Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that calls for ahealth care (...) policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine. (shrink)

One of the career options Ede Christian University for higher professional education offers is nursing. As a Christian professional school, the ECU provides learning environments for nursing students to become professionals who are to exhibit a Christian life style, values and professional ethics. Nursing graduates of our school in general may have a Christian disposition regarding major issues in health care like displaying respect for patients, having a correct attitude, practising informed consent, displaying confidentiality, and avoiding euthanasia etc. A worrying (...) development for educators, though, is that often within a year after their graduation these young nursing professionals may adopt the secularized behaviour predominant in their workplace, even when that behaviour in some respects contrasts with the values they internalized during their nursing education. . Apparently, the shaping force of the social context of a professional practice can be stronger than the personal beliefs young professionals adopt before their graduation. (shrink)

In this paper we try to identify the roots of the persistent contemporary problems in our modernized agriculture: overproduction, loss of biodiversity and of soil fertility, the risk of large animal disease, social controversies on the lack of animal welfare and culling of animals, etc. Attention is paid to the historical development of present-day farming in Holland as an example of European agriculture. We see a blinkered quest for efficiency in the industrialization of agriculture since the Second World War. Key (...) factor is the cultural mindset at the foundation of our modern society, originating from the ideas of the enlightenment. It makes people vulnerable to ideologies, causing them to focus on a certain goal without considering the consequences. Due to the overemphasis on efficiency, modern industrial agriculture has never been comfortably embedded in its ecological and social context, and as a result displays the characteristics of an ideology. The cause of the inability to solve today’s problems is therefore deeper than simply a failure to apply the right mix of standard remedies. Unless stakeholders in farming start to counter this very one-sided approach to efficiency, modernization will continue to cause all kinds of friction. The implications of the results for agricultural policy, farming and further research are discussed. (shrink)

The rise of the mechanistic worldview in the seventeenth century had a major impact on views of biological generation. Many seventeenth century naturalists rejected the old animist thesis. However, the alternative view of gradual mechanistic formation in embryology didn’t convince either. How to articulate the peculiarity of life? Researchers in the seventeenth century proposed both “animist” and mechanistic theories of life. In the eighteenth century again a controversy in biology arose regarding the explanation of generation. Some adhered to the view (...) that life is a physical property of matter, others saw living entities as the result of the development of pre-existing germs. Naturalists, lacked a convincing account that could guide their research. In interaction with leading naturalists of his time Immanuel Kant articulated an approach to explaining generation. Kant’s account, delineated in his Kritik der Urteilskraft, is a combination of Newtonian non-reductionist mechanism in explanation, and a concept of natural end comparable to Stahl’s formal conception of organic bodies. It consists of two claims: a) in biology only mechanical explanation is explanatory, and b) living entities contain some original organisation, which is mechanically unexplainable. In the nineteenth century this approach influenced naturalists as Müller, Virchow, and Von Baer, in their physiological research. Dissatisfied with a sheer mechanistic or, on the other hand, a sheer teleological approach, they appreciated the Kantian account of mechanical explanation of natural ends. In Germany, in the second halve of the nineteenth century, Ernst Haeckel reopened the debate about abiogenesis, which still continuous. (shrink)

Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control.

The role of faith and religion in international development cooperation is hotly debated today. The legitimacy of this role remains, however, often confided to instrumental reasons. Yet, thinking about faith and religion only in instrumental terms leaves unquestioned the possibility of a religious background of development cooperation as a practice itself and the potential role of faith through individual practitioners that operate within secular NGOs, and research and policy institutes. The aim of the present paper is therefore to consider the (...) structural role of faith and worldview in relation to agricultural development, moving beyond the discourse of instrumentality. We do this by focusing on Giller and Andersson’s political agronomy analysis of the promotion of Conservation Agriculture in Zimbabwe by the faith-based organisation ‘Foundations for Farming’. We argue that a distinction should be made between religion as a practice of believers and faith functioning as a worldview in every practice. In addition, we argue that it is helpful to distinguish between different kinds of practices involved in agricultural development in sub-Saharan Africa, namely farming practice, agronomic scientific practice, and faith practice. The value of this philosophical analysis is that it challenges a dichotomous model of ‘science-based versus faith-based’ approaches to agricultural development. Furthermore, specific kinds of normativity are identified as always already functioning inside practices, rather than practices being neutral spaces that are infused with normativity by applying external ethical standards. (shrink)

This article describes the results of research that investigated whether student nurses identified the moral aspects of everyday nursing care situations and, if so, how they dealt with them. We intended to elucidate the role of mentoring situations in moral development. Student written documents reflecting discussions during mentoring situations were analysed quantitatively and qualitatively. The students studied in one of the three nursing schools involved in the research. In only a small proportion of cases (<13%) did the students identify the (...) ethical questions in those situations. The results indicate that the nursing students rarely identified moral issues, implying that there was little conscious moral reflection and deliberation in their mentoring situations dealing with their problematic experiences during their internship. Additional competences will be required for session leaders in order to allow mentoring situations to play a more prominent role in moral development. (shrink)

