Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses’ attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better (...) not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 62-64, June 2011.

Within a period of one year, two countries have enacted laws that articulate conditions under which euthanasia and physician assisted suicide are permitted. Belgium and the Netherlands thus distinguish themselves from all other countries of the world.In Belgium, palliative care organisations have been pro-actively involved in the debate on the contents of the law, highlighting that if euthanasia can ever be justified, it is necessary to provide good palliative care for all and to include in the euthanasia law what has (...) been called a palliative filter, i.e. a compulsory prior consultation with a specialised palliative care team. In the Netherlands, before the euthanasia law was enacted, there had been a policy of pragmatic tolerance for decades. The enactment itself did not give rise to intense debate. It can be questioned whether the new law would change anything at all since it only officially sanctioned an existing practice. This however does not mean that caregivers in palliative care, together with palliative care organisations, have not participated in the euthanasia debate.In the first part of this article the input of palliative care organisations in the Dutch euthanasia debate is described and explained by situating it in its broader context. First opinions on euthanasia of a variety of palliative care organisations are described. Secondly the Dutch debate on palliative care and euthanasia is analysed and evaluated. In a second part of this article a brief introduction to Belgian palliative care is given. This introduction is followed by an overview of the way organised palliative care has been active in the Belgian euthanasia debate. Attention too is given to the Belgian discussion on palliative sedation, sedation being presented by some as the palliative alternative to euthanasia but seen by others as nothing but euthanasia in disguise. (shrink)

Surveys carried out among palliative care physicians have shown that most participants do not support euthanasia and assisted suicide. Belgium, however, is one of the few countries in the world in which voluntary euthanasia is allowed by law. The potential influence of this legal dimension thus warranted a study of the attitudes of Belgian palliative care physicians toward euthanasia and assisted suicide. To this end, an anonymous self-administered questionnaire in Dutch was sent to all physicians working in Flemish palliative care. (...) 99 physicians responded .A majority of the physicians who responded are of the opinion that voluntary euthanasia can be ethically justified . Most physicians believe, nonetheless, that non-voluntary euthanasia is always unethical . More than three quarters of the respondents favour the inclusion of a ‘palliative filter’ in the law on euthanasia. Using a traditional cluster algorithm, the following three clusters were obtained: staunch advocates of euthanasia , opponents of euthanasia , and an intermediate group . There were no significant differences between the clusters on the level of gender, age, and years of experience in palliative care. A statistically significant association exists, however, between the euthanasia clusters and the religious or ideological clusters we had obtained in an earlier study. Church attending respondents are least likely to be staunch advocates of euthanasia. The majority of the physicians favour legalisation on assisted suicide. There is no significant association between the euthanasia clusters and attitudes toward assisted suicide.We conclude that although most Flemish palliative care physicians agree that there may be circumstances in which a euthanasia request is justified, they also strongly believe in the effects of good palliative care and want the ‘palliative filter’ to be included in the law on euthanasia. Religion and worldview are an important factor determining attitudes towards euthanasia. (shrink)

Background: Empirical studies in Muslim communities on organ donation and blood transfusion show that Muslim counsellors play an important role in the decision process. Despite the emerging importance of online English Sunni fatwas, these fatwas on organ donation and blood transfusion have hardly been studied, thus creating a gap in our knowledge of contemporary Islamic views on the subject.Method: We analysed 70 English Sunni e-fatwas and subjected them to an in-depth text analysis in order to reveal the key concepts in (...) the Islamic ethical framework regarding organ donation and blood transfusion.Results: All 70 fatwas allow for organ donation and blood transfusion. Autotransplantation is no problem at all if done for medical reasons. Allotransplantation, both from a living and a dead donor, appears to be possible though only in quite restricted ways. Xenotransplantation is less often mentioned but can be allowed in case of necessity. Transplantation in general is seen as an ongoing form of charity. Nearly half of the fatwas allowing blood transfusion do so without mentioning any restriction or problem whatsoever. The other half of the fatwas on transfusion contain the same conditional approval as found in the arguments pro organ transplantation.Conclusion: Our findings are very much in line with the international literature on the subject. We found two new elements: debates on the definition of the moment of death are hardly mentioned in the English Sunni fatwas and organ donation and blood transfusion are presented as an ongoing form of charity. (shrink)

