The current debate on euthanasia in the Lowlands is a perfect examplification of the predominance of the principle of respect for autonomy in present-day medical-ethical decisionmaking. The aim of this article is the exploration of the more fundamental philosophical issues concerning the current status of autonomy in medical ethics. The starting point for this exploration is an analysis of the principle of respect for autonomy. The authors argue that the view on autonomy in contemporary bioethical discussions is more related to (...) the Millian understanding of autonomy rather than to Kant’s conception of respect for autonomy. The uncompromising veneration of personal autonomy and the subsequent view on the human self as unencumbered is placed under critique because this portrayal of the human person is rather unreal especially in medical-ethical decisionmaking where the fragility of human life is at stake. Furthermore, extending the claims of autonomy risks to undermine the public sphere. The defence of the principle of autonomy is taken on by the quality-of-life ethic that values human life because of its qualities. Being capable of making autonomous decisions is one of this main qualities. By this, the quality-of-life approach runs counter to an idea that is deeply ingrained in medicine, viz. the sanctity of human life that holds both the inviolability and the equal value of human life. These two approaches can, however, be integrated in Christian ethics by adopting a view on quality-of-life judgements in which the proportionality of benefits and burdens has a pivotal function. To conclude this article, the authors argue for a non-absolutist account of autonomy based on two modes of decentrement of the human self: the fundamental passivity at the core of the human person and the intersubjectivity of the human existence. (shrink)

Belgium is the second country in the world that decriminalized euthanasia. On May 28, 2002 the Belgian Parliament approved the bill on euthanasia. With this approval, the political majority in the Belgian Parliament took a momentous decision concerning how we as a society deal with life and death.For many, euthanasia holds a promise. They take euthanasia literally as the ‘good death’. Others identify the recourse to euthanasia as a symptom of a ‘culture of death’. Given the importance of legislation on (...) euthanasia, an ethical reflection on the rationale and course of the Belgian debate on euthanasia urges itself.It is the aim of this contribution to shed light on the Belgian debate on euthanasia from an ethical perspective. The focus is thus rather on the arguments underlying the debate and their ethical assessment which implies the clarification of the values involved and the options made in the eventual legislation.To understand how and why the Belgian debate evolved as it did resulting in the final vote on the law on euthanasia, two reports of the Belgian Federal Advisory Committee on Bioethics are cardinal: the Advice n° 1 concerning the Desirability of Legislation on Euthanasia and the Advice n° 9 concerning the Termination of Life of Incompetent Patients .These two reports expressed the opinions and moral viewpoints present in Belgian society. After the presentation of the two reports and their underlying axiology we will examine what their relationship is with the eventual law on euthanasia which was the tailpiece of five years of public and political debate.In this examination, the pivotal question will be whether the legislature has succeeded in doing justice to the different moral viewpoints and the tendencies to a moral consensus that were formulated in the two reports. (shrink)

