Raphaël Van Daele L’expression chinoise ziran 自然 s’entend aussi bien à propos de la « nature », cette région de l’être dont l’émergence et les processus ne relèvent pas de la volonté ou de l’action humaine, qu’à propos d’un certain type d’agir humain. Le geste expert de l’artiste est l’exemple privilégié d’un tel agir. Loin de nuire à la cohérence de cette notion, le fait que celle-ci soit mobilisée dans le discours théorique sur l’art autant que dans le discours (...) sur la nature témoigne d’un lien organique qui, dans la pensée chinoise, unit différents domaines de la réflexion. Le présent article propose d’esquisser une lecture philosophique de la notion de ziran. Pour ce faire, nous explorerons le rôle joué par ziran dans l’oeuvre esthétique de Cai Yong 蔡邕 (133-192) et dans la pensée de Guo Xiang 郭象 († 312). (shrink)

This paper draws on an in-depth phenomenological analysis of some interviews taken from volunteers, inviting them to reflect on their lived experiences of meaningfulness in the context of volunteering and citizenship. It is found that while some testimonies reinforce the standard conceptions of meaningfulness, other testimonies vary from it. The main challenge of this contribution consists in phenomenologically describing this alternative picture of meaningfulness, depicted as the event of witnessing. In a final part, the authors consider how volunteering is at (...) times especially prone to further experiences of witnessing. (shrink)

The credit policy of the«Communal Bank» is based on objective criteria in order to respect local autonomy. The financial results of the consolidation are difficult to determine. Several factors could have influenced the present state of municipal finances : the consolidation being done in a period of economic difficulties, the crisis of the public finances, the reform of the Municipal Fund, and the transformation of the Centers for Public Assistance into Public Centers for Social Welf are. The consolidations did not (...) generale any savings, but it al,so did not cause an alarming increase of expenses. With respect to budget balancing, the amalgamated municipalities should do better than the non-amalgamated municipalities. To keep the increase of expenses low in comparison with the revenues, the municipalities had to make cuts in several sectors.As to the current fniancial situation in the three regions, the municipalities of the Brussels regon are in a very painful situation ; in Flanders, the number of municipalities with deficits is higher than in Wallonia, but the deficits in W allonia are bigger. To stop this negative evolution one must strive for balanced budgets and reshape them into reliable instruments. (shrink)

Creatively operationalizing Claude Lévi-Strauss’ predicament that food is good to think with, I initiate a methodological conceptualization of food by exploring the ways in which it is apt to study Sri Lankan domestic and collective village life. Food is approached as an assemblage that is an emergent resultant of heterogeneous aspects with which it is deeply entangled and by way of which it turns into a potent agent shaping life. More specifically, I explore the vibrancy of these different components that (...) co-create the overall soundscape of food that as such becomes the conductor of Sri Lankan life. Food shapes domestic life by way of its preparation and consumption, and through its cultivation also conducts the collective rhythms at the village level. The conceptualization of food as an assemblage seeks to develop it as a methodology that opens up for a holistic integration and interdisciplinary collaboration. (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)

In this comment on Johan Von Essen’s contribution on the meaning of volunteering we make some remarks about Von Essen’s starting point, which reveals a particular perspective on meaningfulness, namely that people perceive reality as meaningful when their actions and the things they encounter are part of a meaningful whole. By introducing another perspective on meaningfulness, namely that the shattering of a meaningful whole is full of meaning, we question if practices of volunteering which occur in face-to-face situations—and thus outside (...) the public realm—can be fully captured by the five predicates that make up the phenomenological structure of volunteering. (shrink)

Food and life are intimately entangled. To grasp the underlying complexity of this seemingly simple statement, this article first introduces the approach to food/eating as an assemblage enacted by various heterogeneous components, and further develops it by engaging with actor network theory and material semiotics. Thereafter the focus turns to ‘entanglement’, as inspired by quantum physics, to elicit the basic dynamics of the entanglement of food and more-than-human beings, conceived of as involving mutual and differential becomings within and among assemblages. (...) The article illustrates these entangled becomings by drawing upon examples from Sri Lanka, which in an intercultural philosophical fashion serve to establish an articulation (in the sense of a connection) between the proposed abstract approach to food and some basic premises of Buddhism and Ayurveda, a South Asian health system. Overall, the article crafts a conceptual toolbox and performs ontological groundwork wherein food and human beings as entangled assemblages provide a productive, refined, and sensitive research apparatus for the intimate study of more-than-human life and organization while also spurring novel theorizations through food/eating. (shrink)

The essay describes with great clarity the situation of publishing in the XVI-XVII Centuries, focussing on several important examples of Flemish books.

