If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

Health checks identify disease in individuals without a medical indication. More and more checks are offered by more providers on more risk factors and diseases, so we may speak of an omnipresence of health checks. Current ethical evaluation of health checks considers checks on an individual basis only. However, omnipresent checks have effects over and above the effects of individual health checks. They might give the impression that health is entirely manageable by individual actions and strengthen the norm of individual (...) responsibility for health to the point where people hold themselves and others responsible for health outcomes they cannot reasonably be held accountable for. This process of so-called ‘over-responsibilization’ may result in increased feelings of guilt over health, decreased health solidarity and unfairly distributed health outcomes. Moreover, effects on privacy and peace of mind may be observed. Taking into account all possible harms and benefits of health checks in their ethical evaluation requires evaluation of health checks on an individual basis as well as on the level of all checks. Therefore, we urge the amendment of existing ethical evaluation to include the effects of an omnipresence of health checks. We make a first attempt at the formulation of amended criteria. (shrink)

Health checks identify disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as ‘personal health checks’. Health check providers’ perspective of ‘good’ health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for ‘good’ health checks, and the role these criteria play in their practices. Providers unanimously formulate a (...) number of minimal criteria: Checks must focus on treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health checks potential conflicts between criteria and underlying values should be explicated, guidance in weighing of criteria should be provided and the larger context should be taken into account: other actors than providers need to take up responsibility, and ideally benefits and harms of health checks should be weighed against other measures targeting disease. (shrink)

Health checks or health screenings identify disease in people without a specific medical indication. So far, the perspective of health check users has remained underexposed in discussions about the ethics and regulation of health checks. In 2017, we conducted a qualitative study with lay people from the Netherlands. We asked what participants consider characteristics of good and bad health checks, and whether they saw a role for the Dutch government. Participants consider a good predictive value the most important characteristic of (...) a good health check. Information before, during and after the test, knowledgeable and reliable providers, tests for treatable disease, respect for privacy, no unnecessary health risks and accessibility are also mentioned as criteria for good health checks. Participants make many assumptions about health check offers. They assume health checks provide certainty about the presence or absence of disease, that health checks offer opportunities for health benefits and that the privacy of health check data is guaranteed. In their choice for provider and test they tend to rely more on heuristics than information. Participants trust physicians to put the interest of potential health check users first and expect the Dutch government to intervene if providers other than physicians failed to do so by offering tests with a low predictive value, or tests that may harm people, or by infringing the privacy of users. Assumptions of participants are not always justified, but they may influence the choice to participate. This is problematic because choices for checks with a low predictive value that do not provide health benefits may create uncertainty and may cause harm to health; an outcome diametrically opposite to the one intended. Also, this may impair the relationship of trust with physicians and the Dutch government. To further and protect autonomous choice and to maintain trust, we recommend the following measures to timely adjust false expectations: advertisements that give an accurate impression of health check offers, and the installation of a quality mark. (shrink)

This paper is an update of the documents we have concerning the Acts of the Christian martyrs, focused on three main aspects: 1) the kind of acts we know of and their classification from the point of view of their historic value; 2) the versions or editions of the texts that are most accepted by scholars; 3) the relevance of the different parts that make up these documents in order to discern the original text from passages that were rewritten or (...) underwent later variations. In this way, the article offers an exhaustive list of the documents for use in researching Christian martyrs in the Roman period. (shrink)

In recent literature, panpsychism has been defended by appeal to two main arguments: first, an argument from philosophy of mind, according to which panpsychism is the only view which successfully integrates consciousness into the physical world (Strawson 2006; Chalmers 2013); second, an argument from categorical properties, according to which panpsychism offers the only positive account of the categorical or intrinsic nature of physical reality (Seager 2006; Adams 2007; Alter and Nagasawa 2012). Historically, however, panpsychism has also been defended by appeal (...) to a third argument based on considerations about the nature and observability of causation. This argument has not been much discussed in recent times. Here is a concise version from William James: "… the concrete perceptual flux, taken just as it comes, offers in our own activity-situations perfectly comprehensible instances of causal agency … If we took these experiences as the type of what actual causation is, we should have to ascribe to cases of causation outside of our life, to physical cases also, an inwardly experiential nature. In other words, we should have to espouse a so-called “pan-psychic” philosophy" (James 1911: 218). James here suggests that we have direct experience of causation in our own agency. He thereby directly contradicts David Hume, who famously denied that we have any experience of causation. James goes on to claim that if this experience is representative of causation in general, it follows that all causation is mental, and that panpsychism is true. This kind of argument for panpsychism can be called the argument from (experience of) causation. This chapter offers, first, a history of this argument and arguments closely related to it, and second, an analysis of the argument – is it valid, are its premises in any way defensible, and how does it relate to the other, more popular arguments for panpsychism from philosophy of mind and categorical properties? (shrink)

Ibn al-ʻArabī, 1165-1240; views on freedom; Sufism; Islamic philosophy.

