Dutch developments on euthanasia have drawn much attention over the years. Defenders and opponents have been telling very different stories about the practice of euthanasia and the frequency of cases, and the Dutch government has been struggling with the legal and moral problems involved. Concern about the procedures followed by physicians as well as questions on the “real” figures led the government to decide to organize an epidemiological study on the extent and the decision making. The results of the study (...) were published in November 1991. Interpretation of the data may lead to a final settlement of the debate on euthanasia and has inevitably led to a revival of the moral debate of the 1970s. For the moment it has been decided that euthanasia will remain officially illegal under the Penal Code. However, in cases where euthanasia does occur, Attorneys General will continue to check the procedures followed by physicians to ensure no abuses have occurred and to safeguard physicians against prosecution. In this contribution, we discuss the development and intertwinement of legal, medical, and moral aspects of euthanasia in The Netherlands and the effects of the empirical studies of 1991, both on definitions and procedures for medical decisions at the end of life. (shrink)

In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or (...) physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998). (shrink)

The approach to AIDS as a disease and a threat for social discrimination is used as an example to illustrate a conceptual thesis. This thesis is a claim that concerns what we call a medical issue or not, what is medicalised or needs to be demedicalised. In the friction between medicalisation and demedicalisation as discursive strategies the latter approach can only be effected through the employment of discourses or discursive strategies other than medicine, such as those of the law and (...) of economics. These discourses each realise different values, promote a different subject, and have a different concept of man. The concept of discourse is briefly outlined against concepts such as the linear growth concept of science and the growth model of science as changes in paradigm. The issue of testing for AIDS shows a conflict between the medical and the legal discourse and illustrates the title of our contribution: the human body as field of conflict between discourses. (shrink)

The open practice of euthanasia in The Netherlands stood alone in the world until the government of the Northern Territories in Australia accepted the possibility of physician-assisted suicide. Even though the active ending of lives in The Netherlands is still a crime by law, the current practice allows it and acquits physicians if certain conditions have been met. Of the many facets of euthanasia, the teaching of this practice represents a further logical step. In this contribution, we intend to describe (...) the comprehensive teaching program of euthanasia of the Free University of Amsterdam's Postgraduate Family Medicine Program. Here students receive university-based training for 1 day a week in a cohort of 12 and on the job training for 4 days with individual family physicians for 2 consecutive years. We especially intend to portray the integration of euthanasia into the wider teaching of the process of counseling and aid of the dying. (shrink)

Important bioethcs changes are underway in the Netherlands that carry, for better or worse, far-reaching social consequences. The two major areas of change involve economics and containing soaring health costs and end-of-life care as reflected in several high-profile cases: in a decision handed down by the Dutch Supreme Court on reviewing the procedures for the termination of life, in the discussion surrounding The Groningen Protocol and the active ending of lives in neonatology, and in a report of a Royal Dutch (...) Medical Society's Committee on the role of physicians in ending life in cases of requests to die outside the area of terminal diseases. (shrink)

Hospital ethics committees in The Netherlands have had the unique responsibility of developing euthanasia policies for their institutions. Although each policy necessarily reflects a particular facility, family resemblances necessarily remain. In the interest of ethics committees outside The Netherlands that may soon face the same challenge, two such policies are presented here accompanied by commentary high-lighting their similarities and differences.

The debate on the ethical permissibility of euthanasia in medicine has a corollary in the ethical application of drugs. The overall moral limits of medical treatment apply evenly to the moral acceptability of the pharmacological aspect of the act of euthanasia. The pharmacological aspect of the act is of ethical importance not only for the person requesting an active ending of his or her life, but also for the grieving family. Keywords: effectivity, ideal euthanaticum, patient's/family's interest, pharmacology of euthanasia, routes (...) of application CiteULike Connotea Del.icio.us What's this? (shrink)

