The aim of this study was to explore and describe how Flemish nurses experience their involvement in the care of hospitalized patients with dementia, particularly in relation to artificial nutrition or hydration (ANH). We interviewed 21 hospital nurses who were carefully selected from nine hospitals in different regions of Flanders. ‘Being touched by the vulnerability of the demented patient’ was the central experience of the nurses, having great impact on them professionally as well as personally. This feeling can be described (...) as encompassing the various stages of the care process: the nurses' initial meeting with the vulnerable patient; the intense decision-making process, during which the nurses experienced several intense emotions influenced by supporting or hindering contextual factors; and the final coping process, a time when nurses came to terms with this challenging experience. From our examination of this care process, it is obvious that nurses' involvement in ANH decision-making processes that concern patients with dementia is a difficult and ethically sensitive experience. On the one hand, the feeling of ‘being touched’ can imply strength, as it demonstrates that nurses are willing to provide good care. On the other hand, the feeling of ‘being touched’ can also imply weakness, as it makes nurses vulnerable to moral distress stemming from contextual influences. Therefore, nurses have to be supported as they carry out this ethically sensitive assignment. Practical implications are given. (shrink)

The aim of this study was to explore and describe how Flemish nurses experience their involvement in the care of hospitalized patients with dementia, particularly in relation to artificial nutrition or hydration (ANH). We interviewed 21 hospital nurses who were carefully selected from nine hospitals in different regions of Flanders. ‘Being touched by the vulnerability of the demented patient’ was the central experience of the nurses, having great impact on them professionally as well as personally. This feeling can be described (...) as encompassing the various stages of the care process: the nurses' initial meeting with the vulnerable patient; the intense decision‐making process, during which the nurses experienced several intense emotions influenced by supporting or hindering contextual factors; and the final coping process, a time when nurses came to terms with this challenging experience. From our examination of this care process, it is obvious that nurses' involvement in ANH decision‐making processes that concern patients with dementia is a difficult and ethically sensitive experience. On the one hand, the feeling of ‘being touched’ can imply strength, as it demonstrates that nurses are willing to provide good care. On the other hand, the feeling of ‘being touched’ can also imply weakness, as it makes nurses vulnerable to moral distress stemming from contextual influences. Therefore, nurses have to be supported as they carry out this ethically sensitive assignment. Practical implications are given. (shrink)

As football clubs are facing different ethical challenges, many clubs are turning to ethical codes to counteract unethical behaviour. However, both in- and outside the sport field, uncertainty remains about the effectiveness of these ethical codes. For the first time, a longitudinal study design was adopted to evaluate code effectiveness. Specifically, a sample of non-professional football clubs formed the subject of our inquiry. Ethical code effectiveness was assessed by the measurement of the ethical climate. A repeated-measurements ANOVA revealed a positive (...) evolution of the ethical climate within the studied football clubs. This evolution could not be ascribed to the mere presence of an ethical code. However, several potential code effectiveness determining characteristics were also included in the research design. Some of these accounted partly for the evolution of the ethical climate of the football clubs. Results suggest that football clubs should incorporate their ethical code into a broader ethical programme, with attention for professionalization initiatives, stakeholder management, ethical leadership, and whistle-blowing protection. (shrink)

This article examines the municipal ID card programs in New Haven and San Francisco. With a municipal ID card, undocumented immigrants can access basic city services and identify themselves with police and other city officials. The article draws on twenty-eight interviews with key stakeholders to show that city officials navigated the conflicting demands of ID card supporters and opponents to create a local membership policy focused on improving city administration, not expanding the rights of undocumented immigrants. In capitalizing on their (...) discretionary administrative powers to develop programs that safeguard the health, safety, and welfare of all city residents, officials in New Haven and San Francisco managed to promote the integration of undocumented immigrants into city affairs without upsetting the federal monopoly over immigration and citizenship powers. This new form of local bureaucratic membership has implications for the urban citizenship literature and illustrates that city officials have some freedom to develop programs that benefit undocumented immigrants. (shrink)

