Purpose The search for cause of death is important to improve knowledge and provide answers for the relatives of the deceased. Medical autopsy following unexplained death in hospital is one way to identify cause of death but is difficult to carry out routinely. Post mortem sampling (PMS) of tissues via thin biopsy needle or ‘mini incisions’ in the skin may be a useful alternative. A study was undertaken to assess how this approach is perceived by intensive care doctors and also (...) to evaluate how this practice is considered in ethical terms in France. Methods A study of PMS practices immediately after death in 10 intensive care departments was performed. The medical director of each centre was interviewed by telephone and asked to describe practices in their unit and to outline the questions raised by this practice. Results PMS is routinely performed in 70% of the units which responded, without systematically obtaining formal consent and without precise rules for communicating results. Approaches to PMS differed between centres, but all physicians felt that PMS is useful for the scientific information it gives and also for the information it provides for relatives. All physicians regret the lack of standards to structure PMS practices. Conclusion Information from post mortem examinations is important for society to inform about causes of death, for doctors to improve practices and for decision-makers responsible for organising care. Debate persists regarding the balance between individual rights and community interests. It is suggested that an approach for identifying cause of death could easily be integrated into the relationship between carers and relatives, provided full transparency is maintained. (shrink)

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

This is the first comprehensive study of Nietzsche's earliest (and extraordinary) book, The Birth of Tragedy (1872). When he wrote it, Nietzsche was a Greek scholar, a friend and champion of Wagner, and a philosopher in the making. His book has been very influential and widely read, but has always posed great difficulties for readers because of the particular way Nietzsche brings his ancient and modern interests together. The proper appreciation of such a work requires access to ideas that cross (...) the boundaries of conventional specialisms. This is now provided by M. S. Silk and J. P. Stern in their joint study of Nietzsche's book. They examine in detail its content, style and form; its strange genesis and hybrid status; its biographical background and the controversy engendered by its publication; its value as an account of ancient Greek culture and as a theory of tragedy and music; its relation to other theories of tragedy; and its place in the history of German ideas and in Nietzsche's own philosophical career. (shrink)

Context: Strict finitism is usually not taken seriously as a possible view on what mathematics is and how it functions. This is due mainly to unfamiliarity with the topic. Problem: First, it is necessary to present a “decent” history of strict finitism and, secondly, to show that common counterarguments against strict finitism can be properly addressed and refuted. Method: For the historical part, the historical material is situated in a broader context, and for the argumentative part, an evaluation of arguments (...) and counterarguments is presented. Results: The main result is that strict finitism is indeed a viable option, next to other constructive approaches, in mathematics. Implications: Arguing for strict finitism is more complex than is usually thought. For future research, strict finitist mathematics itself needs to be written out in more detail to increase its credibility. In as far as strict finitism is a viable option, it will change our views on such “classics” as the platonist-constructivist discussion, the discovery-construction debate and the mysterious applicability problem . Constructivist content: Strict finitism starts from the idea that counting is an act of labeling, hence the mathematician is an active subject right from the start. It differs from other constructivist views in that the finite limitations of the human subject are taken into account. (shrink)

The first comprehensive study of Nietzsche's earliest book, The Birth of Tragedy, this important volume by M. S. Silk and J. P. Stern examines the work in detail: its place in Nietzsche's philosophical career; its value as an account of ancient Greek culture; its place in the history of German ideas, and its value as a theory of tragedy and music. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Lesley Chamberlain, illuminating its enduring (...) importance and relevance to philosophical enquiry, this accessible study has been revived for a new generation of readers. (shrink)

_Naturalism_ provides a rigorous analysis and critique of the major varieties of contemporary philosophical naturalism. The authors advocate the thesis that contemporary naturalism should be abandoned, in light of the serious objections raised against it. Contributors draw on a wide range of topics including: epistemology, the philosophy of science, the philosophy of mind and agency, and natural theology.

Contemporary theories of institutions as clusters of stable solutions to recurrent coordination problems can illuminate and explain some unresolved difficulties and problems adhering to institutional definitions of art initiated by George Dickie and Arthur Danto. Their account of what confers upon objects their institutional character does not fit well with current work on institutions and social ontology. The claim that “the artworld” confers the status of “art” onto objects remains utterly mysterious. The “artworld” is a generic notion that designates a (...) sphere of human activity that involves practices that create goals that have led to the emergence of formal and informal institutions. But those institutions, rather than magically “creating” objects subjected to esthetic appreciation, merely solve familiar and ubiquitous coordination problems created by artistic activity in ways other institutions in other areas solve similar and/or analogous coordination problems. (shrink)

Albert and De Ruiter provide an introduction to the Conversation Analytic approach to ‘repair’: the ways in which people detect and deal with troubles in speaking, hearing and understanding in conversation. They explain the basic turn‐taking structures involved, provide examples, explain recent developments in the field and highlight some important points of contact and contrast with work in the Cognitive Sciences.

During the 1970s, prenatal screening technologies were in their infancy, but were being swiftly harnessed to uncover and prevent spina bifida. The historical rise of this screening process and prevention programme is analysed in this paper, and the role of ethical debates in key studies, editorials and letters reported in the Lancet, and other related texts and governmental documents between 1972 and 1983, is considered. The silence that surrounded rigorous ethical debate served to highlight where discussion lay—namely, within the justifications (...) offered for the prevention of spina bifida, and the efficacy and benefits of screening. In other words, the ethical justification for screening and prevention of spina bifida, when the authors are not explicitly interested in ethics, is considered. These justifications held certain notions of disability as costly to society, with an imperative to screen and prevent spina bifida for the good of the society. (shrink)

Onderwerp en gezegde, door D. M. Bakker.--Enkele opmerkingen over het Godsbegrip van Justinus Martyr, door J. den Boeft.--Heidegger, Descartes, Luther, door J. van der Hoeven.--"Geschichtlichkeit" bij Carl Friedrich von Weizsäcker, door G. Horsman.--Menselijke ontmaskering en Bijbels démasqué , door R. Huson.--Kleine geschiedenis van het begrip "niets" in de antieke wijsbegeerte (tot e met de Sofisten en Plato), door P. A. Meijer.--De structuur van opvoeden en opvoedkunde, door J. W. Mojet.--Individualiteit in de fysica, door M. D. (...) Stafleu. (shrink)

The research investigates the role of leadership in the transformation of denominational structures towards a missional ecclesiology, and focusses on the Highveld Synod of the Dutch Reformed Church. It describes the missional journey of the denomination, and interprets the transformation. The theory of ‘complex leadership’ in complex systems is applied to the investigation of the impact of leadership on a denominational structure. The theory identifies three mechanisms used by leaders as enablers in emergent, self-organisation systems: Leaders disrupt existing patterns, they (...) encourage novelty, and they act as sensemakers. These insights are applied as a tool to interpret the missional transformation of a denomination. (shrink)

Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

This article revisits a reduced model of cardiac electro-physiology which was proposed to understand the genesis of unidirectional block pathology and of ectopic foci. We underline some specificities of the model from the viewpoint of dynamical systems and bifurcation theory. We point out that essentially the same properties are shared by a simpler system more accessible to analysis. With this simpler system, it becomes possible to give a new presentation of the phenomenon in a phase plane with time moving slow (...) manifolds. This presentation can be of interest both for cardiac electro-physiologists and for mathematicians. (shrink)