Ever since the start of the twentieth century, a growing interest and importance of studying fatwas can be noted, with a focus on Arabic printed fatwas (Wokoeck 2009). The scholarly study of end-of-life ethics in these fatwas is a very recent feature, taking a first start in the 1980s (Anees 1984; Rispler-Chaim 1993). Since the past two decades, we have witnessed the emergence of a multitude of English fatwas that can easily be consulted through the Internet (‘e-fatwas’), providing Muslims worldwide (...) with a form of Islamic normative guidance on a huge variety of topics. Although English online fatwas do provide guidance for Muslims and Muslim minorities worldwide on a myriad of topics including end-of-life issues, they have hardly been studied. This study analyses Islamic views on (non-)voluntary euthanasia and assisted suicide as expressed in English Sunni fatwas published on independent—i.e. not created by established organisations—Islamic websites. We use Tyan’s definition of a fatwa to distinguish between fatwas and other types of texts offering Islamic guidance through the Internet. The study of e-fatwas is framed in the context of Bunt’s typology of Cyber Islamic Environments (Bunt 2009) and in the framework of Roy’s view on the virtual umma (Roy 2002). ‘(Non-)voluntary euthanasia and assisted suicide’ are defined using Broeckaert’s conceptual framework on treatment decisions at the end of life (Broeckaert 2008). We analysed 32 English Sunni e-fatwas. All of the e-fatwas discussed here firmly speak out against every form of active termination of life. They often bear the same structure, basing themselves solely on Quranic verses and prophetic traditions, leaving aside classical jurisprudential discussions on the subject. In this respect they share the characteristics central in Roy’s typology of the fatwa in the virtual umma. On the level of content, they are in line with the international literature on Islamic end-of-life ethics. English Sunni e-fatwas make up an influential and therefore important developing body of Islamic orthodox normative authority on end-of-life ethics that is still open for further research. (shrink)

First published in 1986, Knowledge, Belief, and Witchcraft remains the only analysis of indigenous discourse about an African belief system undertaken from within the framework of Anglo-American analytical philosophy. Taking as its point of departure W. V. O. Quine's thesis about the indeterminacy of translation, the book investigates questions of Yoruba epistemology and of how knowledge is conceived in an oral culture.

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim here is (...) to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

While many western countries now have large Muslim communities, relatively little scholarly attention is given to the attitudes of Muslims regarding end-of-life issues. Meanwhile, we receive strong and significant signals from physicians and pastoral care teams on the difficulty of discussing pain treatment with Muslim patients. With this study of Islamic views on pain control and palliative sedation in English Sunni e-fatwas we wish to make a contribution from the field of religious studies to a better understanding of how Muslim (...) patients balance their personal needs for pain treatment with the Islamic normative background. Using Broeckaert’s conceptual framework on treatment decisions in advanced disease, we conducted an in-depth analysis of English Sunni e-fatwas on pain control and palliative sedation. The e-fatwas were selected using Bunt’s typology of Cyber Islamic Environments and Tyan’s definition of a fatwa. We found that references to the use of sedative medication to reduce the consciousness of the patient for pain treatment were very scarce in the texts we analysed. Although the idea of patiently enduring pain is present in the e-fatwas, it does not dominate the discussion, since the alleviation of pain is equally encouraged. When the pain medication used is addictive, alters the patient’s state of consciousness or contains alcohol making it problematic from an Islamic normative point of view, the use of this type of medication can be permitted on the basis of a principle in Islamic jurisprudence: necessity permits breaking the law. The possible danger of death after the administration of high doses of pain medicine is countered based on the intention of the treating physician: he or she aims to alleviate the pain and not kill the patient. The study of English Sunni e-fatwas on pain and symptom control indicates the absence of an insurmountable ethical problem connected to the use of heavy pain medication. (shrink)

It is common to account for our senses on the basis of our sensory organs. One way of glossing why Aristotle famously counted five senses—and why his count became common sense in the West and elsewhere—is because there are five rather obvious organs of sense. In more modern accounts, this organ criterion of the senses has transformed into a neurobiological criterion; that is to say, part of what it means to be a sense is to have an associated organ with (...) appropriate physiological properties. For example, part of the claim that humans have a sense of vision is that we have a non-vestigial organ (the eye) that has cells (photoreceptors) especially sensitive to the properties of electromagnetic radiation. However, the nature of this “organ criterion” is a point of some contention. Is it a sufficient criterion? Necessary? To be called “vision” need the organ mediating it give rise to “visual experiences”? This chapter will consider the neurobiological criterion as it was originally presented in Aristotle and later reconceptualized in 19th-century neurophysiologist Johannes Müller’s “Law of Specific Nerve Energies.” By understanding the role of neurobiology in these accounts, we will be able to explore the deficiencies of contemporary accounts that downplay neurobiology in differentiating the senses. We will consider one of these accounts in detail: Alva Noë’s recent arguments in favor of an enactive approach to perceptual psychology. (shrink)

Most quantitative studies that survey nurses’ attitudes toward euthanasia and/or assisted suicide, also attempt to assess the influence of religion on these attitudes. We wanted to evaluate the operationalisation of religion and world view in these surveys. In the Pubmed database we searched for relevant articles published before August 2008 using combinations of search terms. Twenty-eight relevant articles were found. In five surveys nurses were directly asked whether religious beliefs, religious practices and/or ideological convictions influenced their attitudes, or the respondents (...) were requested to mention the decisional basis for their answers on questions concerning end-of-life issues. In other surveys the influence of religion and world view was assessed indirectly through a comparison of the attitudes of different types of believers and/or non-believers toward euthanasia or assisted suicide. In these surveys we find subjective religious or ideological questions (questions inquiring about the perceived importance of religion or world view in life, influence of religion or world view on life in general, or how religious the respondents consider themselves) and objective questions (questions inquiring about religious practice, acceptance of religious dogmas, and religious or ideological affiliation). Religious or ideological affiliation is the most frequently used operationalisation of religion and world view. In 16 surveys only one religious or ideological question was asked. In most articles the operationalisation of religion and world view is very limited and does not reflect the diversity and complexity of religion and world view in contemporary society. Future research should pay more attention to the different dimensions of religion and world view, the religious plurality of Western society and the particularities of religion in non-Western contexts. (shrink)