The results of two independent empirical studies with Flemish citizens were combined to address the problem of a short fall of information provision about higher welfare products. The research objectives were (1) to improve our understanding of how citizens conceptualize farm animal welfare, (2) to analyze the variety in the claimed personal relevance of animal welfare in the food purchasing decision process, and (3) to find out people’s needs in relation to product information about animal welfare and the extent to (...) which the current information caters to these needs. The first study consisted of a survey conducted in three consecutive years (2000–2002, n = 521) and was complemented with more recent qualitative data from four focus group discussions (2006, n = 29). Citizens’ conceptualization of farm animal welfare matched reasonably well with those in the scientific literature, although it is clearly influenced by a lower level of practical experience and a higher weight of empathy. In general, respondents indicated that animal welfare was an important product attribute, although it was less important than primary product attributes such as quality, health, and safety. Moral issues, rather than a perception of higher quality, were the main influence on preferences for higher welfare products. At present, higher standards of animal welfare are mostly guaranteed within more general quality assurance schemes. Yet people’s decisions to not choose higher welfare products seems to be related to the perceptual disconnection between eating animal food products and the living producing animals. Respondents generally thought better information provision was required and the present level of provision was strongly criticized. In combination, the findings of both studies help inform the discussion about how citizens can be informed about animal welfare and the preferred content, source, and medium of such information. The paper also provides insights into citizens’ semantic interpretation of the concept of animal welfare (what wordings they use) and the range of relevance that animal welfare has for different groups that, in turn is useful in identifying which segments can be targeted. This can contribute to a more effective valorization of animal welfare as a product attribute. (shrink)

The results of two independent empirical studies with Flemish citizens were combined to address the problem of a short fall of information provision about higher welfare products. The research objectives were (1) to improve our understanding of how citizens conceptualize farm animal welfare, (2) to analyze the variety in the claimed personal relevance of animal welfare in the food purchasing decision process, and (3) to find out people’s needs in relation to product information about animal welfare and the extent to (...) which the current information caters to these needs. The first study consisted of a survey conducted in three consecutive years (2000–2002, n = 521) and was complemented with more recent qualitative data from four focus group discussions (2006, n = 29). Citizens’ conceptualization of farm animal welfare matched reasonably well with those in the scientific literature, although it is clearly influenced by a lower level of practical experience and a higher weight of empathy. In general, respondents indicated that animal welfare was an important product attribute, although it was less important than primary product attributes such as quality, health, and safety. Moral issues, rather than a perception of higher quality, were the main influence on preferences for higher welfare products. At present, higher standards of animal welfare are mostly guaranteed within more general quality assurance schemes. Yet people’s decisions to not choose higher welfare products seems to be related to the perceptual disconnection between eating animal food products and the living producing animals. Respondents generally thought better information provision was required and the present level of provision was strongly criticized. In combination, the findings of both studies help inform the discussion about how citizens can be informed about animal welfare and the preferred content, source, and medium of such information. The paper also provides insights into citizens’ semantic interpretation of the concept of animal welfare (what wordings they use) and the range of relevance that animal welfare has for different groups that, in turn is useful in identifying which segments can be targeted. This can contribute to a more effective valorization of animal welfare as a product attribute. (shrink)

Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. We have collected and analysed available evidence on human rights violations in the organ procurement practice in China. We demonstrate that the (...) practice not only violates international ethics standards, it is also associated with a large scale neglect of fundamental human rights. This includes organ procurement without consent from prisoners or their families as well as procurement of organs from incompletely executed, still-living prisoners. The human rights critique of these practices will also address the specific situatedness of prisoners, often conditioned and traumatized by a cascade of human rights abuses in judicial structures. To end the unethical practice and the abuse associated with it, we suggest to inextricably bind the use of human organs procured in the Chinese transplant system to enacting Chinese legislation prohibiting the use of organs from executed prisoners and making explicit rules for law enforcement. Other than that, the international community must cease to abet the continuation of the present system by demanding an authoritative ban on the use of organs from executed Chinese prisoners. (shrink)

There are no moral cookbooks—no algorithms for whipping up moral confections to suit every occasion. But more modest and flexible tools might still be useful for practical ethics. One team describes how professionals can be taught to use a framework for understanding moral problems.

