Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

These are the proceedings of the Workshop on Quantum Logic held in Erice (Sicily), December 2 - 9, 1979, at the Ettore Hajorana Centre for Scientific Culture. A conference of this sort was originally proposed by Giuliano Toraldo di Francia, who suggested the idea to Antonino Zichichi, and thus laid the foundation for the Workshop. To both of them we express our appreciation and thanks, also on behalf of the other participants, for having made this conference possible. There were approximately (...) fifty participants; their names and institutions are listed in the text. Quantum logic, which has now a history of some forty or more years, has seen remarkable growth during the sixties and seventies. The papers in the present volume presuppose, by and large, some acquaintance with the elements of the subject. These may be found in the well-known books by J.H. Jauch (Foundations of Quantum Hechanics; Reading, 1968), V.S. Varadarajan (Geometry of Quantum Theory: Princeton, 1968), and C. Piron (Foundations of Quantum Theory; New York, 1976). The initial program for the conference listed about twenty-five invited papers. But in the context of a very active and qualified attendance, other contributions were offered. This volume contains all of them. The program listed six main topics: I. Classification or different areas of quantum logic, and open problems. II. Comparison and unification of different approaches to quantum theories; problems of interpretation. III. Formal quantum logic; axiomatics. IV. Hodal interpretations of quantum logic. v vi FOREWORD V. Quantum set theory. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half (...) of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

Probability kinematics is the theory of how subjective probabilities change with time, in response to certain constraints . Rules are classified by the imposed constraints for which the rules prescribe a procedure for updating one's opinion. The first is simple conditionalization , and the second Jeffrey conditionalization . It is demonstrated by a symmetry argument that these rules are the unique admissible rules for those constraints, and moreover, that any probability kinematic rule must be equivalent to a conditionalization preceded by (...) a determination of the values x i to be given to the members of such a partition. Next two rival rules which can go beyond such conditionalization are described. INFOMIN and MTP . Their properties are investigated and compared. (shrink)