Volume 20, Issue 8, August 2020, Page 104-106.

The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse the guideline's argumentation strategy with which euthanasia is demarcated from palliative sedation. First, we will analyse the guideline's main premise, which entails that palliative sedation is normal medical treatment. After this, we will critically discuss three crucial propositions of (...) the guideline that are used to support this premise: (1) the patient's life expectancy should not exceed 2 weeks; (2) the aim of the physician should be to relieve suffering and (3) expert consultation is optional. We will conclude that, if inherent problematic aspects of palliative sedation are taken seriously, palliative sedation is less normal than it is now depicted in the guideline. (shrink)

It is unclear what proper remuneration for surrogacy is, since countries disagree and both commercial and altruistic surrogacy have ethical drawbacks. In the presence of cross-border surrogacy, these ethical drawbacks are exacerbated. In this article, we explore what would be ethical remuneration for surrogacy, and suggest regulations for how to ensure this in the international context. A normative ethical analysis of commercial surrogacy is conducted. Various arguments against commercial surrogacy are explored, such as exploitation and commodification of surrogates, reproductive capacities, (...) and the child. We argue that, although commodification and exploitation can occur, these problems are not specific to surrogacy but should be understood in the broader context of an unequal world. Moreover, at least some of these arguments are based on symbolic rhetoric or they lack knowledge of real-world experiences. In line with this critique we argue that commercial surrogacy can be justified, but how and under what circumstances depends on the context. Surrogates should be paid a sufficient amount and regulations should be in order. In this article, the Netherlands and India are case examples of contexts that differ in many respects. In both contexts, surrogacy can be seen as a legitimate form of work, which requires the same wage and safety standards as other forms of labor. Payments for surrogacy need to be high enough to avoid exploitation by underpayment, which can be established by the mechanisms of either minimum wage, or Fair-Trade guidelines. An international treaty governing commercial surrogacy should be in place, and local professional bodies to protect the interests of surrogates should be required. Commercial surrogacy should be permitted across the globe, which would also reduce the need for intended parents to seek surrogacy services abroad. (shrink)

The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...) of facilitator implies that respondents want to think along with and assist researchers in order to help medical science progress. As educators, the respondents want to raise ethical and methodological awareness of researchers. The role of advisor implies that respondents bring in their own expertise. The role of assessor points to contributing to the overall evaluation of the research proposal. Various tensions were identified within and between roles. Within the role of protector, a tension is experienced between paternalism and autonomy. Between the role of protector and facilitator tensions occur when the value of a study is questioned while risks and burdens for the subjects are negligible. Within the role of assessor, a tension is felt between the implicit nature of judgments and the need for more explicit formulations. Awareness of various roles and responsibilities may prevent one-sided views on MREC work, not only by members themselves, but also by researchers. Tensions within and between the roles require reflection by MREC members. (shrink)

The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...) of facilitator implies that respondents want to think along with and assist researchers in order to help medical science progress. As educators, the respondents want to raise ethical and methodological awareness of researchers. The role of advisor implies that respondents bring in their own expertise. The role of assessor points to contributing to the overall evaluation of the research proposal. Various tensions were identified within and between roles. Within the role of protector, a tension is experienced between paternalism and autonomy. Between the role of protector and facilitator tensions occur when the value of a study is questioned while risks and burdens for the subjects are negligible. Within the role of assessor, a tension is felt between the implicit nature of judgments and the need for more explicit formulations. Awareness of various roles and responsibilities may prevent one-sided views on MREC work, not only by members themselves, but also by researchers. Tensions within and between the roles require reflection by MREC members. (shrink)

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)

This article discusses the latest developments regarding euthanasia and palliative care in the Netherlands. On the one hand, a legally codified practice of euthanasia has been established. On the other hand, there has been a strong development of palliative care. The combination of these simultaneous processes seems to be rather unique. This contribution first focuses on these remarkable developments. Subsequently, the analysis concentrates on the question of how these new developments have influenced the ethical debate.

