The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)

After having defined the KARO logic for specifying intelligent agents in earlier work we now turn to the question how to realise agents specified in the KARO framework. To this end we look at agent programming languages that we have defined, and investigate how programs in these languages can be linked to the KARO logic.

This is the first detailed study to explore the little-understood notions of "knowing who someone is," "knowing a person's identity," and related locutions. It locates these notions within the context of a general theory of believing and a semantical theory of belief- and knowledge-ascriptions.The books's main contention is that what one knows, when one knows who someone is, is not normally an identity in the numerical sense of "a = b," but rather a certain sort of predication to know who (...) someone is is just to know that that person is F, where "F" is a predicate that is "important," in a technical sense defined by the authors, for the purposes determined by context. Their book offers a rigorous formal semantics for ascriptions of knowing and of knowing-who in particular, solving such well-known problems and paradoxes as Kripke's Puzzle, and Quines difficulties with de re belief, along the way.The authors apply their analysis to each of several important issues in philosophy of language, philosophy of mind, and ethical theory in which the previously unexamined notion of "knowing who" has loomed large-the mechanics of linguistic referring, the foundations of epistemic logic, problems of self-knowledge and self-regarding belief, universalizability and "Golden Rule" arguments in ethics, and moral "personalism" versus "impartialism."Stephen Boër is Professor of Philosophy at the Ohio State University. William Lycan is Professor of Philosophy at the University of North Carolina and author of Logical Form in Natural Language. A Bradford Book. (shrink)

The main question of this paper is how people may agree in their interpersonal comparisons of wellbeing. These comparisons are important in social ethics and for policy purposes. The paper firstly examines grounds for convergence in easy cases. Then comes a more difficult case of low convergence in order to explore a way to increase it. For this, concepts from the empirical subjective well-being literature are used: life satisfaction and vignettes. Ideas of John Harsanyi and Serge Kolm thereby receive a (...) new look. (shrink)

Jackendoff's scenario of the evolution of language is a major contribution towards a more rigorous theory of the origins of language, because it is theoretically constrained by a testable theory of modern language. However, the theoretical constraints from evolutionary theory are not really recognized in his work. We hope that Jackendoff's lead will be followed by intensive cooperation between linguistic theorists and evolutionary modellers.

Does philosophical critique have a future? What are its possibilities, limits, and presuppositions? Bringing together outstanding scholars from various traditions, this collection of essays is the first to examine the forms of critique that have shaped modern and contemporary continental thought. Through critical analyses of key texts by, among others, Spinoza, Kant, Hegel, Marx, Adorno, Habermas, Foucault, and Rancière, it traces the way critique has time and again geared itself towards new cultural, social, and political problems, shedding those of its (...) assumptions no longer deemed tenable. It is our hope that the many voices of critique that arise from the present volume will produce effects – new doubts, new insights, new challenges, or new resources – that none could have achieved on their own. (shrink)

Scholarly debates on the Critique of Pure Reason have largely been shaped by epistemological questions. Challenging this prevailing trend, Kant's Reform of Metaphysics is the first book-length study to interpret Kant's Critique in view of his efforts to turn Christian Wolff's highly influential metaphysics into a science. Karin de Boer situates Kant's pivotal work in the context of eighteenth-century German philosophy, traces the development of Kant's conception of critique, and offers fresh and in-depth analyses of key parts of the (...) Critique of Pure Reason, including the Transcendental Deduction, the Schematism Chapter, the Appendix to the Transcendental Analytic, and the Architectonic. The book not only brings out the coherence of Kant's project, but also reconstructs the outline of the 'system of pure reason' for which the Critique was to pave the way, but that never saw the light. (shrink)

Science is highly dependent on the technologies needed to observe scientific objects. In How Scientific Instruments Speak, Bas de Boer develops a philosophical account of instruments in scientific practice, focusing on the cognitive neurosciences. He argues for an understanding of scientific instruments as mediating technology.

although mostly known to specialists nowadays, Kenelm Digby was a remarkable figure on the intellectual scene of the early seventeenth century. He has been described as “one of the most influential natural philosophers” of his time,1 and corresponded with many of the great scholars of his days, including Descartes, and the French pioneer of atomism, Pierre Gassendi. In the later years of his life, Digby, alongside men like Robert Boyle, became one of the founding members of the Royal Society.2Digby authored (...) one major work of philosophy: the Two Treatises of 1644. This work consisted of a long First Treatise on bodies, and a shorter, Second Treatise on the human soul. In the First Treatise, Digby argued... (shrink)

