Theoretical models for physician-patient communication in clinical practice are described in literature, but none of them seems adequate for solving the communication problem in clinical practice that emerges in case of factitious disorder. Theoretical models generally imply open communication and respect for the autonomy of the patient. In factitious disorder, the physician is confronted by lies and (self)destructive behaviour of the patient, who in one way or another tries to involve the physician in this behaviour. It is no longer controversial (...) that the physician should communicate his consideration of a factitious disorder without insistence that the patient accepts this diagnosis. However, the balance between patient autonomy and open communication on the one hand, and the preservation of the patient's health, physician integrity and of a constructive physician-patient relationship on the other is easily disrupted. In this article, an epistemological model is described to facilitate a positive outcome of confrontation in treatment of factitious disorder. Analysing the problem in terms of systems theory will help the physician to assess what information is appropriate to use in which phase of the patient's treatment, while preserving the physician-patient relationship. (shrink)

Theoretical models for physician-patient communication in clinical practice are described in literature, but none of them seems adequate for solving the communication problem in clinical practice that emerges in case of factitious disorder. Theoretical models generally imply open communication and respect for the autonomy of the patient. In factitious disorder, the physician is confronted by lies and (self)destructive behaviour of the patient, who in one way or another tries to involve the physician in this behaviour. It is no longer controversial (...) that the physician should communicate his consideration of a factitious disorder without insistence that the patient accepts this diagnosis. However, the balance between patient autonomy and open communication on the one hand, and the preservation of the patient's health, physician integrity and of a constructive physician-patient relationship on the other is easily disrupted. In this article, an epistemological model is described to facilitate a positive outcome of confrontation in treatment of factitious disorder. Analysing the problem in terms of systems theory will help the physician to assess what information is appropriate to use in which phase of the patient's treatment, while preserving the physician-patient relationship. (shrink)

Phenomenology of religion can refer to three distinct groups of phenomenological projects reflecting on religion. The term is used in the field of religious studies to designate the search for patterns of religious experiences or practices across traditions and to the methodology that shows religion to be a unique human experience deserving its own field of study. Philosophical phenomenology in the Husserlian tradition also engages religious questions at times. Finally, there is a group of contemporary French philosophers who advocate a (...) phenomenology of religious experience. The first two groups are examined in this article and the third in the sequel. For the first group, the article briefly considers the projects of Rudolf Otto, Mircea Eliade, Brede Kristensen, and Gerardus van der Leeuw, as well as their contemporary interpreters in the field of religious studies. As representative of the second approach, the article considers Max Scheler, Edith Stein, and Gerda Walther as well as commenting briefly on the contemporary work of Natalie Depraz and Anthony Steinbock. (shrink)

This work details the theological sources and moral significance of the life and work of the Scottish moral philosopher Adam Smith (1723-1790). The panel of contributors deepen our understanding of Adam Smith in his religious and theological context and the significance of this understanding for contemporary moral, economic, and political challenges to modern social life. The chapters cover a broad range of disciplinary and historical concerns, from Smith's view of providence and his famous "invisible hand" to the role of self-interest (...) and benevolence in Smith's social and economic thought. A better appreciation for the moral and theological dimensions of Smith's thought provides not only a better understanding of Smith's own context and significance in the Scottish Enlightenment, but also promises to assist in meeting the perennial challenges of properly connecting economic realities to moral responsibility. The book is of interest to advanced students and scholars of the history of economic thought, historical and moral theology, intellectual history, political science and philosophy. (shrink)

By sounding the work of John Calvin and Karl Barth as mirrors of reflection and experience, justice is done to the tension between the premodern and postkantian ...

In the recent literature on formation in online theological education, a number of thematic strands can be delineated: the apologetic, didactic, pedagogical, empirical, and geographical strands. However, apart from the early apologetic stage of the discussion theological reflection plays a minor role in the literature. In this article, I argue that theology plays a limited and superficial role in contemporary writings about formation in online theological education. Yet, spiritual formation in online theological education needs theological grounding. Given the accelerated shift (...) to forms of online education across the world, such theological grounding is an urgent task. In this renewed theological engagement, three areas especially call for sustained attention: the multi-faceted nature of spiritual formation; the question of agency in spiritual formation and the consequences for the theological curriculum; and engagement with theological traditions that offer ample material to guide our contemporary thinking about spiritual formation. (shrink)

