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)

The framework of elementary probabilistic operations (EPO) explains the structure of elementary probabilistic reasoning tasks as well as people’s performance on these tasks. The framework comprises three components: (a) Three types of probabilities: joint, marginal, and conditional probabilities; (b) three elementary probabilistic operations: combination, marginalization, and conditioning, and (c) quantitative inference schemas implementing the EPO. The formal part of the EPO framework is a computational level theory that provides a problem space representation and a classification of elementary probabilistic problems based (...) on computational requirements for solving a problem. According to the EPO framework, current methods for improving probabilistic reasoning are of two kinds: First, reduction of Bayesian problems to a type of probabilistic problems requiring less conceptual and procedural competencies. Second, enhancing people’s utilization competence by fostering the application of quantitative inference schemas. The approach suggests new applications, including the teaching of probabilistic reasoning, using analogical problem solving in probabilistic reasoning, and new methods for analyzing errors in probabilistic problem solving. (shrink)

Humean Supervenience is a metaphysical model of the world according to which all truths hold in virtue of nothing but the total spatiotemporal distribution of perfectly natural, intrinsic properties. David Lewis and others have worked out many aspects of HS in great detail. A larger motivational question, however, remains unanswered: As Lewis admits, there is strong evidence from fundamental physics that HS is false. What then is the purpose of defending HS? In this paper, we argue that the philosophical merit (...) of HS is largely independent of whether it correctly represents the world’s fundamental structure. In particular, we show that insofar as HS is an apt model of the world’s higher-level structure, it thereby provides a powerful argument for reductive physicalism and explains otherwise opaque inferential relations. Recent criticism of HS on the grounds that it misrepresents fundamental physical reality is, therefore, beside the point. (shrink)

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)

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)

Dispositional essentialism is a non-Humean view about the essences of certain fundamental or natural properties that looms large in recent metaphysics , not least because it promises to explain neatly the natural modalities such as laws of nature, counterfactuals, causation and chance. In the current paper, however, several considerations are presented that indicate a serious tension between its essentialist core thesis and natural “metaphysical” interpretations of its central explanatory claims.

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)

"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.".

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)

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

Owen Griffiths has recently argued that Etchemendy’s account of logical consequence faces a dilemma. Etchemendy claims that we can be sure that his account does not overgenerate, but that we should expect it to undergenerate. Griffiths argues that if we define the relationship between formal and natural language as being dependent on logical consequence, then Etchemendy’s claims are not true; and if we define the relationship as being independent of logical consequence, then we cannot assess the truth of the claims (...) without further information. I argue that Griffiths misconstrues Etchemendy’s theory and overstates the first horn of the dilemma: Etchemendy does see the relationship as being dependent on logical consequence, but that does not mean that his claims are not true. (shrink)

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

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)

Recombination maps of ancestral species can be constructed from comparative analyses of genomes from closely related species, exemplified by a recently published map of the human‐chimpanzee ancestor. Such maps resolve differences in recombination rate between species into changes along individual branches in the speciation tree, and allow identification of associated changes in the genomic sequences. We describe how coalescent hidden Markov models are able to call individual recombination events in ancestral species through inference of incomplete lineage sorting along a genomic (...) alignment. In the great apes, speciation events are sufficiently close in time that a map can be inferred for the ancestral species at each internal branch ‐ allowing evolution of recombination rate to be tracked over evolutionary time scales from speciation event to speciation event. We see this approach as a way of characterizing the evolution of recombination rate and the genomic properties that influence it. (shrink)

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

The all-affected principle is a widely accepted solution to the problem of constituting the demos. Despite its popularity, a basic question in relation to the principle has not received much attention: why does the fact that an individual is affected by a certain decision ground a right to inclusion in democratic decision-making about that matter? An answer to this question must include a reason that explains why an affected individual should be included because she is affected. We identify three such (...) reasons in the literature – to wit, interest protection, self-government and welfare – and show why they all fail. We then propose two alternative reasons, equal relations and fairness, and show why they are also deficient. Surprisingly, the all-affected principle then appears groundless, which supports withholding belief in the all-affected principle or(/and) investing future research in identifying the thus-far unidentified reason why being affected grounds a claim to inclusion. (shrink)

Construed as a theory of justice, relational egalitarianism says that justice requires that people relate as equals. Construed as a theory of what makes democracy valuable, it says that democracy is a necessary, or constituent, part of the value of relating as equals. Typically, relational egalitarians want their theory to provide both an account of what justice requires and an account of what makes democracy valuable. We argue that relational egalitarians with this dual ambition face the justice-democracy dilemma: Understanding social (...) relations in such a way that renders relational egalitarianism plausible as an answer to what makes democracy valuable comes at the price of understanding social relations in a way that makes it less plausible as a theory of justice, and vice versa. We also argue that there is no easy way out of the dilemma and that relational egalitarians, who want relational equality to provide both accounts mentioned, may simply have to set their ambitions lower on behalf of relational equality. (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 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)

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)