BackgroundIn the Netherlands, patients have the legal right to make a request for euthanasia to their physician. However, it is not clear what it means in a moral sense for a physician to receive a request for euthanasia. The aim of this study is to explore the moral values of physicians regarding requests for euthanasia. MethodsSemi-structured interviews were conducted with nine primary healthcare physicians involved in decision-making about euthanasia. The data were inductively analyzed which lead to the emergence of themes, (...) one of which was about values regarding end-of-life decisions.ResultsFour clusters of values related to euthanasia requests are described: values related to 1) the patient; 2) the family; 3) the physician; and 4) life and death. The data show that the participants value patient autonomy as a necessary but not sufficient condition for meeting a euthanasia request. A good relationship with the patient and the family are important. For the physician, the values physician autonomy, responsibility, understanding the patient and relief of suffering play a role. Life as an intrinsic good and a peaceful death are also important values.ConclusionThis study shows that next to patient autonomy and the relationship with the patient and the family, it is important for the participants to act in accordance with their professional values and to do justice to values related to life and death. The awareness of going against the intrinsic value of life is crucial, even if performing euthanasia may result in a feeling of relief or gratitude afterwards. (shrink)

Hegel is most famous for his view that conflicts between contrary positions are necessarily resolved. Whereas this optimism, inherent in modernity as such, has been challenged from Kierkegaard onward, many critics have misconstrued Hegel's own intentions. Focusing on the Science of Logic, this transformative reading of Hegel on the one hand exposes the immense force of Hegel's conception of tragedy, logic, nature, history, time, language, spirit, politics, and philosophy itself. Drawing out the implications of Hegel's insight into tragic conflicts, on (...) the other hand, De Boer brings into play a form of negativity that allows us to understand why the entanglement of complementary positions always tends to turn into their conflict, but not necessarily into its resolution. (shrink)

A central issue in postphenomenology is how to explain the multistability of technologies: how can it be that specific technologies can be used for a wide variety of purposes (the “multi”), while not for all purposes (the “stability”)? For example, a table can be used for the purpose of sleeping, having dinner at, or even for staging a fencing match, but not for baking a cake. One explanation offered in the literature is that the (material) design of a technology puts (...) constraints on the purposes for which technologies can be used. In this paper, I argue that such an explanation—while partly correct—fails to address the role of the environment in which human beings operate in putting constraints on technology use. I suggest that James Gibson’s affordance theory helps highlighting how stabilities in technology use arise in the interaction between human being and environment. Building on more recent approaches in affordance theory, I suggest that the environment can be conceptualized as a “rich landscape of affordances” that solicits certain actions, which are not just cued by the environment’s material structure, but also by the normativity present in the form of life in which a human being participates. I briefly contrast the approach to affordances developed in this paper with how Klenk (2020) and Tollon (2021) have conceptualized the “affordance character” of technological artifacts, and highlight how a focus on the situated nature of affordances augments these earlier conceptualizations. (shrink)

Translated from the Dutch, this book offers a systematic interpretation of Heidegger's thought, focusing particularly on recently published works.

INTRODUCTION In the first part of this study I will deal with the publications of Husserl's first period, ie Ueber den Begriff der Zahl (his "Habilita- ...

This paper focuses on a particular method which is used in contemporary empirical happiness studies, namely measuring people’s happiness by scoring their emotions (Kahneman is a prominent scholar). I examine the presupposition in this field that emotion scores can be added or subtracted, that throughout affective space runs a straight axis that plots hedonic tone or pleasure.

in a late note, dated 1797, Kant refers to the schematism of the pure understanding as one of the most difficult as well as one of the most important issues treated in the Critique of Pure Reason.1 His treatment of this theme is indeed notorious for its obscurity.2 As I see it, part of the problem is caused by the fact that Kant frames his discussion in terms that he could expect his readers to be familiar with, while he gradually (...) develops ideas that breach any traditional account of cognition. This holds for his references to the power of judgment and the related view that cognition is a matter of subsuming intuitions under concepts3 as well as for the suggestion that there is an initial gap between categories... (shrink)

