Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has passed an amendment to the Public Health Act that would grant certain terminally ill patients an explicit right to continuous deep sedation until they pass away. Such a (...) framework would be unique in the world. In this paper we will highlight and reflect on four relevant aspects and shortcomings of the proposed bill. First, that the bill suggests that continuous deeps sedation should be considered as a sui generis practice. Second, that it requires that sedation should always be accompanied by the withholding of all artificial nutrition and hydration. In the most recently amended version of the legal proposal it is stated that life sustaining treatments are withheld unless the patient objects. Third, that the French bill would not require that the suffering for which continuous deep sedation is initiated is unbearable. Fourth, the question as to whether the proposal should be considered as a way to avoid having to decriminalise euthanasia and/or PAS or, on the contrary, as a veiled way to decriminalise these practices. The French proposal to amend the Public Health Act to include a right to continuous deep sedation for some patients is a unique opportunity to clarify the legality of continuous deep sedation as an end-of-life practice. Moreover, it would recognize that the practice of continuous deep sedation raises ethical and legal issues that are different from those raised by symptom control on the one hand and assisted dying on the other hand. Nevertheless, there are still various issues of significant ethical concern in the French legislative proposal. (shrink)

Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying...

Deflationists believe that the question “What is truth?” should be answered not by means of a metaphysical inquiry into the nature of truth, but by figuring out what use we make of the concept of truth, and the word ‘true’, in practice. This article accepts this methodology, and it thereby rejects pluralism about truth that is driven by ontological considerations. However, it shows that there are practical considerations for a pluralism about truth, formulated at the level of use. The theory (...) expounded by this article states that truth is a dual-purpose tool; it can be used as a device for transferring justificatory burdens and, for select areas of discourse, it can also be used as a standard, a norm. This contrast in how truth is used introduces a bifurcation in our discourse that is reminiscent of metaphysical divides traced by more traditional versions of alethic pluralism. However, my pluralism “at the level of use” states that truth is plural solely at the level of use. It is unified at both the conceptual as well as the metaphysical level. At those levels, the theory takes its cue from deflationism. As such, this theory is offered as a midway point and as a potential way forward in the debate between deflationism and pluralism. (shrink)

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our goal (...) is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

In this chapter, we defend an explanationist version of proper functionalism. After explaining proper functionalism’s initial appeal, we note two major objections to proper functionalism: creatures with no design plan who appear to have knowledge (Swampman) and creatures with malfunctions that increase reliability. We then note how proper functionalism needs to be clarified because there are cases of what we call warrant-compatible malfunction. We then formulate our own view: explanationist proper functionalism, which explains the warrant-compatible malfunction cases and helps to (...) block the above objections. We also advance a positive argument for explanationist proper functionalism. (shrink)

According to commonsense, some collections of objects compose wholes, and others do not. However, philosophers have found serious difficulties with attempts to preserve this thesis, and especially with attempts to preserve the existence of just those composite objects recognized by commonsense. In this paper, I defend a classical solution to this problem: "it is the mind that maketh each thing to be one" (Berkeley, Siris, sect. 356). According to this view, which I call 'mereological idealism,' it is when a plurality (...) is united in thought under a concept that a unified whole comes to exist. After explaining the view in more detail, I show how it escapes three standard arguments against commonsense views of composition. (shrink)

This paper explores how phenomenological notions of rhythm might accommodate a richer description of preverbal infant-caregiver dialogue. Developmental psychologists have theorized a crucial link between rhythm and intercorporeality in the emergence of intersubjectivity and self. Drawing on the descriptions of rhythm in the phenomenology of Maurice Merleau-Ponty, Erwin Straus, Henri Maldiney and Maxine Sheets-Johnstone, the paper emphasizes the role of art and aesthetic processes proposing that they not only be considered as metaphorical or representational aspects of rhythm but as primary (...) resources that can enrich and deepen our understanding of self-emergence and intercorporeality in preverbal infant-caregiver dialogue. (shrink)

Probes the nature of linguistic or symbolic action as it relates to specific novels, plays, and poems.

