Après avoir montré brièvement la place et le rôle de l'énigme en culture littéraire, cet article s'attache à montrer les procédés littéraires à l'oeuvre dans l'analyse augustinienne de deux grandes énigmes : l'homme-individu, l'homme-société. L'énigme qu'Augustin trouve au fond de l'homme, c'est d'abord une controversia , conflit qui le conduit à postuler la présence de ce qu'on appelle aujourd'hui l'inconscient ; mais ici l'herméneutique est menée avec des concepts littéraires et non médico-biologiques. D'autre part, les rapports sociaux de l'homme ne (...) sont pas analysés en termes de production, ni de pouvoir politique, mais plutôt en référence aux mythologies religieuses, c'est-à-dire en fonction de l'interprétation du Livre. Loin d'être économico-politique, le déchiffrage repose sur la manière dont Romains, Juifs, chrétiens, manichéens, donatistes lisent les signes de l'Ecriture. L'article s'achève enfin sur une brève description de l'épistémologie qui organise les lignes de force de cette herméneutique.After briefly showing the place and the role of the enigm in literary culture, this article goes on to show the literary procedures at work in the Augustinian analysis of two great enigmas : man-individual, man-society. The enigma which Augustin finds at the basis of man is first of all a controversia , a conflict which leads him to postulate the presence of what today is called the unconscious. But here hermeneutics is pursued with literary rather than with medico-biological concepts. Moreover, man's social relations are not analysed in terms of production, nor of political power, but with reference to religious mythologies, that is, as a function of the interpretation of the Book. Far from being an economic and political interpretation, the interpretation here is based on the way Romans, Jews, Christians, Manicheans, and Donatists read the signs of scripture. The article concludes with a short description of the epistemology which organizes the lines of force of this hermeneutic. (shrink)

This is the only general selection available of the writings of the renowned English idealist philosopher F. H. Bradley; it is the ideal introduction to his thought. Bradley's original texts are given an editorial framework in the introductions to each section, allowing students to investigate his philosophy first-hand and yet to be guided through the difficulties presented by his work.

La 4e de couverture indique : "Comment se pratique la philosophie du droit en ce début de XXIe siècle à la suite des bouleversements politiques et théoriques observés lors du siècle précédent? Comment se pose la question du droit pour et dans la philosophie, et quelles sont les spécificités du rapport que les juristes nouent à la philosophie dans le déploiement de leur pratique juridique, ainsi que dans leur propre réflexion sur le droit? Les textes présents dans ce volume, rédigés (...) en l'honneur de Guy Haarscher par des amis et des collègues influencés par son travail, abordent ce questionnement en profitant, à sa suite, de la multiplicité des espaces de croisement entre les discours juridiques et philosophiques, qu'il s'agisse de la spécificité des droits de l'homme ou du droit constitutionnel dans le champ juridique, des choix moraux à l'oeuvre lors des conflits entre droits fondamentaux, de la place de la rhétorique ou de l'utilisation de la philosophie dans la procédure judiciaire, du statut réservé à la technique juridique dans la tradition philosophique occidentale, d'un légalisme commun au jusnaturalisme et au juspositivisme, d'une forme de moralité purement interne à la pratique du droit, de la question du tribunal de l'histoire ou encore du sens juridique de la laïcité.". (shrink)

