OBJECTIVES: Cognitive and sensory difficulties frequently jeopardize informed consent of frail elderly patients This study is the first to test whether preliminary research experience could enhance geriatric patients' capacity to consent. DESIGN/SETTING: A step-wise consent procedure was introduced in a study on fluid balance in geriatric patients. Eligible patients providing verbal consent participated in a try-out of a week, during which bioelectrical impedance and weight measurements were performed daily. Afterwards, written informed consent was requested. Comprehension, risk and inconvenience scores (ranges: (...) 0-10) were obtained before and after the try-out by asking ten questions about the study's essentials and by asking for a risk and inconvenience assessment on a ten-points rating scale. SUBJECTS AND RESULTS: Seventy of the 78 eligible subjects started the try-out and 53 (68%) provided written consent. The comprehension score increased from 5.0 (+/- 2.3) to 7.0 (+/- 1.9) following the try-out (P < 0.001). The number of subjects capable of weighing risks and inconveniences increased from 32 to 48 (P < 0.001). CONCLUSIONS: Research experience improved the capacity to consent, still enabling an acceptable participation rate. Therefore, experienced consent seems a promising tool to optimize informed consent in frail elderly subjects. (shrink)

The first quodlibetal question by William of Alnwick is a reply to John Duns Scotus' Quaestio de Formalitatibus, where the latter clarified his understanding of the formal distinction: ‘formal non-identity’ of the personal properties in God (and of the divine attributes) does not preclude a formal distinction if the latter is conceived as a distinction weakened by the modifier ‘formal’. Whereas Scotus' Quaestio has been subjected to a detailed analysis by Stephen Dumont, “Duns Scotus’ Parisian Question”, there is as yet (...) no such analysis of Alnwick's response. In the present paper his position is explained in detail. Alnwick rejects Scotus' view of ‘formal’ as a weakening modifier; he argues that the formal distinction necessarily is unqualified and may still import too much of unwanted realism in the matter at hand. Both Scotus and Alnwick acknowledge that the formal non-identity reflects the nature of things without falling back to a real distinction. But for Alnwick the right kind of distinction is a qualified distinction that is not a formal distinction. (shrink)

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

In this interview with Jan Hendrik van den Berg, the Dutch phenomenologist and psychiatrist addresses the origins of his work, his most significant influences, and the purpose of metabletic phenomenology in the modern age. In the course of the interview. Dr. Van den Berg provides a basic overview of his work, and highlights the central finding of his metabletic analyses: a loss of wonder before nature, which results from the more fundamental loss of genuine spirituality in the modern world.

Meta-theories, base-theories and theories of practice in Pratical Theology The problem of meta-theories and base-theories, their interaction and the influence of each on the scientific process, have widely been debated in practical theology. In South Africa two meta-theories namely the system- theory together with the theory that social science is busy with the study of actions, are having the greater deal of attention. The purpose of this article is to point out the fact that an early and absolute choice of (...) particular meta-theories, restricts the work of practical theology because it will influence your base-theories, and can weaken the theological content of practical theology. An attempt is made to offer a model by which the interaction between, meta-theories, base-theories and theories of practice can he understood and which can also help the theologian, busy with practical theology, to steer clear of problems and understand the meta- influences in his own scientific work. (shrink)

The festive and the quotidian offer two fundamentally different perspectives on the human world. The quotidian attitude opens to us a workaday world structured by mental and physical barriers which require to be leveled or removed. The festive attitude gives access to a world of the threshold in which we play the role of host and guest and in which it is possible for things and living beings to make their personal appearance. Modernity can be understood as an era in (...) which a quotidian, work-oriented attitude was made to dominate and reconfigure all areas of human existence and in which the festive was progressively removed from public, and finally from private life. The renewal of psychology requires a re-understanding and a re-integration of the festive dimension in our lives. (shrink)

Selection on grandparental investment is more complex than Coall & Hertwig (C&H) propose. Patterns of investment are subject to an intergenerational conflict over how resources should be distributed to maximize fitness. Grandparents may be selected to distribute resources unevenly, while their descendants will be selected to manipulate investment in their own favor. Here we outline the evolutionary basis of this conflict.

A theory of the joint measurement of quantum mechanical observables is generalized in order to make it applicable to the measurement of the local observables of field theory. Subsequently, the property of local commutativity, which is usually introduced as a postulate, is derived by means of the theory of measurement from a requirement of mutual nondisturbance, which, for local observables performed at a spacelike distance from each other, is interpreted as a requirement of macrocausality. Alternative attempts at establishing a deductive (...) relationship between relativistic causality and local commutativity are reviewed, but found wanting, either because of the assumption of an unwarranted objectivity of the object system (algebraic approach) or because of the use of a projection postulate (operational approach). Finally, the quantum mechanical nonobjectivity is related to certain features of nonlocality which are present in the formalism of quantum mechanics. (shrink)