Background: Patient participation in clinical ethics support services has been marked as an important issue. There seems to be a wide variety of practices globally, but extensive theoretical or empirical studies on the matter are missing. Scarce publications indicate that, in Europe, patient participation in CESS varies from region to region, and per type of support. Practices vary from being non-existent, to patients being a full conversation partner. This contrasts with North America, where PP seems more or less standard. While (...) PP seems to be on the rise in Europe, there is no data to confirm this. This study sought a deep understanding of both habits and the attitudes towards PP in the Netherlands, including respondents’ practical and normative perspectives on the matter. Methods and Results: We developed a national survey on PP for Dutch CESS staff. Our survey comprised a total of 25 open and close-ended questions, focused on four topics related to PP goals of CESS, status quo of PP, ideas and ideals concerning PP, and obstacles for PP. Discussion: The four most important findings were that: Patient participation in Dutch CESS is far from standard. Views on patient participation are very much intertwined with the goals of ethics support. Hesitations, fears and perceived obstacles for PP were not on principle and Most respondents see PP as a positive opportunity, yet requiring additional training, practical guidance and experience. Conclusions: Various normative reasons require PP. However, PP seems far from standard and somewhat rare in Dutch CESS settings. Our respondents did not raise many principled objections to PP. Instead, reasons for the lack of PP are intertwined with viewpoints on the goals of CESS, which seemingly focus on supporting health care professionals. Training and practical guidance was thought to be helpful for gaining experience for both CESS staff and HCPs. (shrink)
This article presents a social learning perspective as a means to analyze and facilitate collective decision making and action in managed resource systems such as platforms. First, the social learning perspective is developed in terms of a normative and analytical framework. The normative framework entails three value principles, namely, systems thinking, experimentation, and communicative rationality. The analytical framework is built up around the following questions: who learns, what is learned, why it is learned, and how. Next, this perspective is used (...) to analyze two managed resource systems: Fishery management in Lake Aheme, Benin and water resources management in Gelderland, The Netherlands. To assess platform performance in resource use negotiation, emerging lessons from the case studies are combined with propositions concerning membership of platforms, accessibility of platform meetings, skills and relations of platform members, realization of platforms, and third party facilitation of platform activities. (shrink)
The goal of this paper is to introduce the false hope harms (FHH) argument, as a new concept in healthcare. The FHH argument embodies a conglomerate of specific harms that have not convinced providers to stop endorsing false hope. In this paper, it is submitted that the healthcare profession has an obligation to avoid collaborating or participating in, propagating or augmenting false hope in medicine. Although hope serves important functions—it can be ‘therapeutic’ and important for patients’ ‘self-identity as active agents’— (...) the presentation of false hope along the hope continuum entails a misconstrued balancing act. By not speaking up against unrealistic patient and family requests—including some requests for rights to try, resuscitative efforts in terminally ill patients, or other demands for non-beneficial treatments—healthcare providers precipitate harms, i.e., the FHH. These harms arise on both individual and communal levels and cannot be ignored. The goal of this paper is not to offer a definition of false hope, because the phenomenon of false hope is too complex for any simple definition. Instead, this paper seeks to make four points while outlining the FHH argument: consumer medicine and false hope are connected; providers and patients are very vulnerable in the system of consumer medicine; providers have a responsibility to stand up against false hope; and how the FHH argument could perhaps offer a footing to resist giving in to false hope. (shrink)
Snyder’s book ‘Exploiting hope’ is as relevant as ever. His book is about the hope of desperate individuals seeking treatments that cannot be found in conventional medicine. The book engages with hope in the setting of phase I cancer trials, stem cell interventions, right-to-try laws and crowd funding, offering a new language to explain our discomfort with some of these quests. At the same time the book seems particularly relevant given current events. While despair and quests for novel interventions touched (...) only a few patients with specific conditions up to a year ago, they are now familiar to us all. Early on in the COVID-19 pandemic all of us probably experienced hope for interventions that could save us... (shrink)
