Introduction: The Dutch Euthanasia Act states that euthanasia is not punishable if the attending physician acts in accordance with the statutory due care criteria. These criteria hold that: there should be a voluntary and well-considered request, the patient’s suffering should be unbearable and hopeless, the patient should be informed about their situation, there are no reasonable alternatives, an independent physician should be consulted, and the method should be medically and technically appropriate. This study investigates whether physicians experience problems with these (...) criteria in medical practice.Methods: In 2006, questionnaires were sent to a random, stratified sample of 2100 Dutch physicians . Physicians were asked about problems in their decision-making related to requests for euthanasia or assisted suicide after enforcement of the 2002 Euthanasia Act.Results: Of all physicians who had received a request for euthanasia or assisted suicide , 25% had experienced problems in the decision-making with regard to at least one of the criteria of due care. Physicians who had experienced problems mostly indicated to have had problems related to evaluating whether or not the patient’s suffering was unbearable and hopeless and whether or not the patient’s request was voluntary or well considered .Discussion: Physicians in The Netherlands most frequently reported problems related to aspects in which they have to evaluate the patient’s subjective perspective. However, it can be questioned whether placing emphasis on these subjective aspects is an adequate fulfilment of the duties imposed on physicians, as laid down in the Dutch Euthanasia Act. (shrink)

Introduction With an ageing population, end-of-life care is increasing in importance. The present work investigated characteristics and time trends of older peoples' attitudes towards euthanasia and an end-of-life pill. Methods Three samples aged 64 years or older from the Longitudinal Ageing Study Amsterdam (N=1284 (2001), N=1303 (2005) and N=1245 (2008)) were studied. Respondents were asked whether they could imagine requesting their physician to end their life (euthanasia), or imagine asking for a pill to end their life if they became tired (...) of living in the absence of a severe disease (end-of-life pill). Using logistic multivariable techniques, changes of attitudes over time and their association with demographic and health characteristics were assessed. Results The proportion of respondents with a positive attitude somewhat increased over time, but significantly only among the 64–74 age group. For euthanasia, these percentages were 58% (2001), 64% (2005) and 70% (2008) (OR of most recent versus earliest period (95% CI): 1.30 (1.17 to 1.44)). For an end-of-life pill, these percentages were 31% (2001), 33% (2005) and 45% (2008) (OR (95% CI): 1.37 (1.23 to 1.52)). For the end-of-life pill, interaction between the most recent time period and age group was significant. Conclusions An increasing proportion of older people reported that they could imagine desiring euthanasia or an end-of-life pill. This may imply an increased interest in deciding about your own life and stresses the importance to take older peoples' wishes seriously. (shrink)

Introduction In 2007, a national review committee was instituted in The Netherlands to review cases of active ending of life for newborns. It was expected that 15–20 cases would be reported. To date, however, only one case has been reported to this committee. Reporting is essential to obtain societal control and transparency; the possible explanations for this lack of reporting were therefore explored. Methods Data on end-of-life decision-making were scrutinised from Dutch nation-wide studies (1995, 2001 and 2005), before institution of (...) the committee. Physicians received a questionnaire about their medical decision-making for stratified samples of deceased infants up to 1 year, drawn from the central death registry. Results In 2005, 58% of all deaths were preceded by an end-of-life decision, compared with 68% in 2001 and 62% in 1995. The use of drugs with a possible life-shortening effect tended to be lower. In 2005, all four cases in the study in which an infants' life was actively ended were preceded by a decision to forego life-prolonging treatment. In three cases, the infant's life expectancy was short; one case involved a longer life expectancy. Discussion The expected number of cases is probably an overestimation due to changes in medical practice such as the tendency to attribute less life-shortening effects to opioids. The lack of reports is probably also associated with requirements in the regulation; it may be difficult to fulfil them due either to time constraints or the nature of the suffering that is addressed. If societal control of active ending of life is considered useful, changes in the regulation may be needed. (shrink)

