Cette étude analyse la pensée actuelle sur les décisions-fin-de-vie (DfdV) en France d’un point de vue hollandais. Un nombre limité d’interviews avec des ‘opinion-leaders’ français est pris comme base du project. Jusqu’au jour présent, le domaine des DfdV en France a été troublé en l’absence de définitions et de législation plus spécifiques. Les médecins français pourront faire face à un dilemme en soignant un malade mourant, pris en étau entre le caractère illégal officiel de l’euthanasie d’une part et l’obligation professionnelle (...) de traiter chaque cas de façon particulière d’autre part. La conséquence de l’environnement réglementaire incertain est une déresponsabilisation des médecins français vis-à-vis de leurs collègues et des patients. L’adoption de réformes législatives, en ayant la possibilité d’augmenter le nombre de cas d’euthanasie, se heurtait en France à des arguments cartésiens, paternalistes et religieux. En Novembre 2004, l’Assemblée Nationale a adopté une proposition de loi ayant pour but de rendre plus transparente la mise en pratique des limitations et des arrêts de traitement et de reduire la crainte des médecins de poursuites pénales. Cette proposition de loi a été par la suite approuvée par le Sénat. Aux Pays-Bas, l’euthanasie–la terminaison active de la vie–est légale et régulée par des critères précis. L’approche hollandaise fait référence au concept anglo-saxon d’autonomie du patient et correspond à la préférence générale de la société hollandaise pour la révélation et la régulation des activités controversielles plutôt que de tolérer leur existence sub rosa. Depuis l’entrée en vigueur de la régulation sur l’euthanasie aux Pays-Bas le nombre de cas rapportés a augmenté, mais pas le nombre d’euthanasies. Les règles sont respectées et la qualité de la communication entre médecin et patient est élevée. La vigilance Française pour l’autonomie professionnelle offre un exemple de valeur pour les Hollandais. Les Hollandais, de leur part, fournissent des exemples concrets pour la régulation du domaine des DfdV en France dont on a fait un début récemment. (shrink)

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

In the present article we argue that emotional interactions are not appropriately captured in present emotion research and theorizing. Emotional stimuli or antecedents are dynamic and change over time because they often interact and have a specific relationship with the subject. Earlier emotional interactions may, for example, intensify later emotional reactions to a specific person, or our anger reactions towards powerful or powerless others may differ considerably. Thus, we suggest that such social factors not only affect the intensity, but also (...) the nature of emotional experiences and expressions, and specifically the nature of the social movement (e.g., moving towards, away, or against). We discuss different processes that are implicated in the relation between the social environment and our emotions, describe how emotional expressions shape social behavior, and provide suggestions for incorporating the social dimension of emotion in future research. (shrink)

Previous research has yielded inconsistent findings concerning the relationship between envy and schadenfreude. Three studies examined whether the distinction between benign and malicious envy can resolve this inconsistency. We found that malicious envy is related to schadenfreude, while benign envy is not. This result held both in the Netherlands where benign and malicious envy are indicated by separate words (Study 1: Sample A, N = 139; Sample B, N = 150), and in the USA where a single word is used (...) to denote both types (Study 2, N = 180; Study 3, N = 349). Moreover, the effect of malicious envy on schadenfreude was independent of other antecedents of schadenfreude (such as feelings of inferiority, disliking the target person, anger, and perceived deservedness). These findings improve our understanding of the antecedents of schadenfreude and help reconcile seemingly contradictory findings on the relationship between envy and schadenfreude. (shrink)