The network society is generally challenging for today's communication practitioners because they are no longer the sole entities responsible for communication processes. This is a major change for many of them. In this paper, it will be contended that the normative practice model as developed within reformational philosophy is beneficial for clarifying the structure of communication practices. Based on this model, we argue that government communication should not be considered as primarily an activity that focuses on societal legitimation of policy; (...) rather, it focuses on clarifying the meaning of the actions of the government. If the government can convincingly answer the question about the reason for their actions, societal legitimation will subsequently follow. Hence, it is argued that government communication is primarily linguistically qualified. (shrink)

In his contribution to this special issue, Michael Northcott argues that there is a historic association between Protestant cultures and the origins of environmentalism. It seems to me, however, that the connection between Protestantism and environmentalism is more complicated and ambivalent than the positive relation he highlights. In this paper, I will problematize that relation on the basis of various theoretical and empirical contributions in the literature on religion and environmentalism. Different positions in this regard within Protestantism will be identified (...) and related to theological positions and the historic impact of Protestantism on culture. In the final section, the impact of environmental degradation on the poor will be highlighted, which leads to the identification of a tension between an orthodox/evangelical Protestant stance towards the poor and towards the environment. (shrink)

In the Netherlands the government's proposal for the legal regulation of euthanasia, assisted suicide and the termination of a patient's life without request has been approved by Parliament. The defence of this proposal is to a large extent based on a specific interpretation of data about the practice of euthanasia in that country, published in 1991 (the Remmelink Report). This paper discusses both the interpretation of the data and the new law. On the basis of that and other data, the (...) author concludes that many cases of euthanasia, assisted suicide and termination of a patient's life without request remain unnotified and therefore unreviewed by the legal authorities. It is argued that the new law will not guarantee an improvement to this situation. In short, the new law will not protect effectively the lives of patients, and must, therefore, be open to ethical and legal objection. (shrink)

In 2010, the Dutch Scientific Council for Governmental Policy called for an explicit and adequate intervention ethics for policy on international development cooperation. Yet, as appears from a careful reading of their report, the council’s own overall commitment to a modernist worldview hinders the fruitful development of such an intervention ethics. There is, however, a strand in their thinking that draws attention to the importance of practical knowledge. We argue specifically that an intervention ethics for development cooperation in agriculture should (...) start from this practical knowledge, which points to the inherent normativity of agricultural development cooperation. That is, agricultural development cooperation is a normative practice of which the inherent normativity consists in facilitating other practices in the agricultural domain. As such, agricultural development cooperation should respect the normativity inherent in those other practices. (shrink)

This book examines the role of new technologies and the way social practices are influenced by them, creating all sorts of new challenges for maintaining a coherent practice without clashed between norms.

Professional autonomy interferes at a structural level with the various aspects of the health care system. The health care systems that can be distinguished all feature a specific design of professional autonomy, but experience their own governance problems. Empirical health care systems in the West are a nationally coloured blend of ideal type healthcare systems. From a normative perspective, the optimal health care system should consist of elements of all the ideal types. A workable optimum taking national values into account (...) could be attained by governance structures that also introduce elements from other ideal type systems. Thus a normative approach to medical practice guaranteeing an essential degree of professional autonomy for a relationship of trust between the patient and the physician, could be combined with an efficient and equitable allocation of health care resources. (shrink)

In this introductory article, the authors first briefly present the debate on the meaning of sustainability and consider the question of how to connect the concept of sustainability with a Christian-in particular, Reformational-way of doing philosophy. After examining the various uses of Dooyeweerdian philosophy in this regard, this introduction closes with an overview of the contributions to this special issue.

The implementation of a National Ecological Network poses a significant challenge to the Dutch government. The establishment of this ecological network has led to conflicts among various interest groups in the public sphere, each of which defends its own interests. In this struggle for recognition communication fulfils an important role. This article contends that the discourse about nature is driven by deep frames, is comprised of values and is rooted in world-views. The insight that worldviews play a role elucidates the (...) various positions in the debate and shows normative dimensions in communication. This article argues that the network society, more than ever, requires the government to be explicit about its normative choices. (shrink)

The implementation of a National Ecological Network poses a significant challenge to the Dutch government. The establishment of this ecological network has led to conflicts among various interest groups in the public sphere, each of which defends its own interests. In this struggle for recognition communication fulfils an important role. This article contends that the discourse about nature is driven by deep frames, is comprised of values and is rooted in world-views. The insight that worldviews play a role elucidates the (...) various positions in the debate and shows normative dimensions in communication. This article argues that the network society, more than ever, requires the government to be explicit about its normative choices. (shrink)