BackgroundIn gender-affirming medical care (GAMC), ethical challenges in decision-making are ubiquitous. These challenges are becoming more pressing due to exponentially increasing referrals, politico-legal contestation, and divergent normative views regarding decisional roles and models. Little is known, however, about what ethical challenges related to decision-making healthcare professionals (HCPs) themselves face in their daily work in GAMC and how these relate to, for example, the subjective nature of Gender Incongruence (GI), the multidisciplinary character of GAMC and the role HCPs play in assessing (...) GI and eligibility for interventions. Given the relevance and urgency of these questions, we conducted a qualitative study among HCPs providing GAMC to transgender adults in the Netherlands.MethodsIn this qualitative research, we conducted 11 semi-structured interviews between May 2020 and February 2021 with HCPs (six mental health professionals, two HCPs in endocrinology, two in plastic surgery, and one in nursing) working in two distinct GAMC settings. We purposively sampled for professional background and years of experience in GAMC. We analyzed our interview data using thematic analysis. As some respondents were more inclined to speak about what should or ought to be done to arrive at good or right decision-making, we identified both ethical challenges and norms. Furthermore, in our analysis, we differentiated between respondents’ explicit and implicit ethical challenges and norms and ascertained the specific context in which these challenges emerged.ResultsRespondents’ ethical challenges and norms centered on (1) dividing and defining decisional roles and bounds, (2) negotiating decision-making in a (multidisciplinary) team, and (3) navigating various decision-making temporalities. These themes arose in the context of uncertainties regarding (1) GAMC’s guidelines, evidence, and outcomes, as well as (2) the boundaries and assessment of GI.ConclusionsThis interview study provides detailed empirical insight into both the explicit and implicit ethical challenges that HCPs experience and their ethical norms regarding decision-making. It also describes how uncertainties and (implicit) normativities concerning GAMC and GI pre-structure the moral environment in which these challenges and norms manifest. We provide normative reflections and recommendations on handling these ethical challenges in a way that is sensitive to the context in which they arise. (shrink)

Borsboom and colleagues have recently proposed a “network theory” of psychiatric disorders that conceptualizes psychiatric disorders as relatively stable networks of causally interacting symptoms. They have also claimed that the network theory should include non-symptom variables such as environmental factors. How are environmental factors incorporated in the network theory, and what kind of explanations of psychiatric disorders can such an “extended” network theory provide? The aim of this article is to critically examine what explanatory strategies the network theory that includes (...) both symptoms and environmental factors can accommodate. We first analyze how proponents of the network theory conceptualize the relations between symptoms and between symptoms and environmental factors. Their claims suggest that the network theory could provide insight into the causal mechanisms underlying psychiatric disorders. We assess these claims in light of network analysis, Woodward’s interventionist theory, and mechanistic explanation, and show that they can only be satisfied with additional assumptions and requirements. Then, we examine their claim that network characteristics may explain the dynamics of psychiatric disorders by means of a topological explanatory strategy. We argue that the network theory could accommodate topological explanations of symptom networks, but we also point out that this poses some difficulties. Finally, we suggest that a multilayer network account of psychiatric disorders might allow for the integration of symptoms and non-symptom factors related to psychiatric disorders and could accommodate both causal/mechanistic and topological explanations. (shrink)

Paul applies apocalyptic language not only to the End and Christ's parousia but also to the gospel he proclaims and the faith it creates. The whole of God's saving activity in Jesus Christ, from beginning to end, is apocalyptic.

Aristotle's highly influential work on the soul, entitled De anima, formed part of the core curriculum of medieval universities and was discussed intensively. It covers a range of topics in philosophical psychology, such as the relationship between mind and body and the nature of abstract thought. However, there is a key difference in scope between the so-called "science of the soul," based on Aristotle, and modern philosophical psychology. This book starts from a basic premise accepted by all medieval commentators, namely (...) that the science of the soul studies not just human beings but all living beings. As such, its methodology and approach must also apply to plants and animals. The Science of the Soul discusses how philosophers from Thomas Aquinas to Pierre d'Ailly dealt with the difficult task of giving a unified account of life and traces the various stages in the transformation of the science of the soul between 1260 and 1360. The emerging picture is that of a gradual disruption of the unified approach to the soul, which will ultimately lead to the emergence of psychology as a separate discipline. (shrink)

The review by De Bie et al. (2023) provides an overview of the current ethical literature on artificial womb technology (AWT). Two characteristics stand out, and provide the basis for our commentar...

