to ethical dilemmas for individuals; and (4) initiatives at the firm or institute level aimed at compliance with professional ethical standards will by themselves have little effect on individual ethical behavior. Research into ethical behavior of practitioners will capture self-conscious and biased responses unless it is designed so as to permit indirect observation and recording of spontaneous comments. To assure valid research findings, practitioners should be interviewed and their motives assessed indirectly. A longitudinal approach is recommended, beginning with students who are choosing an accounting career. Two types of questions for use in these interviews are described. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

Most people would agree that compulsive lying is a "sickness." In his provocative Lying, Paul Griffiths suggests that consistent truth telling might evoke a similar response. After all, isn't unremitting honesty often associated with stupidity, insanity, and fanatical sainthood? Drawing from Augustine's writings, and contrasting them with the work of other Christian and non-Christian thinkers, Griffiths deals with the two great questions concerning lying: What is it to lie? When, if ever, should or may a lie be told? Examining (...) Augustine's answers to these questions, Griffiths grapples with the difficulty of those answers while rendering them more accessible. With rhetorical savvy Augustine himself would applaud, Griffiths aims to "seduce" rather than argue his readers into agreement with Augustine. Augustine's historically significant, characteristically Christian, and undeniably radical thoughts on lying ignite Griffiths's searching discussion of this challenging and crucial topic. Marvelously erudite and energetic, Lying will draw Augustine enthusiasts, students of ethics, and anyone who is committed to living a more honest life. (shrink)

The vulnerability of patients receiving significantly innovative neurosurgical procedures, either as research or as non-standard therapy, presents particularly potent challenges for those attempting to substantially advance clinical Neurosurgical practice in the most ethically and efficacious manner. This beginning formulation has built into it several important notions about research participation, balancing values, and clinical advancement in the context of neurological illness. For the time being, allow vulnerability to act as a placeholder for circumstances or states of being wherein the established checks (...) and balances of power and interest are no longer sufficient in promoting the just treatment of persons. Further, the phrase to substantially advance Neurosurgical practice encompasses radical innovation as well as significant research into new procedures. Finally, few of these explorations involve true randomized placebo controlled trials, but rather they enroll patients rightfully hoping for some benefit by means of undergoing the procedure.When a neurosurgeon asks me, as an ethicist, to meet with a patient who has medically refractory disease and no good standard therapy options remaining, he is asking for help concerning whether to offer, as a last chance, an unproven therapy as either innovation or research. (shrink)

ABSTRACTHélène Landemore's Democratic Reason offers a new justification for democracy and for broad-based citizen participation, appealing to the “emergent” intelligence of large, diverse groups. She argues that ordinary citizens should rule as directly as possible because they will make better informed, more intelligent decisions than, for example, appointed officials, councils of experts, or even elected representatives. The foundation of this conclusion is the premise that “diversity trumps ability” in a wide range of contexts. But the main support for that claim (...) is merely a series of computer experiments that are strongly biased toward that result and tell us essentially nothing about decision making in real-world political settings. Moreover, Landemore's analyses of alternative forms of rule deal only in abstract comparisons between sharply distinguished ideal types. Among other difficulties, they entirely overlook the central consideration in such comparisons: the relative ability of any decision-making process to go beyond stereotyped, intrinsic strategies and integrate multiple sources and varieties of information. In the end, Landemore's claims for the superior intelligence of broadly participatory forms are thus not supported by credible evidence. (shrink)

In their analysis Childress et al. (2023) suggest that withdrawal of extracorporeal membrane oxygenation (ECMO) over a patient’s dissent is not justified by existing ethical arguments. The alternat...

