Objectives: The objective of this study is to estimate the proportion of different types of end‐of‐life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium). The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practice. Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N=166) received an anonymous self‐administered mail questionnaire per death case (max. 5/doctor) Results: the response rate was 55% (...) (N=269). In 37.3% of all cases at least one ELD was made (16.5% non‐treatment decisions; 16% potential life‐shortening by intensifying the treatment of pain and symptoms; 4.8% administration, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristics were clearly related to the type of ELD. There was no influence of physician characteristics, except for commitment to life‐stance. In 71.3% of the cases the ELD was in no way discussed with the patient. 8.1% of the ELD‐cases were in response to a direct request from the patient Conclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviour of physicians at the end of their patients' life. The patient's and her family's entitlements to participation in the decision making process were rather poorly respected. (shrink)

International Rules brings together exemplary works from the most prominent approaches to international rules of International Law and International Relations disciplines. Included are chapters on Natural Law, Legal Positivism, Classical Realism, the New Haven School, Institutionalism, Structural Realism, the New Stream, and Feminist Voices. Each of the eight chapters begins with a brief overview, offers a representative work or works, and concludes with a selected bibliography. From Hugo Grotius to David Kennedy, from George Kennan to Robert Keohane, the featured (...) authors provide valuable insights into their common subject: international rules. Despite divergent methods and objectives, they address fundamentally the same questions: What is the nature of such rules? What is their purpose? How do they originate? What role, if any, do they play in politics? Framing the selections assembled are two original chapter-length essays. The first chapter of this volume assesses the prospects for interdisciplinary collaboration; the final one suggests a direction for future research. (shrink)

Rationale In Belgium, several policies regulating reimbursement of acid suppressant drugs and evidence-based recommendations for clinical practice were issued in a short period of time, creating a unique opportunity to observe their effect on prescribing. Aims and objectives To describe the evolution of prescriptions for acid suppressants and explore the interaction of policies and practice recommendations with prescribing patterns. Method Monthly claims-based data for proton pump inhibitors (PPIs) and H-2-antihistamines by general practitioners, internists and "astroenterologists were obtained from the Belgian (...) national health insurance database (1997-2005). The evolution of reimbursed defined daily doses and expenses after introduction of reimbursement regulations and dissemination of practice recommendations was explored. Results Recommendations had no impact on prescribing. All changes can be related to concomitant policies. Lifting reimbursement restrictions for cheaper products did not control growth or save costs in the Iona term. Only restricting reimbursement of all PPIs managed to curb the growth. We observed an unintended increase of non-omeprazole PPIs by gastroenterologists. Conclusions Reimbursement policies influence prescribing, but their effect can be unintended. A dialogue between policymakers and guideline developers, and evidence-based policies that are linked to clinical guidelines, could be an effective way to pursue both cost-containment and quality of care. (shrink)

Objectives: The objective of this study is to estimate the proportion of different types of end‐of‐life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium). The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practice.Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N=166) received an anonymous self‐administered mail questionnaire per death case (max. 5/doctor)Results: the response rate was 55% (N=269). In (...) 37.3% of all cases at least one ELD was made (16.5% non‐treatment decisions; 16% potential life‐shortening by intensifying the treatment of pain and symptoms; 4.8% administration, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristics were clearly related to the type of ELD. There was no influence of physician characteristics, except for commitment to life‐stance. In 71.3% of the cases the ELD was in no way discussed with the patient. 8.1% of the ELD‐cases were in response to a direct request from the patientConclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviour of physicians at the end of their patients' life. The patient's and her family's entitlements to participation in the decision making process were rather poorly respected. (shrink)

Background A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. Objectives To examine to what extent engagement in advance care planning practices, knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Design Survey study. Participants/setting The study involved a purposive sample of 14 nursing homes in Flanders, (...) Belgium. Nurses, care assistants and allied care staff completed a survey. Ethical considerations The study was approved by the University Hospital of Brussels, as part of a cluster randomized controlled trial. Results One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated. After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations and documented advance care planning ; differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses ; 95% confidence interval 0.08–0.17; p < 0.001) and allied staff scoring higher than care assistants. We found no significant differences regarding self-efficacy. Discussion While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Conclusions Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage. (shrink)

Several themes of David Lewis's theory of counterfactuals, especially their sensitivity to context, pave the way for a viable theory of non-trivial counterpossibles. If Lewis was successful in defending his account against the early objections, a semantics of counterpossibles can be defended from similar objections in the same way. The resulting theory will be extended to address 'might' counterfactuals and questions about the relative "nearness" of impossible worlds.