INTRODUCTION In the first part of this study I will deal with the publications of Husserl's first period, ie Ueber den Begriff der Zahl (his "Habilita- ...

Dondeyne, A. Pluriformiteit en eenheid van de filosofie.--Peperzak, A. Wegwijzers naar een dialogiek?--Boer, T. de. De eindigheid van de mens en de oneindigheid van de waarheid.--Hollak, J. Wijsgerige reflecties over de scheppingsidee : St. Thomas, Hegel en de Grieken.--Plat, J. Kants kritiek op de rationele psychologie.--Melsen, A. van. Wijsgerige antropologie en de ontwikkeling van natuurwetenschap en techniek.--Buytendijk, F. Het pathisch aspect van de eindigheid.--Struyker Boudier, H. 's Bergbeklimmers einder.

By drawing on Jean-Luc Nancy’s philosophy of ontological relationality, this article explores what it means to be a ‘we’ in breast cancer. What are the characteristics—the extent and diversity—of couples’ relationally lived experiences of bodily changes in breast cancer? Through analyzing duo interviews with diagnosed women and their partners, four ways of sharing an embodied life are identified. (1) While ‘being different together’, partners have different, albeit connected kinds of experiences of breast cancer. (2) While ‘being there for you’, partners (...) take care of each other in mutually dependent ways. (3) While ‘being reconnected to you’, partners (re-)relate to each other through intimacy and sexuality. (4) While ‘being like you’, partners synchronize their embodied daily lives to one another, sometimes up to the point that the self cannot be distinguished from the other anymore. These ways reveal that being a ‘we’ involves complex affective, bodily encounters in which the many fault lines that both separate partners into individual selves and join them together as a unity are continuously reshaped and negotiated. Being a ‘we’ may be understood as something we have to do. Therefore, in being true to the legacy of Nancy, we argue at the end of this article for a sensible praxis of sharing a life and body, particularly in breast cancer. (shrink)

Scholarly debates on the Critique of Pure Reason have largely been shaped by epistemological questions. Challenging this prevailing trend, Kant's Reform of Metaphysics is the first book-length study to interpret Kant's Critique in view of his efforts to turn Christian Wolff's highly influential metaphysics into a science. Karin de Boer situates Kant's pivotal work in the context of eighteenth-century German philosophy, traces the development of Kant's conception of critique, and offers fresh and in-depth analyses of key parts of the (...) Critique of Pure Reason, including the Transcendental Deduction, the Schematism Chapter, the Appendix to the Transcendental Analytic, and the Architectonic. The book not only brings out the coherence of Kant's project, but also reconstructs the outline of the 'system of pure reason' for which the Critique was to pave the way, but that never saw the light. (shrink)

Abstract: This article contends that the relation of early logical empiricism to Kant was more complex than is often assumed. It argues that Reichenbach's early work on Kant and Einstein, entitled The Theory of Relativity and A Priori Knowledge (1920) aimed to transform rather than to oppose Kant's Critique of Pure Reason. One the one hand, I argue that Reichenbach's conception of coordinating principles, derived from Kant's conception of synthetic a priori principles, offers a valuable way of accounting for the (...) historicity of scientific paradigms. On the other hand, I show that even Reichenbach, in line with Neo-Kantianism, associated Kant's view of synthetic a priori principles too closely with Newtonian physics and, consequently, overestimated the difference between Kant's philosophy and his own. This is even more so, I point out, in the retrospective account logical empiricism presented of its own history. Whereas contemporary reconstructions of this history, including Michael Friedman's, tend to endorse this account, I offer an interpretation of Kant's conception of a priori principles that contrasts with the one put forward by both Neo-Kantianism and logical empiricism. On this basis, I re-examine the early Reichenbach's effort to accommodate these principles to the paradigm forged by Einstein. (shrink)