BackgroundIn December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners.DiscussionIn the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a (...) fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to “voluntarily donate” organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards.ConclusionsOrgan sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with “consent” are now simply labelled as “voluntarily donations from citizens”. The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain. (shrink)

Despite the burgeoning of publications in nursing ethics, only more recently has empirical evidence on nursing ethics been published. How nursing ethics can be empirically studied as well as enriched by empirical data will be the focus of this paper. Two empirical studies will be briefly presented and their contribution to ethics discussed. The first one is a quantitative research project about nurses' ethical behavior in daily practice. Using an adapted version of Kohlberg's theory of moral development, this study tried (...) to describe and explore nurses' responses to ethical dilemmas in daily nursing practice. The second study attempted to describe the specificity of residential palliative care. A qualitative approach was used to explore and describe the processes that take place on an inpatient palliative care unit, and the experiences of patients, relatives and palliative care team members. The analysis of the value of both research projects for ethics underlines the power of empirical understanding in the relationship between research and ethics. The need for integration of both qualitative and quantitative research methodologies is argued. (shrink)

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely (...) and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition ‘to return good in proportion to the good we receive, and to make reparations for the harm we have done’, as a mid-level principle in infectious disease screening policies. More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers’ participation and the benefits for the control of public health. The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases. (shrink)

BackgroundHuntington’s disease has a poor prognosis. For HD patients in the Netherlands, one way of dealing with their poor prognosis is by drawing up an advance euthanasia directive. Little is known about the perspectives of HD patients on their AED.AimTo gain insight into patients’ views on and attitudes towards their AED, and changes over time.MethodsA longitudinal qualitative interview study using 1 to 6 semi-structured interviews over a period of maximum three years. Nine HD patients who either had an AED or (...) were thinking about drawing it up participated in this study.ResultsWe identified two themes that characterize patients’ perspectives on their AEDs: general character of the AED; uncertainty around their AED. Ad The conditions that the participants described in their AED were generally not very specific for the person. Mostly they were general notions of unbearable suffering. Familiarity with HD in the family could play a role in drawing up an AED. Ad Participants generally were aware of the tentative character of their AED and could have doubts concerning their own willingness or the willingness of others in the future. Sometimes these doubts were so great, that it prevented them from drawing up an AED. However, patients did not alter their AED during the follow-up period or changed in their view or attitude on their AED.ConclusionHD patients that draw up an AED usually describe general conditions for euthanasia and recognize that these conditions may change as the disease progresses. An AED or the wish to draw one up may be a good conversation starter for conversations about goals and preferences for future care. (shrink)

ABSTRACT Match-fixing is a major ethical issue in sports. Although research interest in match-fixing has increased in recent years, we remain largely in the dark regarding how both betting- and non-betting-related match-fixing relate to the moral decision-making of those involved. Drawing on Rest’s theory of morality and on the perceptions of a large sample of participants in Flemish sports, this study indicates that most match-fixing incidents are non-betting-related, while moral motivation and associated challenges clearly differ according to the type of (...) match-fixing. Therefore, each type of match-fixing requires different preventive measures. (shrink)

BackgroundWith advances in sequencing technologies, increasing numbers of people are being informed about a genetic disease identified in their family. In current practice, probands are asked to inform at-risk relatives about the diagnosis. However, previous research has shown that relatives are sometimes not informed due to barriers such as family conflicts. Research on family communication in genetic diseases aims to explore the difficulties encountered in informing relatives and to identify ways to support probands in this.Main bodyResearch on family communication may (...) also reveal that participants did not inform their relatives about the risk of a serious genetic condition, even when preventive and treatment options are available. Researchers may then face a dilemma: Do they need to warn at-risk relatives about the finding? Or do they keep silent due to prior confidentiality agreements with study participants?ConclusionsWe believe that the absolute confidence promised to research participants outweighs the interests of their relatives, even though it can be claimed that relatives at risk of a genetic disease do, in principle, have a right to know information collected about their health. Not respecting confidentiality agreements could cause distrust between researchers and research participants and possibly harm the relationship between probands and relatives. Relatives' health interests can still be taken into account without jeopardizing participant trust, by considering alternative scenarios, including sharing general study findings on the barriers participants experience with their healthcare professionals and by offering participants psychosocial support for family communication. (shrink)