Belgium and the Netherlands are the first countries in the world that have legalized euthanasia and assisted suicide. Since September 23, 2002, Belgian physicians can perform an act of euthanasia without at the same time performing a criminal act. In the Netherlands, the act on euthanasia went into force already on April 1, 2002. This special issue of Ethical Perspectives on ‘Euthanasia in the Low Countries’ offers a forum for critical dialogue on the different aspects of this new legal situation (...) in Belgium and the Netherlands.First, the legal situation will be introduced. In his contribution, Herman Nys makes a careful comparison of both laws. In spite of the fact that Belgium and the Netherlands are the first countries in the world that legalized euthanasia, the differences between the Belgian and Dutch law are fundamental. As Nys indicates, the scope of the Dutch law is more specified since it explicitly includes physician-assisted suicide while it remains unclear whether the Belgian act is also applicable in cases of assisted suicide. There are also fundamental differences regarding the persons regulated by the law, the health condition of the patient, the obligations of the physician with respect to the request and the health status of the patient, and the notification procedure.However, not only are there fundamental differences between Belgium and the Netherlands on the level of the law. Also the public debate and the values underlying the the debate show dissimilarities. In the Netherlands this debate took more than twenty years and the subsequent law on euthanasia reflected an existing medical practice. In Belgium, on the contrary, the parliament came to vote on the euthanasia law after only half a decade of debate. In our contribution , we identify the right to autonomy understood as ‘self-possession’ as the central value in the Belgian debate. Guy Widdershoven asserts that the moral basis of euthanasia in the Netherlands is different. He argues that the Dutch debate — and by now Dutch practice — cannot be reduced to the "principlist canon of autonomy and beneficence". Instead, the values of responsibility, deliberation and care are claimed to be central to Dutch euthanasia practice.In his contribution, Daniel Sulmasy offers an exhaustive analysis of the notion of dignity that constantly arises in the debate on euthanasia. For Christian churches and Catholic healthcare institutions, the recent legalization of euthanasia and assisted suicide is at least challenging. Jan Jans describes the way in which the main Christian churches in Belgium and the Netherlands engaged in the debate and reacted to the eventual legalization. Chris Gastmans presents the view of the Flemish Association of Catholic Healthcare Institutions.Law-making with respect to euthanasia is one thing. Bringing the law into practice is somewhat different. The question arises to what extent the new legal situation will bear upon the medical practice. Particularly, the responses of physicians are difficult to assess in advance. Physicians face the dilemma to report or not to report. They can take up their responsibility and report their practices of euthanasia, thereby exposing themselves to critical examination and possibly criminal prosecution. On the other hand, the physician can opt for safety and decide not to report his involvement in one of his patients’ euthanasia. In the latter case, the introduction of new legislation would have missed the mark. To this day, the only available data with regard to physicians’ reactions to an established legal framework wherein euthanasia is legalized come from the Netherlands. In his contribution, Albert Klijn presents the reactions of Dutch physicians to the new legal situation in their country and, particularly, the performance of their duty to report cases of euthanasia. Since the vote on the law in 2000 and the establishment of ‘regional review committees for termination of life on request and assisted suicide’ in 2001, the reports of euthanasia have declined. Klijn considers two possible explanations. On the one hand, there is insecurity about how the newly established regional review committees will evaluate physician' reports. On the other hand, the increased investment in research on palliative care and the availability of palliative sedation are held responsible for the drop in reported cases.This very interesting suggestion by Klijn needs further clarification. Therefore, the meaning of palliative care and the possibility of palliative sedation are elaborated in the contribution of Bert Broeckaert and Rien Janssens.With this special issue on ‘Euthanasia in the Low Countries’ we hope to have answered the numerous requests for further information on the Belgian and Dutch situation. Data, clarification and critical review may shed more light on the development of a practice, which some still consider as non-medical behaviour. This issue may therefore also function as a catalyst for further medical, ethical and legal debate. (shrink)

(2004). From an Exercise in Professional Etiquette to Society's Wish List? Review of American Medical Association, Code of Medical Ethics: Current Opinions with Annotations. The American Journal of Bioethics: Vol. 4, No. 2, pp. 69-70. doi: 10.1162/152651604323097907.

Because of their responsibilities for providing high-quality care, at times when they are continuously confronted with inherent professional and ethical challenges, nurses should meet high ethical standards of practice and conduct. Contrary to other countries, where codes of ethics for nurses are formulated to support those standards and to guide nurses’ professional practice, Belgian nurses do not have a formal code of ethics. Nevertheless, professional ethics is recognized as an important aspect in legal and other professional documents. The aim of (...) this article is to illustrate that codes of ethics are not the only professional documents reflecting nurses’ values, norms and responsibilities. Other documents can also set out professional nursing ethics, and as such replace codes of ethics. (shrink)