Philosophie als -sterben wollen- (Platon) bestimmt die Tradition bis hin zur -Geworfenheit zum Tode- (Heidegger). Die Welt fuhrt sich mit diesem Menschenbild entsprechend auf. Sich absolut setzende Wahrheiten blenden die Wahrnehmung aus, dass wir in einer falschen Welt mit falschem Bewusstsein leben. Der Poet Schiller mokiert sich in seinem Gedicht "Die Taten der Philosophen" (1795) hierzu. In der Schlusszeile spricht er die Krafte an, die aus dem Leben alle Wesen und in besonderer Weise den Menschen bestimmen: HUNGER und LIEBE. Vorliegende (...) Arbeit ist der Versuch einer Theorie des poetischen Menschen aus diesen Urkraften des Lebens. Es ist der Versuch der Wiedervereinigung von KUNST und Mensch und Absage an alle Wahrheits-Ideologien. Der poetische Mensch kennt nur Wahrheiten -auf Zeit-. Einzig im Willen zum Leben kann eine neue Welt gedichtet werden...". (shrink)

Following considerable debate, the practice of euthanasia was legalized in Belgium in 2002, thereby making Belgium one of the few places in the world where this practice is legal. In 2014 the law was amended for the first time. The 2014 amendment makes euthanasia legally possible for all minors who repeatedly and voluntarily request euthanasia and who are judged to possess “capacity of discernment”, as well as fulfil a number of other criteria of due care. This extension of the 2002 (...) euthanasia law generated a lot of national and international debate and has been applauded by many and heavily criticized by others. This evolution is clearly of interest to end-of-life debates in the entire world. This paper will therefore describe how this amendment came to get passed using official documents from Belgium's Senate and Chamber of Representatives where this amendment was discussed and subsequently passed. Next, some of the most commonly given arguments in favour of the law are identified, as well as the arguments most often voiced against the amendment. All these arguments will be expanded upon and it will be examined whether they hold up to ethical scrutiny. Analysing the official documents and identifying the most commonly voiced arguments gives valuable insight into how Belgium came to amend its euthanasia law and why it did so in 2014. It also becomes clear that although the current amendment is often seen as far-reaching, more radical ideas were proposed during the drafting of the law. Also, in analysing those arguments in favour of the amendment and those against, it is clear that the validity of some of these is questionable. (shrink)

1. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety and phobias are common in schizophrenia, and anxiety is often part of the dysphoric mood (A...

Immanuel Kant's ‘Critique of Judgment’ is often read either in terms of art appreciation or teleology. In this paper however, the object is to examine the ‘Critique of Judgment’, especially the concepts of the Beautiful and the Sublime, in relation to the Kantian version of the Enlightenment. The main theses in the paper are as following: That Beauty can provide us with the sensuous experience of the possibility of the moral law and that the Sublime can provide us with the (...) sensuous experience of the possibility that we as rational beings can effectuate the actual existence of the moral law. (shrink)

I en dobbelt forstand kan døden siges at være uomgængelig, og i en dobbelt forstand fremstår det som et uomgængeligt problem for vor livsglade civilisation, idag tilsyneladende mere end nogensinde.

1. Aritmofobi Adomo definerede en gang i sine senere år en musiker som et menneske på flugt fra sin matematiklærer 1) denne definition kan uden tvivl udstrækkes til at gælde størstedelen af de få overlevende, som endnu forsøger at praktisere en humanistisk tænkning på trods af existensen af en "totalt forvaltet verden" udenfor.

From surrealism’s beginnings around a Parisian séance table, it oscillated between the occult and the political. One of its key methods, automatism, provided access to both the esoteric and the exoteric: it took form in the mid-19th century as a spiritualist technique for communicating with the other side while, simultanously, this other side could address political issues as equal rights, de-colonisation and a utopian future with an authority coming from beyond the individual. By tracing the development of automatism, the article (...) shows how automatism in surrealism became a call for both a re-orientation of life and an institutional re-organisation by becoming a divination tool for a future community looking back to hermeticism to find a way forward. The article argues that not only can surrealism fruitfully be understood in the light of an occult revival in reaction to crises but, additionally, that it marks the return of and a reaction to a kind of magical thinking in the modern – due to waning religious and socio-economic orthodoxies – that echoes eerily into our own big data contemporary of social medias where we tend to substitute equations with associations. (shrink)

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)

If biotechnology can be used to "upgrade" humans physically and mentally, should it be done? And if so, to what extent? How will biotechnology affect societal cohesion, and can the development be controlled? Or is this a Pandora's box that should remain closed? These are just a few of the many questions that arise as a result of the increasing ability of technology to change biology and, eventually, transform human living conditions. This development has created a new horizon of a (...) posthuman future that will influence contemporary life and politics in a number of ways. The book gathers researchers within the fields of biotechnology, medicine, ethics, politics, and aesthetics. Among the contributors are Francis Fukuyama, Julian Savulescu, Maxwell Mehlman, Lone Frank and Chris Hables Gray. (shrink)