Sports organizations face various ethical challenges. To tackle these, ethical codes are becoming increasingly popular instruments. However, a lot of questions remain concerning their effectiveness. There is a particular lack of knowledge when it comes to their form and content, and on the influence of these features on the effectiveness of these codes of ethics. Therefore, we developed a framework to analyze ethical codes and used this to assess codes of ethics in sports clubs from six disciplines. The form and (...) content characteristics of the codes were tested for their impact on the ethical climate of sports clubs. Our results show that most codes focus on the themes of integrity, and on solidarity among the members of sports clubs. Deontological phrasing is dominant in ethical codes in sports clubs. The occurrence of comprehension aids, such as examples, and procedural content, such as the mentioning of sanctions, is low. When it comes to code effectiveness, i.e., the influence on the ethical climate, we see a positive significant effect of the use of consequentialist oriented statements, and of the combination of regulatory and inspirational phrasing. Also the presence of explicit guidelines for the members of the board had a positive significant affect. This shows that codes should be a source of inspiration and stimulate moral awareness, rather than merely guide behavior by simple rules. Other content elements do not influence code effectiveness, suggesting that ethical codes merely have a function of raising ethical awareness in sports clubs. These results help to shed light on what it takes for a code of ethics to become a useful and effective instrument to tackle unethical behavior in sports clubs. (shrink)

Asylum-seeking and refugee women (ASRW) are population groups characterized by diverse social, economic and legal backgrounds as well as diverse needs. Their backgrounds of forced migration have a profound impact on their overall health, including their sexual and reproductive health (SRH). In Europe, the SRH needs of ASRW are usually more pressing than those of the host country population. In the context of refugee health, it is important to distinguish between asylum seekers and statutory refugees, as asylum seekers have distinct (...) needs and often limited rights in their host country. Yet both groups face many barriers in accessing national health services. This article addresses the issue of entitlements to health services for asylum-seeking women in Europe, and highlights the wide range of difficulties of both asylum-seeking and refugee women in accessing (sexual and reproductive) health services. (shrink)

BackgroundPatient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients’ and nurses’ perspective seems crucial.AimTo explore how patients and their nurses perceive the importance and enactment of values in their healthcare.Research designAn observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and (...) empowerment) as described in the taxonomy of Bastemeijer et al.Participants and research contextThe survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium.Ethical considerationsThis study was approved by the ethical committee of the Ghent University Hospital (B670201836799).Findings(1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients.DiscussionOur findings challenge nurses’ overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs.ConclusionOur findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients. (shrink)

This paper motivates institutional epistemic trust as an important ethical consideration informing the responsible development and implementation of artificial intelligence (AI) technologies (or AI-inclusivity) in healthcare. Drawing on recent literature on epistemic trust and public trust in science, we start by examining the conditions under which we can have institutional epistemic trust in AI-inclusive healthcare systems and their members as providers of medical information and advice. In particular, we discuss that institutional epistemic trust in AI-inclusive healthcare depends, in part, on (...) the reliability of AI-inclusive medical practices and programs, its knowledge and understanding among different stakeholders involved, its effect on epistemic and communicative duties and burdens on medical professionals and, finally, its interaction and alignment with the public’s ethical values and interests as well as background sociopolitical conditions against which AI-inclusive healthcare systems are embedded. To assess the applicability of these conditions, we explore a recent proposal for AI-inclusivity within the Dutch Newborn Screening Program. In doing so, we illustrate the importance, scope, and potential challenges of fostering and maintaining institutional epistemic trust in a context where generating, assessing, and providing reliable and timely screening results for genetic risk is of high priority. Finally, to motivate the general relevance of our discussion and case study, we end with suggestions for strategies, interventions, and measures for AI-inclusivity in healthcare more widely. (shrink)

A variety of recent philosophical discussions, particularly on topics relating to complexity, have begun to reemploy the concept of 'emergence'. Although multiple concepts of 'emergence' are available, little effort has been made to systematically distinguish them. In this paper, I provide a taxonomy of higher-order properties that (inter alia) distinguishes three classes of emergent properties: (1) ontologically basic properties of complex entities, such as the mythical vital properties, (2) fully configurational properties, such as mental properties as they are conceived of (...) by functionalists and computationalists, and (3) highly configurational/holistic properties, such as the higher-level patterns characteristic of complex dynamical systems. Or more simply: emergence as ontological liberality, emergence as multiple realizability, and emergence as interactive complexity. (shrink)

