This paper deals with the explanation the maxim of relevance provides for the way utterances in argumentative discourse follow each other in an orderly and coherent fashion. Several senses are distinguished in which utterances can be considered relevant. It is argued that an utterance can be considered relevant as an interactional act, as an illocutionary act, as a propositional act, and as an elocutionary act. These four kinds of relevance manifest the rational organization of discourse, which is aimed at bringing (...) about mutual alignment between the participants, enabling them jointly to work out certain interactional outcomes that are acceptable to both of them. (shrink)

In this article, the conceptual instrument that pragma-dialectical argumentation theory offers is elaborated for the analysis and evaluation of problem-solving discussions. The elaboration is aimed expressly at taking into account the discussion character of the discourse, in order to show how the developing process evolves and what the obstacles are therein. In addition, it focuses expressly on the verbal behaviour of the participants and on showing how this behaviour controls the evolving process. The analysis and evaluation is based on insights (...) and methods of conversational analysis and discourse analysis. One fragment of a problem-solving discussion is analysed and evaluated. (shrink)

In this article, the conceptual instrument that pragma-dialectical argumentation theory offers is elaborated for the analysis and evaluation of problem-solving discussions. The elaboration is aimed expressly at taking into account the discussion character of the discourse, in order to show how the developing process evolves and what the obstacles are therein. In addition, it focuses expressly on the verbal behaviour of the participants and on showing how this behaviour controls the evolving process. The analysis and evaluation is based on insights (...) and methods of conversational analysis and discourse analysis. One fragment of a problem-solving discussion is analysed and evaluated. (shrink)

This paper deals with the explanation the maxim of relevance provides for the way utterances in argumentative discourse follow each other in an orderly and coherent fashion. Several senses are distinguished in which utterances can be considered relevant. It is argued that an utterance can be considered relevant as an interactional act, as an illocutionary act, as a propositional act, and as an elocutionary act. These four kinds of relevance manifest the rational organization of discourse, which is aimed at bringing (...) about mutual alignment between the participants, enabling them jointly to work out certain interactional outcomes that are acceptable to both of them. (shrink)

This paper explores the possibilities for strategic maneuvering of the argumentative technique that Perelman and Olbrechts-Tyteca (The New Rhetoric. A Treatise on Argumentation, University of Notre Dame Press, Notre Dame/London, 1969) called dissociation. After an exploration of the general possibilities that dissociation may have for enhancing critical reasonableness and rhetorical effectiveness, the use of dissociation in the successive stages of a critical discussion is examined. For each stage, first, the dialectical moves that dissociation can be employed in are specified, then, (...) the specific ways in which dissociation contributes to fulfilling the dialectical tasks that are associated with these moves are delineated, and, finally, the rhetorical gain that␣dissociation can bring in the fulfillment of these tasks is discussed. Some general conclusions are drawn for research that aims at understanding the potential of an argumentative technique for strategic maneuvering. (shrink)

In this article, the pragma-dialectical model of a critical discussion is demonstrated to provide a useful instrument for discovering causes of an unsatisfactory development of problem-solving discussions. First a sketch is given of the development of a problem-solving discussion which, in the opinion of the participants themselves, developed in an unsatisfactory fashion. Then it is argued that this development can be traced back to flaws in the execution of the stages of a critical discussion.

In this article, after arguing that present approaches to improving problem-solving discussions for various reasons are not satisfactory, I turn to the pragma-dialectic approach to argumentative discourse to derive a normative framework that can serve as a point of departure to enhance the quality of problem-solving discussions. I then show how this approach can be used as analytical and evaluative instrument that can help the analyst to establish whether participants in actual practice act in a fashion that is in accord (...) with the norms posited. Two real-life problem-solving discussions provide the material for this demonstration. (shrink)

