The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our goal (...) is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

PART I : THE GOD-QUESTION TODAY -- God as a problem -- The denial of God in modern atheism -- The predicament of theology in the face of atheism -- Experience of God and knowledge of God -- Knowledge of God in faith. PART II : THE MESSAGE ABOUT THE GOD OF JESUS CHRIST -- God, the father almighty -- Jesus Christ, son of God -- The Holy Spirit, Lord, and giver of life. PART III : THE TRINITARIAN MYSTERY OF (...) GOD -- Establishment of the doctrine of the Trinity -- Exposition of the doctrine of the Trinity. (shrink)

From 1827 to 1831 the German historian Leopold von Ranke travelled through Germany, Austria, and Italy, hunting for documents and archives. During this journey Ranke developed a new model for historical research that transformed the archive into the most important site for the production of historical knowledge. Within the archive, Ranke claimed, the trained historian could forget his personal predispositions and political loyalties, and write objective history. This essay critically examines Ranke's model for historical research through a study of the (...) obstacles, frustrations, and joys that he encountered on his journey. It shows how Ranke's archival experiences inspired him to re-evaluate his own identity as a historian and as a human being, and investigates some of the affiliations between his model for historical research and the political realities of Prince Metternich's European order. Finally, the essay compares Ranke's historical discipline to other nineteenth-century disciplines, such as anthropology and archaeology. (shrink)

Name der Zeitschrift: Jahrgang: 13 Heft: 2 Seiten: 170-189.

Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying...

"The idea for this book arose in connection with the Workshop on Semantic functions of complementizers in European languages, which we organized in October 28-29, 2011, at the University of Copenhagen, Denmark. Around two thirds of the book chapters are elaborations on contributions to this workshop, the remaining one third arose independently of the workshop.".

BackgroundThe aim of this study is to compare depression and loneliness among adult siblings of people on the autism spectrum, adult siblings of normotypic individuals, and adults raised alone. In recent years, an increasing interest in the perspective of siblings of children diagnosed with autism has been observed, with studies among this population particularly concerned with the developmental trajectories of children and adolescents at “high risk” for ASD, rarely focusing on their mental well-being.MethodsThe respondents filled out: the survey on sociodemographic (...) data designed by the authors, Beck Depression Inventory II, and De Jong Gierveld Loneliness Scale.ResultsA rise in BDI and an increase in the DJGLS score were predicted by having a sibling diagnosed with ASD. Those effects were independent of subjects’ sex, educational status, place of residence, or a number of siblings.ConclusionThe results underline a fundamental need for the development of mental hygiene programs for families where children with autism spectrum are accompanied by healthy siblings. (shrink)

Recently there has been some discussion concerning a particular type of enhancement, namely ‘moral enhancement’. However, there is no consensus on what precisely constitutes moral enhancement, and as a result the concept is used and defined in a wide variety of ways. In this article, we develop a clarificatory taxonomy of these definitions and we identify the criteria that are used to delineate the concept. We think that the current definitions can be distinguished from each other by the criteria used (...) for determining whether an intervention is indeed moral enhancement. For example, some definitions are broad and include moral enhancement by any means, while other definitions focus only on moral enhancement by means of specific types of intervention. Moreover, for some definitions it suffices for an intervention to be aimed or intended to morally enhance a person, while other definitions only refer to ‘moral enhancement’ in relation to interventions that are actually effective. For all these differences in definitions we discuss some of their implications. This shows that definitions are significantly less descriptive and more normative than they are regularly portrayed to be. We therefore hope that the taxonomy developed in this paper and the comments on the implications for the normative debate of the variety of definitions will provide conceptual clarity in a complex and highly interesting debate. (shrink)