A variety of recent philosophical discussions, particularly on topics relating to complexity, have begun to reemploy the concept of 'emergence'. Although multiple concepts of 'emergence' are available, little effort has been made to systematically distinguish them. In this paper, I provide a taxonomy of higher-order properties that distinguishes three classes of emergent properties: ontologically basic properties of complex entities, such as the mythical vital properties, fully configurational properties, such as mental properties as they are conceived of by functionalists and computationalists, (...) and highly configurational/holistic properties, such as the higher-level patterns characteristic of complex dynamical systems. Or more simply: emergence as ontological liberality, emergence as multiple realizability, and emergence as interactive complexity. (shrink)

Impaired hand proprioception can lead to difficulties in performing fine motor tasks, thereby affecting activities of daily living. The majority of children with unilateral cerebral palsy experience proprioceptive deficits, but accurately quantifying these deficits is challenging due to the lack of sensitive measurement methods. Robot-assisted assessments provide a promising alternative, however, there is a need for solutions that specifically target children and their needs. We propose two novel robotics-based assessments to sensitively evaluate active and passive position sense of the index (...) finger metacarpophalangeal joint in children. We then investigate test-retest reliability and discriminant validity of these assessments in uCP and typically developing children, and further use the robotic platform to gain first insights into fundamentals of hand proprioception. Both robotic assessments were performed in two sessions with 1-h break in between. In the passive position sense assessment, participant's finger is passively moved by the robot to a randomly selected position, and she/he needs to indicate the perceived finger position on a tablet screen located directly above the hand, so that the vision of the hand is blocked. Active position sense is assessed by asking participants to accurately move their finger to a target position shown on the tablet screen, without visual feedback of the finger position. Ten children with uCP and 10 age-matched TDC were recruited in this study. Test-retest reliability in both populations was good >0.79). Proprioceptive error was larger for children with uCP than TDC, indicating discriminant validity. The active position sense was more accurate than passive, and the scores were not correlated, underlining the need for targeted assessments to comprehensively evaluate proprioception. There was a significant effect of age on passive position sense in TDC but not uCP, possibly linked to disturbed development of proprioceptive acuity in uCP. Overall, the proposed robot-assisted assessments are reliable, valid and a promising alternative to commonly used clinical methods, which could help gain a better understanding of proprioceptive impairments in uCP, facilitating the design of novel therapies. (shrink)

Several attempts to conceptualize farm animal welfare have been criticized for diverging reasons, among them often the failure to incorporate the public concern and opinion. This paper’s objective is to develop a conception of farm animal welfare that starts from the public’s perception and integrates the opinion of different stakeholder representatives, thus following a fork-to-farm approach. Four qualitative citizen focus group discussions were used to develop a quantitative questionnaire, which has been completed by a representative sample of Flemish citizens ( (...) n = 459). Exploratory and confirmatory factor analyses were applied to develop a conception of farm animal welfare starting from an extended list of aspects that relate to animal production and associate with farm animal welfare in the public’s perception. In depth interviews with stakeholder representatives were used to match and adapt the structure of the animal welfare conception model. The resulting conception revealed seven dimensions grouped in two different levels. Three dimensions were animal-based: “Suffering and Stress,” “Ability to Engage in Natural Behavior,” and “Animal Health.” Four dimensions were resource-based: “Housing and Barn climate,” “Transport and Slaughter,” “Feed and Water,” and “Human-Animal Relationship.” This conception is distinct from earlier attempts since it is based on public perceptions; it addresses the opinion of different stakeholders, and it distinguishes empirically between animal-based and resource-based dimensions in the conceptualization of farm animal welfare. The relevancy of a popular definition is supported by the present demand oriented economy, in which animal welfare is a non-trade concern, and mainly left to the market where consumers still mainly act as individuals who calculate and weigh pros and cons. (shrink)

