Surveys carried out among palliative care physicians have shown that most participants do not support euthanasia and assisted suicide. Belgium, however, is one of the few countries in the world in which voluntary euthanasia is allowed by law. The potential influence of this legal dimension thus warranted a study of the attitudes of Belgian palliative care physicians toward euthanasia and assisted suicide. To this end, an anonymous self-administered questionnaire in Dutch was sent to all physicians working in Flemish palliative care. (...) 99 physicians responded .A majority of the physicians who responded are of the opinion that voluntary euthanasia can be ethically justified . Most physicians believe, nonetheless, that non-voluntary euthanasia is always unethical . More than three quarters of the respondents favour the inclusion of a ‘palliative filter’ in the law on euthanasia. Using a traditional cluster algorithm, the following three clusters were obtained: staunch advocates of euthanasia , opponents of euthanasia , and an intermediate group . There were no significant differences between the clusters on the level of gender, age, and years of experience in palliative care. A statistically significant association exists, however, between the euthanasia clusters and the religious or ideological clusters we had obtained in an earlier study. Church attending respondents are least likely to be staunch advocates of euthanasia. The majority of the physicians favour legalisation on assisted suicide. There is no significant association between the euthanasia clusters and attitudes toward assisted suicide.We conclude that although most Flemish palliative care physicians agree that there may be circumstances in which a euthanasia request is justified, they also strongly believe in the effects of good palliative care and want the ‘palliative filter’ to be included in the law on euthanasia. Religion and worldview are an important factor determining attitudes towards euthanasia. (shrink)

Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses’ attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better (...) not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units. (shrink)

The article puts into question the idea that the nucleus of religion - the God-talk - is peaceful , whereas all aggression should be located on the side of humankind, through differentiating a conceptual model of relating war to the concept of God in the Jewish-Christian tradition. He urges a more complex model of connecting God to issues of war and peace.

This article discusses the question of the possibility of moral and ethical grounds for the justification of the use of violence in modern times international conflicts. And specifically, how does the tradition of just war fit into this discussion? For this, a closer look at what just war thinking means is necessary. In this respect we would describe just war thinking more as a just war tradition than a just war theory, as there is no encompassing theory on just war. (...) In history you see a development from the justification of war to a more problematic relation to the possibility of the use of military force. This can be illustrated by the more recent shift from just war thinking towards just peace thinking. This leads to the question: what kind of peace? We argue in this article that peace and justice are connected, and that you cannot have true peace without true justice. (shrink)

Life-science phenomena are often explained by specifying the mechanisms that bring them about. The new mechanistic philosophers have done much to substantiate this claim and to provide us with a better understanding of what mechanisms are and how they explain. Although there is disagreement among current mechanists on various issues, they share a common core position and a seeming commitment to some form of scientific realism. But is such a commitment necessary? Is it the best way to go about mechanistic (...) explanation? In this article, we propose an alternative antirealist account that also fits explanatory practice in the life sciences. We pay special attention to mechanistic models, i.e. scientific models that involve a mechanism, and to the role of coherence considerations in building such models. To illustrate our points, we consider the mechanism for the action potential. 1 Introduction2 Some Core Features of Mechanistic Explanation3 Scientific Realism and Mechanistic Explanation4 Antirealist Mechanistic Explanation: The Case of the Action Potential5 Some Outstanding Issues for the Antirealist Mechanist6 Two Problems for the Realist Mechanist7 Conclusions. (shrink)

Background Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design A descriptive (...) qualitative study to explore collaborative deliberation in consultations between clients and professionals. Six organisations providing long-term care were included. Data collection of nine clients involved observations of consultation with field notes and audio-records, interviews with clients and professionals shortly and 3–6 months after the consultation and questionnaires to collect background information. The data were analysed by deductive content analysis. Findings Constructive engagement was visible in all consultations. Clients and professionals showed respect, empathy and curiosity towards each other. In most consultations, two or more alternative actions are recognised and discussed. Comparative learning appears to be two sided, the client and the professional learn from each other's knowledge and experiences. Construction and elicitation of preference, and preference integration, seems to be present, but difficult to recognise in all consultations. Discussion/conclusion Although all propositions could be identified, there seems room for improvement in preference elicitation and integration of these preferences in the discussions on courses of action. Assistance seems needed with preference elicitation, both for the clients and for the professional. (shrink)

Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences of patients (...) with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

‘Waar blijven de intellectuelen?’ vroeg Balkenende in het najaar van 2006 . Waar blijven die maatschappelijke wetenschappers die eens in de zoveel jaar met een nieuw boek komen dat Nederland een Spiegel voorhoudt en aan het Denken zet? Een doorwrocht wetenschappelijk, maar toch uitstekend leesbaar boek dat de opiniepagina's wekenlang beheerst en ons zelfbegrip voor altijd verandert. Waar blijven de nieuwe Bram de Swaan, Trudy Dehue, Cees Schuyt, Hans Achterhuis, Christien Brinkgreve, Anton Zijderveld of Lolle Nauta? Wie gaat ons waarschuwen (...) voor de gevaren van utopieën of protoprofessionalisering of ons aansporen tot kleine deugden ? (shrink)

Meta-arguments are arguments about one or more arguments, or argumentation in general. They contrast to ground-level arguments, which are about natural phenomena, historical events, human actions, abstract entities, etc. Although meta-arguments are common in all areas of human cognitive practice, and although implicit studies of them are found in many works, and although a few explicit scholarly contributions exist, meta-argumentation has never been examined explicitly, directly, and systematically in book-length treatment. This lacuna is especially unfortunate because such treatment can offer (...) not only an understanding of a special class of arguments, but also a promising way of doing logic and argumentation theory. This is the first book that attempts a systematic treatment of meta-arguments, providing both an illustration of the meta-argumentational approach to logical theory, and an analysis of an especially rich collection of meta-arguments. First, it elaborates an empirical methodology derived partly from a critical appreciation of Stephen Toulmin's applied-logic approach, and partly from a novel application of the author's historical-textual approach. Then it examines theoretical meta-arguments, by such scholars as Tony Blair, Robert Fogelin, Alvin Goldman, Trudy Govier, David Hitchcock, Ralph Johnson, Henry Johnstone, Erik Krabbe, Frans van Eemeren, Carl Wellman, and John Woods, on such topics as defining argument, methods of criticism, deep disagreements, and conductive or pro-and-con arguments. Thirdly, it studies famous meta-arguments by such classics as John Stuart Mill, David Hume, and Galileo Galilei, on such topics as freedom of discussion, women's liberation, the existence of God and intelligent design, and the motion of the earth. (shrink)

There are two dominant trends in the humanitarian care of 2019: the ‘technologizing of care’ and the centrality of the humanitarian principles. The concern, however, is that these two trends may conflict with one another. Faced with the growing use of drones in the humanitarian space there is need for ethical reflection to understand if this technology undermines humanitarian care. In the humanitarian space, few agree over the value of drone deployment; one school of thought believes drones can provide a (...) utility serving those in need while another believes the large scale deployment of drones will exacerbate the already prevalent issues facing humanitarian aid providers. We suggest in this paper that the strength of the humanitarian principles approach to answer questions of aid provision can be complimented by a technology-facing approach, namely that of robot ethics. We have shown that for humanitarian actors we ought to be concerned with the risks of a loss of contextualization and de-skilling. For the beneficiary, we raise three concerns associated with the threat to the principle of humanity for this group: a loss of dignity by reducing human-to-human interactions; a threat to dignity through a lack of informational transparency; and, a threat to dignity by failing to account for the physiological and behavioral impacts of the drone on human actors. Although we acknowledge the obstacles associated with understanding the physiological and behavioral impacts we insist that the moral acceptability and desirability of drones in humanitarian contexts is dependent on the findings from such studies and that tailored ethical guidelines for drone deployment in humanitarian action be created to reflect the results of such studies. (shrink)