Dutch euthanasia and physician-assisted suicide stand on the eve of important legal changes. In the summer of 1999, a new government bill concerning euthanasia and physician-assisted suicide was sent to Parliament for discussion. This bill legally embodies a ground for exemption from punishment for physicians who conduct euthanasia or physician-assisted suicide and comply with certain requirements. On November 28, 2000, the Dutch parliament approved an adapted version of this bill. Since the approval by the Dutch Senate can be regarded as (...) a formality, it is expected that the bill will come into force in the course of this year (2001). In this paper we discuss these new developments. (shrink)

Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress.

Si l’héroïsme médiéval s’élabore avant tout, dans sa composante guerrière, au masculin singulier, la tradition narrative française prévoit néanmoins quelques espaces à l’expression de la prouesse féminine. Du xiie au xve siècle, les romans illustrent plusieurs figures d’amazones ou de veuves viriles. Cependant, cette promotion à l’héroïsme semble difficile à concevoir dans le cas de personnages féminins assumant le rôle d’épouse ou d’amante. Pour vérifier cette constatation, l’enquête se tourne vers les romans idylliques qui ont connu un certain succès au (...) Moyen Age. La relation d’amour réciproque et relativement égalitaire pourrait nous laisser croire que les jeunes amants sont susceptibles de partager le renom de leurs aventures. L’analyse de plusieurs romans montre qu’il n’en est rien. Une exception cependant permet de distinguer le Roman de Floriant et Florete et surtout sa source directe, Erec et Enide de Chrétien de Troyes comme ferment possible d’un héroïsme de l’épouse. (shrink)

In this paper I build a case for considering the pioneering behaviourist philosopher Grace de Laguna as one of the grandmothers of analytic philosophy. I argue against the ‘Great Men’ narrative of analytic philosophy as composed of Moore, Russell, Wittgenstein and their followers, and in favour of a more inclusive ‘movement’ narrative of analytic philosophy as a broad and varied movement with an anti-idealist and naturalistic orientation aimed at fitting around novel development in the sciences, including Einsteinian physics and psychology. (...) I compare de Laguna’s prescient early views to Whitehead’s; both share an anti-idealist but also anti-atomist solution to the problem of perception, and both oppose the bifurcation of nature, with de Laguna expressing these views before Whitehead did. I conclude that while both opposed the narrower project of logical atomism, both count as ancestors of the wider analytic movement. (shrink)

This comment on 'Economic theories and their Dueling interpretations' questions the descriptive adequacy of the ‘sociology of economics' proposed by Gilboa, Postlewaite, Samuelson, and Schmeidler (GPSS) (2022). We ask whether economists still perceive the role of microeconomic theory as central as do GPSS. In particular, is present-day economics unified by the principles of maximising, subject to constraints and equilibrium analysis? We argue that this is not the case. GPSS’ appeal to the interpretative flexibility of economic theories appears apologetic, especially the (...) suggestion that theories and models, which once were considered positive descriptions or predictive instruments, are now cast as analytical or methodological exercises. We conclude on a more constructive note, drawing from the recent philosophical discussion of modelling which, quite paradoxically, grants highly idealized and simplified models a more important role than GPSS appear to allow. (shrink)

Jules Janssens a construit une œuvre importante, qui, pour de nombreux chercheurs, a ouvert des perspectives de recherches nouvelles et fécondes. Ses travaux ont fait date. Ils portent principalement sur la philosophie d'Avicenne, ses sources, ses rapports avec la pensée musulmane, son influence sur la théologie ash'arite (al-Ghazālī, Fakhr al-Dīn al-Rāzī) et sa réception dans le monde latin. Pour lui rendre hommage, quatorze collègues et amis de renommée internationale se sont réunis pour poursuivre ses réflexions sur ces thèmes. L'ouvrage (...) qui en est issu offre un état des lieux de la recherche contemporaine sur Avicenne et sa postérité arabo-latine. (shrink)