In this article, after arguing that present approaches to improving problem-solving discussions for various reasons are not satisfactory, I turn to the pragma-dialectic approach to argumentative discourse to derive a normative framework that can serve as a point of departure to enhance the quality of problem-solving discussions. I then show how this approach can be used as analytical and evaluative instrument that can help the analyst to establish whether participants in actual practice act in a fashion that is in accord (...) with the norms posited. Two real-life problem-solving discussions provide the material for this demonstration. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (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.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Although euthanasia and assisted suicide in people with psychiatric disorders is relatively rare, the increasing incidence of EAS requests has given rise to public and political debate. This study aimed to explore support of the public and physicians for euthanasia and assisted suicide in people with psychiatric disorders and examine factors associated with acceptance and conceivability of performing EAS in these patients. A survey was distributed amongst a random sample of Dutch 2641 citizens and 3000 physicians. Acceptance and conceivability of (...) performing EAS, demographics, health status and professional characteristics were measured. Multivariable logistic regression analyses were performed. Of the general public 53% were of the opinion that people with psychiatric disorders should be eligible for EAS, 15% was opposed to this, and 32% remained neutral. Higher educational level, Dutch ethnicity, and higher urbanization level were associated with higher acceptability of EAS whilst a religious life stance and good health were associated with lower acceptability. The percentage of physicians who considered performing EAS in people with psychiatric disorders conceivable ranged between 20% amongst medical specialists and 47% amongst general practitioners. Having received EAS requests from psychiatric patients before was associated with considering performing EAS conceivable. Being female, religious, medical specialist, or psychiatrist were associated with lower conceivability. The majority of the psychiatrists were of the opinion that it is possible to establish whether a psychiatric patient’s suffering is unbearable and without prospect and whether the request is well-considered. The general public shows more support than opposition as to whether patients suffering from a psychiatric disorder should be eligible for EAS, even though one third of the respondents remained neutral. Physicians’ support depends on their specialization; 39% of psychiatrists considered performing EAS in psychiatric patients conceivable. The relatively low conceivability is possibly explained by psychiatric patients often not meeting the eligibility criteria. (shrink)

Considering Pragma-Dialectics honors the monumental contributions of one of the foremost international figures in current argumentation scholarship: Frans van Eemeren. The volume presents the research efforts of his colleagues and addresses how their work relates to the pragma-dialectical theory of argumentation with which van Eemeren’s name is so intimately connected. This tribute serves to highlight the varied approaches to the study of argumentation and is destined to inspire researchers to advance scholarship in the field far into the future. Replete with (...) contributions from highly-esteemed academics in argumentation study, chapters in this volume address such topics as: *Pragma-dialectic versus epistemic theories of arguing and arguments; *Pragma-dialectics and self-advocacy in physician-patient interactions; *The pragma-dialectical analysis of the ad hominem family; *Rhetoric, dialectic, and the functions of argument; and *The semantics of reasonableness. As an exceptional volume and a fitting tribute, this work will be of interest to all argumentation scholars considering the astute insights and scholarly legacy of Frans van Eemeren. (shrink)

Considering Pragma-Dialectics honors the monumental contributions of one of the foremost international figures in current argumentation scholarship: Frans van Eemeren. The volume presents the research efforts of his colleagues and addresses how their work relates to the pragma-dialectical theory of argumentation with which van Eemeren’s name is so intimately connected. This tribute serves to highlight the varied approaches to the study of argumentation and is destined to inspire researchers to advance scholarship in the field far into the future. Replete with (...) contributions from highly-esteemed academics in argumentation study, chapters in this volume address such topics as: *Pragma-dialectic versus epistemic theories of arguing and arguments; *Pragma-dialectics and self-advocacy in physician-patient interactions; *The pragma-dialectical analysis of the ad hominem family; *Rhetoric, dialectic, and the functions of argument; and *The semantics of reasonableness. As an exceptional volume and a fitting tribute, this work will be of interest to all argumentation scholars considering the astute insights and scholarly legacy of Frans van Eemeren. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

Summary This article discusses the development of German Social Democratic Party strategy in the fourth quarter of the nineteenth century and the first decade of the twentieth, as a result of the works of Friedrich Engels and Karl Kautsky. It ties the evolution of Marxist orthodoxy to the emergence of parliamentary democracy in different European societies. In particular, it discusses the way parliamentary conditions impacted on how the proletarian revolution was imagined. Revolution was newly defined as the establishment through parliamentary (...) means of a new government representing a new social class. Also, the early Marxist strategy of ?permanent revolution?, which had allowed proletarian-socialist minority rule, was abandoned. (shrink)

This article argues that the 'permanent revolution' represented the dominant element in Karl Marx and Friedrich Engels' political discourse, and that it tended to overrule considerations encapsulated in 'historical materialism'. In Marx and Engels's understanding, permanent revolution did not represent a historical shortcut under exceptional circumstances, but the course revolutions in the modern era would normally take. Marx and Engels traced back the pattern to the sixteenth century. It is argued here that, in Marx and Engels, the proletarian revolution does (...) not enter the historical agenda when industrial capitalism reaches the stage of integral development, but immediately after the bourgeois revolution, even in semi-developed countries like Germany and > France where the industrial proletariat formed only a small section of the population. Marx and Engels worked out a political rather than an economic sociology of revolution. (shrink)