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

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

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

Le présent livre est audacieux et marque, à n’en pas douter, une avancée pour les recherches sur la pensée de Damascius. Tiré de la thèse de doctorat de l’auteur, le livre interroge le concept de causalité comme procession dans le Traité des premiers principes (De principiis) de Damascius. Pelin entend se distancier de ce qu’il estime être une tendance dominante des études damascéennes (p. 32-33) : plutôt que de lire le De principiis dans une perspective épistémologique et d’y voir une (...) enquêt... (shrink)

Strengthening the abilities of smallholder farmers in developing countries, particularly women farmers, to produce for both home and the market is currently a development priority. In many contexts, ownership of assets is strongly gendered, reflecting existing gender norms and limiting women’s ability to invest in more profitable livelihood strategies such as market-oriented agriculture. Yet the intersection between women’s asset endowments and their ability to participate in and benefit from agricultural interventions receives minimal attention. This paper explores changes in gender relations (...) and women’s assets in four agricultural interventions that promoted high value agriculture with different degrees of market-orientation. Findings suggest that these dairy and horticulture projects can successfully involve women and increase production, income and the stock of household assets. In some cases, women were able to increase their control over production, income and assets; however in most cases men’s incomes increased more than women’s and the gender-asset gap did not decrease. Gender- and asset-based barriers to participation in projects as well as gender norms that limit women’s ability to accumulate and retain control over assets both contributed to the results. Comparing experiences across the four projects, especially where projects implemented adaptive measures to encourage gender-equitable outcomes, provides lessons for gender-responsive projects targeting existing and emerging value chains for high value products. Other targeted support to women farmers may also be needed to promote their acquisition of the physical assets required to expand production or enter other nodes of the value chain. (shrink)

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

Christian theology conceives of ‘sacrificium intellectus’ to account for the message of Saint Paul that he will “take every thought captive to obey Christ”. Human insight gives way to the revealed truths of religion. In modern western cultures to explain the natural world has become the domain of science, and the imposition of collective rules of how we should live was shifted to democratically elected parliaments. In Germany legislation of bioethical issues is often justified with reasons that violate standards of (...) cognitive rationality. Is this another case of sacrificium intellectus? The Federal Constitutional Court refrains from the control of legislative arguments by conceding a broad margin of appreciation for the legislator. People have, however, a right to justification; they must not be subjected to arbitrary legal power. While the practice of democratic rule may seldom comply with the expectations of ‘government by discussion’, it is neither likely to gain acceptance as ‘government without discussion’. To impose legal force on the basis of false arguments and unsound reasoning is not a legitimate sacrificium intellectus, it is an intellectual scandal. (shrink)

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

This article discusses whether ecology represents an alternative type of natural science, that is normatively committed. Central questions are: -- how man and human action are integrated into the subject matter of ecology; -- whether evaluative concepts like 'health' are incorporated into the conceptual structure of ecology; and -- whether ecology transcends the image of natural knowledge as control of nature. It is concluded that all hypotheses of ecology being inherently judgmental in character must be rejected.

In recent years, facial difference is increasingly on the public and academic agenda. This is evidenced by the growing public presence of individuals with an atypical face, and the simultaneous emergence of research investigating the issues associated with facial variance. The scholarship on facial difference approaches this topic either through a medical and rehabilitation perspective, or a psycho-social one. However, having a different face also encompasses an embodied dimension. In this paper, we explore this embodied dimension by interpreting the stories (...) of individuals with facial limb absence against the background of phenomenological theories of the body, illness and disability. Our findings suggest that the atypical face disrupts these individuals’ engagement with everyday projects when it gives rise to disruptive perceptions, sensations, and observations. The face then ceases to be the absent background to perception, and becomes foregrounded in awareness. The disruptions evoked by facial difference call for adjustments: as they come to terms with their altered face, the participants in our study gradually develop various new bodily habits that re-establish their face’s absence, or relate to its disruptive presence. It is through these emergent habits that facial difference comes to be embodied. By analyzing the everyday experiences of individuals with facial limb absence, this article provides a much-needed exploration of the embodied aspects of facial difference. It also exemplifies how a phenomenological account of illness and disability can do justice both to the impairments and appearance issues associated with atypical embodiment. (shrink)

