Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)

ABSTRACT Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health‐related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks. Aim: to (...) explore the ways in which clinicians distinguish important from unimportant health risks. Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in‐depth interviews on their interpretation of what makes a health risk important. Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance. Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)

Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health-related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks.Aim: to explore the (...) ways in which clinicians distinguish important from unimportant health risks.Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in-depth interviews on their interpretation of what makes a health risk important.Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance.Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction. (shrink)

Nowadays creativity is fashionable. Writers on management and organisation, for example, mention creativity as vital to entrepreneurship.1 They consider it to be as important as land, labour and capital, which form the traditional factors of production.2 And related terms such as ‘genius’ are in use again. An example of this is the widely read book Built to Last.3 Moreover, creativity and rationality are presented as alternatives. To be creative, managers are urged to put rationality aside: ‘being reasonable does not win (...) the day’ they are assured4 and ‘all progress depends on the unreasonable man’.5 This view that rationality and creativity oppose each other is, however, unsatisfactory involving, as it does, a form of epistemological schizophrenia. One excludes the other only if we adopt a simplistic concept of rationality and an esoteric view of creativity. This article, therefore, sets out to clarify the relationship between the concepts of creativity and rationality. Three ideal-type concepts of rationality will be introduced (algorithmic, judgemental, reflective) and their tolerance of novelty discussed. Then two modes of creativity (explorative and transcendentive) are distinguished, followed by a discussion of whether rationality can enhance creativity. I conclude by reviewing some factors involved in creativity, such as tolerance for ambiguity, playfulness and attentiveness, and with a short discussion of the relationship of creativity to power.6. (shrink)

Although Taylor’s scientific management is often severely criticised, his publications are seldom the subject of scrutinised, philosophical, reading. The latter is the aim of the present text. Attention is given to the idea of science, the role of extra-scientific values, the relationship of theory and practice, the societal meaning of management, presenting demarcations, presuppositions and unclarities. The conclusion notes several topics, implied by Taylor’s views and still worth reflecting upon. One example is efficiency as a seemingly context-independent concept.

Weights of evidence and logistic regression are two loglinear methods for mineral potential mapping. Both models are limited by their respective basic assumptions in application. Ideally, WofE indicator patterns have the property of conditional independence with respect to the point pattern of mineral deposits to be predicted; in LR, there supposedly are no interactions between the point pattern and two or more of the indicator patterns. If the CI assumption is satisfied, estimated LR coefficients become approximately equal to WofE contrasts (...) and the two methods produce similar results; additionally, bias then is avoided in that the sum of all estimated posterior probabilities becomes approximately equal to the number of observed discrete events. WofE allows construction of input layers that have missing data as a separate category in addition to known presence-absence type input, while logistic regression as such is not capable of handling missing data. As an improved WofE model based on LR, modified weights of evidence inherit the advantages of both LR and WofE, i.e., eliminates bias due to lack of CI and can handle missing data as well. Pixel or unit area input for MWofE consists of positive and negative weights for presence and absence of a pattern plus zeros for missing data. MWofE first is illustrated by application to simple examples. Next, it is applied to a study area with 20 known gold occurrences in southwestern Nova Scotia in relation to four input layers based on geological and lake geochemical data. Assuming that geochemical data were missing for the northern part of the study area, MWofE, like WofE but unlike LR, provides posterior probabilities for the entire area. (shrink)

This collection of articles and review essays, including many hard to find pieces, comprises the most important and fundamental studies of Indian logic and linguistics ever undertaken. Frits Staal is concerned with four basic questions: Are there universals of logic that transcend culture and time? Are there universals of language and linguistics? What is the nature of Indian logic? And what is the nature of Indian linguistics? By addressing these questions, Staal demonstrates that, contrary to the general assumption among (...) Western philosophers, the classical philosophers of India were rationalists, attentive to arguments. They were in this respect unlike contemporary Western thinkers inspired by existentialism or hermeneutics, and like the ancient Chinese, Greeks, and many medieval European schoolmen, only--as Staal says--more so. Universals establishes that Asia's contributions are not only compatible with what has been produced in the West, but a necessary ingredient and an essential component of any future human science. (shrink)

It might seem as if the Weltbild emanating from Aeschylus's plays in general—and the Oresteia in particular, as that shall be my main focus in what follows—exhibits an almost dreamlike incoherence. Building on the works of James J. Helm, I argue that, contrary to this reading, it is fruitful and plausible to read the trilogy as expounding a coherent moral outlook.

