This article presents the results of a qualitative study on the ethical aspects of inclusion practice for radiotherapy patients taking part in clinical research. The study focused on the standards and values of this process. Patients and physicians were interviewed about their views and experiences. Analysis of these interviews showed that candidate research participants need better protection from unwanted factors that could influence their choice about participation. Researchers need proper education about regulation, codes and directives in the field of research (...) ethics, and they should be aware of the underlying ethical concepts of these regulations. A sound institutional ethics policy is necessary in order to guide medical staff in decisions about the inclusion of patients in trials. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

This report explores the relationship between philosophy and medicine in the Netherlands. In Section 1 we outline the ups and downs of medico-philosophical research in our country: pre-war flourishing, post-war decline, and modern renaissance. In Section 2 we review recent Dutch literature in the philosophy of medicine. The topics dealt with include methodology of medical science, alternative medicine, the basic concepts of medicine, anthropological medicine, medicalization, medicine and culture, and health care ethics.

This study explored the experiences and views of Dutch nurses on the content, function, dissemination and implementation of their codes of ethics. A total of 39 participants, who differed in age, qualifications, length of work experience and health care setting, took part in focus groups. The findings revealed common unfamiliarity with and a rather implicit use of codes, and negative comments on the growing number of codes available in the Netherlands. Limited dissemination, implementation and functioning of codes of ethics were (...) also identified. The findings were discussed using concepts from the literature, nursing practice and personal experience. (shrink)

Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. The most common form of ethical guidance is a code of ethics/professional practice; however, little research on how codes are viewed or used in practice has been undertaken. This study, carried out in six European countries, explored nurses’ opinions of the content and function of codes and their use in nursing practice. A total of 49 focus (...) groups involving 311 nurses were held. Purposive sampling ensured a mix of participants from a range of specialisms. Qualitative analysis enabled emerging themes to be identified on both national and comparative bases. Most participants had a poor understanding of their codes. They were unfamiliar with the content and believed they have little practical value because of extensive barriers to their effective use. In many countries nursing codes appear to be ‘paper tigers’ with little or no impact; changes are needed in the way they are developed and written, introduced in nurse education, and reinforced/implemented in clinical practice. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the (...) most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the (...) most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the (...) most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia or (...) assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the ‘slippery slope’. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half (...) of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses found it (...) too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics and inserting an infusion needle to administer the euthanatics should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide. (shrink)

What role do nurses play in euthanasia? How do they experience this role and what should be their ideal role? These are the questions of a study undertaken to gain insight into the role of nurses in euthanasia. Answers to these questions were derived from 20 semistructured in-depth interviews with nurses employed in a Dutch hospital. To make clear the role of nurses in euthanasia, the issue was split up into four phases: observation of a request for euthanasia; decision making; (...) carrying out of the request; and after-care. This article is a brief report on the most important results regarding these four phases. Special attention will be paid to nurses who have conscientious objections. To evaluate the study results, an unambiguous interpretation of the concept of ‘euthanasia’ is of most importance. For that reason, Dutch laws and other regulations concerning euthanasia will be explained. (shrink)

This study analysed teaching of nurses’ codes of ethics in basic nursing education in Finland. A total of 183 educators and 214 students responded to a structured questionnaire. The data was analysed by SPSS. Teaching of nurses’ codes was rather extensive. The nurse-patient relationship was highlighted. Educators assessed their teaching statistically significantly more extensive than what students’ perceptions were. The use of teaching and evaluation methods was conventional, but differences between the groups concerning the use of these methods were statistically (...) significant. Students’ knowledge of and their ability to apply the codes was mediocre. Most educators and students assessed educators’ knowledge of the codes as adequate for teaching. These educators also taught the codes more extensively and these students perceived the teaching as more extensive. Otherwise educators’ and students’ socio-demographic variables had little association with the teaching. Research should focus on the organization and effectiveness of ethics education, and on educators’ competence. (shrink)

This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half (45%) of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses (58.2%) (...) found it too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics (62.9%) and inserting an infusion needle to administer the euthanatics (54.1%) should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% were suitable for analysis. The results show that in about half of (...) the cases nurses were involved in the decision making by the physician and that nurses were frequently involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

As public research organisations are increasingly driven by their national and regional governments to engage in knowledge transfer, they have started to support the creation of companies. These research based spin-off companies (RBSOs) often keep contacts with the research institutes they originate from. In this paper we present the results of a study of four research institutes within two universities and two non-university public research organisations (PROs) in the Netherlands. We show that research organisations have distinct motivations to support the (...) creation of spin-off companies. In terms of resources RBSOs contribute, mostly in a modest way, to research activities by providing information, equipment and monetary resources. In particular, RBSOs are helpful for researchers competing for research grants that demand participation of industry. Furthermore, RBSOs may be seen as a proactive response by Dutch public research organisations to demands of economic relevance from their institutional environment. RBSOs enhance the prestige of their parent organisations and create legitimacy for public funds invested in PROs. At the same time, most RBSOs do not have a significant impact on the direction of the research conducted at the PROs. (shrink)

Ariès traces Western man's attitudes toward mortality from the early medieval conception of death as the familiar collective destiny of the human race to the modern tendency, so pronounced in industrial societies, to hide death as if it were an embarrassing family secret.