The Greek philosopher Aristotle, writing over two thousand years before Wall Street, called people who engaged in activities which did not contribute to society "parasites." In his latest work, renowned scholar Robert C. Solomon asserts that though capitalism may require capital, but it does not require, much less should it be defined by the parasites it inevitably attracts. Capitalism has succeeded not with brute strength or because it has made people rich, but because it has produced responsible citizens and--however (...) unevenly--prosperous communities. It cannot tolerate a conception of business that focuses solely on income and vulgarity while ignoring traditional virtues of responsibility, community, and integrity. Many feel that there is too much lip-service and not enough understanding of the importance of cooperation and integrity in corporate life. This book rejects the myths and metaphors of war-like competition that cloud business thinking and develops an "Aristotelean" theory of business. The author's approach emphasizes several core concepts: the corporation as community, the search for excellence, the importance of integrity and sound judgment, as well as a more cooperative and humane vision of business. Solomon stresses the virtues of honesty, trust, fairness, and compassion in the competitive business world, and confronts the problem of "moral mazes" and what he posits as its solution--moral courage. (shrink)

Perfect for students with no background in logic or philosophy, Simple Formal Logic provides a full system of logic adequate to handle everyday and philosophical reasoning. By keeping out artificial techniques that aren’t natural to our everyday thinking process, Simple Formal Logic trains students to think through formal logical arguments for themselves, ingraining in them the habits of sound reasoning. Simple Formal Logic features: a companion website with abundant exercise worksheets, study supplements (including flashcards for symbolizations and for deduction rules), (...) and instructor’s manual two levels of exercises for beginning and more advanced students a glossary of terms, abbreviations and symbols. This book arose out of a popular course that the author has taught to all types of undergraduate students at Loyola University Chicago. He teaches formal logic without the artificial methods–methods that often seek to solve farfetched logical problems without any connection to everyday and philosophical argumentation. The result is a book that teaches easy and more intuitive ways of grappling with formal logic–and is intended as a rigorous yet easy-to-follow first course in logical thinking for philosophy majors and non-philosophy majors alike. (shrink)

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

This important book charts the development of philosophical thinking about history over the past 250 years, combining extracts from key texts with new explanatory and critical discussion. The book is designed to make the work of thinkers such as Hume, Herder, Hegel, Dilthey, Nietzsche, Heidegger and Foucault accessible to students with no prior knowledge of Western philosophy. An introductory section is followed by nine further chapters exploring contrasting schools of thought. The volume reveals the origins of contemporary trends in the (...) discipline and relates wider philosophical reflections to the study of history itself. It also points to connections between philosophy of history and literary and cultural theory which have developed in recent decades. (shrink)

Plausibly, no agent ever performs an action without some desire to perform that action. If so, a regress argument shows that, given incompatibilism, we are only rarely free. The argument sidesteps recent objections to this thesis.

Contemporary philosophers have grown increasingly skeptical toward both morality and moral theory. Some argue that moral theory is a radically misguided enterprise that does not illuminate moral practice, while others simply deny the value of morality in human life. In this important new book, Louden responds to the arguments of both "anti-morality" and "anti-theory" skeptics. In Part One, he develops and defends an alternative conception of morality, which, he argues, captures more of the central features of both Aristotelian and Kantian (...) ethics than do other contemporary models, and enables the central importance of morality to be convincingly reaffirmed. In Louden's model, morality is primarily a matter of what one does to oneself, rather than what one does or does not do to others. This model eliminates the gulf that many anti-morality critics say exists between morality's demands and the personal point of view. Louden further argues that morality's primary focus should be on agents and their lives, rather than on right actions, and that it is always better to be morally better--i.e. it is impossible to be "too moral." Part Two presents Louden's alternative conception of moral theory. Here again he draws on the work of Aristotle and Kant, showing that their moral theories have far more in common than is usually thought, and that those features that they share can be the basis for a viable moral theory that is immune to the standard anti-theory objections. Louden reaffirms the necessity and importance of moral theory in human life, and shows that moral theories fulfill a variety of genuine and indispensable human needs. (shrink)