Book synopsis: Passion and Action explores the place of the emotions in seventeenth-century understandings of the body and mind, and the role they were held to play in reasoning and action. Interest in the passions pervaded all areas of philosophical enquiry, and was central to the theories of many major figures, including Hobbes, Descartes, Malebranche, Spinoza, Pascal, and Locke. Yet little attention has been paid to this topic in studies of early modern thought. Susan James surveys the inheritance of ancient (...) and medieval doctrines about the passions, showing how these were incorporated into new philosophical theories in the course of the seventeenth century. She examines the relation of the emotions to will, knowledge, understanding, desire, and power, offering fresh analyses and interpretations of a broad range of texts by little-known writers as well as canonical figures, and establishing that a full understanding of these authors must take account of their discussions of our affective life. Passion and Action also addresses current debates, particularly those within feminist philosophy, about the embodied character of thinking and the relation between emotion and knowledge. This ground-breaking study throws new light upon the shaping of our ideas about the mind, and provides a historical context for burgeoning contemporary investigations of the emotions. (shrink)
Environmental pollution, animal diseases, and food scandals have marked the agricultural sector in the Netherlands and elsewhere in the 1990s. The sector was high on the political and societal agenda and plans were developed to redesign the sector into a more sustainable direction. Generally, monitoring of the agricultural sector is done by means of quantitative indicators to measure social, ecological, and economic performance. To give more attention to the normative character of sustainable development, the Dutch Ministry of Agriculture, Nature, and (...) Food Quality requested for a participatory approach to evaluate Dutch agriculture, which was characterized by stakeholder workshops, dialogue, and learning. This article describes and reflects on this approach, using the Fourth Generation Evaluation framework developed by Guba and Lincoln (Fourth generation evaluation, 1989). Although there are several improvements to be made, the evaluation approach was successful in the way that it gave insight into perceptions, visions, and ambitions of agricultural stakeholders with regard to sustainability. It also encouraged learning about ways to make the agricultural sector more sustainable. And it contributed to the development of a monitoring approach that is complementary to the quantitative, indicator-based, evaluation approach that is generally used and that can be used every few years to see how perceptions and ambitions of stakeholders have developed. (shrink)
Family values are argued to enable ethical family business conduct. However, how these arise, evolve, and how family leaders articulate them is less understood. Using an ‘identity work’ approach, this paper finds that the values underpinning identity work: arise from multiple sources, evolve in tandem with the context; and, that their articulation is relational and aspirational, rather than merely historical. Prior research mostly understood family values as rooted in the past and relatively stable, but our rhetorical analysis unlocks a more (...) dynamic and promising research direction advancing family business ethics. (shrink)
The Clarke-Collins correspondence was widely read and frequently printed during the 18th century. Its central topic is the question whether matter can think. Samuel Clarke defends the immateriality of the human soul against Anthony Collins’ materialism. Clarke argues that consciousness must belong to an indivisible entity, and matter is divisible. Collins contends that consciousness could belong to a composite subject by emerging from material qualities that belong to its parts. While many early modern thinkers assumed that this is not possible, (...) this correspondence offers an unusually detailed discussion of this issue. Clarke rejects emergentism because real qualities of a composite must be homogeneous with the qualities of the parts. This rejection is based on considerations about the nature of causation. In addition, the disagreement derives in part from a disagreement between Clarke and Collins about the limits of our knowledge. (shrink)
Lyman Tower Sargent has had a personal and professional impact upon me. I cannot separate the effects of reading his work from engaging with him as a mentor—and more. Hence, this piece will focus on personal and professional texts and their contexts. I revisit Sargent's “An Ambiguous Legacy: The Role and Position of Women in the English Eutopia,” an essay he contributed to my Future Females: A Critical Anthology. I include passages from my novels Oy Pioneer! and Oy Feminist Planets: (...) A Fake Memoir which describe protagonist Sondra Lear's relationship with Thurston Howell III, interactions stemming from my longstanding association with Sargent. I describe a prominent male scholar's positive—almost utopian—influence on what I am here calling a retrospective autobiographical portrait of the professor as a young woman. This piece emphasizes that a festschrift contribution is about reciprocity between author and honoree. (shrink)