For many physicists quantum theory contains strong conceptual difficulties, while for others the apparent conclusions about the reality of our physical world and the ways in which we discover that reality remain philosophically unacceptable. This book focuses on recent theoretical and experimental developments in the foundations of quantum physics, including topics such as the puzzles and paradoxes which appear when general relativity and quantum mechanics are combined; the emergence of classical properties from quantum mechanics; stochastic electrodynamics; EPR experiments and Bell's (...) Theorem; the consistent histories approach and the problem of datum uniqueness in quantum mechanics; non-local measurements and teleportation of quantum states; quantum non-demolition measurements in optics and matter wave properties observed by neutron, electron and atomic interferometry. Audience: This volume is intended for graduate students of physics and those interested in the foundations of quantum theory. (shrink)

OBJECTIVES: To identify the factors that influence the assessment of reported cases of physician-assisted death by members of the public prosecution. DESIGN/SETTING: At the beginning of 1996, during verbal interviews, 12 short case-descriptions were presented to a representative group of 47 members of the public prosecution in the Netherlands. RESULTS: Assessment varied considerably between respondents. Some respondents made more "lenient" assessments than others. Characteristics of the respondents, such as function, personal-life philosophy and age, were not related to the assessment. Case (...) characteristics, i.e. the presence of an explicit request, life expectancy and the type of suffering, strongly influenced the assessment. Of these characteristics, the presence or absence of an explicit request was the most important determinant of the decision whether or not to hold an inquest. CONCLUSIONS: Although the presence of an explicit request, life expectancy and the type of suffering each influenced the assessment, each individual assessment was dependent on the assessor. The resulting danger of legal inequality and legal uncertainty, particularly in complicated cases, should be kept to a minimum by the introduction of some form of protocol and consultation in doubtful or boundary cases. The notification procedure already promotes a certain degree of uniformity in the prosecution policy. (shrink)

In this paper, we introduce the methodology and techniques of metaargumentation to model argumentation. The methodology of meta-argumentation instantiates Dung's abstract argumentation theory with an extended argumentation theory, and is thus based on a combination of the methodology of instantiating abstract arguments, and the methodology of extending Dung's basic argumentation frameworks with other relations among abstract arguments. The technique of meta-argumentation applies Dung's theory of abstract argumentation to itself, by instantiating Dung's abstract arguments with meta-arguments using a technique called flattening. (...) We characterize the domain of instantiation using a representation technique based on soundness and completeness. Finally, we distinguish among various instantiations using the technique of specification languages. (shrink)

In this paper, we introduce the methodology and techniques of meta-argumentation to model argumentation. The methodology of meta-argumentation instantiates Dung’s abstract argumentation theory with an extended argumentation theory, and is thus based on a combination of the methodology of instantiating abstract arguments, and the methodology of extending Dung’s basic argumentation frameworks with other relations among abstract arguments. The technique of meta-argumentation applies Dung’s theory of abstract argumentation to itself, by instantiating Dung’s abstract arguments with meta-arguments using a technique called flattening. (...) We characterize the domain of instantiation using a representation technique based on soundness and completeness. Finally, we distinguish among various instantiations using the technique of specification languages. (shrink)

New and Emerging Science and Technology (NEST) based innovations, e.g. in the field of Life Sciences or Nanotechnology, frequently raise societal and political concerns. To address these concerns NEST researchers are expected to deploy socially responsible R&D practices. This requires researchers to integrate social and ethical aspects (SEAs) in their daily work. Many methods can facilitate such integration. Still, why and how researchers should and could use SEAs remains largely unclear. In this paper we aim to relate motivations for NEST (...) researchers to include SEAs in their work, and the requirements to establish such integration from their perspectives, to existing approaches that can be used to establish integration of SEAs in the daily work of these NEST researchers. Based on our analyses, we argue that for the successful integration of SEAs in R&D practice, collaborative approaches between researchers and scholars from the social sciences and humanities seem the most successful. The only way to explore whether that is in fact the case, is by embarking on collaborative research endeavours. (shrink)

Thanks to the exchange of arguments, groups outperform individuals on some tasks, such as solving logical problems. However, these results stem from experiments conducted among Westerners and they could be due to cultural particularities such as tolerance of contradiction and approval of public debate. Other cultures, collectivistic cultures in particular, are said to frown on argumentation. Moreover, some influential intellectual movements, such as Confucianism, disapprove of argumentation. In two experiments, the hypothesis that Easterners might not share the benefits of argumentation (...) was tested. In Experiment 1, Japanese participants had to solve a standard logical problem individually and then in groups. They performed significantly better in groups. In Experiment 2, Japanese participants had to estimate the weight of various animals. They did so individually, then after learning of another participant's estimates, then after discussing these estimates with the other participant, and then indi.. (shrink)