1.1 Manifolds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Tangent Vectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (...) . . . . . . . . . . . 7 1.3 Vector Fields, Integral Curves, and Flows . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 1.4 Tensors and Tensor Fields on Manifolds . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 1.5 The Action of Smooth Maps on Tensor Fields . . . . . . . . . . . . . . . . . . . . . . . . . 31 1.6 Lie Derivatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 1.7 Derivative Operators and Geodesics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 1.8 Curvature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 1.9 Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 1.10 Hypersurfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 1.11 Volume Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96.. (shrink)

В книге собраны статьи по актуальным вопросам политической теории, которые находятся в центре дискуссий отечественных и зарубежных философов и обществоведов. Книга имеет полемический характер и предназначена всем.

For German townsmen, life during the sixteenth and seventeenth centuries was characterized by a culture of arms, with urban citizenry representing the armed power of the state. This book investigates how men were socialized to the martial ethic from all sides, and how masculine identity was confirmed with blades and guns.

Background: Empirical studies in Muslim communities on organ donation and blood transfusion show that Muslim counsellors play an important role in the decision process. Despite the emerging importance of online English Sunni fatwas, these fatwas on organ donation and blood transfusion have hardly been studied, thus creating a gap in our knowledge of contemporary Islamic views on the subject. Method: We analysed 70 English Sunni e-fatwas and subjected them to an in-depth text analysis in order to reveal the key concepts (...) in the Islamic ethical framework regarding organ donation and blood transfusion. Results: All 70 fatwas allow for organ donation and blood transfusion. Autotransplantation is no problem at all if done for medical reasons. Allotransplantation, both from a living and a dead donor, appears to be possible though only in quite restricted ways. Xenotransplantation is less often mentioned but can be allowed in case of necessity. Transplantation in general is seen as an ongoing form of charity. Nearly half of the fatwas allowing blood transfusion do so without mentioning any restriction or problem whatsoever. The other half of the fatwas on transfusion contain the same conditional approval as found in the arguments pro organ transplantation. Conclusion: Our findings are very much in line with the international literature on the subject. We found two new elements: debates on the definition of the moment of death are hardly mentioned in the English Sunni fatwas and organ donation and blood transfusion are presented as an ongoing form of charity. (shrink)

We become ill in ways our parents and grandparents did not, with diseases unheard of and treatments undreamed of generations ago. This text tells the story of the modern experience of illness, linking ideas of illness, health, and postmodernism.

The sixteen essays in this volume confront the current debate about the relationship between philosophy and its history. On the one hand intellectual historians commonly accuse philosophers of writing bad - anachronistic - history of philosophy, and on the other, philosophers have accused intellectual historians of writing bad - antiquarian - history of philosophy. The essays here address this controversy and ask what purpose the history of philosophy should serve. Part I contains more purely theoretical and methodological discussion, of such (...) questions as whether there are 'timeless' philosophical problems, whether the issues of one epoch are commensurable with those of another, and what style is appropriate to the historiography of the subject. The essays in Part II consider a number of case-histories. They present important revisionist scholarship and original contributions on topics drawn from ancient, early modern and more recent philosophy. All the essays have been specially commissioned, and the contributors include many of the leading figures in the field. The volume as a whole will be of vital interest to everyone concerned with the study of philosophy and of its history. (shrink)

It is worthwhile comparing Hylomorphic and Animalistic accounts of personal identity since they both identify the human animal and the human person.The topics of comparison will be three: The first is accounting for our intuitions in cerebrum transplant and irreversible coma cases. Hylomorphism, unlike animalism, appears to capture “commonsense” beliefs here, preserves the maxim that identity matters, and does not run afoul of the Only x and y rule. The next topic of comparison reveals how the rival explanations of transplants (...) and comas are both at odds with some compelling biological assumptions. The third issue deals with our practical concerns, most notably, the possibility of an afterlife. It turns out that the hylomorphic treatment of Purgatory raises the spectra of the “too many thinkers” problem and some considerable unfairness. Contrary to expectations, an animalist insistence on uninterrupted bodily continuity between this life and the next does not involve deceptive body snatching. (shrink)

Philosophers have lately seized upon Sperling's partial report technique and subsequent work on iconic memory in support of controversial claims about perceptual experience, in particular that phenomenology overflows cognitive access. Drawing on mounting evidence concerning postdictive perception, I offer an interpretation of Sperling's data in terms of cue-sensitive experience which fails to support any such claims. Arguments for overflow based on change-detection paradigms (e.g. Landman et al., 2003; Sligte et al., 2008) cannot be blocked in this way. However, such paradigms (...) are fundamentally different from Sperling's and, for rather different reasons, equally fail to establish controversial claims about perceptual experience. (shrink)