Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using in-depth (...) face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

In this article some of the presuppositions that underly the current ideas about decision making capacity, autonomy and independence are critically examined. The focus is on chronic disorders, especially on chronic physical disorders. First, it is argued that the concepts of decision making competence and autonomy, as they are usually applied to the problem of legal (in)competence in the mentally ill, need to be modified and adapted to the situation of the chronically (physically) ill. Second, it is argued that autonomy (...) and dependence must not be considered as two mutually exclusive categories. It is suggested that decision making may take on the form of a more or less conscious decision not to be involved in making all kinds of explicit and deliberate decisions. Elaborating on Agich's distinction between ideal and actual autonomy, the concept of Socratic autonomy is introduced. (shrink)

It is a commonly held position in the literature on distributive justice that choices individuals make from an equalized background may lead to inequalities of outcome. This raises the question of how to assign consequences to particular types of behaviour. Theories of justice based on the concept of moral responsibility offer considerable guidance as to how society should be structured, but they rarely address the question of what the consequences of making a particular choice should be. To fill this lacuna, (...) these theories must rely on a theory of consequences. I argue that the most plausible theories of consequences are substantive rather than procedural in nature. Such theories of consequences are inherently based on the concept of desert. By evaluating individuals' choices society may determine the appropriate consequences of choices for which they are responsible. (shrink)

With this paper I aim to demonstrate that a look beyond the Aristotelian square of opposition, and a related non-conservative view on logical determiners, contributes to both the understanding of Aristotelian syllogistics as well as to the study of quantificational structures in natural language.

If one wishes to give individuals what they deserve, one must find some way of appraising those characteristics that render them deserving. In modern democratic societies, it seems attractive to base this appraisal on an aggregation of the valuations individuals hold of the desert bases under consideration. Some have argued that the market can provide such an appraisal. However, I argue that the market does not provide a satisfactory democratic appraisal that is relevant for desert, as it allows for the (...) existence of net consumer surplus. Nevertheless, I submit that a procedure that does not leave any net consumer surplus would succeed where the market fails. Taking the average valuation of the individuals in society for a given desert base would meet this requirement. Hence, I claim that such a procedure can provide the satisfactory democratic appraisal that the market cannot, and can be used to give individuals what they deserve. (shrink)

In his concept of an anthropological physiology, F.J.J. Buytendijk has tried to lay down the theoretical and scientific foundations for an anthropologically-oriented medicine. The aim of anthropological physiology is to demonstrate, empirically, what being specifically human is in the most elementary physiological functions. This article contains a sketch of Buytendijk''s life and work, an overview of his philosophical-anthropological presuppositions, an outline of his idea of an anthropological physiology and medicine, and a discussion of some episternological and methodological problems. It is (...) demonstrated that Buytendijk''s design of an anthropological physiology is fragmentary and programmatic and that his methodology offers few points of contact for specific anthropological experimental research.Notwithstanding, it is argued that Buytendijk''s description of the subjective, animated body forms a pre-eminent point of reference for all research in physiology and psychology in which the specific human aspect is not ignored beforehand. (shrink)

With the rapid advance of bio-genetic technology, it will soon be possible for parents to design children who are born with certain genetic traits. This raises the question whether parents should be allowed to use this technology to engineer their children as they please. In this context it is often thought and argued that liberalism, which has a reputation for being permissive of all kinds of practices, grants parents the right to do so. However, I will argue that, on an (...) understanding of liberalism that is identical to the one used by the defenders of genetic design, liberals should wary of such practices. Liberalism, in its most general form, requires that any time individuals exercise power over others they justify it without relying on any particular conception of what a good life is. When we design children to have certain traits that are only useful for realising some conceptions of the good life, we are implicitly endorsing those conceptions. Hence this practice cannot be justified in neutral terms, and liberals should be sceptical of it. Only when we engineer our children to have traits that are useful for all conceptions of the good life can liberals allow the use of this new technology. Indeed, liberalism holds that this is morally required. (shrink)

In this paper we generalize the pigeonhole principle by using isols as our fundamental counting tool.

