Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects (...) leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

_Verificationism_ is the first comprehensive history of a concept that dominated philosophy and scientific methodology between the 1930s and the 1960s. The verificationist principle - the concept that a belief with no connection to experience is spurious - is the most sophisticated version of empiricism. More flexible ideas of verification are now being rehabilitated by a number of philosophers. C.J. Misak surveys the precursors, the main proponents and the rehabilitators. Unlike traditional studies, she follows verificationist theory beyond the demise of (...) positivism to examine its reappearance in the work of modern philosophers. Most interestingly, she argues that despite feminism's strenuous opposition to positivism, verificationist thought is at the heart of much of contemporary feminist philosophy. _Verificationism_ is an excellent assessment of a major and influential system of thought. (shrink)

This edition of Martin Ostwald's revised version of J. B. Skemp's 1952 translation of _Statesman_ includes a new selected bibliography, as well as Ostwald's interpretive introduction, which traces the evolution in Plato's political philosophy from _Republic_ to _Statesman to Laws_--from philosopher-king to royal statesman.

"This edition, which replaces the original Loeb edition..., offers text, translation, and annotation that are fully current with modern scholarship"--Front flap of dust jacket, volume 1.

Kengo Miyazono, in his work Delusions and Beliefs, defends a teleo-functional account of delusions. In my contribution to this symposium, I question one of Miyazono’s motivations for appealing to teleo-functionalism over its main rival, dry-functionalism. Miyazono suggests that teleo-functionalism, unlike dry-functionalism, can account for the compatibility of the theses (i) that delusions are genuine doxastic states (doxasticism about delusions) and (ii) that delusions do not perform the typical causal roles of beliefs (the causal difference thesis). I argue, however, that there (...) are also ways for dry-functionalism to account for this compatibility. If what I have to say is correct, then Miyazono is perhaps too hasty—at least in one important respect—to opt for teleo-functionalism over dry-functionalism. Dry-functionalism has an equally good chance of satisfying some of Miyazono’s explanatory goals. (shrink)

Abstract:This article is about how a very specific section of the Rio Grande was transformed through human intervention over the course of the twentieth century. Geographically, I focus on the stretch of river between and around the twin border towns of El Paso, Texas and Ciudad Juárez, Chihuahua. This is an important area of analysis not only because of the historic importance of the urban complex to U.S.-Mexico relations, but also because it is a desert. I analyze two major river (...) engineering projects, one in the 1930s, the other in the 1960s, as well as the transformation of the water itself due to increased toxicity beginning in the 1990s. In sum, the river was straightened, completely relocated, lined in concrete, and poisoned. No other place on the entire international divide underwent such extreme changes. I explain this by arguing that both political forces and environmental conditions combined to produce such totalizing interventions in the riverine ecosystem. I also argue that these processes reversed the age-old meaning of water in the desert. Historically, water in the desert has been associated with life and biodiversity, but over the course of the twentieth century the desert section of the Rio Grande border was converted into a deadened zone. (shrink)

Christology seems to fall fairly clearly into two divisions. The first is concerned with the truth of the two propositions: ‘Christ is God’ and ‘Christ is a man’. The second is concerned with the mutual compatibility of these propositions. The first part of Christology tends to confine itself to what is sometimes called ‘positive theology’: that is to say, it is largely given over to examining the Jons revelationis —let us not prejudge currently burning issues by asking what this is—to (...) see what evidence can be found for the truth of these propositions. Clearly, the methods used will be above all those of New Testament exegesis. The second part of Christology will necessarily consist entirely of that speculative theology which is contrasted with positive theology. Even if the earliest speculation on this topic is to be found in the New Testament itself and thus becomes fair game for the exegetes, any attempt to relate the primary truths, ‘Christ is God’ and ‘Christ is a man’, to eachother is a work of reflection, and in the terminology I am using speculative. (shrink)

A lack of consensus persists as to whom exactly the dialogues of Wittgenstein's Philosophical Investigations are between: Wittgenstein and an interlocutor? Or perhaps a variety of interlocutors, none of whom can be identified with Wittgenstein himself? I argue here that this lack of consensus is possibly due to an ambiguity in the ordinary concept of “talking to oneself,” and that a new concept of “talking to oneself” appropriate to Wittgenstein's dialogues is needed to properly understand them. Wittgenstein is talking to (...) himself—but he is doing so in the way we talk to other people. (shrink)

One of the most extensive yet least conclusive methodological debates within religious studies revolves around the question of what, precisely, the phenomenology of religion is and what contribution it can make to the study of religion. I do not intend to answer this important question here. To do so satisfactorily would require a range of historical, philosophical and methodological inquiry which would go quite beyond the bounds of a single article. My intention in this paper is, by comparison, unambitious. It (...) is to take one view of what phenomenology of religion is and to consider an area outside that usually explored by students of religion which can, nonetheless, shed some light on how religions might be studied in a way which is in accordance with the phenomenology of religion so understood. What follows will offer an answer to the question of what contribution one particular understanding of phenomenology might make to the study of religion, but no attempt will be made to establish whether or not this particular understanding ought to be regarded as normative. (shrink)

Deze korte studie biedt niet de zoveelste inleiding in het denken van Spinoza, maar doet verslag van de persoonlijke, vijfentwintig jaar durende zoektocht om de vaak moeilijke thema's van Spinoza onder de knie te krijgen. Om via Spinoza's filosofie meer te begrijpen van de wereld en van het eigen leven. Om de vreugde te ervaren die dit verbeterde inzicht, in oorzaken en gevolgen, en ook in de eigen beperktheid, ons biedt. Elk hoofdstuk gaat over een onderwerp dat de auteur bijzonder (...) aanspreekt. Bestaat er een levenswil, Spinoza's conatus, die mensen voort doet leven ook onder de meest bittere omstandigheden? Is kennis en inzicht gradueel van aard? Wat is het verschil tussen adequate en inadequate kennis van de oorzaken van ons handelen? Hoe ontwikkelt een machtsstaat zich tot een rechtsstaat? (shrink)