The conceptual pair of own-world and common world constitutes an archaic pair, originally introduced by Heraclitus. More than two millennia after its introduction, Binswanger picked up this conceptual pair in the attempt to understand existence and mental disorder. Ever since, this conceptual pair has been part of the conceptualization of schizophrenia in phenomenological psychopathology. However, the concepts of ídios kósmos and koinós kósmos have seldomly been elaborated and expanded upon, and certain unclarities rest within the literature. This paper resolves some (...) of these unclarities and contributes to a theory of anthropological proportions, which furthers our understanding of ídios kósmos and koinós kósmos. The paper begins with an exploration of the theoretical underpinnings of this conceptual pair, i.e., it discusses the concept of world, what is understood by common world, and what it means to live in an own-world. This theoretical exploration segues into an in-depth analysis of the alterations of experiential life in schizophrenia, which can be illuminated via this conceptual pair. It is further argued that this conceptual pair contributes to an understanding of the puzzling phenomenon of double bookkeeping. Finally, the paper concludes in a discussion of clinical implications of this conceptual pair, stressing the importance of a mindfulness of the alterations to the ídios kósmos and koinós kósmos in schizophrenia. (shrink)

_The Grundtvigian Case for Museums_ This article investigates the notion that museums are caught between two opposites when it comes to defining the institutions Raison d'être: either you entertain, or you enlighten. Using Barbara Rosenwein’s thoughts on emotional communities, this museological dichotomy between emotion and intellect is challenged by a certain ‘Grundtvigian position’ that was inspired by the philosophy of pastor poet N.F.S. Grundtvig. At the turning point of the 19 th century this position resulted in numerus museums that made (...) the radical statement: the dichotomy is false. A museum should speak to emotions _ and _ the intellect. As opposed to the rationalistic, archeological approach that the National Museum represented, the grundtvigians saw themselves as mediators of a living history that needed to be told under the pressure of modern techniques and customs. (shrink)

This article investigates the emergence of the archive as the primary venue for the production of historical knowledge in the 19thcentury. The turn to archival research, the article argues, may be considered as a response to the discussions about the problems of testimony that dominated 18th- and early 19th-century German writings on the methodology and epistemology of historical research. These discussions, especially regarding the epistemic virtues of witnesses, also helped create the particular culture of knowledge-making within German historical scholarship that (...) enabled the archival turn. The article illustrates these developments through the examples of Johann Peter von Ludewig, who was one of the most prominent historians of the early German Enlightenment, and Leopold von Ranke, who is normally considered the founder of the modern historical discipline and the most important advocate of the 19th-century archival turn. (shrink)

Pragmatism and the correspondence theory of truth are longtime foes. Nevertheless, there is an argument to be made that pragmatists must embrace truth as correspondence. I show that there is a distinctive pragmatic utility to taking truth to be correspondence, and I argue that it would be inconsistent for pragmatists to accept the utility of the belief that truth is correspondence while resisting the premise that this belief is correct. -/- In order to show how pragmatists can embrace truth as (...) correspondence, I develop a kind of alethic pluralism, which treats pragmatist truth as theoretically fundamental to truth as correspondence. This theoretical fundamentality of pragmatist truth allows the pragmatist to conditionally accept truth as correspondence for certain discourses without falling prey to the typical pragmatist objections to correspondence. This pluralist account of truth thus allows pragmatists to concede that, for certain domains of discourse, truth is correspondence, without thereby betraying their pragmatist principles. (shrink)

In The Myth of Morality Richard Joyce presents a simple and very influential argument for the truth of moral error theory. In this paper I point out that the argument does not have the form Joyce attributes to it, the argument is not valid in an extensional propositional logic and on the most natural way of explicating the meanings of the involved terms, it remains invalid. I conclude that more explanation is needed if we are to accept this particular argument (...) for moral error theory. (shrink)

In 2002 with the passing of the Euthanasia Law, Belgium became one of the few countries worldwide to legalize euthanasia. In the 18 years since the passing of the law, much has changed. We argue that in Belgium a widening of the use of euthanasia is occurring and that this can be ethically and legally problematic. This is in part related to the fact that several legal requirements intended to operate as safeguards and procedural guarantees in reality often fail to (...) operate as such. We focus on three kinds of safeguards or procedural guarantees: the legally defined due care criteria for eligibility for euthanasia; the consultation of a second physician; and the reporting of euthanasia cases to the Federal Control and Evaluation Commission for Euthanasia. We will show how each of these three safeguards can exhibit shortcomings in theory and practice. (shrink)