This remarkable book--the fruit of almost two decades of study--traces in compelling fashion the changes in Western attitudes toward death and dying from the earliest Christian times to the present day. A truly landmark study, The Hour of Our Death reveals a pattern of gradually developing evolutionary stages in our perceptions of life in relation to death, each stage representing a virtual redefinition of human nature. Starting at the very foundations of Western culture, the eminent historian Phillipe Aries shows how, (...) from Graeco-Roman times through the first ten centuries of the Common Era, death was too common to be frightening; each life was quietly subordinated to the community, which paid its respects and then moved on. Aries identifies the first major shift in attitude with the turn of the eleventh century when a sense of individuality began to rise and with it, profound consequences: death no longer meant merely the weakening of community, but rather the destruction of self. Hence the growing fear of the afterlife, new conceptions of the Last Judgment, and the first attempts (by Masses and other rituals) to guarantee a better life in the next world. In the 1500s attention shifted from the demise of the self to that of the loved one (as family supplants community), and by the nineteenth century death comes to be viewed as simply a staging post toward reunion in the hereafter. Finally, Aries shows why death has become such an unendurable truth in our own century--how it has been nearly banished from our daily lives--and points out what may be done to "re-tame" this secret terror. The richness of Aries's source material and investigative work is breathtaking. While exploring everything from churches, religious rituals, and graveyards (with their often macabre headstones and monuments), to wills and testaments, love letters, literature, paintings, diaries, town plans, crime and sanitation reports, and grave robbing complaints, Aries ranges across Europe to Russia on the one hand and to England and America on the other. As he sorts out the tangled mysteries of our accumulated terrors and beliefs, we come to understand the history--indeed the pathology--of our intellectual and psychological tensions in the face of death. (shrink)

This book provides an interdisciplinary examination of international law by addressing four critical questions: How are international legal rules distinctive? How does an investigator determine the existence of a rule of international law? Does international law really matter in international politics? and What effect could the changing nature of international relations have on international law? Using Constructivist theory, Arend argues that international law can alter the identity of states, and, consequently, have a profound impact on state behavior.

L’auteur a pris le risque de traiter d’une question qui, aujourd’hui encore, fait polémique : celle du rapport qu’entretient le philosophe et romancier Jean-Jacques Rousseau avec la différence sexuelle. L’un des mérites de l’étude de Laure Challandes est d’argumenter, avec une grande précision, sur la nécessaire frontière qui existe entre les textes théoriques, Lettre à d’Alembert sur les spectacles, Du contrat social, Émile ou de l’éducation, entre autres, et les textes fictifs, parmi lesque...

Hayek’s The Road to Serfdom has been interpreted as a general warning against state intervention in the economy.1 We review this argument in conjunction with Hayek’s later work and discern an institutional thesis about which forms of state intervention and economic institutions could threaten personal and political freedom. Economic institutions pose a threat if they allow for coercive interventions, as described by Hayek in The Constitution of Liberty: by giving someone the power to force others to serve one’s will by (...) threatening to inflict harm, in the absence of general rules of conduct. According to the logic of the argument, welfare-state provisions are not coercive insofar as they do not allow the identification and discriminatory treatment of individuals. By contrast, we claim that a structure of coercion is likely to emerge from the command-and-control nature of protectionist institutions and immigration restrictions currently advocated by the radical right. (shrink)

We report to which extent elementary particles and the nucleons can be described by an Ansatz that is alternative to the established standard model, and can still yield predicted results that reproduce the observed ones, without using the formalism of quantum mechanics. The different Ansatz is motivated by the attempt to explain known properties of elementary particles as a consequence of an inner structure, in contrast to the approach of the standard model, where the properties are ascribed to point-like particles. (...) Based on the assumption of the existence of photons, the possibility of the creation of fermion and anti-fermion in an interaction of two photons of equal energy is shown. The properties of these created elementary material particles are found to agree with the ones observed. Also the possibility of the creation of a neutron by interaction of two photons of equal energy is shown. In this case, the newly formed neutron rests in the center of the collision system as a combined system of the localized two photons. The created neutron is shown to have the known properties of the neutron, and in addition, to have a definite shape of definite size. The proton is described as the particle formed by decay of the neutron, also owning the observed properties, and in addition a definite shape. For all particles described by the Ansatz, their properties are consequences of an inner structure. The merits of the alternative description as compared to the standard model and the application of quantum mechanics are discussed. (shrink)