The current orthodoxy in the philosophy of mind can be thought of as a kind of third-person imperialism, viz. the view that consciousness, like other natural phenomena, will yield to scientific explanation at some level of analysis. Among its dissenters are a group of antireductionists and antimaterialists who advocate a kind of first-person isolationism, viz. the view that consciousness, unlike other natural phenomena, will fail to yield to scientific explanation at any level of analysis. In its various forms, the latter (...) view is based on arguments that identify first-person phenomena, such as subjectivity and qualia, that no third-person approach to consciousness can explain. ;I argue that neither subjectivity nor qualia constitute insuperable obstacles for scientific explanations of consciousness. By identifying a set of persistent ambiguities within the subjectivity-based arguments of antiphysicalists, I provide a general framework for systematically locating fallacies within them. I then examine the common antiphysicalist assumption that the meanings of phenomenal concepts are fully determined by the conscious mental states to which they refer. By showing how it results in a commitment to the existence of essentially private language, I contend that this assumption is indefensible, and that antiphysicalist arguments that rely on it are therefore unsound. ;I then argue that qualia are intrinsic, basic, and subjective properties of conscious mental states, and that, contrary to antireductionists' suggestions, this higher-order classification is compatible with qualia reduction. I show this compatibility by examining the putative higher-order properties of qualia and comparing them to the higher-order properties characteristic of connectionist models of cognitive processes. I contend that the higher-order properties characteristic of connectionist networks approximate the putative higher-order properties of qualia sufficiently well to conclude that qualia reductionism can accommodate claims that qualia are intrinsic, basic, and subjective properties, and explain the motivating intuitions for those claims generated by inverted, absent, and alien qualia thought experiments. In this way I argue that the putative higher-order classifications of qualia not only fail to defeat qualia reduction but, ironically, turn out to support it. (shrink)

Antireductionist philosophers have argued for higher-order classifications of qualia that locate consciousness outside the scope of conventional scientific explanations, viz., by classifying qualia as intrinsic, basic, or subjective properties, antireductionists distinguish qualia from extrinsic, complex, and objective properties, and thereby distinguish conscious mental states from the possible explananda of functionalist or physicalist explanations. I argue that, in important respects, qualia are intrinsic, basic, and subjective properties of conscious mental states, and that, contrary to antireductionists' suggestions, these higher-order classifications are compatible (...) with qualia reduction. I demonstrate this compatibility by examining the putative higher-order properties of qualia and comparing them to the higher-order properties characteristic of connectionist models of cognitive processes. I contend that the higher-order properties characteristic of connectionist networks approximate the putative higher-order properties of qualia sufficiently well to conclude that qualia reductionism can accommodate claims that qualia are intrinsic, basic, and subjective properties, and explain the motivating intuitions for those claims generated by inverted, absent, and alien qualia thought experiments. In this way I argue that the putative higher-order classifications of qualia not only fail to defeat qualia reduction but, ironically, turn out to support it. (shrink)

Focusing solely on the near-death cognizance of the dying, rather than the material perspective of the living, reveals a new understanding of death. Its significance to psychology, philosophy, and religion is huge for what emerges is a long overlooked phenomenon: a nonsupernatural, relativistic, and timelessly eternal consciousness, which can be a natural afterlife. Ironically, the validity of the theory of a natural eternal consciousness (NEC) assumes the loss of all materially based consciousness with death—more specifically, the permanent loss of time (...) perception. The theory claims, and the article deduces from empirical knowledge, that by imperceptibly entering the timelessness before death, one’s last conscious moment, whatever the type, becomes by default—psychologically, from one’s perspective—a forever present moment. To help explain and validate the theory, the article presents thought experiments and a formal model of all of life’s moments and all transitions between periods of time perception and those of timelessness. An open-minded reading should reveal that the NEC does not threaten faith in a god or a heaven. (shrink)

For centuries humans have considered just two main possibilities for what awaits us at death: a “nothingness” like that of our before-life or some type of supernatural afterlife. The theory of a natural afterlife defines a vastly different, real possibility. The natural afterlife embodies all of the sensory perceptions, thoughts, and emotions present in the final moment of a near-death, dreamlike experience. With death this moment becomes timeless and everlasting to the dying person—essentially, a never-ending experience. The relativeness and timelessness (...) of the natural afterlife must be clearly understood to appreciate why it’s not supernatural yet indeed an afterlife and potentially the optimal heaven. The theory of a natural afterlife is now only a hypothesis; however, science, human experience, and logical deduction suggest that it’s extremely plausible and advances in science and technology could someday make it a scientific theory. This paper states the theory, describes the unconventional afterlife it defines, extensively analyzes its validity, and briefly addresses how it can significantly impact how people view death. Analytical tools, typically used for system modeling and language definition, are applied here to present an abstract model of a lifetime within time eternal. The model is used to support and explain the theory. (shrink)