Deflationists believe that the question “What is truth?” should be answered not by means of a metaphysical inquiry into the nature of truth, but by figuring out what use we make of the concept of truth, and the word ‘true’, in practice. This article accepts this methodology, and it thereby rejects pluralism about truth that is driven by ontological considerations. However, it shows that there are practical considerations for a pluralism about truth, formulated at the level of use. The theory (...) expounded by this article states that truth is a dual-purpose tool; it can be used as a device for transferring justificatory burdens and, for select areas of discourse, it can also be used as a standard, a norm. This contrast in how truth is used introduces a bifurcation in our discourse that is reminiscent of metaphysical divides traced by more traditional versions of alethic pluralism. However, my pluralism “at the level of use” states that truth is plural solely at the level of use. It is unified at both the conceptual as well as the metaphysical level. At those levels, the theory takes its cue from deflationism. As such, this theory is offered as a midway point and as a potential way forward in the debate between deflationism and pluralism. (shrink)

Background: The 21-item Nurses’ Moral Courage Scale was developed and validated in 2018 in Finland with the purpose of measuring moral courage among nurses. Objectives: The objective of this study was to make a Dutch translation of the Nurses’ Moral Courage Scale to describe the level of nurses’ self-assessed moral courage and associated socio-demographic factors in Flanders, Belgium. Research design: A forward–backward translation method was applied to translate the English Nurses’ Moral Courage Scale to Dutch, and a pilot study was (...) conducted to improve readability and understandability. A non-experimental, descriptive cross-sectional exploratory design was used to conduct a survey. Descriptive analysis was used. Participants: The data were collected from a convenience sample of 559 nurses from two hospitals in Flanders. Ethical considerations: Ethical approval was obtained from the university ethics committee, permission to conduct the study was obtained from the participating hospitals. Participants received a guide letter and gave their informed consent. Findings: The readability and understandability of the Dutch Nurses’ Moral Courage Scale were positively evaluated, and the scale revealed a good level of internal consistency for the total scale and all subscales. Nurses’ mean score of the 21-item Nurses’ Moral Courage Scale was 3.77. The total Nurses’ Moral Courage Scale score was associated with age, experience, professional function, level of education and personal interest. Discussion and Conclusion: The Nurses’ Moral Courage Scale was successfully translated to Dutch. The Flemish nurses perceived themselves as morally courageous, especially when they were in a direct interpersonal relationship with their patients. Acting courageously in ethical dilemmas that involved other actors or organizations appeared to be more challenging. The results strongly suggest the important role of education and ethical leadership in developing and supporting this essential virtue in nursing practice. (shrink)

Immanuel Kant's ‘Critique of Judgment’ is often read either in terms of art appreciation or teleology. In this paper however, the object is to examine the ‘Critique of Judgment’, especially the concepts of the Beautiful and the Sublime, in relation to the Kantian version of the Enlightenment. The main theses in the paper are as following: That Beauty can provide us with the sensuous experience of the possibility of the moral law and that the Sublime can provide us with the (...) sensuous experience of the possibility that we as rational beings can effectuate the actual existence of the moral law. (shrink)

Owen Griffiths has recently argued that Etchemendy’s account of logical consequence faces a dilemma. Etchemendy claims that we can be sure that his account does not overgenerate, but that we should expect it to undergenerate. Griffiths argues that if we define the relationship between formal and natural language as being dependent on logical consequence, then Etchemendy’s claims are not true; and if we define the relationship as being independent of logical consequence, then we cannot assess the truth of the claims (...) without further information. I argue that Griffiths misconstrues Etchemendy’s theory and overstates the first horn of the dilemma: Etchemendy does see the relationship as being dependent on logical consequence, but that does not mean that his claims are not true. (shrink)