Greek text, english translation and commentary on the surviving fragments of Empedocles (fragments as known in 1981, does not include more recent finds).

Contrary to Vaesen's argument that humans are unique with respect to nine cognitive capacities essential for tool use, we suggest that although such cognitive processes contribute to variation in tool use, it does not follow that these capacities arenecessaryfor tool use, nor that tool use shaped cognition per se, given the available data in cognitive neuroscience and behavioral biology.

Cardiovascular health checks test risk factors for cardiovascular disease. They are offered to improve health: in case of an increased risk, participants receive lifestyle advice and medication. With this review, we investigate what is known about the reasons why people do or do not test for CVD risk factors. To what extent do these reasons relate to health monitoring and/or improvement? And do reasons differ in different contexts in which health checks are offered? We conducted a literature search and included (...) 22 papers in which we identified a broad range of motives. We conclude that people have reasons to test related to health improvement and reasons other than health improvement, practical reasons related to the way health checks are offered play an important role and motives should be understood in the context of the situation in which health checks are offered. Our results are relevant for public health officials and providers of health checks: first, if people undergo testing for reasons unrelated to health, this could explain why participation in health checks does not necessarily lead to health improvement. Second, efforts to improve uptake not necessarily serve justice and may hamper informed consent. (shrink)

There are obvious benefits to be gained from the study of logic: heightened ability to express ideas clearly and concisely, increased skill in defining one's terms, enlarged capacity to formulate arguments rigorously and to analyze them critically. But the greatest benefit, in my judgment, is the recognition that reason can be applied in every aspect of human affairs.

This paper is devoted to the study of some subvarieties of the variety Qof Q-Heyting algebras, that is, Heyting algebras with a quantifier. In particular, a deeper investigation is carried out in the variety Q 3 of three-valued Q-Heyting algebras to show that the structure of the lattice of subvarieties of Qis far more complicated that the lattice of subvarieties of Heyting algebras. We determine the simple and subdirectly irreducible algebras in Q 3 and we construct the lattice of subvarieties (...) (Q 3 ) of the variety Q 3. (shrink)

Traditional Chinese commentators rightly see that understanding Zhuangzi's way with words is the presupposition for understanding Zhuangzi at all. They are not sure, however, if Zhuangzi's words are super-effective or pure nonsense. I consider Zhuangzi's experience with language, and then turn to Heidegger's word of being to see if it may throw light on Zhuangzi's way of saying. I argue that a conversation between Heidegger and Zhuangzi on language is possible, but only by expanding Heidegger's notion of Gestell and through (...) a destruction of the dominant Confucian discourse that obscures Zhuangzi's way of saying. (shrink)

Introduction Max Horkheimer was born on February in Stuttgart. By the time he died, on 7 July in Nuremberg, he had played a decisive role in launching and ...

The philosophical problem of mental causation concerns a clash between commonsense and scientific views about the causation of human behaviour. On the one hand, commonsense suggests that our actions are caused by our mental states—our thoughts, intentions, beliefs and so on. On the other hand, neuroscience assumes that all bodily movements are caused by neurochemical events. It is implausible to suppose that our actions are causally overdetermined in the same way that the ringing of a bell may be overdetermined by (...) two hammers striking it at the same time. So how are we to reconcile these two views about the causal origins of human behaviour? One philosophical doctrine effects a nice reconciliation. Neuralism, or the token-identity theory, states that every particular mental event is a neurophysiological event and that every action is a physically specifiable bodily movement. If these identities hold, there is no problem of causal overdetermination: the apparently different causal pathways to the behaviour are actually one and the same pathway viewed from different perspectives. This attractively simple view is enjoying a recent revival in fortunes. (shrink)