In his note [5] Hausner states a simple combinatorial principle, namely: $$(H)\left\{ {\begin{array}{*{20}c} {if f is a function a non - empty finite set \sigma into itself, p a} \\ {prime, f^p = i_\sigma and \sigma _0 the set of fixed points of f, then } \\ {\left| \sigma \right| \equiv \left| {\sigma _0 } \right|(mod p).} \\\end{array}} \right.$$ .He then shows how this principle can be used to prove:Fermat's little theorem,Cauchy's theorem for finite groups,Lucas' theorem for binomial numbers.Letε=(0,1, ...),ℱ (...) 1−1 the family of all one-to-one functions from a subset ofε intoε andℳ 1−1 the family of all p.r. (i.e., partial recursive) one-to-one functions from a subset ofε intoε. A subsetα of ε is finite, ifα is not equivalent to a proper subset under a function inℱ 1−1. The setα is calledisolated, if it is not equivalent to a proper subset under a function inℳ 1−1. An isolated set can also be defined as a subset ofε which has no infinite r.e. (i.e., recursively enumerable) subset. While every finite set is isolated, there are $c = 2^{\aleph _0 }$ infinite sets which are isolated; these sets are calledimmune. It is the purpose of this paper to generalize (H) to a principle (H*) for isolated sets and to show how (H*) can be used to prove generalizations of Fermat's little theorem and Cauchy's theorem for finite groups. We have been unable to generalize Lucas' theorem in a similar manner. (shrink)

In this paper we discuss the following contributions to recursion theory made by John Myhill: two sets are recursively isomorphic iff they are one-one equivalent; two sets are recursively isomorphic iff they are recursively equivalent and their complements are also recursively equivalent; every two creative sets are recursively isomorphic; the recursive analogue of the Cantor–Bernstein theorem; the notion of a combinatorial function and its use in the theory of recursive equivalence types.

In the last decade the enterprise of formal semantics has been under attack from several philosophical and linguistic perspectives, and it has certainly suffered from its own scattered state, which hosts quite a variety of paradigms which may seem to be incompatible. It will not do to try and answer the arguments of the critics, because the arguments are often well-taken. The negative conclusions, however, I believe are not. The only adequate reply seems to be a constructive one, which puts (...) several pieces of formal semantics, in particular dynamic semantics, together again.In this paper I will try and sketch an overview of tasks, techniques, and results, which serves to at least suggest that it is possible to develop a coherent overall picture of undeniably important and structural phenomena in the interpretation of natural language. The idea is that the concept of meanings as truth conditions after all provides an excellent start for an integrated study of the meaning and use of natural language, and that an extended notion of goal directed pragmatics naturally complements this picture. None of the results reported here are really new, but we think it is important to re-collect them. (shrink)

ABSTRACT: When considering normative concepts, such as distributive justice, one must consider both the question how concepts can have normative force and which particular conceptions of these concepts have this normative force. In this article I consider the view that the human capacity for autonomy accounts for normativity, and argue that adopting this view commits one to a responsibility-sensitive theory of distributive justice. This conclusion puts me directly at odds with the work of John Rawls, who derives his responsibility-insensitive difference (...) principle from a similar account of autonomy. However, I argue that such an argument would be based on a mischaracterisation of what is significant about the human capacity for autonomy. RÉSUMÉ : Pour envisager des concepts normatifs, tels que la justice distributive, il faut à la fois considérer la question de savoir comment les concepts peuvent avoir une force normative et se demander aussi quelles conceptions de ces concepts en sont dotés. Cet article considère que la capacité propre à l’humain d’être autonome rend compte de la normativité nous engage à adopter une théorie de justice distributive qui est sensible à la responsabilité. Cette conclusion entre directement en conflit les théories de Rawls, qui tire d’une explication similaire sur l’autonomie son principe de responsabilité qui ne tient pas compte de la différence. Un tel argument se fonde sur une mauvaise caractérisation de ce qui est important dans la capacité propre à l’humain d’être autonome. (shrink)

This paper deals primarily with countable, simple, connected graphs and the following two conditions which are trivially satisfied if the graphs are finite: (a) there is an edge-recognition algorithm, i.e., an effective procedure which enables us, given two distinct vertices, to decide whether they are adjacent, (b) there is a shortest path algorithm, i.e., an effective procedure which enables us, given two distinct vertices, to find a minimal path joining them. A graph $G = \langle\eta, \eta\rangle$ with η as set (...) of vertices and η as set of edges is an α-graph if it satisfies (a); it is an ω-graph if it satisfies (b). G is called r.e. (isolic) if the sets ν and η are r.e. (isolated). While every ω-graph is an α-graph, the converse is false, even if G is r.e. or isolic. Several basic properties of finite graphs do not generalize to ω-graphs. For example, an ω-tree with more than one vertex need not have two pendant vertices, but may have only one or none, since it may be a 1-way or 2-way infinite path. Nevertheless, some elementary propositions for finite graphs $G = \langle\nu, \eta\rangle$ with $n = \operatorname{card}(\nu), e = \operatorname{card}(\eta)$ , do generalize to isolic ω-graphs, e.g., n - 1 ≤ e ≤ n(n - 1)/2. Let N and E be the recursive equivalence types of ν and η respectively. Then we have for an isolic α-tree $G = \langle\nu, \eta\rangle: N = E + 1$ iff G is an ω-tree. The theorem that every finite graph has a spanning tree has a natural, effective analogue for ω-graphs. The structural difference between isolic α-graphs and isolic ω-graphs will be illustrated by: (i) every infinite graph is isomorphic to some isolic α-graph; (ii) there is an infinite graph which is not isomorphic to any isolic ω-graph. An isolic α-graph is also called a twilight graph. There are c such graphs, c denoting the cardinality of the continuum. (shrink)