In the Critique of Pure Reason and elsewhere, Kant uses the term ‘object’ in various ways and often without clearly signaling its different meanings. As a result, it is hard to gauge the extent to which Kant’s account of the object of cognition breaks new ground. In this article, I take the Critique to establish what is required to generate an object of cognition per se soleley by examining the various ways in which the human mind can objectify the content (...) of its representations. To clarify this endeavor, I distinguish four different ways in which the term ‘object’ is used in the Critique, namely, to refer to (1) material things, (2) the content of any type of thought, (3) the mind-immanent correlate of a cognition in the broad sense of the term, and (4) the mind-immanent correlate of a cognition in the strict sense of the term. On my reading, the fourth meaning of the term ‘object’ is key to the Transcendental Deduction and completes Kant’s unprecedented conception of the cognitive acts by means of which the human mind produces objects of cognition out of a manifold of representations. (shrink)

In current phenomenology of medicine, health is often understood as a state of transparency in which our body refrains from being an object of explicit attention. In this paper, I argue that such an understanding of health unnecessarily presupposes an overly harmonious alignment between subjective and objective body, resulting in the idea that our health remains phenomenologically inaccessible. Alternatively, I suggest that there are many occasions in which one’s body in health does become an object of attention, and that technologies (...) mediate how a relation with one’s body is formed. First, I show prominent accounts in current phenomenology of medicine understand health in terms of a harmonious alignment between objective and subjective body. Second, I argue that there are many occasions in which there is a disharmony between objective and subjective body, and suggest that also in health, we cannot escape being an object that we often relate to. Then, I draw on postphenomenology to show how technologies such as digital self-tracking applications and digital twins can be understood as mediating the relationship with one’s own body in a specific way. In conclusion, I argue that both technologies make present the objective body as a site for hermeneutic inquiry such that it can be interacted with in terms of health parameters. Furthermore, I point to some relevant differences in how different technologies make aspects of our own body phenomenologically present. (shrink)

In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which (...) explore the interplay between technologies and morality, we present an analysis of concerns related to the adoption of machine learning-aided medical diagnosis. We analyze anticipated moral issues that machine learning systems pose for different stakeholders, such as bias and opacity in the way that models are trained to produce diagnoses, changes to how health care providers, patients, and developers understand their roles and professions, and challenges to existing forms of medical legislation. Albeit preliminary in nature, the insights offered by the technomoral change and the technological mediation approaches expand and enrich the current discussion about machine learning in diagnostic practices, bringing distinct and currently underexplored areas of concern to the forefront. These insights can contribute to a more encompassing and better informed decision-making process when adapting machine learning techniques to medical diagnosis, while acknowledging the interests of multiple stakeholders and the active role that technologies play in generating, perpetuating, and modifying ethical concerns in health care. (shrink)

Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. Important features were: all professionals (...) who are directly involved with the patient contribute to MEDM; a five-step procedure is used: exploration, agreement on the ethical dilemma/investigation of solutions, analysis of solutions, decision-making, planning actions; meetings are chaired by an impartial ethicist. A 15-item questionnaire to survey staff perceptions on this intervention just before and 8 months after implementation was developed. Results Before and after response rates were 91/105 (87%) and 85/113 (75%). Factor analysis on the questionnaire suggested a four-factor structure: participants' role; structure of MEDM; content of ethical deliberation; and documentation of decisions/conclusions. Effect sizes were 1.67 (p<0.001), 0.69 (p<0.001) and 0.40 (p<0.01) for the first three factors respectively, but only 0.07 (p=0.65) for the fourth factor. Nurses' perceptions of improvement did not significantly exceed those of physicians. Conclusion Professionals involved in ethical case deliberation perceived that the process of decision-making had improved; they were more positive about the structure of meetings, their own role and, to some extent, the content of ethical deliberation. Documentation of decisions/conclusions requires further improvement. (shrink)

This article challenges the prevailing interpretations of Hegel's account of the concept "contradiction" in the Science of Logic by arguing that it is concerned with the principle of Hegel's method rather than with the classical law of non-contradiction. I first consider Hegel's Doctrine of Essence in view of Kant's discussion of the concepts of reflection in the first Critique. On this basis, I examine Hegel's account of the logical principles based on the concepts "identity," "opposition," and "contradiction." Finally, I point (...) out how the principle Hegel derives from the concept of contradiction actually informs his own method. (shrink)