For the theorists of crisis, the revolutionary state comes into existence through violence, and due to its inability to provide an authoritative katechon (restrainer) against internal and external violence, it perpetuates violence until it self-destructs. Writing during extreme economic depression and growing social and political violence, the crisis theorists––Joseph de Maistre, Juan Donoso Cortés, and Carl Schmitt––each sought to blame the chaos of their time upon the Janus-faced postrevolutionary ideals of liberalism and socialism by urging a return to pre-revolutionary moral (...) and religious values. They are united by three counterrevolutionary principles, all of which are purported to remedy revolutionary violence: traditional constitutional fidelity, the philosophy of the decision, and opposition to bourgeois liberalism. This essay is followed by the first complete English translation and publication of Donoso’s letter of October 24, 1851, which contains Donoso’s only reference to the “discussing class,” a political entity later popularized by Schmitt in his 1922 work Political Theology. (shrink)

Several variants of Lewis's Best System Account of Lawhood have been proposed that avoid its commitment to perfectly natural properties. There has been little discussion of the relative merits of these proposals, and little discussion of how one might extend this strategy to provide natural property-free variants of Lewis's other accounts, such as his accounts of duplication, intrinsicality, causation, counterfactuals, and reference. We undertake these projects in this paper. We begin by providing a framework for classifying and assessing the variants (...) of the Best System Account. We then evaluate these proposals, and identify the most promising candidates. We go on to develop a proposal for systematically modifying Lewis's other accounts so that they, too, avoid commitment to perfectly natural properties. We conclude by briefly considering a different route one might take to developing natural property-free versions of Lewis's other accounts, drawing on recent work by Williams. (shrink)

"My work has had nothing to do with gay liberation," Michel Foucault reportedly told an admirer in 1975. And indeed there is scarcely more than a passing mention of homosexuality in Foucault's scholarly writings. So why has Foucault, who died of AIDS in 1984, become a powerful source of both personal and political inspiration to an entire generation of gay activists? And why have his political philosophy and his personal life recently come under such withering, normalizing scrutiny by commentators as (...) diverse as Camille Paglia, Richard Mohr, Bruce Bawer, Roger Kimball, and biographer James Miller? David M. Halperin's Saint Foucault is an uncompromising and impassioned defense of the late French philosopher and historian as a galvanizing thinker whose career as a theorist and activist will continue to serve as a model for other gay intellectuals, activists, and scholars. A close reading of both Foucault and the increasing attacks on his life and work, it explains why straight liberals so often find in Foucault only counsels of despair on the subject of politics, whereas gay activists look to him not only for intellectual inspiration but also for a compelling example of political resistance. Halperin rescues Foucault from the endless nature-versus-nurture debate over the origins of homosexuality ("On this question I have absolutely nothing to say," Foucault himself once remarked) and argues that Foucault's decision to treat sexuality not as a biological or psychological drive but as an effect of discourse, as the product of modern systems of knowledge and power, represents a crucial political breakthrough for lesbians and gay men. Halperin explains how Foucault's radical vision of homosexuality as a strategic opportunity for self-transformation anticipated the new anti-assimilationist, anti-essentialist brand of sexual identity politics practiced by contemporary direct-action groups such as ACT UP. Halperin also offers the first synthetic account of Foucault's thinking about gay sex and the future of the lesbian and gay movement, as well as an up-to-the-minute summary of the most recent work in queer theory. "Where there is power, there is resistance," Michel Foucault wrote in The History of Sexuality, Volume I. Erudite, biting, and surprisingly moving, Saint Foucault represents Halperin's own resistance to what he views as the blatant and systematic misrepresentation of a crucial intellectual figure, a misrepresentation he sees as dramatic evidence of the continuing personal, professional, and scholarly vulnerability of all gay activists and intellectuals in the age of AIDS. (shrink)

Perhaps more than any philosophy written in the past few centuries, the work of Friedrich Nietzsche has given rise to controversy, misunderstanding, and dissent. Today Nietzsche is remembered as the revolutionary author of such polemical ideas as the death of God, the revaluation of values, the will to untruth, and the Übermensch. Yet is Nietzsche’s philosophy as atheistic, relativistic, nihilistic, and immoral as some commentators have claimed? Or ought we perhaps to give more credence to Nietzsche’s own assertion that one (...) writes books “precisely to conceal what one harbors” (BGE, 9, 289)? If “whatever is profound loves masks” (BGE, 2, 40) then might Nietzsche’s more daring claims be interpreted as clever masks behind which he conceals a deeper philosophy and on which he reveals a hidden truth? Is it not possible that the standard readings of Nietzsche are in fact misreadings—that his work invites misreading, that it is intentionally unclear, deceptive, disguised? The goal of this volume is to reread Nietzsche for all that he shows and all that he hides. It is to dig deeper into his work in order to challenge misreadings of old and invite misreadings anew—as, indeed, his work itself calls for and demands. (shrink)