The purpose of this article is to clarify both the role of nurses in ethics meetings and the way in which ethics meetings can function as a catalyst for good nursing care. The thoughts presented are practice based; they arose from our practical experiences as nurses and ethicists with ethics meetings in health care organizations in Belgium. Our reflections are written from the perspective of the nurse in the field who is participating in (inter)professional ethical dialogue. First, the difficulties that (...) nurses experience while participating in ethics meetings are described. Then the possibilities for support of nurses in their ethical responsibility are explored. (shrink)

Health care systems have four objectives: (1) the provision of the best possible care for all; while (2) guaranteeing equal access to health care; (3) maintaining freedom of choice for health care providers and patients; and (4) controlling the costs. In an ideal world with abundant resources the realization of these objectives would pose no significant problems. However, any actual health care system will need a trade-off between the different objectives because resources are limited. In Setting Limits Fairly, Norman Daniels (...) and James Sabin investigate how limits can be set in the allocation of health care resources. (shrink)

In this article, the question is discussed if and how Healthcare Ethics Committees (HECs) should be regulated. The paper consists of two parts. First, authors from eight EC member countries describe the status quo in their respective countries, and give reasons as to the form of regulation they consider most adequate. In the second part, the country reports are analysed. It is suggested that regulation of HECs should be central and weak. Central regulation is argued to be apt to improve (...) HECs’ accountability, relevance and comparability. To facilitate biomedical citizenship and ethical reflection, regulation should at the same time be weak rather than strict. Independence of HECs to deliberate about ethical questions, and to give solicited and unsolicited advice, should be supported and only interfered with by way of exception. One exception is when circumstances become temporary adversarial to ethical deliberation in healthcare institutions. In view of European unification, steps should be taken to develop consistent policies for both Eastern and Western European countries. (shrink)

Ethics committees are the most important practical instrument of clinical ethics in Belgium and fulfil three tasks: the ethical review of experimental protocols, advising on the ethical aspects of healthcare practice, and ethics consultation. In this article the authors examine the current situation of ethics committees in Belgium from the perspective of clinical ethics. Firstly, the most important steps which thus far have been taken in Belgium are examined. Secondly, recent opinion by the Belgian Advisory Committee on Bioethics with regard (...) to ethics committees is presented and the activities of Belgian ethics committees are discussed. Finally, the option to bring research ethics and clinical ethics under the roof of just one committee is criticised using a pragmatic and a methodological argument. Concomitantly, the authors build an argument in favour of the further development of ethics consultation. (shrink)

Around the world, the population is ageing in ways that pose new challenges for healthcare providers. To date these have mostly been formulated in terms of challenges created by increasing costs, and the focus has been squarely on life-prolonging treatments. However, this focus ignores the ways in which many older people require life-enhancing treatments to counteract the effects of physical and mental decline. This paper argues that in doing so it misses important aspects of what justice requires when it comes (...) to older people. (shrink)

Since 1989, widely circulating statistics on gay teen suicide in the United States have acted as catalysts for institutional reforms, scientific research, and the creation of an identity category “gay youth.” While one figure has been replicated scientifically, these numbers originated not from a scientific research study but as risk estimates developed by a social worker and published in a government document. Many people within the public took up these original numbers, attributing their author the status of scientific researcher. In (...) effect, the numbers became “black boxed,” often traveling without citation. Drawing on Ian Hacking’s “dynamic nominalist” perspective, this article utilizes interviews with the author of these statistics and other key claimants, along with textual analysis, to trace the origins, uptake, and effects of these figures. While making vital policy contributions, the numbers have led to some ironic consequences including the fostering of gay youth identification with suicide as a potential correlate of their identity and the potential antigay redeployment of decontextualized numbers. They have also led to a reaction in the form of “resilience” narratives. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.