A nonnegative interger is called a number, a collection of numbers a set and a collection of sets a class. We write ε for the set of all numbers, o for the empty set, N(α) for the cardinality of $\alpha, \subset$ for inclusion and $\subset_+$ for proper inclusion. Let α, β 1 ,...,β k be subsets of some set ρ. Then α' stands for ρ-α and β 1 ⋯ β k for β 1 ∩ ⋯ ∩ β k . For (...) subsets α 1 ,..., α r of ρ we write: $\alpha_\sigma - \{x \in v \ (\nabla i) \lbrack i \in \sigma \Rightarrow x \in \alpha_i\rbrack\} \text{for} \sigma \subset (1, \ldots, r),\\ s_i = \sum \{N(\alpha_\sigma) \mid \sigma \subset (1,\ldots, r) \& N(\sigma) = i\}, \text{for} 0 \leqq i \leqq r$ . Note that α 0 = v, hence s 0 = N(v). If the set v is finite, the classical inclusion-exclusion principle (abbreviated IEP) states $(a) N(\alpha_1 \cup \cdots \cup \alpha_r) = \sum^r_{t=1} (-1)^{t-1} s_t = \sum_{o \subset_+\sigma \subset (1,\ldots,r)}$ (b) N(α' 1 ⋯ α' r ) = ∑ r t=0 (-1) t s t = ∑ (-1) N(σ) N (α σ ). In this paper we generalize (a) and (b) to the case where α 1 ,⋯, α r are subsets of some countable but isolated set v. Then the role of the cardinality N(α) of the set α is played by the RET (recursive equivalence type) Req α of α. These generalization of (a) and (b) are proved in § 3. Since they involve recursive distinctness, this notion is discussed in § 2. In § 4l we consider a natural extension of "the sum of the elements of a finite set σ" to the case where σ is countable. § 5 deals with valuations, i.e., certain mappings μ from classes of isolated sets into the collection λ of all isols which permit us to further generalize IEP by substituting μ(α) for $\operatorname{Req} \alpha$. (shrink)

It is highly desirable for an allocation of goods to be efficient. However, one might also deem it important that an allocation gives individuals what they deserve. This paper investigates whether it is possible for an allocation to be both efficient and give people what they deserve. It will first of all consider comparative desert, and conclude that it is possible to satisfy both desiderata. It will then consider absolute desert by integrating Shelly Kagan’s work on desert and economic theory. (...) The conclusion will be that there are potential conflicts between absolute desert and efficiency. The paper will then examine how to select the best compromise between the two values, considering several different conceptions of absolute desert. (shrink)

In 1961 the Centre for the Study of the History of Education at Ghent University, Belgium published the first issue of the multilingual journal _Paedagogica Historica: International Journal of the History of Education_. This book celebrates its fiftieth volume. In fourteen contributions written by different generations of historians of education, it demonstrates that in an era where the history of education at university level is at risk, both the journal and the discipline are pulsing, and alive and kicking. Was the (...) journal a trendsetter or a follower, and which position did it take with respect to the International Standing Conference for the History of Education? These are questions addressed in the first section of this book. In the second section, a number of articles show national and transnational developments of the history of education. In their diversity, they make clear how the national and the transnational together characterize the discipline. They show why journals in this domain should stimulate the development of broader concepts and theories in order to put national and regional cases in a broader scientific context and to make them attractive for international readership. In the last section authors turn their minds to the future of the history of education. They write about the shaping of new trends and about moving beyond borders, focusing on, among other things, the challenge of neurosciences and of digital humanities. This book was originally published as a special issue of _Paedagogica Historica_. (shrink)

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

Pure Type Systems, PTSs, were introduced as a generalization of the type systems of Barendregt's lambda cube and were designed to provide a foundation for actual proof assistants which will verify proofs. Systems of illative combinatory logic or lambda calculus, ICLs, were introduced by Curry and Church as a foundation for logic and mathematics. In an earlier paper we considered two changes to the rules of the PTSs which made these rules more like ICL rules. This led to four kinds (...) of PTSs. Most importantly PTSs are about statements of the form M:A, where M is a term and A a type. In ICLs there are no explicit types and the statements are terms. In this paper we show that for each of the four forms of PTS there is an equivalent form of ICL, sometimes if certain conditions hold. (shrink)