Animal welfare scientific literature has accumulated rapidly in recent years, but bias may exist which influences understanding of progress in the field. We conducted a survey of articles related to animal welfare or well being from an electronic database. From 8,541 articles on this topic, we randomly selected 115 articles for detailed review in four funding categories: government; charity and/or scientific association; industry; and educational organization. Ninety articles were evaluated after unsuitable articles were rejected. The welfare states of animals in (...) new treatments, conventional treatments or control groups with no treatment were classified as high, medium or low according to one or more. More articles were published in which the welfare of animals in new treatments was better than that of animals in the conventional or no treatment groups, demonstrating a positive result bias. Failure to publish studies with negative or inconclusive results may lead to other scientists unnecessarily repeating the research. The authors’ assessments of the welfare state of the groups were similarly rated high, medium or low, and it was found that new treatments were rated lower if the research was funded by industry, and higher when funded by charities, with government funding agencies intermediate. These differences were not evident in the Five Freedoms assessment, demonstrating an authors’ assessment bias that appeared to support the funding agencies’ interests. North American funded publications rated the welfare of animals in New treatments higher and those in a Conventional or No Treatment lower, compared with European-funded publications. It is concluded that preliminary evidence was provided of several forms of publication bias in animal welfare science. (shrink)

Objective To assess whether the frequency of end-of-life decisions for children under 1 year of age in the Netherlands has changed since ultrasound examination around 20 weeks of gestation became routine in 2007 and after a legal provision for deliberately ending the life of a newborn was set up that same year. Methodology This was a recurrent nationwide cross-sectional study in the Netherlands. In 2010, a sample of death certificates from children under 1 year of age was derived from the (...) central death registry. All 223 deaths that occurred in a 4-month study period were included. Physicians who had reported a non-sudden death (n=206) were sent a questionnaire on the end-of-life decisions made. 160 questionnaires were returned (response 78%). Findings In 2010, 63% of all deaths of children under 1 year of age were preceded by an end-of-life decision—a percentage comparable to other times when this study was conducted (1995, 2001, 2005). These end-of-life decisions were mainly decisions to withdraw or withhold potentially life-sustaining treatment. In 2010, the percentage of cases in which drugs were administered with the explicit intention to hasten death was 1%, while in 1995 and 2001, this was 9% and in 2005, this was 8%. Discussion and conclusion There has been a reduction of infant deaths that followed administration of drugs with the explicit intention to hasten death. One explanation for this reduction relates to the introduction of routine ultrasound examination around 20 weeks of gestation. In addition, the introduction of legal criteria and a review process for deliberately ending the life of a newborn may have left Dutch physicians with less room to hasten death. (shrink)

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

BackgroundRelatives have no formal position in the practice of euthanasia and physician-assisted suicide (EAS) according to Dutch legislation. However, research shows that physicians often involve relatives in EAS decision-making. It remains unclear why physicians do (not) want to involve relatives. Therefore, we examined how many physicians in the Netherlands involve relatives in EAS decision-making and explored reasons for (not) involving relatives and what involvement entails.MethodsIn a mixed-methods study, 746 physicians (33% response rate) completed a questionnaire, and 20 were interviewed. The (...) questionnaire included two statements on relatives’ involvement in EAS decision-making. Descriptive statistics were used, and multivariable logistic regression analyses to explore characteristics associated with involving relatives. In subsequent interviews, we explored physicians’ views on involving relatives in EAS decision-making. Interviews were thematically analysed.ResultsThe majority of physicians want to know relatives’ opinions about an EAS request (80%); a smaller group also takes these opinions into account in EAS decision-making (35%). Physicians who had ever received an explicit EAS request were more likely to want to know opinions and clinical specialists and elderly care physicians were more likely to take these opinions into account. In interviews, physicians mentioned several reasons for involving relatives: e.g. to give relatives space and help them in their acceptance, to tailor support, to be able to perform EAS in harmony, and to mediate in case of conflicting views. Furthermore, physicians explained that relatives’ opinions can influence the decision-making process but cannot be a decisive factor. If relatives oppose the EAS request, physicians find the process more difficult and try to mediate between patients and relatives by investigating relatives’ objections and providing appropriate information. Reasons for not taking relatives’ opinions into account include not wanting to undermine patient autonomy and protecting relatives from a potential burdensome decision.ConclusionsAlthough physicians know that relatives have no formal role, involving relatives in EAS decision-making is common practice in the Netherlands. Physicians consider this important as relatives need to continue with their lives and may need bereavement support. Additionally, physicians want to perform EAS in harmony with everyone involved. However, relatives’ opinions are not decisive. (shrink)