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Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

Making adaptive choices between solution strategies is a central element of contemporary mathematics education. However, previous studies signal that students make suboptimal choices between mental and written strategies to solve division problems. In particular, some students of a lower math ability level appear inclined to use mental strategies that lead to lower performance. The current study uses a pretest-training-posttest design to investigate the extent to which these students’ choices for written strategies and performance may be increased. Sixth graders of below-average (...) mathematics level (N = 147) participated in one of two training conditions: an explicit-scaffolding training designed to promote writing down calculations or a practice-only training where strategy use was not explicitly targeted. Written strategy choices and performance increased considerably from pretest to posttest for students in both training conditions, but not in different amounts. Exploratory results suggest that students’ strategy choices may also be affected by their attitudes and beliefs and the sociocultural context regarding strategy use. (shrink)

This essay considers the intricate relationship between the thought of William James and the political theory of Harold J. Laski mainly in the years 1915 to 1930. I suggest James's arguments and vocabulary have a greater presence in Laski's work than has been previously detailed. The links between James's and Laski's thought are apparent in Laski's accounts of the self and his descriptions of the nature and structure of social experience; each of these in some way derives from James's psychology, (...) empiricist metaphysics and pragmatic method. The links are demonstrated by Laski's explicit references to James's ideas in his books and letters as well as in his adoption of Jamesian terms, phrases and motifs. This essay also shows that in applying James's ideas to political life Laski brought to light the equivocal nature of James's philosophy. Equally however, reading Laski against the background of James's intellectual legacy helps us understand more clearly some of the ambiguities and tensions in Laski's work; for instance how he could move with apparent ease from advocating political pluralism to supporting centralized planning. Finally, this paper illustrates the complex relationship between political theory and metaphysics. (shrink)

_Everyday Life and the Sacred_ offers gender sensitive interdisciplinary perspectives from the fields of feminist theology and religious studies on the everyday and the sacred. The volume aims to re-configure the current domain of religion and gender studies.

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical (...) implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)