In his justly celebrated Expert Political Judgment, Philip E. Tetlock evaluates the judgment of economic and political experts by rigorously testing their ability to make accurate predictions. He finds that ability profoundly limited, implying that expert judgment is virtually useless, if not worse. He concludes by proposing a project that would seek to improve experts' performance by holding them publicly accountable for their claims. But Tetlock's methods severely underestimate the value of expert opinion. Despite their notorious disagreements, experts have highly (...) pertinent information and advice in many areas of public policy. The main problem with experts is that political actors seize on their most extreme views in one direction or the other, and overlook their areas of general agreement and the core of relatively reliable information that they provide. (shrink)

Western Buddhology, the responsible scholarly study of Buddhist languages, history and ideas, is now more than a century and a half old. For most of that time scholars working in this field have been primarily concerned to understand and expound their sources, not to criticize or assess the views found therein, much less to make any attempt at deciding whether the central views of Buddhist philosophers are likely to be true statements of the way things are. There are good reasons (...) for this restriction; before a given set of philosophical views can be assessed it must be understood, and in the case of Buddhism the gaining of such understanding has involved the collective philological labours of several generations of scholars and is still in many respects in its infancy. What is the case for the scholarly community as a whole is magnified for the individual working in this field; the effort involved in becoming competent in several Buddhist canonical languages and in becoming familiar with a range of philosophical ideas and preconceptions which are in many respects alien to one's own culture tends to mean that the Buddhologist's apprenticeship is long, his publications so clogged with jargon as to be inaccessible to any non-specialist, and his appetite for truth stifled by Sanskrit syntax and Tibetan declensions. There is the added problem that the Western intellectual who makes the study of Buddhism his avocation is likely to be, in some more or less well defined sense, a Buddhist; and the dangers of making religious commitment the major motivation for scholarly study have been so amply illustrated by Christian history that they scarcely need rehearsing here. (shrink)

Examining the philosophical, theological, and political teachings of the Tractatus theologico-politicus, this book proposes that Benedict Spinoza fashions a ...

As neural implants transition from engineering design and testing into human subjects research, careful consideration must be paid to the ethical elements in developing research protocols. Although these ethical aspects may be framed by the design choices of the engineering, a number of challenging choices arise. In spite of many ethical considerations for neural implant technologies being shared with generic research ethics questions, there are subsets needing special attention. Even in considerations requiring increased attention, substantial overlap can be found with (...) research ethics questions for general medical implants and for psychiatric pharmaceuticals. The special attention to specific ethical questions in neural implants exists because of the value placed on preserving cognition and control as well as our continued memory of significant past research abuses in neurosurgery. This paper focuses on three issues of particular saliency to neural implant testing: inclusion/exclusion of subjects with psychiatric conditions, consent withdrawal of research subjects, and enhancement as a goal. (shrink)

Through a detailed re-reading of Saussure's work in the light of contemporary developments in the human, life and physical sciences, Paul Thibault provides us with the means to redefine and refocus our theories of social meaning-making. Saussure's theory of language is generally considered to be a formal theory of abstract sign-types and sign-systems, separate from our individual and social practices of making meaning. In this challenging book, Thibault presents a different view of Saussure. Paying close attention to the original (...) texts, including the Cours de Linguistic Generale, he demonstrates that Saussure was centrally concerned with trying to formulate a theory of how meanings are made. In addition to demonstrating the continuing viability of Saussure's thinking through a range of examples, Re-reading Saussure makes an important intervention in contemporary linguistic and semiotic debate. (shrink)

The essay examines the impact of thought insertion on typical conceptions of self-consciousness. Stephens and Graham have recently argued that thought insertion is compatible with the inseparability thesis, which maintains that with regard to self-consciousness subjectivity is a proper part of introspection--introspection and subjectivity are inseparable. They argue that thought insertion is an error of agency and not an error of subjectivity. The essay contends that even if they are correct in their interpretation that thought insertion is an error of (...) agency rather than subjectivity, which is unlikely, they are incorrect to maintain that it is not also an error of subjectivity. Evidence is put forth to indicate that thought insertion is, at best, a mistake of agency and subjectivity. It is concluded that thought insertion is incompatible with the inseparability thesis, and a new inseparability thesis is thereby postulated. (shrink)

The editors of this unique volume have brought together 24 leading emotion theorists with a wide variety of perspectives to address 12 fundamental questions about the subject.