Alexander Pruss and I have proposed an analysis of omnipotence which makes no use of the problematic terms 'power' and 'ability'. However, this raises an obvious worry: if our analysis is not related to the notion of power, then how can it count as an analysis of omnipotence, the property of being all-powerful, at all? In this paper, I show how omnipotence can be understood as the possession of infinite power (general, universal, or unlimited power) rather than the possession of (...) particular powers. I then argue that the ordinary notions of particular powers or abilities can be understood as applying vague limitations to the notion of infinite power. The vagueness of these limitations is the source of the well-known difficulties in the analysis of ability. (shrink)

"The idea for this book arose in connection with the Workshop on Semantic functions of complementizers in European languages, which we organized in October 28-29, 2011, at the University of Copenhagen, Denmark. Around two thirds of the book chapters are elaborations on contributions to this workshop, the remaining one third arose independently of the workshop.".

INTRODUCTION In an age of specialists, Kenneth Burke's writings offend those who are content with a partial view of human motivation. ...

From 1827 to 1831 the German historian Leopold von Ranke travelled through Germany, Austria, and Italy, hunting for documents and archives. During this journey Ranke developed a new model for historical research that transformed the archive into the most important site for the production of historical knowledge. Within the archive, Ranke claimed, the trained historian could forget his personal predispositions and political loyalties, and write objective history. This essay critically examines Ranke's model for historical research through a study of the (...) obstacles, frustrations, and joys that he encountered on his journey. It shows how Ranke's archival experiences inspired him to re-evaluate his own identity as a historian and as a human being, and investigates some of the affiliations between his model for historical research and the political realities of Prince Metternich's European order. Finally, the essay compares Ranke's historical discipline to other nineteenth-century disciplines, such as anthropology and archaeology. (shrink)

Background: The 21-item Nurses’ Moral Courage Scale was developed and validated in 2018 in Finland with the purpose of measuring moral courage among nurses. Objectives: The objective of this study was to make a Dutch translation of the Nurses’ Moral Courage Scale to describe the level of nurses’ self-assessed moral courage and associated socio-demographic factors in Flanders, Belgium. Research design: A forward–backward translation method was applied to translate the English Nurses’ Moral Courage Scale to Dutch, and a pilot study was (...) conducted to improve readability and understandability. A non-experimental, descriptive cross-sectional exploratory design was used to conduct a survey. Descriptive analysis was used. Participants: The data were collected from a convenience sample of 559 nurses from two hospitals in Flanders. Ethical considerations: Ethical approval was obtained from the university ethics committee, permission to conduct the study was obtained from the participating hospitals. Participants received a guide letter and gave their informed consent. Findings: The readability and understandability of the Dutch Nurses’ Moral Courage Scale were positively evaluated, and the scale revealed a good level of internal consistency for the total scale and all subscales. Nurses’ mean score of the 21-item Nurses’ Moral Courage Scale was 3.77. The total Nurses’ Moral Courage Scale score was associated with age, experience, professional function, level of education and personal interest. Discussion and Conclusion: The Nurses’ Moral Courage Scale was successfully translated to Dutch. The Flemish nurses perceived themselves as morally courageous, especially when they were in a direct interpersonal relationship with their patients. Acting courageously in ethical dilemmas that involved other actors or organizations appeared to be more challenging. The results strongly suggest the important role of education and ethical leadership in developing and supporting this essential virtue in nursing practice. (shrink)

This book addresses these three issues: What is discrimination?; What makes it wrong?; What should be done about wrongful discrimination? It argues: that there are different concepts of discrimination; that discrimination is not always morally wrong and that when it is, it is so primarily because of its harmful effects.

The conceptual pair of own-world and common world constitutes an archaic pair, originally introduced by Heraclitus. More than two millennia after its introduction, Binswanger picked up this conceptual pair in the attempt to understand existence and mental disorder. Ever since, this conceptual pair has been part of the conceptualization of schizophrenia in phenomenological psychopathology. However, the concepts of ídios kósmos and koinós kósmos have seldomly been elaborated and expanded upon, and certain unclarities rest within the literature. This paper resolves some (...) of these unclarities and contributes to a theory of anthropological proportions, which furthers our understanding of ídios kósmos and koinós kósmos. The paper begins with an exploration of the theoretical underpinnings of this conceptual pair, i.e., it discusses the concept of world, what is understood by common world, and what it means to live in an own-world. This theoretical exploration segues into an in-depth analysis of the alterations of experiential life in schizophrenia, which can be illuminated via this conceptual pair. It is further argued that this conceptual pair contributes to an understanding of the puzzling phenomenon of double bookkeeping. Finally, the paper concludes in a discussion of clinical implications of this conceptual pair, stressing the importance of a mindfulness of the alterations to the ídios kósmos and koinós kósmos in schizophrenia. (shrink)