L’ouvrage d’A. Wenger est la version remaniée de sa thèse de doctorat complétée par certains développements parus dans des revues spécialisées, Clio. Histoire, Femmes et Sociétés, Dix-huitième Siècle… La reprise de travaux antérieurs a entraîné parfois quelques redondances – sur l’onanisme ou la lectrice, par exemple – qu’une lecture plus attentive aurait pu éviter. Cette restriction est mineure au regard de l’intérêt de cette étude dont « l’objectif est de faire bouger les objets d’analyse t...

Several theoretical publications on the Dirac equation published during the last decades have shown that, an interpretation is possible, which ascribes the origin of electron spin and magnetic moment to an autonomous circular motion of the point-like charged particle around a fixed centre. In more recent publications an extension of the original so called “Zitterbewegung Interpretation” of quantum mechanics was suggested, in which the spin results from an average of instantaneous spin vectors over a Zitterbewegung period. We argue that, the (...) corresponding autonomous motion of the electron should, if it is real, determine non-relativistic spin measurements. Such a direct connection with the established formal quantum mechanical description of spin measurements, into which spin is introduced as a “non-classical” quantity has, to our knowledge, not been reported. In the present work we show that, under certain “model assumptions” concerning the proposed autonomous motion, results of spin measurements, including measurements of angular correlations in singlet systems, can indeed be correctly described using classical probabilities. The success of the model is evidence for the “reality” of the assumed autonomous motion. The resulting model violates the Bell—inequalities to the same extent as quantum mechanics. (shrink)

This paper has two goals. First, we develop frameworks for logical systems which are able to reflect not only non-monotonic patterns of reasoning, but also paraconsistent reasoning. Our second goal is to have a better understanding of the conditions that a useful relation for nonmonotonic reasoning should satisfy. For this we consider a sequence of generalizations of the pioneering works of Gabbay, Kraus, Lehmann, Magidor and Makinson. These generalizations allow the use of monotonic nonclassical logics as the underlying logic upon (...) which nonmonotonic reasoning may be based. Our sequence of frameworks culminates in what we call plausible, nonmonotonic, multiple-conclusion consequences relations . Our study yields intuitive justifications for conditions that have been proposed in previous frameworks and also clarifies the connections among some of these systems. In addition, we present a general method for constructing plausible nonmonotonic relations. This method is based on a multiple-valued semantics, and on Shoham's idea of preferential models. (shrink)

This work focuses on the conception of God of the medieval Jewish philosopher and legal scholar, Hasdai Crescas (1340-1410/11). It demonstrates that Crescas’ God is infinitely creative and good and explores the parallel that Crescas implicitly draws between God as creator and legislator.

Ce deuxième tome des Hommes de la fraternité s'achève avec le règne de Constantin et le concile de Nicée (325). Les quelques deux cent cinquante évêques qui participent à ce concile dit " œcuménique " représentent bien mal, par leur provenance, ce qu'on appelait alors l'oïkouméné (l'ensemble des terres habitées). Mais le concile est présidé par l'empereur, et une ère nouvelle commence pour les chrétiens au sein de l'Empire. Ils sont si bien traités par le prince, ces évêques conciliaires, qu'ils (...) " se demandent s'ils ne sont pas déjà dans le Royaume de Dieu ". Il semble loin le temps de l'épître à Diognète (vers 195) qui parlait des chrétiens en ces termes : " toute terre étrangère leur est une patrie, toute patrie une terre étrangère. " avec Constantin s'inaugure ce qu'on appellera plus tard l'alliance du trône et de l'autel. Ce deuxième tome est celui d'un tournant décisif pour la suite de l'histoire. Mais l'historien qu'est Michel Clévenot se garde bien d'illustrer une thèse, fût-elle éclairante. Il donne au contraire à voir et à entendre la diversité des situations aux quatre coins de l'Empire et au sein des classes sociales si peu homogènes : le lecteur fait connaissance avec le " directeur de conscience " de la bourgeoisie d'Alexandrie, mais il visite aussi les petits agriculteurs d'Italie, d'Afrique du Nord ou des bords du Nil. Les querelles commerciales, les tensions économiques, les controverses théologiques, les affrontements politiques et guerriers, rien de tout cela n'est négligeable pour celui qui entend " l'appel de Jésus à ne pas déserter l'Histoire ". (shrink)