Scientists are seekers of truth; but where science breaks into the everyday world should they be held accountable for the outcome of their actions? The contributors to this volume believe that scientists are more than mere cogs in a machine - science, technology and politics are inseparable. Part 1 describes current scientific practice from three personal perspectives; part 2 looks at the ways in which science, society and the environment could interact given the chance; and part 3 examines the more (...) general aspects of Western science and their relevance to our relationship with the environment, society and all global issues. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)

Our successful engagement with the world is plausibly underwritten by our sensitivity to affordances in our immediate environment. The considerable literature on affordances focuses almost exclusively on affordances for bodily actions such as gripping, walking or eating. I propose that we are also sensitive to affordances for mental actions such as attending, imagining and counting. My case for this ‘Mental Affordance Hypothesis’ is motivated by a series of examples in which our sensitivity to mental affordances mirrors our sensitivity to bodily (...) affordances. Specifically, subjects perceive opportunities to perform a mental action and their doing so leads, under the right conditions, to the automatic preparation of that action. I conclude by sketching a mental affordance research program that would reinforce my case for the Mental Affordance Hypothesis and establish its ramifications for a number of debates across philosophy and psychology. (shrink)

Nearly everyone prefers pain to be in the past rather than the future. This seems like a rationally permissible preference. But I argue that appearances are misleading, and that future-biased preferences are in fact irrational. My argument appeals to trade-offs between hedonic experiences and other goods. I argue that we are rationally required to adopt an exchange rate between a hedonic experience and another type of good that stays fixed, regardless of whether the hedonic experience is in the past or (...) future. (shrink)

The scope of someone's consent is the range of actions that they permit by giving consent. The Scope of Consent investigates the under-explored question of which normative principle governs the scope of consent. To answer this question, the book's investigation involves taking a stance on what constitutes consent. By appealing to the idea that someone can justify their behaviour by appealing to another person's consent, Dougherty defends the view that consent consists in behaviour that expresses a consent-giver's will for how (...) a consent-receiver behaves. The ultimate conclusion of the book is that the scope of consent is determined by certain evidence that bears on the appropriate interpretation of the consent. (shrink)

You are morally permitted to save your friend at the expense of a few strangers, but not at the expense of very many. However, there seems no number of strangers that marks a precise upper bound here. Consequently, there are borderline cases of groups at the expense of which you are permitted to save your friend. This essay discusses the question of what explains ethical vagueness like this, arguing that there are interesting metaethical consequences of various explanations.

The anglophone philosophy profession has a well-known problem with gender equity. A sig-nificant aspect of the problem is the fact that there are simply so many more male philoso-phers than female philosophers among students and faculty alike. The problem is at its stark-est at the faculty level, where only 22% - 24% of philosophers are female in the United States (Van Camp 2014), the United Kingdom (Beebee & Saul 2011) and Australia (Goddard 2008).<1> While this is a result of the (...) percentage of women declining at each point through-out the standard career trajectory, recent large-scale studies in the United States (Paxton et al. 2012) and Australia (Goddard et al. 2008) have identified a key drop-off point as the transi-tion between taking introductory classes and majoring in philosophy. So why do dispropor-tionately few female students choose to major in philosophy? (shrink)

In this paper, we explicitly point out the reasons why Special Relativity must be considered as the source of electron deep orbits, and dominates their behavior. We show that the cause is the quadratic form of the relativistic expression of energy, and this clearly appears when we explicitly develop the relativistic Schrödinger equation and compare it with the non-relativistic one.