Bohr’s work in quantum mechanics posed a challenge to philosophers of science, who struggled with the question of whether and to what degree his theories and methods could be considered rational. This paper focuses on Popper, Feyerabend, Lakatos and Kuhn, all of whom recognized some irrational, dogmatic, paradoxical or even inconsistent features in Bohr’s work. Popper, Feyerabend, and Lakatos expressed strong criticism of Bohr’s approach to quantum physics, while Kuhn argued that such criticism was unlikely to be fruitful: progress in (...) science is generally not made through philosophical reflection. Feyerabend’s criticism of Bohr gradually weakened, as he gained a more detailed understanding of the development of Bohr’s views on quantum mechanics, and this went together with an increasingly critical view of normative philosophy of science and was instrumental to his conversion to ‘anarchism’. This paper aims to show that quantum mechanics played a central role in their debates and disagreements on the rationality of science and the possibility of a normative philosophy of science. (shrink)

ABSTRACT Over the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in (...) medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the ‘special status of human beings’; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation‐stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics. (shrink)

Though we humans are immensely more gifted than other animals, yet we are not the outcome of an inevitable selection of the ‘fittest’. Nor on the other hand is our importance diminished by our evolutionary inheritance. Besides, we are already here! Faith in inevitable progress is a ‘scientific’, not a Christian, delusion. We realise that the universe has its own rules and complications which intrude on our lives and often thwart our choices. It is therefore legitimate to talk of chance, (...) but we often fail to appreciate the real significance of this word. Chance is not a cause; in essence it refers to our own consciousness that we are immersed in circumstance, and it has no reality without our own purposiveness. Thus chance is not some blind and indifferent or even hostile cosmic mystery; it is the occasion of our own responses, and it even offers the opportunity of human growth. Just as we accept the laws (and dangers) of physics (e.g. gravitation), as the framework of our ordered existence, so also we may accept the surprises of chance without any despairing conclusion either from our latest researches in astronomy or from a fatal accident in the street. (shrink)

An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically (...) evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances. (shrink)

The purpose of this note is to observe a generalization of the concept "computable in..." to arbitrary partial combinatory algebras. For every partial combinatory algebra (pca) A and every partial endofunction on A, a pca A[f] is constructed such that in A[f], the function f is representable by an element; a universal property of the construction is formulated in terms of Longley's 2-category of pcas and decidable applicative morphisms. It is proved that there is always a geometric inclusion from the (...) realizability topos on A[f] into the one on A and that there is a meaningful preorder on the partial endofunctions on A which generalizes Turing reducibility. (shrink)

Across numerous languages, the attitude verb "think" is learned later than other attitude verbs like "want." But why? This essays advances a new hypothesis: children initially treat think as a veridical yet non-factive verb akin to a class of verbs I call "confirmatives." This hypothesis is argued to better explain existing data that troubles other hypotheses, and to find support from the ease with which children represent knowledge but not belief.

Partisan epistemology – individuals granting greater credibility to co-partisan sources in evaluating information – is often taken to be evidence of directionally motivated reasoning in which concerns about group membership override concerns about accuracy. Against this dominant view, I outline a novel accuracy-based account of this mode of reasoning. According to this account, partisan epistemology stems from the inference that co-partisans are more likely to be right as they have superior epistemic access to the relevant facts and seek to realize (...) the correct values. I argue that this theory fits better with relevant findings than motivated-reasoning theories of partisan epistemology. Finally, I suggest it has adequate explanatory power vis-à-vis patterns of misinformation belief. (shrink)

Matthijs van Boxsel believes that no one is intelligent enough to understand their own stupidity. In The Encyclopædia of Stupidity he shows how stupidity manifests itself in all areas, in everyone, at all times, proposing that stupidity is the foundation of our civilization. In short sections with such titles as ‘The Blunderers’ Club’, ‘Fools in Hell’, ‘Genealogy of Idiots’, and ‘The Aesthetics of the Empty Gesture’, stupidity is analysed on the basis of fairy tales, cartoons, triumphal arches, garden architecture, Baroque (...) ceilings, jokes, flimsy excuses and science fiction. But Van Boxsel wants to do more than just assemble a ‘shadow cabinet’ of wisdom; he tries to fathom the logic of this opposite world. Where do understanding and intelligence begin and end? He examines mythic fools such as Cyclops and King Midas, cities such as Gotham, archetypes including the dumb blonde, and traditionally stupid animals such as the goose, the donkey and the headless chicken. Van Boxsel posits that stupidity is a condition for intelligence, that blunders stimulate progress, that failure is the basis for success. In this erudite and witty book he maintains that our culture is the product of a series of failed attempts to comprehend stupidity. (shrink)