Against the historically widespread view that divine conservation is a continuation of the act of creation, William Lane Craig argues that conservation is a different kind of act since, unlike creation ex nihilo, it is diachronic and it acts on a patient. Timothy Miller poses a timing objection against Craig's view, arguing that on such a view either the existence of a conserved entity is discontinuous, or the conserving activity overdetermines its effect, or the conserving activity is not continuous. The (...) present paper explores the options that remain for a diachronic, agent-patient account of conservation. It includes several models of conservation on which divine activity is continuous but not overdetermined since its effect at each time is something less specific than the existence of a created being at a time. (shrink)

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

A recently advanced argument for purgatory hinges on the need for complete sanctification before one can enter heaven. The argument has a modal gap.The gap can be exploited to fashion a competing account of how sanctification occurs in the afterlife according to which it is in part a heavenly process.The competing account usefully complicates the overall case for purgatory and raises questions about how the notion ought to be understood.

The best arguments for possible worlds as states of affairs furnish us with equally good arguments for impossible worlds of the same sort. I argue for a theory of impossible worlds on which the impossible worlds correspond to maximal inconsistent classes of propositions. Three objections are rejected. In the final part of the paper, I present a menu of impossible worlds and explore some of their interesting formal properties.

This is a paradigmatic work of contemporary philosophy.

In this enduring text, renowned philosopher Robert C. Solomon provides students with a detailed introduction to modern existentialism.

Robert Stern investigates how scepticism can be countered by using transcendental arguments concerning the necessary conditions for the possibility of experience, language, or thought. He shows that the most damaging sceptical questions concern neither the certainty of our beliefs nor the reliability of our belief-forming methods, but rather how we can justify our beliefs.

How are justified belief and rational belief related? Some philosophers think that justified belief and rational belief come to the same thing. Others take it that justification is a matter of how well a particular belief is supported by the evidence, while rational belief is a matter of how well a belief coheres with a person’s other beliefs. In this paper, I defend the view that justification is a dimension of rationality, a view that can make sense of both of (...) these conflicting accounts. When it modifies belief, ‘rational’ is a multidimensional adjective, as there are multiple dimensions along which a belief can be rational. I will argue that one of these dimensions is justification, an account that can not only explain why philosophers give diverging theories of the relationship between justified belief and rational belief, but can also reveal why rational belief and justified belief are closely related despite being distinct. (shrink)

This chapter focuses on one of the common fallacies in Western philosophy called “adverse consequences”. The argument from adverse consequences can be seen as an argument that is intended to be pragmatic ‐ about what we should do, not about what is true ‐ but then comes to the wrong kind of conclusion. In many genuinely pragmatic arguments, however, adverse consequences are relevant to the conclusion and no fallacy is committed. So it is important to notice exactly what the conclusion (...) of the argument is. (shrink)

This entry provides a brief exposition and formal reconstruction of the argument for possible worlds in David Lewis's _Counterfactuals_.

