This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

The expansion of livestock production throughout the world has led to increased demand for high protein animal feed. This expansion has created economic benefits for livestock farmers and other actors in the chain, but also resulted in environmental and social side effects. This study aims to identify a set of sustainability issues that cover the environmental, economic and social dimensions of soymeal and beef production chains. The method applied combines the results of multiple studies, including a literature review and stakeholder (...) surveys. Stakeholder surveys were conducted for three different interest groups and two geographical regions . Our results reveal that the selection of issues in most sustainability assessment studies is a relatively arbitrary decision, while the literature also states that identifying issues is an important step in a sustainability assessment. Defining sustainability issues from a whole chain perspective is important, as issues of sustainability emerge at various stages along the production chain, and are found to vary across stakeholders’ interests. Business stakeholders, for example, perceived economic issues to be more important, whereas the majority of consumer stakeholders and other stakeholders perceived social and environmental issues, respectively, to be more important. Different education levels, knowledge, and living patterns in various geographical regions can affect the stakeholders’ perceptions. The combination of a heterogeneous group of stakeholders and the consideration of multiple chain stages constitutes a useful approach to identify sustainability issues along food chains. (shrink)

Introduction Families of patients with dementia may need support in difficult end-of-life decision making. Such guidance may be culturally sensitive. Methods To support families in Canada, a booklet was developed to aid decision making on palliative care issues. For reasons of cost effectiveness and promising effects, we prepared for its implementation in Italy, the Netherlands and Japan. Local teams translated and adapted the booklet to local ethical, legal and medical standards where needed, retaining guidance on palliative care. Using qualitative content (...) analyses, we grouped and compared adaptations to understand culturally sensitive aspects. Results Three themes emerged: (1) relationships among patient, physician and other professionals—the authority of the physician was more explicit in adapted versions; (2) patient rights and family position—adding detail about local regulations; and (3) typology of treatments and decisions. Considerations underlying palliative care decisions were detailed (Dutch and Italian versions), and the Japanese version frequently referred to professional and legal standards, and life-prolongation was a competing goal. Text on artificial feeding or fluids and euthanasia was revised extensively. Conclusions Providing artificial feeding and fluids and discussing euthanasia may be particularly sensitive topics, and guidance on these subjects needs careful consideration of ethical aspects and possible adaptations to local standards and practice. The findings may promote cross-national debate on sensitive, core issues regarding end-of-life care in dementia. (shrink)

Automatized scalable healthcare support solutions allow real-time 24/7 health monitoring of patients, prioritizing medical treatment according to health conditions, reducing medical appointments in clinics and hospitals, and enabling easy exchange of information among healthcare professionals. With recent health safety guidelines due to the COVID-19 pandemic, protecting the elderly has become imperative. However, state-of-the-art health wearable device platforms present limitations in hardware, parameter estimation algorithms, and software architecture. This paper proposes a complete framework for health systems composed of multi-sensor wearable health (...) devices, high-resolution parameter estimation, and real-time monitoring applications. The framework is appropriate for real-time monitoring of elderly patients' health without physical contact with healthcare professionals, maintaining safety standards. The hardware includes sensors for monitoring steps, pulse oximetry, heart rate, and temperature using low-power wireless communication. In terms of parameter estimation, the embedded circuit uses high-resolution signal processing algorithms that result in an improved measure of the HR. The proposed high-resolution signal processing-based approach outperforms state-of-the-art HR estimation measurements using the photoplethysmography sensor. (shrink)

1. Naturalism Naturalism, it has been said, is the distinctive development in philosophy over the last thirty years. There has been a naturalistic turn away from the a priori methods of traditional philosophy to a conception of philosophy as continuous with natural science. The doctrine has been extensively discussed and has won considerable following in the USA. This is, on the whole, not true of Britain and continental Europe, where the pragmatist tradition never took root, and the temptations of scientism (...) in philosophy were less alluring. Contemporary American naturalism originates in the writings of Quine, the metaphysician of twentieth-century science. With extraordinary panache, he painted a largescale picture of human nature, of language and of the web of belief. I believe that in almost every major respect, it is, like the picture painted by Descartes, the great metaphysician of seventeenth-century science, mistaken. But it evidently appeals to the spirit of the times. So it is worthy of critical examination and careful refutation. I shall argue that the naturalistic turn is a cul-de-sac – a turn that is to be passed by if we are to keep to the highroad of good sense. Naturalism, like so many of Quine’s doctrines, was propounded in response to Carnap. As Quine understood matters, Carnap had been persuaded by Russell’s Our Knowledge of the External World that it is the task of philosophy to demonstrate that our knowledge of the external world is a logical construction out of, and hence can be reduced to, elementary experiences. Quine rejected the reductionism of Carnap’s Logischer Aufbau, and found the idealist basis uncongenial to his own dogmatic realist behaviourism, inspired by Watson and later reinforced by Skinner. The rejection of reductionism and ‘unregenerate realism’, Quine averred, were the sources of his naturalism (FME 72). What exactly was this? We can distinguish in Quine between three different but inter-related programmes for future philosophy: epistemological, ontological and philosophical naturalism. Naturalized epistemology is to displace traditional epistemology, transforming the investigation into ‘an enterprise within natural science’ (NNK 68) – a psychological enterprise of investigating how the ‘input’ of radiation, etc., impinging on the nerve endings of human beings can ‘ultimately’ result in an ‘output’ of our theoretical descriptions of the external world.. (shrink)

The mathematical works of the French philosopher Charles de Bovelles have received little attention from historians of scientific thought. At the University of Paris, Bovelles studied under Jacques Lefèvre d'Étaples, sharing with him a high regard for the Christian Neoplatonic philosophy of Nicholas of Cusa. One aspect of Cusanus's philosophy was particularly favoured by Lefèvre and Bovelles: the use of geometrical symbolism to provide mathematical guidance to the divine. While Lefèvre was preparing an edition of Cusanus's works , Bovelles wrote (...) a treatise of his own, in which the geometry of the five polyhedra was used to provide an approach to the mystery of the Trinity. Seen in the context of Renaissance syncretism of Platonism and Christianity, Bovelles's treatise adds a theological layer of interpretation to the literal meaning of the polyhedral physics described by Plato in the Timaeus. In so doing, it contributes to the discussion of a problem that was later to concern several Renaissance philosophers and cosmologists, including, at the end of the century, Johannes Kepler. (shrink)