During the Corona pandemic, it became clear that people are vulnerable to potentially harmful nonhuman agents, as well as that our own biological existence potentially poses a threat to others, and vice versa. This suggests a certain reciprocity in our relations with both humans and nonhumans. In his The Visible and the Invisible, Merleau-Ponty introduces the notion of the flesh to capture this reciprocity. Building on this idea, he proposes to understand our relationships with other humans, as well as those (...) with nonhuman beings as having a chiasmic structure: to sense, or perceive another entity in a particular way simultaneously implies to be sensed or perceived in a particular way by this other entity. In this paper, we show how a postphenomenological perspective expands on Merleau-Ponty: first, it more radically interprets Merleau-Ponty’s notion of flesh by not only considering it to be a medium that is the condition of possibility for vision but as pointing to the constitution of an intercorporeal field in which entities—both human and nonhuman—mutually sense one another. Second, it augments Merleau-Ponty’s thought by drawing attention to how technologies mediate chiasmic relations. This is clarified through the example of the facemask, which reveals the chiasmic structure of our relation with nonhuman entities, and shows that technologies co-constitute interpersonal relationships by making humans present to one another in a particular way. We suggest that these aspects are not unique to the facemask, but point to a general technologically mediated chiasmic structure of human-world relations. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

René Descartes, among others, tried to downplay the role of the human imagination by identifying man’s true inner nature with our rational thinking self, a view that according to many became central to the modern self-understanding. In the wake of the 20th-century critiques of this Cartesian view of man, imagination is finally making its comeback. What is often overlooked, however, is that for a long time imagination was deemed vitally important. This project takes a close look at philosophical theories of (...) the imagination in a crucial, but neglected, period in which it was still considered by many, for better or worse, to belong to human nature no less than reason (1350–1600). (shrink)

From the time of his very first courses, Heidegger seeks to thematize the radically finite dynamic for human life. As he considers traditional metaphysics to be incapable of facing this finitude, he engages in a critical examination of its most fundamental presuppositions. This article attempts to elucidate Heidegger's critique by means of twodifferent detours. First I show that the idea of self-realization, which Aristotle understood to be the most perfect movement, is unable to account for the tragic, unstable and internally (...) divided structure of human life. Whereas the idea of self-realization determined the ensuing history of metaphysics — including Hegel — to a considerable extent, I understand Heidegger to develop against the background of this tradition a dynamic principle which allows us to conceive of every human striving as essentially threatene by the very principle that makes it possible. I then turn to Greek tragedy, especially to Oedipus Rex, to clarify this radically finite principle in terms of the essential structure of the tragic as such. The tendency of both human life and philosophy to turn away from this essentially tragic movement can be understood as the 'fall' which is inherent in all efforts of the human being to raise itself above itself. Heidegger's own thinking, on the other hand, can be characterized as a finite attempt to withstand this predominant tendency of western philosophy. (shrink)

The current crisis makes it clear that the financial sector has an ever greater impact on national and international politics. This development poses a challenge not only to Europe, but also to our philosophical understanding of the relationship between politics and the market. In order to use Hegel’s Philosophy of Right for the purpose of reflecting on this relationship, I begin by arguing that recent commentators, including Honneth and Pippin, unduly play down Hegel’s critique of the liberalist conception of freedom (...) as well as the conception of the state that follows from this critique. Turning to Hegel’s analysis of the relationship between civil society and the state, I submit that we can learn from Hegel that it is crucial for modern societies to let citizens pursue their own interests, but that a one-sided focus on this element threatens to undermine the society as a whole. This is the case if the political domain, which ought to be devoted to the long-term interests of the society as a whole, fails to sufficiently distinguish itself from the struggle between contending particular interests that characterizes civil society. (shrink)

In 1974, Winfried Fauser published his edition of Radulphus Brito’s commentary on the third book of Aristotle’s De anima. This contribution continues his project by providing an edition of Brito’s commentary on the first book and the first third of the second book. An analysis of this part of the commentary shows that Brito developed some original views that had an impact on the fourteenth-century commentary tradition.