Van Goghs Malerei vollzieht den Wandel vom traditionellen Verständnis des Bildes als Repräsentation zum Bild als einer a-mimetischen, eigengesetzlichen Wirklichkeit, der sich äusserst anregend auf den Expressionismus und auf die abstrakte Malerei ausgewirkt hat. Weniger bekannt ist die Tatsache, dass sein Werk auch zur Entstehung von modernen Dichtungs- und Kunsttheorien beitrug. So wies es Rilke den Weg zur Sachlichkeit des Sagens, Hofmannsthal ermöglichte es ein neues Verständnis von Wirklichkeit, Heidegger unterstützte es bei der Erweiterung und Verwandlung der Metaphysik, während es (...) Jaspers zur Entwicklung seiner künftigen Existenzphilosophie anstiess. (shrink)

Recently there has been some discussion concerning a particular type of enhancement, namely ‘moral enhancement’. However, there is no consensus on what precisely constitutes moral enhancement, and as a result the concept is used and defined in a wide variety of ways. In this article, we develop a clarificatory taxonomy of these definitions and we identify the criteria that are used to delineate the concept. We think that the current definitions can be distinguished from each other by the criteria used (...) for determining whether an intervention is indeed moral enhancement. For example, some definitions are broad and include moral enhancement by any means, while other definitions focus only on moral enhancement by means of specific types of intervention. Moreover, for some definitions it suffices for an intervention to be aimed or intended to morally enhance a person, while other definitions only refer to ‘moral enhancement’ in relation to interventions that are actually effective. For all these differences in definitions we discuss some of their implications. This shows that definitions are significantly less descriptive and more normative than they are regularly portrayed to be. We therefore hope that the taxonomy developed in this paper and the comments on the implications for the normative debate of the variety of definitions will provide conceptual clarity in a complex and highly interesting debate. (shrink)

Animating Maurice Merleau-Ponty’s phenomenological idea of the body as a pre-reflective organizing principle in perception, consciousness and language has become a productive and popular endeavor within philosophy of mind during the last two decades. In this context Merleau-Ponty’s descriptions of an embodied mind has played a central role in the attempts to naturalize phenomenological insights in relation to cognitive science and neuropsychological research. In this dialogue the central role of art and aesthetics in phenomenology has been neglected or at best (...) treated as a peripheral phenomenon. In this article I argue that the failure to place art and aesthetics at the center of thought within phenomenology leads to a neglect of the expressive primacy of the body in movement. In the current naturalization of phenomenology the questions related to expressive movement are often consigned to the notions of motor intentionality or gesture. However, in his book How the Body Shapes the Mind the philosopher Shaun Gallagher interestingly concludes, based on experimental results, that bodily movements of gesture cannot be accounted for by the phenomenologically adapted notions of ‘body image’ and ‘body schema’. Symptomatically, Gallagher ends his chapter on bodily gesture with a section title asking the relevant question that remains unanswered within a phenomenology of mind: Expressive movement from the beginning? The search for an answer to this question points, in my view, to the possibility of a more radical understanding of the embodied mind based on the primacy of expressive experimentation rather than representational experience, which makes the question of art and aesthetics a core issue. Following the image of thought in the philosophy of Gilles Deleuze I argue that art, as the production of sensation through experimentation, presents us with a mode of thinking that accounts for expressive bodily movement as a constitutive force in subjective thought and experience. (shrink)

Name der Zeitschrift: Cognitive Linguistics Jahrgang: 27 Heft: 1 Seiten: 67-100.