The European Union welfare standardsfor intensively kept pigs have steadilyincreased over the past few years and areproposed to continue in the future. It isimportant that the cost implications of thesechanges in welfare standards are assessed. Theaim of this study was to determine theprofitability of rearing pigs in a range ofhousing systems with different standards forpig welfare. Models were constructed tocalculate the cost of pig rearing (6–95 kg) in afully-slatted system (fulfilling minimum EUspace requirements, Directive 91630/EEC); apartly-slatted system; a high-welfare,straw-based system (...) (complying with the UK-basedRoyal Society for the Prevention of Cruelty toAnimals, Freedom Food standards) and afree-range system. The models were also used toassess the consequences of potential increasesin space allowance, and to estimate the cost ofrearing pigs under organic standards.The cost of rearing pigs ranged from92.0 p/kg carcass weight (cw) and 94.6 p/kgcw forthe partly-slatted and fully-slatted systems,to 98.8 p/kgcw and 99.3 p/kgcw for the FreedomFood and free-range systems respectively. Whenspace allowance was increased by 60% to levelsin a recent proposal to revise pig welfareDirective (91/630/EEC), the rearing costs wereunchanged for the free-range system but rose by4.6 p/kgcw for the fully-slatted system. Rearingcosts under organic standards were 31% higherthan in the free-range system. These resultssuggest that improved pig welfare can beachieved with a modest increase in cost. (shrink)

Ample research demonstrates that parents’ experience-based mental representations of attachment—cognitive models of close relationships—relate to their children’s social-emotional development. However, no research to date has examined how parents’ attachment representations relate to another crucial domain of children’s development: brain development. The present study is the first to integrate the separate literatures on attachment and developmental social cognitive neuroscience to examine the link between mothers’ attachment representations and 3- to 8-year-old children’s brain structure. We hypothesized that mothers’ attachment representations would relate (...) to individual differences in children’s brain structures involved in stress regulation—specifically, amygdala and hippocampal volumes—in part via mothers’ responses to children’s distress. We assessed 52 mothers’ attachment representations and children’s brain structure. Mothers’ secure base script knowledge was significantly related to children’s smaller left amygdala volume but was unrelated to hippocampal volume; we found no indirect links via maternal responses to children’s distress. Exploratory analyses showed associations between mothers’ attachment representations and white matter and thalamus volumes. Together, these preliminary results suggest that mothers’ attachment representations may be linked to the development of children’s neural circuitry related to stress regulation. (shrink)

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the (...) study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

This book appears in the Indiana Series in the philosophy of technology, edited by Don Ihde. Hickman emphasizes Dewey as a philosopher of technology and aims to make Dewey's perspective and contributions available to specialists. Still, as claimed on the book jacket, Hickman aims at a "comprehensive yet accessible overview of Dewey's philosophical work." The link between the two projects is the interpretation of Dewey's instrumentalism as a "critique of technology" (p. xi).

This article deals with the question of how ethicists respond to practical moral problems emerging in health care practices. Do they remain distanced, taking on the role of an expert, or do they become engaged with nurses and other participants in practice and jointly develop contextualized insights about good care? A basic assumption of dialogical ethics entails that the definition of good care and what it means to be a good nurse is a collaborative product of ongoing dialogues among various (...) stakeholders engaged in the practice. This article discusses the value of a dialogical approach to ethics by drawing on the work of various nursing scholars. We present a case example concerning the quality of freedom restrictions for intellectually disabled people. Issues for discussion include the role and required competences of the ethicist and dealing with asymmetrical relationships between stakeholders. (shrink)

Whether and how music is involved in evoking emotions is a matter of considerable debate. In the target article, Juslin & Vll (J&V) argue that music induces a wide range of both basic and complex emotions that are shared with other stimuli. If such a link exists, it would provide a common basis for considering the interactions among music, emotion, timing, and time perception.

The question of whether Do Not Resuscitate orders should be sustained in the operating room was brought to our ethics committee by a pulmonologist and involved one of his patients for whom he serves as a primary care physician. His patient, a woman with chronic obstructive lung disease was electing, for comfort purposes, to have a hip pinning following a fracture. At the same time, she wished to have a DNR order covering her entire hospital stay. The anesthesiologist described her (...) direction as “improper” and refused to participate in surgical procedures if DNR orders extended to the operating room. The patient refused to rescind the order during surgery. As a result, the surgery was canceled to the great chagrin of the patient. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