Lara Buchak argues that her version of rank-weighted utilitarianism can accommodate an implication of the separateness of persons known as “the shift,” since it requires individuals to be more willing to accept risk for themselves than to accept inequality in society. I argue that this is mistaken. Buchak’s model fails to yield the shift when the decision-maker is distinct from the affected individual, as well as in certain social decisions where the risk attitude of the group is known. These findings (...) suggest that models which derive social choice rules from individual decision rules will generally fail to uphold separateness. (shrink)

This special issue arises from the observation that an exploration of the role of non-evidential considerations in epistemology through a broader lens is missing from the current landscape of philosophical research. The present collection of contributions fills this research gap by bringing together three central and much-discussed epistemological topics for which non-evidential considerations become relevant.

Van Riper kept this class grade book for second semester, 1916- 1917, for philosophy and psychology classes he taught at Pennsylvania State College.

### ­ In Who shall go first? A multicriteria approach to patient selection for first clinical trials of cardiac xenotransplantation, Kögel et al recommend the inclusion of patients who (1) have a (high) medical need for an allograft, (2) have the capacity to benefit from a xenograft, (3) have a ‘real’ choice between enrolment in a first-in-human clinical trial and an alternative life-sustaining treatment option and (4) have no clear record of previous non-compliance.1 As the authors discuss, patient selection must (...) promote the goal of gaining reliable and valid knowledge about the risks and benefits of cardiac xenotransplantation. While the four criteria outlined above certainly promote this goal, we argue it is crucial to add a fifth criterion emphasising the need to include diverse populations, particularly regarding sex, age, ethnicity and socioeconomic background.i In this commentary, we present two arguments for our claim and discuss the impact of neglecting diversity from the first trials on. ### The scientific rationale for including diverse populations First, including diverse populations in the first clinical trials of cardiac xenotransplantation enhances the scientific value of the data by assessing safety and efficacy among various populations. Treatment response can differ among patient (sub)groups as a result of genetic, physiological and socioeconomic factors.2 By including diverse populations from the first trials on, researchers can identify these …. (shrink)

This essay review explores Steven Mithen’s interdisciplinary approach to the origins and evolution of language in _The Language Puzzle_ ( 2024 ). It focuses mainly on what I call his _iconic vocal origins hypothesis_. Mithen challenges the prevalent gestural origins hypothesis, suggesting instead that early prehistoric languages were predominantly vocal and iconic, with conventionalization – as characteristic of symbol use – emerging later. _The Language Puzzle_ draws on research from archaeology, philosophy, computer science, developmental psychology, and many other fields, thus (...) assembling a wealth of insights from various disciplines. While intriguing, Mithen’s suggestion that prehistoric languages may have relied on iconicity instead of conventionalization faces substantial problems, which are discussed in this review essay. In the final section, I also briefly review the important conclusion chapter of Mithen’s book, which contains an imaginative outline of how language evolved from the last common ancestor up until modern _H. sapiens._ My criticisms of the iconic vocal origins hypothesis notwithstanding, _The Language Puzzle_ is a valuable resource for anyone interested in language evolution, and once again showcases Mithen’s wide-ranging expertise and masterful writing. (shrink)

Despite its basically syllogistic character, Richard Whately's Elements of logic presents the subject in a modern theoretical setting. Whately, for instance, regarded logic as an abstract science, and defined the syllogism as a purely formal device to be used as a means of determining the validity of all arguments. In this paper, I argue that such instances of abstractive ascent place Whately's theory in closer proximity to later 19th-century developments than to the work of his 17th-century predecessors. In addition to (...) discussing the theory itself, other sections deal with its historical setting, and various reactions to it. (shrink)