When a new intervention or drug is developed, this has to pass through various phases of clinical testing before it achieves market approval, which can take many years. This raises an issue for drugs which could benefit terminally ill patients. These patients might set their hopes on the experimental drug but are unable to wait since they are likely to pass away before the drug is available. As a means of nevertheless getting access to experimental drug, many seriously ill and (...) terminally ill patients are therefore very willing to participate in randomised controlled trials. However, only very few terminally ill patients are able to actually participate, and those that do participate are at risk of participating solely as a way of getting experimental drugs. Currently, there are, however, ways of getting access to drugs that have not gained market approval. One such mean is via expanded access or compassionate use programs where terminally ill patients receive experimental new drugs that are not yet market approved. In this paper, I examine some of the common justifications for such programs. The most frequently voiced justifications for compassionate use or expanded access programs could be put in one of three categories. First, there are justifications of justice, where compassionate use programs could be seen as a just or fair way to distribute experimental new drugs to patients who are denied access to RCT’s through no fault of their own. Second, such programs could be justified by reference to the ethical principle of beneficence where it could be claimed that terminally ill patients stand to benefit greatly at very little risk. Third, there are considerations of autonomy where, it is claimed, patients should be able to exercise their autonomy and have access to such drugs if that is there free choice and they are fully aware of the risks associated with that choice. In this paper, I argue currently all justifications are potentially problematic. If they truly form the basis for justification, compassionate use programs should be designed to maximize justice, beneficence and autonomy. (shrink)

Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the ‘natural death’ hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a ‘natural’ death by medical practitioners, patients' relatives (...) and patients.We attempt to show that the label ‘natural’ cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as ‘natural’ death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases. (shrink)

Construed as a theory of justice, relational egalitarianism says that justice requires that people relate as equals. Construed as a theory of what makes democracy valuable, it says that democracy is a necessary, or constituent, part of the value of relating as equals. Typically, relational egalitarians want their theory to provide both an account of what justice requires and an account of what makes democracy valuable. We argue that relational egalitarians with this dual ambition face the justice-democracy dilemma: Understanding social (...) relations in such a way that renders relational egalitarianism plausible as an answer to what makes democracy valuable comes at the price of understanding social relations in a way that makes it less plausible as a theory of justice, and vice versa. We also argue that there is no easy way out of the dilemma and that relational egalitarians, who want relational equality to provide both accounts mentioned, may simply have to set their ambitions lower on behalf of relational equality. (shrink)

Relational egalitarianism says that moral equals should relate as equals. We explore how moral unequals should relate.

In the perhaps most decisive reopening of philosophy in the twentieth century, Heidegger presented an existential analytic. This can be viewed as the highly complex analysis of one simple action: being-there. In the paper at hand, a Spinozist interpretation of this action is proposed. This implies a shift in the Aristotelian conceptuality, which, to a large extent, informs Heidegger’s analysis. The action of being-there is not a movement from potentiality to actuality. It is a force of existence. However, this force (...) is located right at the threshold between potentiality and actuality. Accordingly, it is not a matter of dismissing Aristotle’s concepts, but—with Heidegger—to observe carefully their deconstruction and pursue it to the point where these concepts become indistinct and where—beyond Heidegger—a Spinozian force of existence emerges. (shrink)

The all-affected principle is a widely accepted solution to the problem of constituting the demos. Despite its popularity, a basic question in relation to the principle has not received much attention: why does the fact that an individual is affected by a certain decision ground a right to inclusion in democratic decision-making about that matter? An answer to this question must include a reason that explains why an affected individual should be included because she is affected. We identify three such (...) reasons in the literature – to wit, interest protection, self-government and welfare – and show why they all fail. We then propose two alternative reasons, equal relations and fairness, and show why they are also deficient. Surprisingly, the all-affected principle then appears groundless, which supports withholding belief in the all-affected principle or(/and) investing future research in identifying the thus-far unidentified reason why being affected grounds a claim to inclusion. (shrink)