The research climate plays a key role in fostering integrity in research. However, little is known about what constitutes a responsible research climate. We investigated academic researchers’ perceptions on this through focus group interviews. We recruited researchers from the Vrije Universiteit Amsterdam and the Amsterdam University Medical Center to participate in focus group discussions that consisted of researchers from similar academic ranks and disciplinary fields. We asked participants to reflect on the characteristics of a responsible research climate, the barriers they (...) perceived and which interventions they thought fruitful to improve the research climate. Discussions were recorded and transcribed at verbatim. We used inductive content analysis to analyse the focus group transcripts. We conducted 12 focus groups with 61 researchers in total. We identified fair evaluation, openness, sufficient time, integrity, trust and freedom to be mentioned as important characteristics of a responsible research climate. Main perceived barriers were lack of support, unfair evaluation policies, normalization of overwork and insufficient supervision of early career researchers. Possible interventions suggested by the participants centered around improving support, discussing expectations and improving the quality of supervision. Some of the elements of a responsible research climate identified by participants are reflected in national and international codes of conduct, such as trust and openness. Although it may seem hard to change the research climate, we believe that the realisation that the research climate is suboptimal should provide the impetus for change informed by researchers’ experiences and opinions. (shrink)

Introduction With an ageing population, end-of-life care is increasing in importance. The present work investigated characteristics and time trends of older peoples' attitudes towards euthanasia and an end-of-life pill. Methods Three samples aged 64 years or older from the Longitudinal Ageing Study Amsterdam (N=1284 (2001), N=1303 (2005) and N=1245 (2008)) were studied. Respondents were asked whether they could imagine requesting their physician to end their life (euthanasia), or imagine asking for a pill to end their life if they became tired (...) of living in the absence of a severe disease (end-of-life pill). Using logistic multivariable techniques, changes of attitudes over time and their association with demographic and health characteristics were assessed. Results The proportion of respondents with a positive attitude somewhat increased over time, but significantly only among the 64–74 age group. For euthanasia, these percentages were 58% (2001), 64% (2005) and 70% (2008) (OR of most recent versus earliest period (95% CI): 1.30 (1.17 to 1.44)). For an end-of-life pill, these percentages were 31% (2001), 33% (2005) and 45% (2008) (OR (95% CI): 1.37 (1.23 to 1.52)). For the end-of-life pill, interaction between the most recent time period and age group was significant. Conclusions An increasing proportion of older people reported that they could imagine desiring euthanasia or an end-of-life pill. This may imply an increased interest in deciding about your own life and stresses the importance to take older peoples' wishes seriously. (shrink)

BackgroundThere is increasing evidence that research misbehaviour is common, especially the minor forms. Previous studies on research misbehaviour primarily focused on biomedical and social sciences, and evidence from natural sciences and humanities is scarce. We investigated what academic researchers in Amsterdam perceived to be detrimental research misbehaviours in their respective disciplinary fields.MethodsWe used an explanatory sequential mixed methods design. First, survey participants from four disciplinary fields rated perceived frequency and impact of research misbehaviours from a list of 60. We then (...) combined these into a top five ranking of most detrimental research misbehaviours at the aggregate level, stratified by disciplinary field. Second, in focus group interviews, participants from each academic rank and disciplinary field were asked to reflect on the most relevant research misbehaviours for their disciplinary field. We used participative ranking methodology inducing participants to obtain consensus on which research misbehaviours are most detrimental.ResultsIn total, 1080 researchers completed the survey (response rate: 15%) and 61 participated in the focus groups (3 three to 8 eight researchers per group). Insufficient supervision consistently ranked highest in the survey regardless of disciplinary field and the focus groups confirmed this. Important themes in the focus groups were insufficient supervision, sloppy science, and sloppy peer review. Biomedical researchers and social science researchers were primarily concerned with sloppy science and insufficient supervision. Natural sciences and humanities researchers discussed sloppy reviewing and theft of ideas by reviewers, a form of plagiarism. Focus group participants further provided examples of particular research misbehaviours they were confronted with and how these impacted their work as a researcher.ConclusionWe found insufficient supervision and various forms of sloppy science to score highly on aggregate detrimental impact throughout all disciplinary fields. Researchers from the natural sciences and humanities also perceived nepotism to be of major impact on the aggregate level. The natural sciences regarded fabrication of data of major impact as well. The focus group interviews helped to understand how researchers interpreted ‘insufficient supervision’. Besides, the focus group participants added insight into sloppy science in practice. Researchers from the natural sciences and humanities added new research misbehaviours concerning their disciplinary fields to the list, such as the stealing of ideas before publication. This improves our understanding of research misbehaviour beyond the social and biomedical fields. (shrink)