Policy makers call upon researchers from the natural and social sciences to collaborate for the responsible development and deployment of innovations. Collaborations are projected to enhance both the technical quality of innovations, and the extent to which relevant social and ethical considerations are integrated into their development. This could make these innovations more socially robust and responsible, particularly in new and emerging scientific and technological fields, such as synthetic biology and nanotechnology. Some researchers from both fields have embarked on collaborative (...) research activities, using various Technology Assessment approaches and Socio-Technical Integration Research activities such as Midstream Modulation. Still, practical experience of collaborations in industry is limited, while much may be expected from industry in terms of socially responsible innovation development. Experience in and guidelines on how to set up and manage such collaborations are not easily available. Having carried out various collaborative research activities in industry ourselves, we aim to share in this paper our experiences in setting up and working in such collaborations. We highlight the possibilities and boundaries in setting up and managing collaborations, and discuss how we have experienced the emergence of ‘collaborative spaces.’ Hopefully our findings can facilitate and encourage others to set up collaborative research endeavours. (shrink)

Three arguments are given to show that neural constructivism lacks an essential ingredient to explain cognitive development. Based on results in the theory of adaptive signal analysis, adaptive biological pattern information and self-organization in nonlinear systems of information processing, it is concluded that neural constructivism should be further extended to accommodate the occurrence of phase transitions generating qualitative development in the sense of Piaget.

In this introduction to the first installment of the Common Knowledge symposium “Peace by Other Means,” the journal's editor questions the assumptions that underwrite standard approaches in the social sciences to the issue of how non-state, tribal societies have dealt with matters of war and peace. He in particular examines and finds wanting the approach that Jared Diamond takes in The World until Yesterday: What Can We Learn from Traditional Societies?. Whereas Diamond's theme is that modern states can learn much (...) about many things from traditional hunter-gatherer societies, with respect to peacemaking and peace-keeping he finds traditional societies distinctly inferior, and the arguments by which he reaches this conclusion are tautological and also beg the question. This prefatory essay explains that “Peace by Other Means” will analyze and detail non-Western and premodern European means of keeping peace that modern theorists of conflict resolution are reluctant to credit or incompetent to assess. (shrink)

The opportunity cost model (OCM) aims to explain various phenomena, among which the finding that performance degrades if executive functions are used repeatedly (). We argue that an OCM account of resource depletion requires two unlikely assumptions, and we discuss an alternative that does not require these assumptions. This alternative model describes the interplay between executive function and motivation.

The dominant view of the ventral and dorsal visual systems is that they subserve perception and action. De Wit, Van der Kamp, and Masters suggested that a more fundamental distinction might exist between the nature of information exploited by the systems. The present study distinguished between these accounts by asking participants to perform delayed matching , pointing and perceptual judgment responses to masked Müller–Lyer stimuli of varying length. Matching and pointing responses of participants who could not perceptually judge stimulus length (...) at brief durations remained sensitive to veridical stimulus length , but not the illusion , which was effective at long durations. Distinct thresholds for egocentric and allocentric information pick up were thus evident irrespective of whether perception or action responses were required. It was concluded that the dorsal and ventral systems may be delineated fundamentally by fast egocentric- and slower allocentric information pick up, respectively. (shrink)

In response to an increasing amount of policy papers stressing the need for integrating social and ethical aspects in Research and Development (R&D) practices, science studies scholars have conducted integrative research and experiments with science and innovation actors. One widely employed integration method is Midstream Modulation (MM), in which an ‘embedded humanist’ interacts in regular meetings with researchers to engage them with the social and ethical aspects of their work. While the possibility of using MM to enhance critical reflection has (...) been demonstrated in academic settings, few attempts have been made to examine its appropriateness in industry. This paper describes the outcomes of a case study aiming to find out firstly whether MM can effectively be deployed to encourage and facilitate researchers to actively include social and ethical aspects in their daily R&D practice, and secondly to what extent the integration activities could form an integral part of the engaged industrial researchers’ professional activities. Our data show that after MM, researchers display increased reflexive awareness on the social and ethical aspects of their work and acknowledge the relevance and utility of such aspects on their daily practice. Also, all participants considered actively reflecting on social and ethical aspects to be part of their work. Future research on the role of MM in industrial settings could focus on how to embed social and ethical integration as a regular part of innovation practice. We suggest that one possibility would be through aligning social and ethical aspects with innovation Key Performance Indicators. (shrink)