There are many objections to statistical discrimination in general and racial profiling in particular. One objection appeals to the idea that people have a right to be treated as individuals. Statistical discrimination violates this right because, presumably, it involves treating people simply on the basis of statistical facts about groups to which they belong while ignoring non-statistical evidence about them. While there is something to this objection—there are objectionable ways of treating others that seem aptly described as failing to treat (...) them as individuals—it needs to be articulated carefully. First, most people accept that many forms of statistical discrimination are morally unproblematic, let alone morally justified all things considered. Second, even treating people on the basis of putative non-statistical evidence relies on generalizations. Once we construe treating someone as an individual in a way that respects this fact, it becomes apparent: (1) that statistical discrimination is compatible with treating people as individuals, and (2) that one may fail to treat people as individuals even without engaging in statistical discrimination. Finally, there are situations involving the expression of messages of inclusion where we think it is good, morally speaking, that we are not treated as individuals. (shrink)

Name der Zeitschrift: Jahrgang: 13 Heft: 2 Seiten: 170-189.

Bringing together evidence from natural and social sciences, the work introduces the non-reductionist Instruction Grammar programme. Viewed from within the practicalities of the lifeworld, utterances are described as instructions to simulate perceptions and attributions for action. The approach provides solutions to long-standing philosophical problems of cognitive grammar theories and traditionally puzzling syntactic phenomena.

This chapter contains sections titled: Introduction Hegel's Semantics of Singular Cognitive Reference Hegel's Justification of His Semantics of Singular Cognitive Reference in “Consciousness” “Self‐Consciousness,” Thought, and the Semantics of Singular Cognitive Reference Hegel's Interim Critique of the Ego‐Centric Predicament Conclusion References.

In this book Kasper Lippert-Rasmussen address the complexities of his question "Is affirmative action morally justifiable?" by analyzing the prevailing contemporary arguments both for and against affirmative action. The book applies current political philosophy to demonstrate that arguments on both sides justify different conclusions given different specific cases, though it ultimately does argue in favor of affirmative action based on the relative strength and significance of the anti-discrimination- and equality of opportunity-based positions.

In The Myth of Morality Richard Joyce presents a simple and very influential argument for the truth of moral error theory. In this paper I point out that the argument does not have the form Joyce attributes to it, the argument is not valid in an extensional propositional logic and on the most natural way of explicating the meanings of the involved terms, it remains invalid. I conclude that more explanation is needed if we are to accept this particular argument (...) for moral error theory. (shrink)

This article investigates the emergence of the archive as the primary venue for the production of historical knowledge in the 19thcentury. The turn to archival research, the article argues, may be considered as a response to the discussions about the problems of testimony that dominated 18th- and early 19th-century German writings on the methodology and epistemology of historical research. These discussions, especially regarding the epistemic virtues of witnesses, also helped create the particular culture of knowledge-making within German historical scholarship that (...) enabled the archival turn. The article illustrates these developments through the examples of Johann Peter von Ludewig, who was one of the most prominent historians of the early German Enlightenment, and Leopold von Ranke, who is normally considered the founder of the modern historical discipline and the most important advocate of the 19th-century archival turn. (shrink)

In 2002 with the passing of the Euthanasia Law, Belgium became one of the few countries worldwide to legalize euthanasia. In the 18 years since the passing of the law, much has changed. We argue that in Belgium a widening of the use of euthanasia is occurring and that this can be ethically and legally problematic. This is in part related to the fact that several legal requirements intended to operate as safeguards and procedural guarantees in reality often fail to (...) operate as such. We focus on three kinds of safeguards or procedural guarantees: the legally defined due care criteria for eligibility for euthanasia; the consultation of a second physician; and the reporting of euthanasia cases to the Federal Control and Evaluation Commission for Euthanasia. We will show how each of these three safeguards can exhibit shortcomings in theory and practice. (shrink)

This chapter contains sections titled: Introduction The Co‐extensiveness of Understanding and Sensibility Identity and Predication Objective Purport and Kant's Transcendental Deduction Proving Mental Content Externalism Transcendentally Notes References.

“Buddhisms” captures the challenge inherent in the diverse practices and beliefs of this religion. In this book, grounding the analysis in the bodies of practitioners provides a new opportunity for coherence that reaches across vast expanses of time and space.