This book is a major contribution to the study of the philosopher F. H. Bradley, the most influential member of the nineteenth-century school of British Idealists. It offers a sustained interpretation of Bradley's Principles of Logic, explaining the problem of how it is possible for inferences to be both valid and yet have conclusions that contain new information. The author then describes how this solution provides a basis for Bradley's metaphysical view that reality is one interconnected experience and how this (...) gives rise to a new problem of truth. (shrink)

We develop a multi-agent deontic action logic to study the logical behaviour of two types of deontic conditionals: (1) conditional obligations, having the form "If group H were to perform action aH, then, in group F's interest, group G ought to perform action aG" and (2) conditional permissions, having the form "If group H were to perform action aH, then, in group F's interest, group G may perform action aG". First, we define a formal language for multi-agent deontic action logic (...) and a class of consequentialist models to interpret the formulas of the language. Second, we define a transformation that converts any strategic game into a consequentialist model. Third, we show that an outcome a* is a Nash equilibrium of a strategic game if and only if a conjunction of certain conditional permissions is true in the consequentialist model that results from the transformation of that strategic game. (shrink)

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

Thomas Jefferson and Philosophy: Essays on the Philosophical Cast of Jefferson’s Writings is a collection of essays on topics that relate to philosophical aspects of Jefferson’s thinking over the years. Much historical insight is given to ground the various philosophical strands in Jefferson’s thought and writing on topics such as political philosophy, moral philosophy, slavery, republicanism, wall of separation, liberty, educational philosophy, and architecture.

BackgroundThe Dutch Euthanasia Act applies to patients 12 years and older, which makes euthanasia for minors younger than 12 legally impossible. The issue under discussion specifically regards the capacity of minors to request euthanasia.ObjectiveGain insight in paediatric experts’ views about which criteria are important to assess capacity, from what age minors can meet those criteria, what an assessment procedure should look like and what role parents should have.MethodsA Delphi study with 16 experts (paediatricians, paediatric nurses and paediatric psychologists) who work (...) in Children Comfort Teams in Dutch academic hospitals. The questionnaire contained statements concerning criteria for capacity and procedural criteria. Consensus was defined as ≥80% agreement.ResultsThe experts agreed that five criteria for capacity, found in a previous literature study, are all important. They agreed that some children between ages 9 and 11 could meet all the criteria. Consensus was reached for the statements that the entire medical team should be involved in the decision making and that a second independent expert must assess the case. Experts agreed that the parents’ opinion is relevant and should always be taken into account, but it need not be decisive.ConclusionThis study shows that the age limit of 12 years in the Dutch Euthanasia Act is too strong according to paediatric experts. Letting go of the age limit or lowering the age limit combined with adequate capacity assessment for minors younger than 12 are options that should be discussed further. (shrink)

Although T. H. Green is primarily remembered today as a moral and political philosopher, many of his philosophical concerns owe their origins to the Victorian crisis of faith in which a widespread belief in the literal truth of Scripture confronted seemingly incompatible scientific theories. Green attributed this crisis to the inability of science and religion to find accommodation in the popular version of empiricism widely accepted by educated men and women of his day. In his 371-page introduction to Hume’s Treatise, (...) Green argued that this philosophy was unacceptable, even on its own terms, and that it needed to be replaced with a new philosophy of life, one recognizing that both knowledge and human action are .. (shrink)