‘SWAMPLAB’ is a strong case for intuitive insights through arts, sciences, and technologies to engage the self and establish meaningful social interactions including humans and non-humans. While zigzagging through processes of privatization, globalization, ecological, economic, social and political challenges, the power of such residencies or labs stems from the interplay with the local context and its habitants, in this case, nature reserve De Zegge, a 111 hectares swamp in the Northern part of Belgium. Mediation and participation are a core condition (...) for the design of knowledge and engagement since without informed consent and participants understanding the nature of the process, no change is possible. The more individuals express and explore their knowledge through social encounters, narratives, and dialogs, the more crucial tacit knowledge can be shared. Making things disputable is another responsibility. In society at large, there are very few examples where people feel interconnected and yet at the same time can disagree. The notion of Swamplab is rather a call for wonderment, for not using each other as a stepping stone but setting up open dialogs, listening and reflecting together, playing around, tinkering, since messiness is allowed. Including non-humans, be they wolves, moles or avatars, and virtual agents, is key to cracking the individual resistance to change understandings, opinions, and behavior. The result may lead to deeper engagement and Buckminster Fuller’s “comprehensive anticipatory design science” or what Bruno Latour calls a “progressive composition of the good common world”. (shrink)
This chapter contains section titled: Descartes's Novel Conception of the Mind Dualism, Substances, and Principal Attributes Thinking Without a Body Principal Attributes and the Nature of Body Conclusion References and Further Reading.
Descartes held that the human mind or soul is indivisible, unlike body. In this paper I argue that his treatment of this feature of the soul is intimately connected to his engagement with Aristotelian scholasticism. I discuss two strands in Descartes. There is a long tradition of arguing for the immortality of the human soul on the basis of this view. Descartes did use this view in defense of dualism, but I argue that he held that the soul’s immortality should (...) be established rather on the basis of its status as a substance. This line of thought, I contend, is connected to his rejection of (most) Aristotelian substantial forms. Furthermore, the indivisibility of the human soul emerges repeatedly in connection to the union and interaction of mind and body in ways that connect to Aristotelian scholastic treatments of these issues. (shrink)
The Clarke-Collins correspondence was widely read and frequently printed during the 18th century. Its central topic is the question whether matter can think, or be conscious. Samuel Clarke defends the immateriality of the subject of the mental against Anthony Collins’ materialism. This paper examines important assumptions about the nature of body that play a role in their debate. Clarke argued that consciousness requires an “individual being”, an entity with some sort of significant unity as its subject. They agree that body (...) does not have this type of unity, because it consists of actually distinct parts. (shrink)
Despite the fact that various authors have expressed concern about a general decline of civic engagement in Western societies, other indicators portray a transition from traditional and formal participation formats to more informal participation forms. This replacement thesis, however, entails the question whether these new forms can still be regarded as a form of political participation. The Alternative Food Circles in Belgium can be considered as a typical grass-roots example of 'political consumerism', which is portrayed as a contemporary alternative for (...) institutionalised politics. In a member survey, 163 members of the Circles were questioned about their motives to participate. They clearly paid little attention to influencing the political system, but notions of solidarity and social change were clearl y present. This form of political consumerism therefore cannot be considered a full form of political participation, but it clearly is a form of 'life style politics'. (shrink)
Suárez held that the vital faculties of the soul are really distinct from the soul itself and each other and that they cannot causally interact. This means that he needed to account for the connections between the activities of the faculties: they both interfere with and contribute to each other’s activities. Suárez does so by giving the soul a direct causal role in these activities. This role requires the unity of the soul of a living being and Suárez used it (...) to argue against the view that a living being, in particular a human being, has more than one soul. This line of thought displays some affinity with arguments for the simplicity of the soul from the unity of consciousness. One important difference is that Suárez was talking not just about mental activities but about all vital activities. (shrink)