The theory of possible worlds has permeated analytic philosophy in recent decades, and its best versions have a consequence which has gone largely unnoticed: in addition to the panoply of possible worlds, there are a great many impossible worlds. A uniform ontological method alone should bring the friends of possible worlds to adopt impossible worlds, I argue, but the theory's applications also provide strong incentives. In particular, the theory facilitates an account of counterfactuals which avoids several of the implausible results (...) of David Lewis's account, and it paves the way for the analogues of Kripkean semantics for epistemic and relevant logics. On the theories of possible worlds as abstract objects, worlds bear a strong resemblance to propositions. I contend that if there are distinct necessarily false propositions, then there are likewise distinct impossible worlds. However, one who regards possible worlds as concrete objects must not recognize impossible worlds, in part because concrete worlds cannot misrepresent certain features of reality, as some impossible worlds must. Accordingly, I defend and develop a theory of impossible worlds as maximal impossible states of affairs. Impossible worlds perform admirably in the analysis of counterfactuals with impossible antecedents. I argue that, contrary to standard accounts, not all counterpossibles are trivially true, and I develop a Lewis-style semantics which allows this result. The point is crucial, since many views presuppose that some counterpossibles are substantive philosophical truths. Finally, I show that impossible worlds hold great promise for doxastic and relevant logics. Epistemic logic needs a domain of propositions which is not closed under strict implication to avoid the problem of logical omniscience, and relevant logic needs such a domain to avoid the famous paradoxes of implication. In sum, impossible world theory promises natural, elegant solutions to philosophical problems in numerous areas where possible worlds alone flounder. These solutions come to most possible world theorists at no cost, since the existence of impossible worlds is entailed by theses they already hold. (shrink)

Robert Hanna presents a fresh view of the Kantian and analytic traditions that have dominated continental European and Anglo-American philosophy over the last two centuries, and of the connections between them. But this is not just a study in the history of philosophy, for out of this emerges Hanna's original approach to two much-contested theories that remain at the heart of contemporary philosophy. Hanna puts forward a new 'cognitive-semantic' interpretation of transcendental idealism, and a vigorous defense of Kant's theory (...) of analytic and synthetic necessary truth, making this compelling reading for all who are interested in these fundamental philosophical issues. (shrink)

Permissivism says that for some propositions and bodies of evidence, there is more than one rationally permissible doxastic attitude that can be taken towards that proposition given the evidence. Some critics of this view argue that it condones, as rationally acceptable, sets of attitudes that manifest an untenable kind of arbitrariness. I begin by providing a new and more detailed explication of what this alleged arbitrariness consists in. I then explain why Miriam Schoenfield’s prima facie promising attempt to answer the (...) Arbitrariness Objection, by appealing to the role of epistemic standards in rational belief formation, fails to resolve the problem. Schoenfield’s strategy is, however, a useful one, and I go on to explain how an alternative form of the standards-based approach to Permissivism – one that emphasizes the significance of the relationship between people’s cognitive abilities and the epistemic standards that they employ – can respond to the arbitrariness objection. (shrink)

In this essay I discuss an important but neglected controversy in which the Stoics sought to discredit Epicurus' teaching on justice by showing that the Epicurean wise man, if immune from detection or punishment, will commit injustice whenever he may profit from it. Under the influence of this criticism, tradition has developed a view of Epicurus' position that makes it so weak and vulnerable that it is difficult to see how Epicureans could have defended it over the course of several (...) centuries. There is decisive evidence, however, that Epicurus' critics seriously misrepresented his position, and that the tradition influenced by their polemic stands in need of fundamental revision.1 My purpose here is to prove that the Epicurean wise man will not commit injustice, secretly or openly, because it is in his self–interest to be just; to reconstruct Epicurus' arguments for this teaching; to show how he defends his position against natural right theorists; and to clarify the larger issues at stake in his controversy with the Stoics. I begin by sketching the Stoic criticisms and the Epicurean response. (shrink)

IntroductionBurnout is a growing problem among young researchers, affecting individuals, organizations and society. Our study aims to identify burnout profiles and highlight the corresponding job demands and resources, resulting in recommendations to reduce burnout risk in the academic context.MethodsThis cross-sectional study collected data from young researchers at five Flemish universities through an online survey measuring burnout risk, work engagement, sleeping behavior, and the most prominent job demands and resources. We conducted Latent Profile Analysis to identify burnout profiles in young researchers (...) and subsequently compared these groups on job demands and resources patterns.ResultsFive burnout profiles were identified: High Burnout Risk, Cynical, Overextended, Low Burnout Risk, and No Burnout Risk. Each burnout profile was associated with a different pattern of job demands and resources. For instance, high levels of meaningfulness decreased the odds to being classified in the Cynical profile.ConclusionOur findings show that the Cynical profile corresponds to a relatively high number of young researchers, which may imply that they are particularly vulnerable to the cynicism dimension of burnout. Additionally, work-life interference and perceived publication pressure seemed the most significant predictors of burnout risk, while meaningfulness, social support from supervisor and learning opportunities played an important protective role. (shrink)