This article treats Stalin's contributions todialectical and historical materialism. It argues that the latterfound his theses of the `enormous' role of ideas, and of theexistence of social phenomena that do not belong either to thebasis or to the superstructure, in Georgij Plekhanov's `monism'.Nevertheless, Stalin did add some new points of his own.Furthermore, his adopting Plekhanov's monism also helps usunderstand the apparent contradiction between Stalin's emphasison non-economic and non-class factors in human history and hisrejection of `idealist' rudiments in dialectics.

This article concerns the research done by the author in Stalin's private library. The notes made in the works of Marx, Engels and Lenin suggest that until the end of his life Stalin felt himself in general agreement with these "classics." The choice of books and the notes support the thesis that, despite his historical interest and his identification with some of the tsars as powerful rulers, Stalin always continued to consider himself a Marxist, and that he was uninterested in (...) other systems of thought, including those of traditional Russia. (shrink)

How do we measure happiness? Focusing on subjective measures as a proxy for welfare and well-being, this book finds ways to do that. Subjective measures have been used by psychologists, sociologists, political scientists, and, more recently, economists to answer a variety of scientifically and politically relevant questions. Van Praag, a pioneer in this field since 1971, and Ferrer-i-Carbonell present in this book a generally applicable methodology for the analysis of subjective satisfaction. Drawing on a range of surveys on people's satisfaction (...) with their jobs, income, housing, marriages, and government policy, among other areas of life, this book shows how satisfaction with life "as a whole" is an aggregate of these domain satisfactions. Using German, British, Dutch, and Russian data, the authors cover a wide range of topics. This groundbreaking book presents a new and fruitful methodology that constitutes a welcome addition to the social sciences. The paperback edition has been revised to bring the literature review up-to-date and the chapter on poverty has been revised and extended to take account of new research. (shrink)

The Gesta Normannorum Ducum is one of the most important sources for the history of Normandy and England in the eleventh and twelfth centuries, and contains the earliest prose account of the Norman Conquest. It was written by a succession of authors, the first of whom was William of Jumieges, who wrote for William the Conqueror. Later historians, such as Orderic Vitalis and Robert of Torigni, interpolated and extended the chronicle as far as King Henry I. The later accretions reveal (...) much not only about changing attitudes towards the Norman invasion of England, but also about views of the early Viking foundations of Normandy.Elisabeth van Houts's two-volume edition is based on a study of all forty-seven extant manuscripts of the Gesta, including the earliest surviving copy of c. 1100, unknown until very recently. The full original text of William of Jumieges is supplied, as well as the integral text of the subsequent revisions and additions. Volume I contains Dr van Houts's introduction to the whole work, together with the text and translation of books i-iv. Volume II contains books v-viii. The edition forms an important contribution to our understanding of Anglo-Norman politics. (shrink)

A adoção de um catálogo constitucional de direitos e o fortalecimento do judicial review, trouxeram como consequência a judicialização da política em inúmeras democracias, onde se verifica uma expansão da atuação do Poder Judiciário em detrimento das esferas representativas do Estado. Neste contexto, tem se observado em países do Sul Global, o emprego de novos mecanismos procedimentais em casos que envolvem a violação contínua e generalizada de direitos fundamentais, de alguns grupos menos favorecidos, decorrente de bloqueios políticos e institucionais, denominados (...) de “litígios estruturais”. (shrink)

Until 1917 Lenin and Trotsky believed that an isolated revolutionary Russia would have no chance of survival. However, from 1917 to 1923 Lenin's standpoint on this matter underwent a complete reversal. First he came to the conclusion that socialism could be built in an isolated Russia, although it would remain incomplete in the absence of the world revolution. By 1923 he was abandoning that latter qualification too. The standpoint of Stalin and Bukharin in the debate on socialism in one country (...) of 1925–26 was more orthodox-Leninist than the position taken by Trotsky, who had at first also embraced the notion of incomplete socialism, but subsequently returned to the old concept, abandoned by Lenin, that the restoration of capitalism was inevitable in the absence of the world revolution. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

ABSTRACTBoth auditory and visual emotional memories can be made less emotional by loading working memory during memory recall. Taxing WM during recall can be modality specific (giving an audit...

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up to (...) 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)