On the 24th of november 1991 the Belgian voters elected the 716 members of the nine provincial councils.The socialists are the biggest losers of this election, with the Volksunie as a close second. Also the Christian Democrats suffered a serious decline, mainly caused by the loss of the CVP in Flanders. The electoral gain of the Flemish Liberals is neutralized by the decline of the Liberal party in Wallonia. The Greens gain 32 seats, the Far Right 35. These national aggregates (...) hide striking regional differences. The national success of the Green is mainly due to the spectacular growth of Ecolo in the Walloons. The success of the Far Right is the sole result of a multiplication of votes for Vlaams Blok in Flanders. These results show that both the Flemish and the Walloon voters have sanctioned the traditional parties in a similar way. They opted, however, for totally different alternatives: the Flemish for the Far Right, the Walloons for the ecologists.The outcome of the provincial elections in the bilingual province of Brabant neatly mirrors these tendencies.In 1991 the outcome of the provincial elections showed a profile quite different from that of the national elections which were held on the same day. This is explained by the fact that the Flemish party Rossem, which won 3.2% of the votes, only ran for the national elections and not for the provincial elections. Hence, a considerable difference in voting behaviour on the national versus the local level. The comparison of the results of the national elections with those of the provincial confirms the claim that smaller parties generally score better at a lower level. In 1991 it can, however, not be said that the bigger parties did better on the national level. (shrink)
Early modern philosophers rejected various important aspects of Aristotelianism. Current scholarship debates the question to what extent the early moderns rejected final causation. Leibniz explicitly endorsed it. I argue that his notion of final causation should be understood in connection with his resurrection of substantial forms and his seeing such forms on the model of the soul. I relate Leibniz’ conception of final causation to the Aristotelian background as well as Descartes’s treatment of teleology. I argue that he agreed with (...) a view found in Aristotelianism that genuine efficiently causal powers require immanent teleology and with Descartes that immanent teleology presupposes cognition in the agent. (shrink)
A pandemic may cause a sudden imbalance between available medical resources and medical needs where fundamental care to a patient cannot be delivered. Inability to fulfil a professional commitment to deliver care as needed can lead to distress among caregivers and patients. This distress is sometimes alleviated through mechanisms that hide the facts that care is rationed and not all medical needs are met. We have identified three mechanisms that jeopardise accountable and optimal allocation of resources: hidden value judgements that (...) allow rationing under the disguise of triage or prioritisation, disguised conflict of interest between societal and individual patient’s needs and concealed biases in the application of medical tools. Under these three pitfalls decisions of resource allocation and who gets treated are handled as medical decisions: normative decisions are concealed and perceived as falling with the realm of medical judgement. Value judgements and moral agency are hidden to offer a ‘false sense of medical judgement’, while in fact there are several ethical judgements and biases at stake. The three pitfalls entail hidden normative deliberation and are inappropriate for sustainable healthcare delivery and resource allocation. We believe it is necessary to maintain transparency in decision making under conditions of insufficient resources to maintain trust in professional care givers and secure fair treatment allocation. Recognition of the pitfalls, by applying our recommendations, may help to ensure transparent and accountable distribution of care and contribute to public acceptance of the ethics behind rationing. (shrink)
Descartes argued that the eternal truths, most prominently the truths of mathematics, are created by God. He was not explicit, however, about the ontological status of these truths. Interpreters have proposed interpretations ranging from Platonism and conceptualism. I argue for an intermediate interpretation: Descartes held they have objective being in God’s mind. In this regard his view was line with a prominent view in Aristotelian scholasticism. I defend this interpretation against objections based on divine simplicity and concerns about causation. I (...) raise questions about the philosophical merit of these objections, but in addition I argue that there is good reason to think that Descartes himself did not think they were problems for the view. Seemingly conceptualist passages in the Principles, I argue, in fact address issues different from the ontological status of the eternal truths. (shrink)