Mortality seems to have no place in the theories on subjectivity in Kant and Husserl. It is suggested that this entente cordiale is an expression of the shared principle at the heart of their philosophy, i.e. the principle of self-preservation. Self-preservation is a principle that in a certain sense excludes mortality. It is argued that the primary sense of this exclusion is not theoretical but practical. Kant and Husserl are both endorsing the imperative that man should not let death attain (...) the dominion of his thoughts . The positive correlate to this is to be found in the demand that man should think of himself as if he was immortal. With special regard to Husserl the predicament that accompanies his relentless attempt to fulfill this demand is described as a sluice through which anthropology threatens to flow into the phenomenological enterprise. (shrink)

The line drawn in this paper is a long one, even far-fetched. It goes all the way from a phenomenology of touch beginning with Aristotle, and from there it will not be finished before it arrives at our present technological condition—a condition for which the French philosopher Jean-Luc Nancy has given us the word ecotechnie. The title of this drawing will be ‘responsiveness and technology’ as it connects exactly these two phenomena. Not in such a way, however, that the paper (...) begins with responsiveness and ends with technology. Rather, the line will begin with their intricate and intimate connection and then unfold until this connection is wholly exposed. And so the paper begins with a technical responsiveness to be found in touch; and it ‘ends’ with a worldwide responsive technology—which will in a sense prove to be without end. (shrink)

The aim of this paper is to catch up with a conjecture designated by the term ‘responsive self-preservation’. This term appears neither strikingly beautiful nor intuitively understandable. Obviously it is a convoluted terminus technicus in need of conceptual clarification. The reasons for introducing it should therefore be good. That this is the case cannot be guaranteed from the outset. What can be offered here is a substitution of good reasons with high ambitions: the concept of ‘responsive self-preservation’ is designed to (...) illuminate the conditio humana. In all brevity the claim is that human beings are responsive beings. This means that they do not just exist. In order to do so, they must respond to their existence. On the one hand the inner drive and utmost aspiration in human responsiveness therefore lies in self-preservation. On the other hand self-preservation is thoroughly transformed when embedded into human responsiveness. The article will thus use the concept of responsiveness and the concept of self-preservation to mutually clarify each other – in order to open the possibilities and avoid the pitfalls in each of them. In doing so, it aspires to intervene in contemporary philosophical anthropology. (shrink)

Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has passed an amendment to the Public Health Act that would grant certain terminally ill patients an explicit right to continuous deep sedation until they pass away. Such a (...) framework would be unique in the world. In this paper we will highlight and reflect on four relevant aspects and shortcomings of the proposed bill. First, that the bill suggests that continuous deeps sedation should be considered as a sui generis practice. Second, that it requires that sedation should always be accompanied by the withholding of all artificial nutrition and hydration. In the most recently amended version of the legal proposal it is stated that life sustaining treatments are withheld unless the patient objects. Third, that the French bill would not require that the suffering for which continuous deep sedation is initiated is unbearable. Fourth, the question as to whether the proposal should be considered as a way to avoid having to decriminalise euthanasia and/or PAS or, on the contrary, as a veiled way to decriminalise these practices. The French proposal to amend the Public Health Act to include a right to continuous deep sedation for some patients is a unique opportunity to clarify the legality of continuous deep sedation as an end-of-life practice. Moreover, it would recognize that the practice of continuous deep sedation raises ethical and legal issues that are different from those raised by symptom control on the one hand and assisted dying on the other hand. Nevertheless, there are still various issues of significant ethical concern in the French legislative proposal. (shrink)

The Danish amateur scholar Christian Jürgensen Thomsen has often been described as a founder of modern “scientific” archaeology. Thomsen's innovation, this essay argues, reflects developments within neighboring fields, such as philology and history. He reacted against historians who limited themselves to histories of texts and therefore abandoned the earliest human history. Instead, he proposed a new history of objects, which included the entire history of humankind. Thomsen's work as director of the Royal Museum of Nordic Antiquities in Copenhagen was especially (...) important for this renewal. The arrangement of artifacts not only helped him formulate his theories, but also allowed him to present his arguments in a language of objects. At the same time, Thomsen's definition of archaeology as a museum science placed his branch of archaeology in a closer relationship with other museum sciences, such as geology and comparative anatomy. From the 1840s, Thomsen's museum became a model for how the study of human artifacts could deliver scientific insights into human nature and the laws of human development. (shrink)

1. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety and phobias are common in schizophrenia, and anxiety is often part of the dysphoric mood (A...