Borsboom and colleagues have recently proposed a “network theory” of psychiatric disorders that conceptualizes psychiatric disorders as relatively stable networks of causally interacting symptoms. They have also claimed that the network theory should include non-symptom variables such as environmental factors. How are environmental factors incorporated in the network theory, and what kind of explanations of psychiatric disorders can such an “extended” network theory provide? The aim of this article is to critically examine what explanatory strategies the network theory that includes (...) both symptoms and environmental factors can accommodate. We first analyze how proponents of the network theory conceptualize the relations between symptoms and between symptoms and environmental factors. Their claims suggest that the network theory could provide insight into the causal mechanisms underlying psychiatric disorders. We assess these claims in light of network analysis, Woodward’s interventionist theory, and mechanistic explanation, and show that they can only be satisfied with additional assumptions and requirements. Then, we examine their claim that network characteristics may explain the dynamics of psychiatric disorders by means of a topological explanatory strategy. We argue that the network theory could accommodate topological explanations of symptom networks, but we also point out that this poses some difficulties. Finally, we suggest that a multilayer network account of psychiatric disorders might allow for the integration of symptoms and non-symptom factors related to psychiatric disorders and could accommodate both causal/mechanistic and topological explanations. (shrink)

Food consumption has been identified as a realm of key importance for progressing the world towards more sustainable consumption overall. Consumers have the option to choose organic food as a visible product of more ecologically integrated farming methods and, in general, more carefully produced food. This study aims to investigate the choice for organic from a cultural–historical perspective and aims to reveal the food philosophy of current organic consumers in The Netherlands. A concise history of the organic food movement is (...) provided going back to the German Lebensreform and the American Natural Foods Movement. We discuss themes such as the wish to return to a more natural lifestyle, distancing from materialistic lifestyles, and reverting to a more meaningful moral life. Based on a number of in-depth interviews, the study illustrates that these themes are still of influence among current organic consumers who additionally raised the importance of connectedness to nature, awareness, and purity. We argue that their values are shared by a much larger part of Dutch society than those currently shopping for organic food. Strengthening these cultural values in the context of more sustainable food choices may help to expand the amount of organic consumers and hereby aid a transition towards more sustainable consumption. (shrink)

Heidegger often stressed that the analysis of Dasein in Being and Time should be understood as a mere preliminary investigation. That this analysis indeed prepares the investigation into the relationship between time, the understanding of Being and ontology,can only become clear when some light is thrown on the never published third section ofBeing and Time. In this section Heidegger would have explicated in what sense time can be understood as condition of possibility for every kind of ontology. As ontology is (...) a specific possibility of human beings, this possibility must be based on the same basic structures as Dasein as such. In Heidegger's analysis of Dasein, the distinction between a proper and an improper mode of existence is understood as based on a different temporalisation of temporality. Improperness results from a temporal movement in which presentness takes the upper hand and determines the way Dasein understands beings, other people and itself. In the proper mode of existence on the other hand, not only presence, but the three ecstasies of time as a whole would constitute the openness of Dasein. Heidegger would have demonstrated in the third section that this same temporal difference also forms the condition of possibility for the improper and proper mode of ontology: the so-called metaphysics of presence and Heideggers own temporal ontology respectively.From the rather formal perspective of our interpretation, the different moments of the analysis of Dasein are read in view of their significance for the investigation into the essence of metaphysics. By doing so, the third section appears to be the aim of Heidegger's questioning and the 'missing link' between the analysis oí Dasein and the destruction of traditional metaphysics. When Being and Time is read with such a focus on the third section, the often used distinction between the early and the later Heidegger looses much of its sharpness, if not its relevance: it is already in Being and Time itselfthat Heidegger tries to decenter the human being in behalf of a temporality that constitutes meaningful openness as such. (shrink)

This paper offers a two dimensional variation of Standard Deontic Logic SDL, which we call 2SDL. Using 2SDL we can show that we can overcome many of the difficulties that SDL has in representing linguistic sets of Contrary-to-Duties (known as paradoxes) including the Chisholm, Ross, Good Samaritan and Forrester paradoxes. We note that many dimensional logics have been around since 1947, and so 2SDL could have been presented already in the 1970s. Better late than never! As a detailed case study (...) illustrating the power of 2SDL, we examine the system DL of Deontic Logic of Andrew Jones and Ingmar Pörn offered in 1985 to solve the Chisholm paradox of Contrary to Duties. The critical examination is done using logics and methods available in 1985 and solutions are proposed using what was available in 1985. (shrink)