Moral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics...

BackgroundMoral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate.The objective of this pilot study is to investigate: 1) the current way of dealing with (...) moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and needs regarding clinical ethics support for dealing with moral questions at the IGZ.MethodsWe performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation.ResultsProfessionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate.ConclusionWe conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation. (shrink)

There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors’ ethical challenges. The objective of this paper (...) is to give an overview of the ethical challenges which health care inspectors encounter in their daily work. A thematic qualitative analysis was performed on cases that were collected from health care inspectors in a moral case deliberation pilot study. Eight themes were identified in health care regulation. These can be divided in two categories: work content and internal collaboration. The work of the health care inspectorate is morally loaded and our recommendation is that some form of ethics support is provided for health care inspectors. (shrink)

This book provides a comprehensive analysis of Kant's treatment of happiness in ethics.

Analyzes the origin, structure and resolution of Kant's antinomies of reason from a systematic rather than a historical perspective, exploring the relationship between the theoretical antinomies and the practical antinomy in order to indicate their similarities and differences and to suggest the dependence of the latter on the former.

Kant claims that the faculty of judgment and the Critique of Judgment are necessary for the completion of the critical system. He states that judgment has a special role to play within the critical system. This view is reiterated by commentators such as Vleeschauwer who says that the third Critique “truly brings to completion the whole Critical philosophy” and Macmillan who calls the third Critique “the ‘crowning phase’ of Critical Philosophy.”.

The book consists of a preface and six chapters in which Aquila analyzes Kant's notion of representation. Aquila's analysis is characterized by his phenomenological interpretation and his use of the language of contemporary analytic philosophy. His account of Kant's theory of knowledge is critical and complex. He concludes again and again that there is ambiguity and unclarity in Kant's views. He systematically considers possible interpretations of Kant's claims but, in the end, he argues that only a phenomenological approach is satisfactory.

Kant commentators have recently begun to pay attention to Kant’s account of friendship. They have asked questions, such as: Is his description of friendship consistent and robust and does it provide an account of friendship that satisfies common intuitions and expectations of friendship? Their answers to these questions have often been negative. At the same time, many of these critics share a common understanding of two basic aspects of Kant’s account of friendship. Kant sees friendship as both a duty and (...) an ideal state. One critic, Patricia Flynn, considers the implications of this dual claim. She argues that the view that friendship is both duty and idea gives rise to a tension in the concept of friendship. This tension makes the duty of friendship different from all other Kantian moral duties and leaves us with a duty that we cannot achieve. My aim is to revisit Flynn’s argument and by reassessing Kant’s claims to show that there is indeed complexity in Kant’s understanding of friendship, but there is no conceptual problem that makes friendship a duty unlike all other duties or makes it an impossible duty. (shrink)

This paper explores Kant’s definition of happiness as it appears in the Groundwork and the Critique of Practical Reason. Three accounts of happiness are considered: contentment, the satisfaction of all one’s inclinations, and, the satisfaction of a system of inclinations. The paper discusses the extent to which there is textual evidence for each of these accounts and considers the arguments of Watson, Paton, Gregor, and Beck in support of these various accounts. It concludes by arguing that the first account of (...) happiness is the weakest and that the third account is the strongest. (shrink)

In this paper, I consider the question of where illegal immigrants should go once their lives have been saved in hospitals and they are ready to be transferred to long-term care situations. I highlight three recent cases in which such a decision was made. In one case, the patient was kept at the hospital, in another the patient was repatriated to his home country, and in the third, the patient was discharged to his family. I consider the relevant moral values (...) and argue that for reasons of fairness we must develop a policy that treats similar cases in similar ways. In order to best uphold patient well-being and minimize costs, the plan proposed here calls for illegal immigrants to be covered by insurance for long-term care. (shrink)

Thomas Hardy’s great and central poem, “The Darkling Thrush,”1 signals that it is to be read as a response to his precursors. “Darkling” evokes Keats’s “Ode to a Nightingale” and Arnold’s “Dover Beach.” Byron had used “cloudy canopy” to describe Parnassus in Childe Harold’s Pilgrimage. A particularly ambitious signal is “coppice,” a variant of “copse,” a crucial word in Wordsworth’s “Tintern Abbey.”2 “Gate” fixes the coppice at the perceptual threshold, whereas Wordsworth located the copse at the center of the landscape.Wordsworth (...) situates the observer opposite, but in connection with, the natural setting. Beyond what is present to the senses lies a remote reality:On the near side, “here, under this dark .. (shrink)

This paper explores Kant’s definition of happiness as it appears in the Groundwork and the Critique of Practical Reason. Three accounts of happiness are considered: contentment, the satisfaction of all one’s inclinations, and, the satisfaction of a system of inclinations. The paper discusses the extent to which there is textual evidence for each of these accounts and considers the arguments of Watson, Paton, Gregor, and Beck in support of these various accounts. It concludes by arguing that the first account of (...) happiness is the weakest and that the third account is the strongest. (shrink)