Recombination maps of ancestral species can be constructed from comparative analyses of genomes from closely related species, exemplified by a recently published map of the human‐chimpanzee ancestor. Such maps resolve differences in recombination rate between species into changes along individual branches in the speciation tree, and allow identification of associated changes in the genomic sequences. We describe how coalescent hidden Markov models are able to call individual recombination events in ancestral species through inference of incomplete lineage sorting along a genomic (...) alignment. In the great apes, speciation events are sufficiently close in time that a map can be inferred for the ancestral species at each internal branch ‐ allowing evolution of recombination rate to be tracked over evolutionary time scales from speciation event to speciation event. We see this approach as a way of characterizing the evolution of recombination rate and the genomic properties that influence it. (shrink)

Following considerable debate, the practice of euthanasia was legalized in Belgium in 2002, thereby making Belgium one of the few places in the world where this practice is legal. In 2014 the law was amended for the first time. The 2014 amendment makes euthanasia legally possible for all minors who repeatedly and voluntarily request euthanasia and who are judged to possess “capacity of discernment”, as well as fulfil a number of other criteria of due care. This extension of the 2002 (...) euthanasia law generated a lot of national and international debate and has been applauded by many and heavily criticized by others. This evolution is clearly of interest to end-of-life debates in the entire world. This paper will therefore describe how this amendment came to get passed using official documents from Belgium's Senate and Chamber of Representatives where this amendment was discussed and subsequently passed. Next, some of the most commonly given arguments in favour of the law are identified, as well as the arguments most often voiced against the amendment. All these arguments will be expanded upon and it will be examined whether they hold up to ethical scrutiny. Analysing the official documents and identifying the most commonly voiced arguments gives valuable insight into how Belgium came to amend its euthanasia law and why it did so in 2014. It also becomes clear that although the current amendment is often seen as far-reaching, more radical ideas were proposed during the drafting of the law. Also, in analysing those arguments in favour of the amendment and those against, it is clear that the validity of some of these is questionable. (shrink)

This contribution explores the connection between health and subjectivity. Up until recently a marginally discussed topic in health theories, recent critical research in health psychology introduces notions of subjectivity to theories of health. These notions can be linked to phenomenology, embodied subjectivity, and psychosocial theories that have moved away from a partial, internal understanding of subjectivity. These recent theories tend to define subjectivity as a coherence of concrete, embodied and situated subjectivity that extends capabilities and activities towards a world of (...) social relations. The article at hand shows that embodied and situated subjectivity is a basic function of health that sustains the qualities of human life. To comprehend health as a subjective practice in human lives, we need an understanding of people’s subjective participation in their everyday social lives. Hence, I will argue for the concept of conduct of life as an important concept for health psychology. The concept of conduct of life enables an analysis of how people conduct their activities and of their access to life possibilities, within social settings and societal power systems. The concept can be used to analyse the connection between subjectivity and health in the cultural and social relations by which people actually live. (shrink)

I en dobbelt forstand kan døden siges at være uomgængelig, og i en dobbelt forstand fremstår det som et uomgængeligt problem for vor livsglade civilisation, idag tilsyneladende mere end nogensinde.

1. Aritmofobi Adomo definerede en gang i sine senere år en musiker som et menneske på flugt fra sin matematiklærer 1) denne definition kan uden tvivl udstrækkes til at gælde størstedelen af de få overlevende, som endnu forsøger at praktisere en humanistisk tænkning på trods af existensen af en "totalt forvaltet verden" udenfor.

Name der Zeitschrift: Cognitive Linguistics Jahrgang: 27 Heft: 1 Seiten: 67-100.