Nastava iz prirodoslovnog područja danas se najčešće temelji na principima konstruktivizma prema kojima djeca trebaju biti aktivni sudionici procesa učenja i izgrađivati svoje znanje na temelju iskustva. Metode i sredstva korištena u nastavi prirodoslovnog područja moraju biti prilagođeni perceptivnim potrebama slijepe djece i djece s oštećenjima vida kako bi im se omogućilo aktivno sudjelovanje u procesu učenja. Cilj ovoga rada je opisati posljednje spoznaje o aktivnom i istraživačkom učenju slijepe djece i djece s oštećenjima vida u nastavi prirodoslovnog područja te (...) otkloniti postojeće zablude. Nadalje, rad predstavlja recentna istraživanja koja ukazuju na prilagođene uspješne i visokokvalitetne odgojno-obrazovne pristupe i metode. S obzirom na navedeno, sadržaj rada bit će od koristi nastavnicima iz prirodoslovnog područja, kao i istraživačima inkluzivnih učionica. (shrink)

To develop a theoretical framework for drawing moral distinctions between instances of sexual misconduct, I defend the “Ameliorative View” of consent, according to which there are three possibilities for what effect, if any, consent has: “fully valid consent” eliminates a wronging, “fully invalid consent” has no normative effect, and “partially valid consent” has an ameliorative effect on a wronging in the respect that it makes the wronging less grave. I motivate the view by proposing a solution to the problem of (...) characterizing the moral effect of consent that is given in response to minor coercion. (shrink)

In this essay, I discuss why consent is invalidated by duress that involves attaching penalties to someone's refusal to give consent. At the heart of my explanation is the Complaint Principle. This principle specifies that consent is defeasibly invalid when the consent results from someone conditionally imposing a penalty on the consent‐giver's refusal to give the consent, such that the consent‐giver has a legitimate complaint against this imposition focused on how it is affects their incentives for consenting. The Complaint Principle (...) says that this consent is defeasibly invalid to make room for the Authorization Principle, which allows sincere authorizations to constitute valid consent, even when these are issued by an agent acting under duress. The Authorization Principle has application only in cases of third‐party duress because when the consent‐receiver is the source of the duress, the consent‐giver is not sincerely authorizing the action. (shrink)

In the middle of the last century, it was common to explain the notion of necessity in linguistic terms. A necessary truth, it was said, is a sentence whose truth is guaranteed by linguistic rules. Quine famously argued that, on this view, de re modal claims do not make sense. “Porcupettes are porcupines” is necessarily true, but it would be a mistake to say of a particular porcupette that it is necessarily a porcupine, or that it is possibly purple. Linguistic (...) theories of necessity fell out of favour with the publication of Kripke’s Naming and Necessity, and Quine’s arguments were put aside. In her recent book, Norms and Necessity, Amie Thomasson presents her modal normativism, which is an updated version of the mid-century theories just described. Quine’s arguments are thus relevant once again. We recapitulate Quine’s central argument, in the context of modal normativism. We then criticise Amie Thomasson’s discussion of de re modality. We finish by briefly presenting an alternative account of de re modal statements, which is compatible with modal normativism. (shrink)

This book explores and explains how deep semantics works, how new deep semantics research can be conducted, and how the new scientific method of deep semantics can be used to create new scientific theories and discoveries.

'By identifying the extent to which Aristotle's thinking about ethics was shaped by notions drawn from the crafts Angier has thrown new light on a surprising number of topics and has deepened our understanding of tensions within Aristotle's thought. It is by now a rare achievement to have said something new, true and important about Aristotle.' -- Alasdair MacIntyre, Emeritus Professor of Philosophy, University of Notre Dame, USA.

In this paper we focus on a kind of perceptual states that we call perceptual motivations, that is, perceptual experiences that plausibly motivate us to act, such as itching, perceptual salience and pain. Itching seems to motivate you to scratch, perceiving a stimulus as salient seems to motivate you to attend to it and feeling a pain in your hand seems to motivate actions such as withdrawing from the painful stimulus. Five main accounts of perceptual motivation are available: Descriptive, Conative, (...) Imperativist, Reflexive and Dual Content views. Some of these have been developed in detail and others are natural extensions of existing views. However, we argue that none provides a satisfactory account of the target perceptual states. Driven by the failings of each account, we identify three conditions that any satisfactory theory of perceptual motivation must meet: Direct Motivational Force, Non-Obligatory Force and Intention-Independent Influence. Then we offer an account that attempts to fulfil these conditions: the Affordance Model. This model of perceptual motivation is premised on the claim that each of the target states involves the perception of a specific affordance for action and the triggering of Automatic Motor Initiations. We suggest that AMIs can explain the motivational force of these perceptual states. (shrink)

I argue for the possibility of an extremely intimate connection between the emotional content of the music and the emotional state of the person who produces that music. Under certain specified conditions, the music may not just influence, but also partially constitute the musician’s emotional state.

