This paper describes a pilot study of a new model for narrative medicine training, “community-based participatory narrative medicine”, which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants’ experiences of the workshop series identified three major themes: the reciprocal and collaborative nature of participants’ relationships; the interplay between self-reflection and receiving feedback from others; and the clinical and pedagogical implications (...) of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented. (shrink)

Three experiments examined whether the mere priming of potential action effects enhances people’s feeling of causing these effects when they occur. In a computer task, participants and the computer independently moved a rapidly moving square on a display. Participants had to press a key, thereby stopping the movement. However, the participant or the computer could have caused the square to stop on the observed position, and accordingly, the stopped position of the square could be conceived of as the potential effect (...) resulting from participants’ action of pressing the stop key. The location of this position was primed or not just before participants had to stop the movement. Results showed that priming of the position enhanced experienced authorship of stopping the square. Additional experimentation demonstrated that this priming of agency was not mediated by the goal or intention to produce the effect. (shrink)

Although community is a core sociological concept, its meaning is often left vague. In this article it is pointed out that it is a social form that has deep connections with human social nature. Human social life and human social history can be seen as unflagging struggles between two contradictory behavioral modes: reciprocity and status competition. Relative to hunter-gatherer societies, present society is a social environment that strongly seduces to engage in status competition. But at the same time evidence increases (...) that communal living is strongly associated with well being and health. A large part of human behavior and of societal processes are individual and collective expressions of on the one hand succumbing to the seductions of status competition and one the other hand attempts to build and maintain community. In this article some contemporary examples of community maintaining, enrichment and building are discussed. The article concludes with a specification of structural conditions for community living and a short overview of ways in which the Internet affects these conditions. (shrink)

Although community is a core sociological concept, its meaning is often left vague. In this article it is pointed out that it is a social form that has deep connections with human social nature. Human social life and human social history can be seen as unflagging struggles between two contradictory behavioral modes: reciprocity and status competition. Relative to hunter-gatherer societies, present society is a social environment that strongly seduces to engage in status competition. But at the same time evidence increases (...) that communal living is strongly associated with well being and health. A large part of human behavior and of societal processes are individual and collective expressions of on the one hand succumbing to the seductions of status competition and one the other hand attempts to build and maintain community. In this article some contemporary examples of community maintaining, enrichment and building are discussed. The article concludes with a specification of structural conditions for community living and a short overview of ways in which the Internet affects these conditions. (shrink)

The current model of technology assessment treats ethics itself as just another problem‐solving technology. Ethics should resist this model to play a more critical role in technology assessment by better understanding the complex relationship between society, medicine, and technology—and by recasting how problems are defined.

This contribution discusses the expression ‘Image of the Father’ as a case in point to Aquinas's approach of naming Christ: Christology and Trinitarian theology, as well as the discussion of analogical naming in divinis, need to be taken together. ‘Image’ and ‘Father’ are predicated differently of Christ and God the Father than of human beings. Moreover, God is ‘Father’ in a different way towards the Son than regarding human beings. Christ is the unique image of the Father: the invisible image (...) of the invisible Father. (shrink)

Originally the Adoro te devote was not a liturgical hymn but a prayer, probably intended by Thomas Aquinas for personal use when attending mass. Quoting the at present most reliable version of the poem, the author studies Adoro te devote from the angle of transformation: poetic, Eucharistic and mystic or eschatological transformation. Structure and form are analysed, and a number of themes discussed: two alternative interpretations of adoration, several concepts of truth intended in the poem, the good thief and doubting (...) Thomas as symbols of moral and spiritual imperfection, and living in connection, in union with God. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

The contemporary philosophy of medicine may be characterized as a continuous struggle with the Cartesian heritage, in order to reach a more satisfying image of man. This paper outlines the influence of Cartesian dualism on the foundations of medicine.The notion of a real distinction between the mental and physical, particularly the mechanistic conception of the human body, made possible the development of the natural sciences as well as scientific medicine, not hampered any longer by the risk of colliding with religion (...) or Church. (shrink)

The hippocampal formation is known for its importance in conscious, declarative memory. Here, we report neuroimaging evidence in humans for an additional role of the hippocampal formation in nonconscious memory. We maskedly presented combinations of faces and written professions such that subjects were not aware of them. Nevertheless, the masked presentations activated many of the brain regions that unmasked presentations of these stimuli did. To induce a nonconscious retrieval of the faces and face-associated occupational information, subjects were instructed to view (...) the previously masked faces and to guess the professional category of each person—academic, artist, and workman. Guessing the professional category of previously masked versus new faces activated the left and right hippocampal formation and right perirhinal cortex as well as bilateral fusiform areas and fronto-temporal areas known to mediate the retrieval of semantic information. These activations within the semantic processing system suggest that conceptual knowledge acquired during masking was nonconsciously retrieved. Our data provide clues to an analogous role of the hippocampus in conscious and nonconscious memory. (shrink)