Offering a unique and wide-ranging examination of the theory of knowledge, the new edition of this comprehensive collection deftly blends readings from the foremost classical sources with the work of important contemporary philosophical thinkers. Human Knowledge: Classical and Contemporary Approaches, 3/e, offers philosophical examinations of epistemology from ancient Greek and Roman philosophy (Plato, Aristotle, Sextus Empiricus); medieval philosophy (Augustine, Aquinas); early modern philosophy (Descartes, Locke, Leibniz, Berkeley, Hume, Reid, Kant); classical pragmatism and Anglo-American empiricism (James, Russell, Ayer, Lewis, Carnap, Quine, (...) Rorty); and other influential Anglo-American philosophers (Chisholm, Kripke, Moore, Wittgenstein, Strawson, Putnam). Organized chronologically and thematically, Human Knowledge, 3/e, features exceptionally broad coverage and nontechnical selections that are easily accessible to students. An ideal text for both undergraduate and graduate courses in epistemology, it is enhanced by the editors' substantial general introduction, section overviews, and up-to-date bibliographies. The third edition offers expanded selections on contemporary epistemology and adds selections by Thomas Reid, Richard Rorty, David B. Annis, Richard Feldman and Earl Conee, Ernest Sosa, Barry Stroud, and Louise M. Antony. Human Knowledge, 3/e, offers an unparalleled introduction to our ancient struggle to understand our own intellectual experience. (shrink)

One of our great behavioral scientists, the bestselling author of Behave, plumbs the depths of the science and philosophy of decision-making to mount a devastating case against free will, an argument with profound consequences Robert Sapolsky's Behave, his now classic account of why humans do good and why they do bad, pointed toward an unsettling conclusion: We may not grasp the precise marriage of nature and nurture that creates the physics and chemistry at the base of human behavior, but (...) that doesn't mean it doesn't exist. Now, in Determined, Sapolsky takes his argument all the way, mounting a brilliant (and in his inimitable way, delightful) full-frontal assault on the pleasant fantasy that there is some separate self telling our biology what to do. Determined offers a marvelous synthesis of what we know about how consciousness works-the tight weave between reason and emotion and between stimulus and response in the moment and over a life. One by one, Sapolsky tackles all the major arguments for free will and takes them out, cutting a path through the thickets of chaos and complexity science and quantum physics, as well as touching ground on some of the wilder shores of philosophy. He shows us that the history of medicine is in no small part the history of learning that fewer and fewer things are somebody's "fault"; for example, for centuries we thought seizures were a sign of demonic possession. Yet, as he acknowledges, it's very hard, and at times impossible, to uncouple from our zeal to judge others and to judge ourselves. Sapolsky applies the new understanding of life beyond free will to some of our most essential questions around punishment, morality, and living well together. By the end, Sapolsky argues that while living our daily lives recognizing that we have no free will is going to be monumentally difficult, doing so is not going to result in anarchy, pointlessness, and existential malaise. Instead, it will make for a much more humane world. (shrink)

Classical American pragmatism: the pragmatist -- Enlightenment-and its problematic semantics -- Analyzing pragmatism: pragmatics and pragmatisms -- A Kantian rationalist pragmatism: pragmatism -- Inferentialism, and modality in Sellars's arguments against -- Empiricism -- Linguistic pragmatism and pragmatism about norms: an arc of -- Thought from Rorty's eliminative materialism to his pragmatism -- Vocabularies of pragmatism: synthesizing naturalism and -- Historicism -- Towards an analytic pragmatism: meaning-use analysis -- Pragmatism, expressivism, and anti-representationalism: -- Local and global possibilities.