The approach to AIDS as a disease and a threat for social discrimination is used as an example to illustrate a conceptual thesis. This thesis is a claim that concerns what we call a medical issue or not, what is medicalised or needs to be demedicalised. In the friction between medicalisation and demedicalisation as discursive strategies the latter approach can only be effected through the employment of discourses or discursive strategies other than medicine, such as those of the law and (...) of economics. These discourses each realise different values, promote a different subject, and have a different concept of man. The concept of discourse is briefly outlined against concepts such as the linear growth concept of science and the growth model of science as changes in paradigm. The issue of testing for AIDS shows a conflict between the medical and the legal discourse and illustrates the title of our contribution: the human body as field of conflict between discourses. (shrink)

This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practised only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated and helped regulate it. Some of them have themselves (...) practised euthanasia. The book will contribute to the world literature on physician-assisted death by providing a comprehensive examination of how euthanasia has been practised and how it has evolved in one specific national and cultural context. It will greatly advance the understanding of euthanasia among both advocates and opponents of the practice. (shrink)

In spite of the seminal work A Philosophical Basis of Medical Practice, the debate on the task and goals of philosophy of medicine still continues. From an European perspective it is argued that the main topics dealt with by Pellegrino and Thomasma are still particularly relevant to medical practice as a healing practice, while expressing the need for a philosophy of medicine. Medical practice is a discursive practice which is highly influenced by other discursive practices like science, law and economics. (...) Philosophical analysis of those influences is needed to discern their effect on the goals of medicine and on the ways in which the self-image of man may be changed. The nature of medical practice and discourse itself makes it necessary to include different philosophical disciplines, like philosophy of science, of law, ethics, and epistemology. Possible scenario's of euthanasia and the human genome project in the USA and Europe are used to exemplify how philosopy of medicine can contribute to a realistic understanding of the problems which are related to the goals of medicine and health care. (shrink)

In pursuit of my ultimate objective of being in control of my self-deliverance at the time when my physical condition no longer warrants continuance, I have joined the Hemlock Society of Los Angeles. The Society urges its members to explore with their personal physicians this subject well in advance of the actual moment of necessity, and in particular the problem of acquiring a lethal dose of a drug that will provide a release consistent in quality with the degree of peace (...) and serenity sought in life. It is my hope that we can find a process commensurate with your moral and professional concerns which will allow us to collaborate. (shrink)

The development of neonatology and the establishment of neonatal intensive care units has led to a vast array of new medical ethical problems and dilemmas centered around discontinuing treatment or nontreatment decisions. Neonatology has become one of the fields that has made clear that medical success is only rarely nonproblematic. The new technology can be a blessing for some, but it may also become a sad experience to others, with life-long repercussions.The ethical problems of neonatology transcend national boundaries. Nevertheless, there (...) are differences in approach among various countries. In The Netherlands, the ethical deliberations have been a matter of public debate, but most of the decision making is left to the medical profession; these decisions are considered too harsh for the general public. Recently, two developments have emerged. The Royal Dutch Medical Association and the Dutch Pediatrics Society have published reports with guidelines and ethical reflections. Over the same period of time, cases have been brought to court for legal analysis and the development of case precedence. (shrink)

As the issue of assisted dying continues toward more expanded legal standing, we shift our primary focus from questions of patients' rights to the largely overlooked challenges that face physicians who elect to assist patients in ending their lives. Dr. Howard Grossman, a Manhattan internist and plaintiff in the unsuccessful New York lawsuit to the Supreme Court, came forward to say, “Anybody who has done it knows that it is a tremendous decision that you carry with you forever.”1 We focus (...) our attention on the psychological experience and philosophical conflicts faced by physicians engaged in physician-assisted dying. Based on those potential conflicts, we argue for a new model of the physician and patient relationship in assisted dying: a medical friendship. a. (shrink)

The growth of knowledge and its effects on the practice of medicine have been issues of philosophical and ethical interest for several decades and will remain so for many years to come. The outline of the present volume was conceived nearly three years ago. In 1987, a conference on this theme was held in Maastricht, the Netherlands, on the occasion of the founding of the European Society for Philosophy of Medicine and Health Care (ESPMH). Most of the chapters of this (...) book are derived from papers presented at that meeting, and for the purpose of editing the book Stuart Spicker, Ph. D., joined two founding members of ESPMH, Henk ten Have and Gerrit Kimsma. The three of them successfully brought together a number of interesting contribu tions to the theme, and ESPMH is grateful and proud to have initiated the production of this volume. The Society intends that annual meetings be held in different European countries on a rotating basis and to publish volumes related to these meetings whenever feasible. In 1988, the second conference was held in Aarhus, Denmark on "Values in Medical Decision Making and Resource Allocation in Health Care". In 1989, a meeting was held in Czestochowa, Poland, on "European Traditions in Philosophy of Medicine. From Brentano to Bieganski". It is hoped that these conferences and the books to be derived from them, will initiate a new European tradition, lasting well into the 21 st century! P. J. (shrink)