This text explores a set of key concepts in Marxist theory as developed and read by Lacan, demonstrating links and connections between Marxist thought and Lacanian practice. The book examines the complexity of these encounters through the structure of a comprehensive vocabulary which covers diverse areas, from capitalism and communism to history, ideology, politics, work, and family. Offering new perspectives on these concepts in psychoanalysis, as well as in the fields of political and critical theory, the book brings together contributions (...) from a range of international experts to demonstrate the dynamic relationship between Marx and Lacan, as well as illuminating 'untranslatable points' which may offer productive tension between the two. The entries trace the trajectory of Lacan's appropriation of Marx's concepts and analyses how they were questioned, criticized and reworked by Lacan, accounting for the wide reach of two thinkers and worlds in constant homology. Each entry also discusses psychoanalytic debates relating to the concept and seeks to refine the clinical scope of Marx's work, demonstrating its impact on the social and individual dimensions of Lacanian clinical practice. With a practical and structured approach, The Marx Through Lacan Vocabulary will appeal to psychoanalysts and researchers in a range of fields, including political science, cultural studies, and philosophy. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

Research on social influences often distinguishes between social and quality incentives to ascribe meaning to the value that popularity conveys. This study examines the neural correlates of those incentives through which popularity influences preferences. This research reports an functional magnetic resonance imaging experiment and a behavioral task in which respondents evaluated popular products with three focus perspectives; unspecified focus, focus on social aspects, and focus on quality. The results show that value derived with a social focus reflects inferences of approval (...) and reward value, and positively affects preferences. Value derived with a quality focus reflects inferences of quality and negatively affects preferences. This study provides evidence of two distinct inferential routes on both a neurological level, represented by different regions in the brain, and a behavioral level. These results provide the first evidence that a single popularity cue can in different ways influence the value derived from product popularity. (shrink)

It is often argued that clinical research should not violate the Kantian principle that people must not be used merely as a means for the purposes of others. At first sight, the practice of clinical research itself, however, seems to violate precisely this principle: clinical research is often beneficial to future people rather than to participants; even if participants benefit, all things considered, they are exposed to discomforts which are absent both in regular care for their diseases and in other (...) areas of daily life. Therefore, in this paper we will consider whether people are used merely as a means by being enrolled in clinical research. On the basis of recent studies of Kantian scholars we will argue that clinical research is compatible with the Kantian principle if the conditions of possible consent and end-sharing have been met. Participants are not used merely as a means if they have sufficient reasons to consent to being enrolled in clinical research and can share the ends of the researchers who use them. Moreover, we will claim that even if people are used merely as a means by participating in clinical research, it may not always be morally wrong to use them in this way. (shrink)

Les décisions politiques sur les risques environnementaux complexes font fréquemment intervenir des éléments scientifiques contestés. Il n’y a généralement pas de « faits » qui conduisent à une politique correcte unique. Les éléments de preuve qui sont intégrés dans les avis scientifiques destinés à une décision politique nécessitent une évaluation de leur qualité. En 2003, l’Agence néerlandaise d’évaluation environnementale a adopté une méthode standardisée, désignée sous le nom de « guide », dans le cadre de laquelle les principaux aspects de (...) la production et de l’utilisation des connaissances sont présentés grâce à une liste de contrôle visant à l’évaluation et à la communication des incertitudes. Dans cet article, nous présentons des résultats de l’application de ce guide à la controverse sur les risques des particules en suspension. La délibération active sur l’incertitude dans un contexte d’expertise entraîne un processus d’apprentissage commun entre les experts et les décideurs politiques, ce qui conduit à une meilleure prise de conscience du phénomène d’incertitude et de ses implications politiques.Policy decisions on complex environmental risks often involve disputed science. Typically, there are no “ facts” to support a single unequivocally correct policy. The evidence provided in scientific studies for policy-making decisions requires high-quality assessment. In 2003, the Netherlands Environmental Assessment Agency adopted a standardized method, referred to as “guidelines”, whereby key quality aspects of knowledge production and use are presented in the form of a checklist for uncertainty assessments and communication. In this article, we present the outcomes of applying the guidelines in controversies on the risks of ambient particulate matter. In the policy–advisory context, active deliberation on uncertainty produces a common learning process for advisors and policy makers, which leads to a deeper understanding and increased awareness of the phenomenon of uncertainty and its policy implications. (shrink)