The theory of a natural eternal consciousness (NEC) states that human consciousness is not extinguished with death but merely paused. That is, the last conscious moment of one’s last experience becomes imperceptibly timeless and deceptively eternal from their perspective. Moreover, if that experience is a vision, dream, or near-death experience (NDE) and is perceived as an afterlife, then the NEC is a natural afterlife. An earlier article by this author explains the NEC theory and claims its validity. This addendum provides (...) a brief overview of that article but, more significantly, these enhancements: (1) an easier to grasp description of the notation used to formally define the NEC and natural afterlife; (2) an extension to this notation to formally define the eventually timeless natural afterlife (etna) — a time-perceiving, activity-filled afterlife that concludes with the timeless natural afterlife and can provide optimal eternal happiness; (3) greater focus on the validity of the NEC theory: the role of self-awareness, the theory of Paused Consciousness in Timelessness (PCT) and its everyday verification, and the improbable falsification of the NEC theory as a hypothesis to the PCT theory; and (4) a new diagram that summarizes the meanings of NEC-related terms and the relationships among them. (shrink)

THIS BOOK REVEALS an amazingly long-overlooked psychological reality that dawned on the author when he woke up from a dream and thought: “Suppose I had never woken up? Though others would know, how would I ever know it was over?” Based on cognitive science research and analysis, the author found that consciousness is not extinguished with death but, from a dying person’s perspective, only imperceptibly “paused.” -/- Given this, from your perspective, you’ll never lose your mind, self, and soul. And, (...) given dreams and near-death experiences, you may experience a timeless natural—i.e., scientifically supported—afterlife, which can be a heaven of utmost happiness. -/- Charles Darwin’s theory of natural selection was an earth-shattering revelation about how life evolved. This book is about an equally earth-shattering scientific theory about how a human life ends, including its possible impact on society and on you. (shrink)

The theory of a natural eternal consciousness (NEC) states that human consciousness is not extinguished with death but merely paused. That is, the last conscious moment of one’s last experience becomes imperceptibly timeless and deceptively eternal from their perspective. Moreover, if that experience is a vision, dream, or near-death experience (NDE) and is perceived as an afterlife, then the NEC is a natural afterlife. An earlier article by this author explains the NEC theory and claims its validity. This addendum provides (...) a brief overview of that article but, more significantly, these enhancements: (1) an easier to grasp description of the notation used to formally define the NEC and natural afterlife; (2) an extension to this notation to formally define the eventually timeless natural afterlife (etna) — a time-perceiving, activity-filled afterlife that concludes with the timeless natural afterlife and can provide optimal eternal happiness; (3) more focus on the validity of the NEC theory: the role of self-awareness, the theory of Paused Consciousness in Timelessness (PCT) and its everyday verification, and the improbable falsification of the NEC theory as a hypothesis to the PCT theory; and (4) a new diagram that summarizes the meanings of NEC-related terms and the relationships among them. (shrink)

Objective: Although nurses have an important role in the care process surrounding artificial food or fluid administration in patients with dementia or in terminally ill patients, little is known about their attitudes towards this issue. The purpose of this study was to thoroughly examine nurses’ attitudes by means of a literature review.Method: An extensive systematic search of the electronic databases PubMed, Cinahl, PsycINFO, The Cochrane Library, FRANCIS, Philosopher’s Index and Social Sciences Citation Index was conducted to identify pertinent articles published (...) from January 1990 to January 2007.Findings: Nurses’ arguments for or against could be categorised as ethical-legal, clinical or social-professional. The most important arguments explicitly for artificial food and fluid administration in patients with dementia or in terminally ill patients were sanctity of life, considering artificial food and fluid administration as basic nursing care, and giving reliable nutrition, hydration or medication. An explicit counter-argument was the high cost of treatment. Arguments used by opponents and proponents were quality of life and dignified death. The arguments were not strikingly different for the two patient populations. It turned out that the nurses’ ethical arguments remarkably reflected the current ethical debate. But some of their clinical presuppositions contradicted current clinical evidence.Conclusion: The interaction between clinical facts and ethical reflections makes the findings of this review extremely relevant for clinical ethics. A large need exists to clearly communicate to nurses the latest clinical evidence and the main results of ongoing ethical debates. (shrink)

Brought together by an impressive, international array of contributors this book presents a representative study of some of the many misinterpretations that have evolved concerning the medieval period.