An odd dissensus between confident metaphysicians and neopragmatist antimetaphysicians pervades early twenty-first century analytic philosophy. Each faction is convinced their side has won the day, but both are mistaken about the philosophical legacy of the twentieth century. More historical awareness is needed to overcome the current dissensus. Lewis and his possible-world system are lionised by metaphysicians; Quine’s pragmatist scruples about heavy-duty metaphysics inspire antimetaphysicians. But Lewis developed his system under the influence of his teacher Quine, inheriting from him his empiricism, (...) his physicalism, his metaontology, and, I will show in this paper, also his Humeanism. Using published as well as never-before-seen unpublished sources, I will make apparent that both heavy-duty metaphysicians and neopragmatist antimetaphysicians are wrong about the roles Quine and Lewis played in the development of twentieth-century philosophy. The two are much more alike than is commonly supposed, and Quine much more instrumental to the pedigree of current metaphysics. (shrink)

Die Frage, ob es eine Geschichte der Weisen gibt, in denen Menschen sich selbst erleben, also eine Geschichte des Subjekts, wird vielfach als eine der sozialen Gebilde dargestellt, die den Einzelnen formen oder 'subjektivieren'. Sie kann sich aber auch auf die wechselnden Formen beziehen, in denen das Subjektsein selbst historisch beschrieben wurde, in all den variierenden Theorieentwürfen, die in der Psychologie, Philosophie, Anthropologie und den anderen Humanwissenschaften aufeinander folgten. Der Band untersucht die These, dass dieses theoretische Selbstwissen mehr bedeutet als (...) eine bloße Reihe ideengeschichtlicher Positionen; dass die Geschichte des Selbstwissens also von größerer Bedeutung für die Geschichte des Subjekts ist, als bisher vielfach zugestanden wurde. Das setzt einen Dialog zwischen (sozialwissenschaftlicher) Subjektivierungstheorie und (geisteswissenschaftlicher) Wissensgeschichte voraus, zu dem der Band eine Vorlage bildet. Mit Beiträgen von:Thomas Alkemeyer, Jens Elberfeld, Christiane Frey, Malte Griesse, Sandra Janßen, Hans-Jörg Rheinberger, Katja Rothe, Laurens Schlicht, Jakob Tanner, Daniel Wrana. (shrink)

Ce volume offre l'édition critique de la traduction latine médiévale (partielle) de la troisième partie de la Physique du Shif?' d'Avicenne. Pour l'édition de la peine première partie traduite à Tolède, qui couvre le prologue et le début du premier chapitre, les mêmes principes ont été maintenus que pour l'édition du second traité. Quant à l'édition de la majeure partie, qui fut traduite à Burgos quasiment un siècle après la tolédane et qui n'a été conservée que dans un seul témoin, (...) les cas où la traduction latine ne correspond pas à la lecture du texte arabe sont analysés de façon particulière et, autant que possible, expliqués sur la base de considérations philologiques et/ou doctrinales. En outre, dans la mesure du possible, les sources historiques des doctrines évoquées par Avicenne dans l'ensemble de ces chapitres ont été précisés. (shrink)

W.V. Quine, a champion of philosophical naturalism and pioneer of mathematical logic, was one of the most important philosophers of the 20th century. This volume provides a full picture of the development of Quine's views on structure and how it permeates and shapes his attitude to a range of philosophical questions.

Examines the early works of German-Jewish philosopher Leo Strauss (1899-1973).

Social media (SM) influence young adults’ communication practices. Artificial Intelligence (AI) is increasingly used for making recommendations on SM. Yet, its effects on different generations of SM users are unknown. SM can use AI recommendations to sort texts and prioritize them, shaping users’ online and offline experiences. Current literature primarily addresses technological or human-user perspectives, overlooking cognitive perspectives. This research aims to propose methods for mapping users’ interactions with AI recommendations (AiRS) and analyzes how embodied interactions mediated by a digital (...) agent can lead to changes in social and cultural practices. For this, this work proposes a comparative analysis of central practices evoked by AI recommendations-mediated communication on SM among users in Italy, Estonia, and the Netherlands in the age category 18–26 years old. The data used in the comparative analysis was collected via semi-structured interviews and elaborated based on cognitive psychology and semiotics. This research highlights the contextual significance of AI recommendations as a mediator in creating new communication practices. Findings confirm that young adults often choose practices that would enhance their digital representations according to AiRS’ dominant patterns and categories. AiRS impacts individual interpretations and practices and can further affect social and cultural levels. (shrink)

_Examines the early works of German-Jewish philosopher Leo Strauss._.