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

The concept of ‘geneticization’ has been introduced in the scholarly literature to describe the various interlocking and imperceptible mechanisms of interaction between medicine, genetics, society and culture. It is argued that Western culture currently is deeply involved in a process of geneticization. This process implies a redefinition of individuals in terms of DNA codes, a new language to describe and interpret human life and behavior in a genomic vocabulary of codes, blueprints, traits, dispositions, genetic mapping, and a gentechnological approach to (...) disease, health and the body. This article analyses the thesis of ‘geneticization’. Explaining the implications of the thesis, and discussing the critical refutations, it is argued that ‘geneticization’ primarily is a heuristic tool that can help to re-focus the moral debate on the implications of new genetic knowledge towards interpersonal relations, the power of medicine, the cultural context and social constraints, rather than emphasizing issues as personal autonomy and individual rights. (shrink)

Two experiments examined similarities and differences in the effects of consciously and unconsciously perceived rewards on the active maintenance of goal-relevant information. Participants could gain high and low monetary rewards for performance on a word span task. The reward value was presented supraliminally or subliminally at different stages during the task. In Experiment 1, rewards were presented before participants processed the target words. Enhanced performance was found in response to higher rewards, regardless whether they were presented supraliminally or subliminally. In (...) Experiment 2, rewards were presented after participants processed the target words, i.e., during maintenance. Performance increased in response to relatively high rewards when they were presented subliminally, but decreased when they were presented supraliminally. We conclude that both consciously and unconsciously perceived rewards boost resources supporting the maintenance of task-relevant information. Conscious processing of rewards can, however, heavily interfere with an ongoing maintenance process and impair performance. (shrink)

Research has shown the importance of engaging in networking behaviors for employees’ career success. Networking behaviors can be seen as a proactive way of creating access to career-related social resources and we argue that this type of proactive career behaviors might be particularly relevant for freelancers who cannot depend on an organizational career system supporting their further development, yet whose careers are characterized by high levels of uncertainty and unpredictability. To date, however, our understanding of how freelancers, being a category (...) of workers that are deprived of an organizational context of support for career development, can safeguard their employability, is limited. Therefore, this study addresses this gap and investigates whether freelancers’ networking behaviors are positively associated with career outcomes, through the mediating role of the need for relatedness fulfillment and employability-enhancing competencies. Hypotheses are tested via Structural Equation Modelling using a sample of 1,874 freelancers from Belgium, France, Germany, the Netherlands and the United Kingdom. The results generally support our hypotheses, providing evidence for a significant association between networking behaviors and need for relatedness fulfillment, and between networking behaviors and employability-enhancing competencies. Moreover, we found a significant association between need for relatedness fulfillment and employability-enhancing competencies, being the mediators in our research model and the outcomes of career satisfaction and future career opportunities. Implications for career development in the contemporary workplace are discussed, with particular attention for need for relatedness fulfillment, employability, and sustainable careers of freelance workers. (shrink)

Solidarity belongs to the basic principles of Catholic Social Teaching (CST) and is part of the ethical repertoire of European moral traditions and European healthcare systems. This paper discusses how leaders of Catholic healthcare organizations (HCOs) can understand their institutional moral responsibility with regard to the preservation of solidarity. In dealing with this question, we make use of Taylor's philosophy of modern culture. We first argue that, just as all HCOs, Catholic ones also can embody and strengthen solidarity by just (...) doing their quintessential job, that is, to care for people with ill health. Second, we focus on the Catholic identity of these organizations and argue that this characteristic can empower a radical commitment to solidarity. Finally, we argue that CST provides a critical ethical framework for approaching solidarity from the perspective of the common good. (shrink)

In 1970 Van Rensselaer Potter was the first to use the term "bioethics" in a publication to advocate the development of a new discipline to address the basic problems of human flourishing. This article analyzes Potter's notion of bioethics in order to understand its origins, sources, and substance. In early publications, Potter conceptualized bioethics as a bridge: between present and future, nature and culture, science and values, and finally between humankind and nature. In later publications, disappointed by a predominant focus (...) on individual and medical issues, and with a wish to underscore the need for a broader perspective, Potter introduced the new term "global bioethics," meant to transcend ethics specialties and integrate them into a new interdisciplinary endeavor to address global problems. A growing interest in global bioethics today means that Potter's original insights are more timely than ever. (shrink)

Background: Spirometry for early detection of chronic obstructive pulmonary disease and smoking cessation is criticised because of the potential negative effects of labelling with disease. Aim: To assess the effects of opinions of smokers with mild to moderate COPD on the effectiveness of spirometry for smoking cessation, the justification of early detection of airflow limitation in smokers and the impact of confrontation with COPD. Design: Qualitative study with data from a randomised controlled trial. Setting: General population of Dutch and Belgian (...) Limburg. Methods: Semistructured ethical exit interviews were conducted with 205 smokers who were motivated to quit smoking and had no prior diagnosis of COPD but were detected with airflows limitation by means of spirometry. They received either counselling, including labelling with COPD, plus with nortriptyline for smoking cessation, counselling excluding labelling with COPD, plus nortriptyline for smoking cessation or care as usual for smoking cessation by the general practitioner, without labelling with COPD. Results: Of the participants, 177 agreed or completely agreed that it is justified to measure lung function in heavy smokers. These participants argued that measuring lung function raises consciousness of the negative effects of smoking, helps to prevent disease or increases motivation to stop smoking. Most of the 18 participants who disagreed argued that routinely measuring lung function in smokers would interfere with freedom of choice. Conclusions: Labelling with disease is probably a less important issue in the discussion about the pros and cons of early detection of COPD. (shrink)