Thirty-four contributors address a variety of topics, from ancestral worship to transsexual masquerades, from metrical verse in the psalms to temples, poetic expression and linguistic performances. They bespeak the unique characteristics of Staal and his ability to break down barriers between academic disciplines. With contributors from around the world, this is a tribute to the forty years of scholarly work Frits Staal has invested in the foundation of a genuinely human science.

In his posthumously published Living Up to Death Paul Ricoeur left an impressive testimony on what it means to live at a high old age with death approaching. In this article I present him as a teacher who reminds us of valuable lessons taught by patients in palliative care and their caretakers who accompany them on their way to death, and also as a guide in our search for a modern ars moriendi, after—what many at least experience as—the breakdown of (...) traditional religious belief in a personal afterlife. These lessons can be summarized in the following theses. ‘Living up to death, one cannot experience one’s own death. Therefore, never consider someone dying as moribund’. ‘Though everybody is alone in dying, nobody should die alone.’ ‘The preparation for death is an affirmation of life’. ‘Life experienced as a gift can be given up’. The plausibility of the last thesis, however, may go beyond the confines of austere philosophical thinking. (shrink)

I argue that given a plausible reading of John Williams’s Stoner (2012 [1965]) the novel throws light on the demands and costs of pursuing a strategy for self-realisation along Platonic lines which seeks unification through the adoption of a single exclusive end in a manner that emulates the Socratic maieutic teacher. The novel does not explicitly argue either for or against such a strategy but rather vividly depicts its difficulties, appeal, and limitations, thus leaving the ultimate evaluation up to the (...) reader. (shrink)

Polemisch essay tegen de strekking van het werk "Over zin en onzin in filosofie, religie en wetenschap" door Frits Staal.

Until less than a century ago, the two prevailing views of dreams as well as of souls were that they are inconsequential or of divine origin. In either case it was assumed that they cannot be objects of rational inquiry. Similar views still prevail regarding mystical experiences and mysticism in general. Modern Western opinion, whether friendly or hostile, holds that the mystical falls squarely within the domain of the irrational. Mr. Staal argues that mysticism can be studied rationally, and that (...) without such study no theory of mind is complete. He exposes the grounds for the belief that mysticism cannot be studied, and shows them to be prejudices issuing from a particular historical development. While his contention has unflattering implications for the contemporary study of the humanities in general, it reveals in particular that existing academic approaches to the study of mysticism, even those that appear sound, are in fact inadequate. This conclusion applies to a variety of dogmatic inquiries and, as becomes clear in these pages, to philological, historical, phenomenological, sociological, physiological, and psychological ones as well. The illustrations in _Exploring Mysticism_ are drawn mainly from Indian forms of mysticism such as Yoga, supplemented with Buddhist, Taoist, Muslim and Christian examples. (shrink)

The biblical love imperative—reframed as "Care for the aging other, as you care for your aging self"—is fundamental for an ethics of aging. Kantian, utilitarian, and eudaemonist theories assume an ageless, rational, active individual. Frail old age, however, comes with dependency and decay. An ethics of aging therefore needs to be relational and must account for the fear of aging. The elderly remind us that death is inescapable; the body, fallible; and self-esteem, transitory. The love command offers a relational ethics (...) that overcomes the fear of aging and enables us to see that love for our aging self makes good elderly care possible. (shrink)