Trait emotional intelligence concerns our perceptions of our emotional abilities, that is, how good we believe we are in terms of understanding, regulating, and expressing emotions in order to adapt to our environment and maintain well-being. In this article, we present succinct summaries of selected findings from research on the location of trait EI in personality factor space, the biological underpinnings of the construct, indicative applications in the areas of clinical, health, social, educational, organizational, and developmental psychology, and trait EI (...) training. Findings to date suggest that individual differences in trait EI are a consistent predictor of human behavior across the life span. (shrink)

Devitt has developed an interesting defense of realism against the threats posed by the Pessimistic Induction and the Argument from Unconceived Alternatives. Devitt argues that the best explanation for the success of our current theories, and the fact that they are superior to the theories they replaced, is that they were developed and tested with the aid of better methods than the methods used to develop and test the many theories that were discarded earlier in the history of science. It (...) is no surprise that theories developed earlier in the history of science needed to be replaced. But our current theories are different, having been developed and tested with the aid of these more recently developed superior methods. I critically analyze Devitt’s defense of realism. I argue that recent developments in methodology cannot support the claims Devitt makes. I present an argument I call the “Argument from Unconceived Methods.” Given the history of science, it seems likely that scientists will continue to develop new methods in the future. And some of these methods will enable scientists to generate data that cannot be reconciled with the currently accepted theories. Consequently, it seems that our current best theories are not immune from being replaced in the future by radically different theories. (shrink)

I evaluate the extent to which we could learn something about how we should be conducting collaborative research in science from the research on groupthink. I argue that Solomon has set us in the wrong direction, failing to recognize that the consensus in scientific specialties is not the result of deliberation. But the attention to the structure of problem-solving that has emerged in the groupthink research conducted by psychologists can help us see when deliberation could lead to problems for a (...) research team. I argue that whenever we need to generate alternative solutions or proposals, groupthink is a genuine threat, and research teams would be wise to allow individuals opportunities to work alone. But the benefits of team work emerge when scientists seek to evaluate the various proposals generated, and determine a course of action. Then the group is less prone is groupthink, and the interaction of group members can be an epistemic asset. (shrink)

PART The Early Wittgenstein Half of what I say is meaningless. I say it so that the other half may reach you. Kahlil Gibran My work consists of two parts ...

This paper evaluates a recent method proposed by Jeremy Gwiazda for calculating the value of gambles that fail to have expected values in the standard sense. I show that Gwiazda’s method fails to give answers for many gambles that do have standardly defined expected values. However, a slight modification of his method (based on the mathematical notion of the ‘Cauchy principal value’ of an integral), is in fact a proper extension of both his method and the method of ‘weak expectations’. (...) I show that this method gives an appropriate value when the ‘tails’ of the gambles that are eliminated in the truncation are ‘stable’, but that the value is not appropriate when the tails are not stable. I do not attempt to give an argument for the use of this method, but just note that it is more general than Gwiazda’s method, and is mathematically quite natural. (shrink)

Machiavellianism has tremendous influence on modern business communities, especially in the U.S.A. and European countries. Businessmen today, it is said, prefer to follow the directions of pragmatism and expediency rather than the dictates of individual conscience.In principles and practices, Indian management by and large follows the Western line. Therefore, the question arises whether Machiavellian influences are perceptibly high on Indian managers. This question is more relevant in the light of a few surveys conducted on the ethical attitudes of Indian managers. (...) These identified a clear contrast between their expressed behaviour and wanted attitudes. The present study on the attitudes of managers from the major cities of India concludes that Niccolo Machiavelli inspires and influences Indian managers, but has not become the final determinant in their decision-making. (shrink)

Taking the critique of writing in the Phaedrus as a starting point, where Socrates argues that a book cannot choose its reader nor can it defend itself against misinterpretation, Reading Plato offers solutions to the problems of interpreting the Platonic dialogues. Thomas A. Slez'ak pursuasively argues that the dialogues are designed to stimulate philosophical inquiry and to elevate philosophy to the realm of oral dialectic.