What conditions on a person’s knowledge must be satisfied in order for them to be morally responsible for something they have done? The first two decades of the twenty-first century saw a surge of interest in this question. Must an agent, for example, be aware that their conduct is all-things-considered … Continue reading Epistemic Conditions of Moral Responsibility →.

In this book, Tom Cochrane develops a new control theory of the emotions and related affective states. Grounded in the basic principle of negative feedback control, his original account outlines a new fundamental kind of mental content called 'valent representation'. Upon this foundation, Cochrane constructs new models for emotions, pains and pleasures, moods, expressive behaviours, evaluative reasoning, personality traits and long-term character commitments. These various states are presented as increasingly sophisticated layers of regulative control, which together underpin the architecture of (...) the mind as a whole. Clearly structured and containing numerous diagrams and examples to illustrate the discussion, this study draws on the latest research from fields including philosophy, psychology and neuroscience, and will appeal to readers interested in the philosophy and cognitive science of emotion. (shrink)

In this paper we focus on a kind of perceptual states that we call perceptual motivations, that is, perceptual experiences that plausibly motivate us to act, such as itching, perceptual salience and pain. Itching seems to motivate you to scratch, perceiving a stimulus as salient seems to motivate you to attend to it and feeling a pain in your hand seems to motivate actions such as withdrawing from the painful stimulus. Five main accounts of perceptual motivation are available: Descriptive, Conative, (...) Imperativist, Reflexive and Dual Content views. Some of these have been developed in detail and others are natural extensions of existing views. However, we argue that none provides a satisfactory account of the target perceptual states. Driven by the failings of each account, we identify three conditions that any satisfactory theory of perceptual motivation must meet: Direct Motivational Force, Non-Obligatory Force and Intention-Independent Influence. Then we offer an account that attempts to fulfil these conditions: the Affordance Model. This model of perceptual motivation is premised on the claim that each of the target states involves the perception of a specific affordance for action and the triggering of Automatic Motor Initiations (AMIs). We suggest that AMIs can explain the motivational force of these perceptual states. (shrink)

I consider the claim that analytic statements are "true in virtue meaning", giving the claim a ground-theoretic interpretation.

It is common to focus on the duties of the wrongdoer in cases that involve injustice. Presumably, the wrongdoer owes her victim an apology for having wronged her and perhaps compensation for having harmed her. But, these are not the only duties that may arise. Are other beneficiaries of an injustice permitted to retain the fruits of the injustice? If not, who becomes entitled to those funds? In recent years, the Connection Account has emerged as an influential account that purports (...) to explain cases such as Embezzlement. This account holds that benefiting from injustice can give rise to a corrective duty - that is, a duty of compensation - owed specifically to the victim of the injustice from which the recipient benefits. This duty is grounded in the connection between the victim and the beneficiary of a given injustice. This paper has two aims. First, I show that we must reject the Connection Account on the grounds that it risks failing correctly to identify those who become entitled to the fruits of injustice. I achieve this by developing and defending the fairness objection. Second, I offer an alternative account: the Moral Taintedness Account. This account states that, when identifying who is entitled to the fruits of injustice, the cause and the degree of the harm suffered by a victim are both relevant considerations, though it does not matter whether the victim is the victim of the injustice that gave rise to the fruits in question. This account avoids the problem associated with the Connection Account, and yields intuitive conclusions in an important range of test cases. (shrink)