Objectives: To investigate why physicians label end-of-life acts as either ‘euthanasia/ending of life’ or ‘alleviation of symptoms/palliative or terminal sedation’, and to study the association of such labelling with intended reporting of these acts. Methods: Questionnaires were sent to a random, stratified sample of 2100 Dutch physicians. They were asked to label six hypothetical end-of-life cases: three ‘standard’ cases and three cases randomly selected, that varied according to type of medication, physician’s intention, type of patient request, patient’s life expectancy and (...) time until death. We identified the extent to which characteristics of cases are associated with physician’s labelling, with multilevel multivariable logistic regression. Results: The characteristics that contributed most to labelling cases as ‘euthanasia/ending of life’ were the administration of muscle relaxants or disproportional morphine. Other important factors were an intention to hasten death and a life expectancy of several months. Physicians were much more willing to report cases labelled as ‘euthanasia’ or ‘ending of life’ than other cases. Conclusions: Similar cases are not uniformly labelled. However, a physicians’ label is strongly associated with their willingness to report their acts. Differences in how physicians label similar acts impede complete societal control. Further education and debate could enhance the level of agreement about what is physician-assisted dying, and thus should be reported, and what not. (shrink)

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

BackgroundAn important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians (...) to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention.MethodsWe examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist.ResultsPhysicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%).ConclusionDutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues. (shrink)

First published in 1982, this reissue contains a critical exposition of the views of Frege, Dedekind and Peano on the foundations of arithmetic. The last quarter of the 19th century witnessed a remarkable growth of interest in the foundations of arithmetic. This work analyses both the reasons for this growth of interest within both mathematics and philosophy and the ways in which this study of the foundations of arithmetic led to new insights in philosophy and striking advances in logic. This (...) historical-critical study provides an excellent introduction to the problems of the philosophy of mathematics - problems which have wide implications for philosophy as a whole. This reissue will appeal to students of both mathematics and philosophy who wish to improve their knowledge of logic. (shrink)

The work of Jacques Ellul is useful in understanding and evaluating the implications of rapidly changing technologies for human values and democracy. Ellul developed three powerful theses about technology: technological autonomy, technological determinism, and technological bluff. In this essay, the authors explicate these views of technology, and place the work of Ellul in dialogue with the ides of other important theorists of technology. Ellul’s too-often overlooked theses about technology are relevant to our present technological society.

Impostors, confidence artists, and artful deceivers seem to have achieved a strange kind of popularity and even prestige in our contemporary political landscape, for reasons that remain elusive, especially given how harmful and socially unwanted such behaviors ostensibly are. Herman Melville’s 1857 novel, The Confidence-Man: His Masquerade, helps us shift our perspective on this seemingly irrational phenomenon because it points out how being susceptible to dupery is linked to the enjoyment of fiction itself. This insight also highlights the importance of (...) epistemological failure in the recent “return to aesthetics” in literary studies, where the positive dimension of unconsciously “willing one’s dupery” directly links aesthetic form to politics. The logic that connects aesthetics to unconscious enjoyment is then elaborated in the work of psychoanalytic thinkers such as Sigmund Freud, Jacques Lacan, Helene Deutsch and others to raise particular questions about how and why the enjoyment of being duped has been associated with feminine sexuality. Reading Melville’s novel while considering psychoanalytic concepts such as the “as if” personality, imposture, and interpassivity illuminates how confidence games play upon the ruses of sexuality, which have profound implications for why the public remains in thrall to the workings of known deceivers. (shrink)

This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

Talks 1952 -- Ojai, California 3 August -- August -- August -- Talks 1953 -- Bombay 4 March -- London 9 April -- Ojai, California 4 July -- Talks 1955 -- Amsterdam 26 May -- London 25 June -- Talks 1956 -- Madanapalle, India 26 February -- Brussels 24 June -- June -- Hamburg 6 September -- New Delhi 31 October -- Madras 26 December -- Talks 1957 -- Colombo, Sri Lanka 23 January -- January -- Talks 1958 -- Poona, (...) India 21 September -- Madras 26 October -- November -- Bombay 28 December -- Talks 1959 -- Madras 6 December -- December -- Bombay 23 December. (shrink)

There has been much discussion about the nature and even existence of so-called “pure conscious events” (PCEs). PCEs are often described as mental events which are non-conceptual and lacking all experiential content (Forman 1990). For a variety of reasons, a number of authors have questioned both the accuracy of such a characterization and even the very existence of PCEs (Katz 1978, Bagger 1999). In this chapter, I take a somewhat different, but also critical, approach to the nature and possibility of (...) PCEs. I focus on several overlapping views found in recent analytic philosophy of mind and examine PCEs in light of them. After introducing terminology and some preliminary matters, I examine whether or not the “higher-order thought (HOT) theory of consciousness” rules out the possibility of PCEs, and conversely, whether or not PCEs show that the HOT theory cannot apply to all conscious states. The HOT theory says that what makes a mental state conscious is that it is accompanied by a higher-order thought to the effect that “I am in mental state M now.” A related theme will be to assess PCEs in light of the recent debate between so-called “conceptualists” and those who believe that there are “non-conceptual contents of experience.” Conceptualism, to which I am very sympathetic, is basically the view that all conscious experience is structured by concepts possessed by the subject. I argue that PCEs are indeed conceptual and so no threat to conceptualism. For example, standard criticisms of conceptualism do not apply to PCEs. Finally, I examine the possibility that PCEs are not conscious at all. In the end, my overall conclusion is that we should hold that PCEs are indeed compatible with both HOT theory and conceptualism or seriously question the idea that PCEs are conscious at all. (shrink)