We examine the sub-field of philosophy of science using a new method developed in information science, Referenced Publication Years Spectroscopy (RPYS). RPYS allows us to identify peak years in citations in a field, which promises to help scholars identify the key contributions to a field, and revolutionary discoveries in a field. We discovered that philosophy of science, a sub-field in the humanities, differs significantly from other fields examined with this method. Books play a more important role in philosophy of science (...) than in the sciences. Further, Einstein’s famous 1905 papers created a citation peak in the philosophy of science literature. But rather than being a contribution to the philosophy of science, their importance lies in the fact that they are revolutionary contributions to physics with important implications for philosophy of science. (shrink)

E.J. Lowe claims that quantum physics provides examples of ontic indeterminacy, of vagueness in the world. Any such claim must confront the Evans-Salmon argument to the effect that the notion of ontic indeterminacy is simply incoherent (Evans 1978, Salmon 1981: 243-46). Lowe argues that a standard version of the Evans-Salmon argument fails quite generally (Lowe 1994). Harold Noonan (1995) has outlined a non-standard version of the argument, but Lowe argues that this non-standard version fails for specifically quantum mechanical reasons (Lowe (...) 1997). He claims that it is perfectly coherent to suppose that his quantum case is an example of ontic indeterminacy. In this paper, I raise some objections to Lowe's claim. (shrink)

In the present study, using event-related functional magnetic resonance imaging, we investigated a group of participants on a grammaticality classification task after they had been exposed to well-formed consonant strings generated from an artificial regular grammar. We used an implicit acquisition paradigm in which the participants were exposed to positive examples. The objective of this studywas to investigate whether brain regions related to language processing overlap with the brain regions activated by the grammaticality classification task used in the present study. (...) Recent meta-analyses of functional neuroimaging studies indicate that syntactic processing is related to the left inferior frontal gyrus (Brodmann's areas 44 and 45) or Broca's region. In the present study, we observed that artificial grammaticality violations activated Broca's region in all participants. This observation lends some support to the suggestions that artificial grammar learning represents a model for investigating aspects of language learning in infants [TICS 4 (2000) 178] and adults [Proceedings of the National Academy of Sciences of United States of America 99 (2002) 529]. (shrink)

I examine the citation patterns to a revolutionary scientific paper, Hess’ “History of Ocean Basins”, which played a significant role in the plate tectonics revolution in the geosciences. I test two predictions made by the geoscientist Menard (in Science: growth and change. Harvard University Press, Cambridge, 1971): (1) that the peak year of citations for Hess’ article will be 1968; and (2) that the rate of citations to the article will then reach some lower level, continuing on accumulating citations at (...) some regular but unimpressive rate. Drawing on data covering the period from 1962 to 2019, I show that Menard was close with respect to the first prediction. But I also show that things are less clear with respect to the second prediction. I explain why the data are less clear with respect to the second prediction. (shrink)

This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this (...) is to ask practising nurses about the real ethical problems they encounter. (shrink)

Context: Metaphysics of perception explores fundamental questions regarding the structure and status of the perceived world or appearance(s. By virtue of perception, the apparent world comes to existence. This, however, does not mean that the apparent world is a projection of mind, that it exists “in the head.” Implications: PL-metaphysics reconciles realism with constructivism. As such, it might be considered either an alternative to constructivism or an improvement and completion of this position. Constructivist content: The article refers to non-Cartesian movements (...) in contemporary philosophy, including radical constructivism, enactive and embodied cognition. Keywords: Perception, metaphysics, radical constructivism, realism, appearance, Jerzy Perzanowski, Plato, Gottfried Willhelm Leibniz, Ernst von Glasersfeld. (shrink)