Benchmarks against which healthcare ethics consultation (HCEC) services can assess their performance are needed. As first-generation benchmarks continue to be developed, it is the obligation of the field to continually evaluate how these measures reflect the performance of any single HCEC service. This will be possible only with widespread reporting of standardized data points. In their article in this issue of The Journal of Clinical Ethics, Glover and colleagues provide a valuable preliminary approach for assessing appropriate consult volumes for a (...) HCEC service. The limitations of their study read as a call to action for the field of clinical ethics to expand and standardize data reporting so that more robust metrics can be developed. In response to this call by Glover and colleagues, the Cleveland Clinic HCEC service provides consult data from 2015 through 2019 for one of its medical centers, and offers an additional volumebased metric, consult-to-ICU-to-bed ratio (CiBR), that may add nuance to any normative assessment of HCEC service consult volume. Given that volume-based metrics are the native language of the clinical environment, efforts to improve such metrics in the field through transparency and standardization are warranted. However, the expositive power of volume-based metrics is limited; additional domains related to quality and outcomes are needed. (shrink)

This contribution offers a detailed presentation of the commentaries on Porphyry’s Isagoge and Aristotle’s De anima by Walter of Wervia. Walter wrote his commentaries between 1445 and 1472 at the University of Paris. Both works bear witness to the influence of John Duns Scotus and Scotism on Parisian Masters of Arts.

What does quilting have to do with electric circuit theory? The answer is just one of the fascinating ways that best-selling popular math writer Paul Nahin illustrates the deep interplay of math and physics in the world around us in his latest book of challenging mathematical puzzles, Mrs. Perkins's Electric Quilt. With his trademark combination of intriguing mathematical problems and the historical anecdotes surrounding them, Nahin invites readers on an exciting and informative exploration of some of the many ways (...) math and physics combine to create something vastly more powerful, useful, and interesting than either is by itself. In a series of brief and largely self-contained chapters, Nahin discusses a wide range of topics in which math and physics are mutually dependent and mutually illuminating, from Newtonian gravity and Newton's laws of mechanics to ballistics, air drag, and electricity. The mathematical subjects range from algebra, trigonometry, geometry, and calculus to differential equations, Fourier series, and theoretical and Monte Carlo probability. Each chapter includes problems--some three dozen in all--that challenge readers to try their hand at applying what they have learned. Just as in his other books of mathematical puzzles, Nahin discusses the historical background of each problem, gives many examples, includes MATLAB codes, and provides complete and detailed solutions at the end. Mrs. Perkins's Electric Quilt will appeal to students interested in new math and physics applications, teachers looking for unusual examples to use in class--and anyone who enjoys popular math books. (shrink)

Since the last century, vaccination has been one of the most important tools we possess for the prevention and elimination of disease. Yet the tremendous gains from vaccination are now threatened by a growing hesitance to vaccinate based on a variety of concerns or objections. Geographic clustering of some families who choose not to vaccinate has led to a number of well-publicized outbreaks of vaccine-preventable diseases. Of note is that some of these outbreaks are centered within some Christian religious groups (...) that increasingly avoid vaccination due to moral concerns, fears about safety, or doubts about the necessity of vaccines. We argue from the perspective of Catholic social teaching on why there is a moral duty to vaccinate. (shrink)

Bringing together specialists in various fields, this volume shows that the transformation from the scholastic to more empirical approaches to psychology was a gradual process.

Historiography of Renaissance philosophy and science has long been characterized by tendencies to minimize the influence of medieval Arabic philosophy and science. According to the standard narrative, the humanists successfully eliminated Arabic writers, along with their Latin scholastic interpreters. Against this background, Dag Nikolaus Hasse calls for a "sober historical approach" in order to "assess the factual influence of Arabic sciences and philosophy in the Renaissance". His narrative is summarized by the title of his impressively erudite and well-documented...