The purpose of this text is to draw attention to eight forgotten heroes: William C. Bagley, Charles DeGarmo, David Felmley, William Torrey Harris, Isaac L. Kandel, Charles McMurry, William C. Ruediger, and Edward Austin Sheldon. They have been marginalized from our profession, and drawing upon their legacy is the best hope for restoring the profession of teaching today. This work also includes a chapter at the end of the book entitled "John Dewey's Forgotten Essays." The audience for this book includes: (...) 1) classroom teachers, 2) school administrators, 3) teacher educators, 4) deans and other university administrators, 5) college and university presidents, 6) legislators, 7) historians of education, 8) curriculum specialists, 9) specialists in teacher training, and 10) the general public. (shrink)

The first English translation of Fichte’s second set of 1804 lectures on the Wissenschaftslehre.

This comprehensive and important volume includes contributions by activists, journalists, lawyers and scholars from twenty-one countries. The essays map the directions the movement for women's rights is taking--and will take in the coming decades--and the concomittant transformation of prevailing notions of rights and issues. They address topics such as the rapes in former Yugoslavia and efforts to see that a War Crimes Tribunal responds; domestic violence; trafficking of women into the sex trade; the persecution of lesbians; female genital mutilation; and (...) reproductive rights. (shrink)

I refer to the social embodiment of creative intelligence as creative democracies. Today’s world pose great challenges and serious threats to human life and cannot be faced by just having new ideas or more knowledge and thoughts. Today’s world requires the power to face the unknown, a key feature of intelligence. Hence the urgent need of societies to mutate into creative democracies. We need to begin with a strong base. We need an understanding and development of human life from its (...) foundations and the simplicity of its origin in the creative freedom of reality and its intra-active intelligence, the power of all humans in our global world to meet and share meaning and interests. This essaysuccinctly highlights their foundations, prefaced by three cautionary reflections. (shrink)