BackgroundThe aim of this study is to compare depression and loneliness among adult siblings of people on the autism spectrum, adult siblings of normotypic individuals, and adults raised alone. In recent years, an increasing interest in the perspective of siblings of children diagnosed with autism has been observed, with studies among this population particularly concerned with the developmental trajectories of children and adolescents at “high risk” for ASD, rarely focusing on their mental well-being.MethodsThe respondents filled out: the survey on sociodemographic (...) data designed by the authors, Beck Depression Inventory II, and De Jong Gierveld Loneliness Scale.ResultsA rise in BDI and an increase in the DJGLS score were predicted by having a sibling diagnosed with ASD. Those effects were independent of subjects’ sex, educational status, place of residence, or a number of siblings.ConclusionThe results underline a fundamental need for the development of mental hygiene programs for families where children with autism spectrum are accompanied by healthy siblings. (shrink)

Relational egalitarianism says that moral equals should relate as equals. We explore how moral unequals should relate.

Walter Kasper, a German cardinal of the Roman Catholic Church, is president emeritus of the Pontifical Council for Promoting Christian Unity, having served as its president from 2001 to 2010. Kasper explains that the interest of theology has been broken off by idealistic thinking, and advocates a new discussion between theology and idealism, of the fundamental importance of the theology of the twentieth century.

Five Groundbreaking Moments in Heidegger's Thinking presents a fresh interpretation of some of Heidegger's most difficult but important works, including his early Beiträge (Contributions) and engages with his theoretical concept of "the reading in thinking." In new translations of central texts, Kenneth Maly invites the reader to think along the way by reading, contemplating, and translating Heidegger's ideas into context. An introduction to the field of philosophy and more specifically to Heidegger's thought, Five Groundbreaking Moments in Heidegger's Thinking asks (...) the reader, in some manner, to actively do the philosophizing. (shrink)

This pioneering translation of Plato's Phaedrus, with detailed summary and full philological and exegetical notes taking into consideration all commentaries since Hermias, followed by a painstaking dialogical analysis of the text that shows what we must think at every moment in order to understand the thinking that brings the Greek text to life. In Kenneth Quandt's treatment, Plato's seminal work is allowed to create its own horizon and a new and profoundly unified interpretation emerges: Socrates's conversation with Phaedrus reaches (...) a vision of eros that explains the paradoxes of human nature, explodes the zero-sum game of master and slave, exposes the crabbed fetishism of the written word, and releases the mind to a life of contemplation fixed in a cloudless noon. (shrink)

When a new intervention or drug is developed, this has to pass through various phases of clinical testing before it achieves market approval, which can take many years. This raises an issue for drugs which could benefit terminally ill patients. These patients might set their hopes on the experimental drug but are unable to wait since they are likely to pass away before the drug is available. As a means of nevertheless getting access to experimental drug, many seriously ill and (...) terminally ill patients are therefore very willing to participate in randomised controlled trials. However, only very few terminally ill patients are able to actually participate, and those that do participate are at risk of participating solely as a way of getting experimental drugs. Currently, there are, however, ways of getting access to drugs that have not gained market approval. One such mean is via expanded access or compassionate use programs where terminally ill patients receive experimental new drugs that are not yet market approved. In this paper, I examine some of the common justifications for such programs. The most frequently voiced justifications for compassionate use or expanded access programs could be put in one of three categories. First, there are justifications of justice, where compassionate use programs could be seen as a just or fair way to distribute experimental new drugs to patients who are denied access to RCT’s through no fault of their own. Second, such programs could be justified by reference to the ethical principle of beneficence where it could be claimed that terminally ill patients stand to benefit greatly at very little risk. Third, there are considerations of autonomy where, it is claimed, patients should be able to exercise their autonomy and have access to such drugs if that is there free choice and they are fully aware of the risks associated with that choice. In this paper, I argue currently all justifications are potentially problematic. If they truly form the basis for justification, compassionate use programs should be designed to maximize justice, beneficence and autonomy. (shrink)

Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the ‘natural death’ hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a ‘natural’ death by medical practitioners, patients' relatives (...) and patients.We attempt to show that the label ‘natural’ cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as ‘natural’ death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases. (shrink)

This collection of essays, written between 1975 and 1987, covers topics including the doctrine of analogy, the Trinity, theological realism, the problims of evil and suffering, ecclesiology, and the so-called theistic proofs. The earlier writings relect the author's training as a philosopher in the Anglo-Aamerican analytic tradition. Later essays have a more explicitly theological focus, and they attempt to deal with and move beyond the tradition through hermeneutics, and literary and social theory. This collection thus addresses a wider list of (...) topics than is usual in works of philsophical theology, and is unique in its use of interdisciplinary methods and approaches. (shrink)