How do people interleave attention when multitasking? One dominant account is that the completion of a subtask serves as a cue to switch tasks. But what happens if switching solely at subtask boundaries led to poor performance? We report a study in which participants manually dialed a UK-style telephone number while driving a simulated vehicle. If the driver were to exclusively return his or her attention to driving after completing a subtask (i.e., using the single break in the xxxxx-xxxxxx representational (...) structure of the number), then we would expect to see a relatively poor driving performance. In contrast, our results show that drivers choose to return attention to steering control before the natural subtask boundary. A computational modeling analysis shows that drivers had to adopt this strategy to meet the required performance objective of maintaining an acceptable lateral position in the road while dialing. Taken together these results support the idea that people can strategically control the allocation of attention in multitask settings to meet specific performance criteria. (shrink)

The feminist movement was from its start in the 19th century involved in the struggle for better health care for women. The first feminists aimed at better information on birth control and sexuality. The second feminist wave focused on the unequal division of power roles between men and women. A lot of the problems women experienced could be seen as a consequence of their subordinate role in society. At the end of the 1980s and in the 1990s, the discipline women (...) and health or women and medicine was developed. In this introduction to the theme, the developments in this discipline are described. The starting points of the new discipline followed the principles of ‘women’s health care’. These principles can be summarized as the emphasis on control and autonomy by the patient, demedicalization, the importance of the psychosocial context of complaints, empowerment of women and good information and communication. The central issue of the article is: what is the actual scientific state of the art and what important changes have been made on the subject gender and health? The article ends with ideas for future research. (shrink)

In September 2002 the President of the United States issued a new National Security Strategy. Under the impact of 9/11 the authors of this NSS argue that the United States needs to pre-emptively attack rogue states that try to develop weapons of mass destruction (WMD) and have links to terrorists who might use these WMDs against the United States or its allies. This article analyzes this so-called ?Bush doctrine? asking about its legality, justice and feasibility in the present world order. (...) Furthermore, it attempts to show which underlying tacit assumptions the authors of the NSS must make to give their argument for a right to forcible regime change plausibility. To do so the NSS is being contrasted with a realistic utopian concept of an idealized international order in which preventive defense and regime change might seem justifiable. (shrink)

The use of coercive measures in the care for the addicted has changed over the past 20 years. Laws that have adopted the “dangerousness” criterion in order to secure patients’ rights to non-intervention are increasingly subjected to critique as many authors plead for wider dangerousness criteria. One of the most salient moral issues at stake is whether addicts who are at risk of causing danger to themselves should be involuntarily admitted and/or treated. In this article, it is argued that the (...) dilemma between coercion on the one hand and abandonment on the other cannot be analysed without differentiated perspectives on the key notions that are used in these debates. The ambiguity these notions carry within care practice indicates that the conflict between the prevention of danger and respect for autonomy is not as sharp as the legal systems seem to imply. Some coercive measures need not be interpreted as an infringement of autonomy—rather, they should be interpreted as a way to provide good care. (shrink)

In this paper, we present a prenex form theorem for a version of Independence Friendly logic, a logic with imperfect information. Lifting classical results to such logics turns out not to be straightforward, because independence conditions make the formulas sensitive to signalling phenomena. In particular, nested quantification over the same variable is shown to cause problems. For instance, renaming of bound variables may change the interpretations of a formula, there are only restricted quantifier extraction theorems, and slashed connectives cannot be (...) so easily removed. Thus we correct some claims from Hintikka [8], Caicedo & Krynicki [3] and Hodges [11]. We refine definitions, in particular the notion of equivalence, and sharpen preconditions, allowing us to restore those claims, including the prenex form theorem of Caicedo & Krynicki [3], and, as a side result, we obtain an application to Skolem forms of classical formulas. It is a known fact that a complete calculus for IF-logic is impossible, but with our results we establish several quantifier rules that form a partial calculus of equivalence for a general version of IF-logic reflecting general properties of information flow in games. (shrink)