This paper argues that for the purposes of any sort of serious discussion about immoral conduct in sport very little is illuminated by claiming that the conduct in question is cheating. In fact, describing some behavior as cheating is typically little more than expressing strong, but thoroughly vague and imprecise, moral disapproval or condemnation of another person or institution about a wide and ill-defined range of improper advantage-seeking behavior. Such expressions of disapproval fail to distinguish cheating from many other types (...) of immoral conduct. The discussion shows that we should set the concept aside and assess the moral disapproval implied by claims of cheating by reference to the moral and other principles that underlie the practice of sport. This allows us to consider carefully the complexity of the issues that are raised when allegations of cheating are made and not be distracted by the emotionally loaded, conversation-stopping tendency of the concept. This means that some types of disputes in sport will be messy and demand more effort to resolve, but the payoff will be better informed and more thoughtful discussions and greater awareness of the moral complexity of sport and of its principled underpinnings. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Bridge From Analysis to Action:Psychodynamic Analyses of Religion and Michael S. Hogue's American ImmanenceAJ Turner (bio)I. IntroductionThe purpose of this essay is to work constructively with Michael S. Hogue's groundbreaking American Immanence: Democracy for an Uncertain World to demonstrate how psychodynamic analyses of religion are essential theoretical allies in the fight for resilient democracy. The "revolution in mind"1 that psychodynamic approaches contribute, especially in their analyses of religion, (...) both complements and complicates socio-political theory as a whole. In the improvisational spirit of "yes-and," the goal here is not to identify and decry the failures and shortcomings of Hogue's theopolitical vision but rather to inspire the recovery of a sibling discourse—a kind of "rebirth of a forgotten alternative"2—that also draws deeply from the American immanental tradition in order to add psychodynamic depth to Hogue's timely and important analysis. Psychodynamic theories of religion shed light on how symbolic identifications, including and especially ultimate concerns, structure personal and collective experience. By engaging religion and theology sympathetically, constructively, and creatively, theorists such as Rollo May, Gordon Allport, Karen Horney, Erich Fromm, and Ernest Becker departed from the skepticism, reductionism, and dismissal that characterized psychoanalytic analyses of religion in the wake of Freud.3 Each of these figures, and especially Becker whose work will be a focus in this essay, are noteworthy interlocutors for extending Hogue's theopolitical theorizing of resilient democracy, particularly in how they drew unique inspiration from the American immanental tradition [End Page 44] in their social analyses. In this respect, they provide a more robust theorization of the psychosocial conditions of the associational ethos needed to connect Hogue's conception of resilient democracy with forms of agonistic organization and democratic activism. Briefly stated, psychodynamic approaches are a helpful bridge for connecting these proposals to strategies of organization, their impediments, and collective action.In this way, both psychodynamic analyses of religion and Hogue's theopolitical innovation insist that no revolutionary political change is possible, and certainly not of the kind or scale needed to counter our wickedly entangled global crises, without a deep engagement with theological imaginaries. They differ, however, in their theoretical aims. Whereas Hogue compellingly argues for the political upshot of a theology deriving from the American immanental tradition, psychodynamic analysts of religion focus on the function of ultimate concerns in individual and collective life. In other words, American Immanence rests on a methodology of analyzing the philosophical and theological assumptions that have contributed to our climate crises and then presenting clear and compelling articulation of an alternative paradigm meant to open up new ways of being. In contrast psychodynamic analyses leverage conceptual clarity of psychic reality for the fundamentally therapeutic aim of transformation. At their best, both approaches share what could be called an etiological orientation to ontological questions in order to provide liberative alternatives through rational understanding and clarification, but the terrain, and thus the problems they hope to mitigate in their analyses are focused differently. Extending the visual metaphor, they are different lenses highlighting different areas of the same landscape. Furthermore, it must be said that neither are sufficient in themselves, but the psychodynamic theorists of religion to be highlighted in this essay share deeply with Hogue's heading in American Immanence.II. A Problematic AssumptionIn emphasizing and attempting to explain4 the role of non-rational processes in the both individual and social processes of perception and organization of experience, psychodynamic theories confound a widely held and problematic assumption that the triumph of rational analysis is the hallmark for building the society to which we should aspire. Political theory in general, [End Page 45] especially as it has taken its cues from a rationalist legacy about the inherently liberating force of Reason, has been weighted toward an assumption that its task of exposing the mystifications of power would suffice in inspiring more "rational" and therefore necessarily equitable social organization. This speaks to the longstanding socio-political interest in "consciousness raising" tactics, which are often meant to dispel "false consciousness." It even comes across in the emphases of Deweyan pragmatists on education. Psychologists of all stripes point out that this approach... (shrink)

Philosophical Analysis Its Development between the Two World Wars.

This new edition of Jurisprudence brings the book fully up to date and incorporates the following new topics: Utilitarianism, Scandinavian realism, Feminism, Liberalism, the New Critics, and the Hart v Dworkin debate. It also includes a separate chapter on Dworkin's Law's Empire, and the previous chapter on Rights has been substantially revised, to make this a useful and highly readable addition to the student's library.

The posterior parietal cortex (PPC) is the most likely site where egocentric spatial relationships are represented in the brain. PPC cells receive visual, auditory, somaesthetic, and vestibular sensory inputs; oculomotor, head, limb, and body motor signals; and strong motivational projections from the limbic system. Their discharge increases not only when an animal moves towards a sensory target, but also when it directs its attention to it. PPC lesions have the opposite effect: sensory inattention and neglect. The PPC does not seem (...) to contain a “map” of the location of objects in space but a distributed neural network for transforming one set of sensory vectors into other sensory reference frames or into various motor coordinate systems. Which set of transformation rules is used probably depends on attention, which selectively enhances the synapses needed for making a particular sensory comparison or aiming a particular movement. (shrink)

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

The philosophical literature on sport and games has had little to say about boredom beyond presuming that sports and games can be important ways of overcoming or preventing it. But boredom is an interesting and often misunderstood phenomenon with overlooked implications in this context. Boredom has significant human value and motivates play in ways that contribute to well-being and culture, often through encouraging engaged agency and exploration of novelty. Understanding boredom can also help to clarify problems and tendencies in sports (...) and games that qualify them as havens from boredom. (shrink)