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

In the fourth section of Goethe’s Zahme Xenien we find the quatrain from which I have taken the theme of such an old and new controversy, which, as I hope, concerns both Germanic studies and the other humanities: “What was it that kept you from us so apart?” I always read Plutarch again and again. “And what was the lesson he did impart?” “They were all human beings—so much is plain.”1 In the very years when Goethe wrote these lines, that (...) is in the 1820s, Hegel repeatedly gave his lectures on the philosophy of history. Right at the beginning he formulated the opposite view which I should like briefly to characterize as “cultural relativism.”Every age has such peculiar circumstances, such individual conditions that it must be interpreted, and can only be interpreted, by reference to itself…. Nothing is shallower in this respect than the frequent appeal to Greek and Roman example which so often occurred among the French at the time of their Revolution. Nothing could be more different than the nature of these peoples and the nature of our own times.2 What is at issue here is not, of course, Hegel’s assertion that ages and peoples differ from each other. We all know that, and Goethe, the attentive reader and traveler, also knew, for instance, that the Roman carnival differed in its character from the celebrations of the Feast of Saint Rochus at Bingen, both of which he had described so lovingly. What makes the cultural historian into a cultural relativist is only the conclusion which we saw Hegel draw, that cultures and styles of life are not only different but wholly incommensurable, in other words that it is absurd to compare the peoples of a region or an age with human beings of other zones because there is no common denominator that would justify us in doing so. 1. ‘Was hat dich nun von uns entfernt?’ Hab immer den Plutarch gelesen. ‘Was has du den dabei gelernt?’ Sind eben alles Menschen gewesen.’ Johann Wolfgang von Goethe, Sämtlich Werke. Jubiläums-ausgabe in 40 Bänden 4:73; with commentary.2. See Georg Wilhelm Friedrich Hegel, Vorselungen über die Philosophie der Geschichte, Werke, 20 vols. , 12:17. E. H. Gombrich was director of the Warburg Institute and Professor of the History of the Classical Tradition at the University of London from 1959 to 1976. His many influential works include The Story of Art, Art and Illusion, Meditations on a Hobby Horse, The Sense of Order, Ideals and Idols, The Image and the Eye, Tributes, Aby Warburg, and New Light on Old Masters. His previous contributions to Critical Inquiry include “The Museum: Past, Present and Future” , “Standards of Truth: The Arrested Image and the Moving Eye” , and “Representation and Misrepresentation”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kinship:The Relationship Between Johnstone's Ideas about Philosophical Argument and the Pragma-Dialectical Theory of ArgumentationFrans H. van Eemeren and Peter Houtlosser1. Johnstone on the Nature of Philosophical ArgumentAs he himself declared in Validity and Rhetoric in Philosophical Argument (1978, 1), the late philosopher Henry W. Johnstone Jr. devoted a long period of his professional life to clarifying the nature of philosophical argument. His well-known view was that philosophical arguments are (...) sui generis, i.e., not to be judged by the standards of argumentation in science or everyday discourse. Philosophical arguments are not ad rem, but are based on premises that are expressed or implied commitments of a party in dialogue. This is why philosophical argumentation is, according to Johnstone, always ad hominem. In philosophical argumentation, every ad rem argument begs the question.Usually, ad hominem argumentation is dismissed as invalid. Johnstone, however, maintains that making use of argumentum ad hominem is the only way to establish a philosophical conclusion. In an argumentum ad hominem, inferences are drawn from propositions stated or implied by the other party and critical questions are raised about the conclusions that were drawn, so that it can be used to refute a philosophical position by showing that this position is inconsistent. As Walton (2001) rightly observes, this type of ad hominem argumentation boils down to arguing from commitments of the other party, i.e., ex concessis.The use of ad hominem argumentation as the criticism of a position in terms of its own presuppositions is, in Johnstone's view, the only valid argument in philosophy, if any philosophical argument is indeed valid. All philosophical polemic is in this perspective in fact addressed ad hominem. This applies not only to philosophical argumentation that concerns self-referential refutation but also to other ad hominem types of philosophical argumentation, including the tu quoque argument (1978, 11–12).According to Johnstone, there is no objective criterion for determining the validity of ad hominem argumentation. Validity must, says Johnstone in the [End Page 51] epilogue of his collected essays on philosophical argument, be viewed as "a regulative ideal" (135). Much earlier, Johnstone had already come to the conclusion that "the valid argument is the one that maintains philosophical discussion" (38). It is this self-perpetuating feature that is the distinctive rationality of philosophy. By forcing the interlocutor to elaborate his philosophical position rather than just repeat it, the gap between the interlocutors is bridged.In order to distinguish between constructive persuasive argumentation and mere repetition or other forms of paralyzing the discourse, the line must be drawn between responsible and irresponsible persuasion. This is a problem for Johnstone. Where the Ancients solved the problem by insisting that the persuader be virtuous, Johnstone proposed to base the distinction between responsible and irresponsible persuasion on the attitude of the philosopher and his interest in maintaining the philosophical enterprise. The philosopher is a critic who criticizes con amore. His intention to do so, however, is revealed "only in the way he goes about his work" (84).A more down to earth criterion for responsible persuasion that Johnstone proposed is that the discourse should not tend to degenerate. Logic, as the discipline concerned with reason, serves to prevent the discussion from degenerating, but it can do so only if the parties concerned have jointly committed themselves to certain logical principles. If in philosophical argument a defendant is under no obligation to acknowledge an inconsistency when the other party points out an inconsistency in his position, then the other party's criticism cannot count as valid. According to Johnstone, however, it will depend on the parties' presuppositions whether or not they consider two statements as being inconsistent. In other words, what is inconsistent for the one party may not be inconsistent for the other party.Few obligations are imposed on everyone; most obligations arise from commitments made by specific individuals or groups of individuals. As Johnstone says, "Even the cogent philosophical argument is not, of course, absolutely cogent; it is cogent only relatively to interlocutors who maintain the premises on which it depends" (27). Once we abandon the search for objective conditions under which philosophical arguments can be valid, according... (shrink)

Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

This study aims to examine the development of diversity and inclusion (D&I) literature and identify its prominent themes and blind spots. The research was conducted using bibliometric analysis on the Web of Science database and included 2510 publications. Results showed that the development of D&I literature had increased exponentially since the 1960s, mainly due to different political and societal events. The geographic development showed that research was primarily conducted in developed countries where quotas and other legislation are implemented. The thematic (...) development revealed a stable but narrow focus on diversity management, board diversity, and team diversity, with little attention to inclusion. The keyword analysis strongly emphasized surface-level diversity, such as gender, race, and cultural diversity, while deep-level diversity received less attention. This study concludes that previous D&I literature has mainly focused on the financial effects of D&I and neglected other elements, such as the effects on social performance, its ethical implications, and the relationship between diversity and inclusion. The study recommends future research to expand the interpretation of diversity, examine the relationship between diversity and inclusion, and explore the effects of diversity on non-financial outcomes such as social performance and ethics. This study provides a valuable contribution to the field of business ethics by highlighting the blind spots in D&I literature and encouraging future research to consider the ethical implications of diversity in the workplace. (shrink)