In recent years more and more scholars of early modern philosophy have come to acknowledge that our understanding of Descartes’s thought benefits greatly from consideration of his intellectual background. Research in this direction has taken off, but much work remains to be done. Dennis Des Chene offers a major contribution to this enterprise. This erudite book is the result of a very impressive body of research into a number of late Aristotelian scholastics, some fairly well known, such as Suárez, others (...) quite obscure. Two thirds of the book is devoted to the Aristotelians, with occasional references to Descartes; the last third focuses on Descartes, although there still much Aristotelian ground is covered. Des Chene indicates three major themes for his book: natural change and agency, the structure of material substance, and finality. (shrink)
I argue that Descartes treated the action of body on mind differently from the action of mind on body, as was common in the period. Descartes explicitly denied that there is a problem for interaction but his descriptions of interaction seem to suggest that he thought there was a problem. I argue that these descriptions are motivated by a different issue, the seemingly arbitrary connections between particular physical states and the particular mental states they produce. Within scholasticism there was already (...) a (yet different) problem concerning action of body on mind. I offer a comparison between Descartes and the scholastics. (shrink)
In the Monadology Leibniz has us imagine a thinking machine the size of a mill in order to show that matter can’t think. The argument is often thought to rely on the unity of consciousness and the notion of simplicity. Leibniz himself did not see matters this way. For him the argument relies on the view that the qualities of a substance must be intimately connected to its nature by being modifications, limitations of its nature. Leibniz thinks perception is not (...) a modification of matter because it is active and matter is passive. At the same time, there are traces in Leibniz of a different argument that relies on the notion of internal action, which may involve the notion of simplicity. Critics have sometimes charged that the Mill Argument is an argument from ignorance, but Leibniz was aware of this problem and made clear that he did not make that mistake. (shrink)
I argue that Descartes's best known argument for dualism relies on claims about intellectual activity and not on claims about mental states generally to establish dualism. I explain that this must be so give his historical context, where arguments for the immateriality of the mind on the basis of the intellect were common. But sensation and other non-intellectual states were regarded as pertaining to the body-soul composite.
For Descartes different substances are really distinct. He frequently connects real distinction with mutual separability. I examine this connection and the notion of real distinction. I then apply the results of this analysis to the controversy over the question whether Descartes held that there is a multiplicity of corporeal substances or only one. I argue that there are several ways of defending the pluralist interpretation against the monist charge that Cartesian bodies are not separable and so not really distinct substances.
IN this paper I explain how Descartes's conception of the mind was novel in relation to Aristotelian scholasticism. I also argue against the standard view that Descartes believed in transparency of the mental, the view that one cannot make mistakes about one's own mental states.
In this paper I analyze Descartes's puzzling claim that the mind is whole in the whole body and whole in its parts, what Henry More called "holenmerism". I explain its historical background, in particular in scholasticism. I argue that like his predecessors, Descartes uses the idea for two purposes, for mind-body interaction and for the union of body and mind.
In this paper I explain several ways in which Descartes denied that the human soul or mind is composite and the role this idea played in his thought. The mind is whole in the whole and whole in the parts of the body because it has no parts. Unlike body, the mind is indivisible, and this is a different idea from the thought that mind and body are incorruptible. Descartes connects the immortality of the soul with its status as a (...) substance and as incorruptible rather than with its indivisibility. (shrink)
Margaret Cavendish is widely regarded as a vitalist: she considers all matter as alive, including an endowment with mental capacities, and rejects dualism. She rejects two important motives for dualism in the period. She agrees with her Cambridge Platonist contemporaries, More and Cudworth that the order in nature ultimately comes from God’s plans. But she rejects their view that matter can’t execute God’s commands and that their execution requires immaterial entities. For Cavendish matter is shot through with rationality and the (...) power to implement plans. This conception of matter comes with an utter rejection of the other prominent motive for dualism: the traditional view that human beings are distinguished from the rest of nature in virtue of their rationality and freedom. This talk is part of a longer paper that I am writing with Alison Simmons on Margaret Cavendish and Anne Conway. (shrink)