This paper offers a two dimensional variation of Standard Deontic Logic SDL, which we call 2SDL. Using 2SDL we can show that we can overcome many of the difficulties that SDL has in representing linguistic sets of Contrary-to-Duties (known as paradoxes) including the Chisholm, Ross, Good Samaritan and Forrester paradoxes. We note that many dimensional logics have been around since 1947, and so 2SDL could have been presented already in the 1970s. Better late than never! As a detailed case study (...) illustrating the power of 2SDL, we examine the system DL of Deontic Logic of Andrew Jones and Ingmar Pörn offered in 1985 to solve the Chisholm paradox of Contrary to Duties. The critical examination is done using logics and methods available in 1985 and solutions are proposed using what was available in 1985. (shrink)

Numerous studies in the fields of Science and Technology Studies and philosophy of technology have repeatedly stressed that scientific practices are collective practices that crucially depend on the presence of scientific technologies. Postphenomenology is one of the movements that aims to draw philosophical conclusions from these observations through an analysis of human–technology interactions in scientific practice. Two other attempts that try to integrate these insights into philosophy of science are Ronald Giere’s Scientific Perspectivism and Davis Baird’s Thing Knowledge. In this (...) paper, these two approaches will be critically discussed from the perspective of postphenomenology. We will argue that Giere and Baird problematically assume that scientific instruments have a determined function, and that all human members of a scientific collective have immediate access to this function. However, these assumptions also allow them to offer a clear answer to the question how scientists can collectively relate to scientific phenomena. Such an answer is not yet formulated within the postphenomenological perspective. By adding a postphenomenological touch to the semiotic approach in Actor-Network Theory, we offer an account of how different individual human–technology relations are integrated into larger scientific collectives. We do so by showing that scientific instruments not only help constitute scientific phenomena, but also the intersubjectivity within such collectives. (shrink)

Science is highly dependent on the technologies needed to observe scientific objects. In How Scientific Instruments Speak, Bas de Boer develops a philosophical account of instruments in scientific practice, focusing on the cognitive neurosciences. He argues for an understanding of scientific instruments as mediating technology.

While we endorse Heidegger’s effort to reclaim Kant’s Critique of Pure Reason as a work concerned with the possibility of metaphysics, we hold, first, that his reading is less original than is often assumed and, second, that it unduly marginalizes the critical impetus of Kant’s philosophy. This article seeks to shed new light on Kant and the Problem of Metaphysics and related texts by relating Heidegger’s interpretation of Kant to, on the one hand, the epistemological approach represented by Cohen’s Kant’s (...) Theory of Experience and, on the other, the metaphysical readings put forward by Heimsoeth, Wundt and others in the 1920s. On this basis, we argue that Heidegger’s interpretation of Kant remains indebted to the methodological distinction between ground and grounded that informed Cohen’s reading and was transferred to the problem of metaphysics by Wundt. Even if Heidegger resists a ‘foundationalist’ mode of this distinction, we argue that his focus on the notions of ground and grounding does not... (shrink)

In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which (...) explore the interplay between technologies and morality, we present an analysis of concerns related to the adoption of machine learning-aided medical diagnosis. We analyze anticipated moral issues that machine learning systems pose for different stakeholders, such as bias and opacity in the way that models are trained to produce diagnoses, changes to how health care providers, patients, and developers understand their roles and professions, and challenges to existing forms of medical legislation. Albeit preliminary in nature, the insights offered by the technomoral change and the technological mediation approaches expand and enrich the current discussion about machine learning in diagnostic practices, bringing distinct and currently underexplored areas of concern to the forefront. These insights can contribute to a more encompassing and better informed decision-making process when adapting machine learning techniques to medical diagnosis, while acknowledging the interests of multiple stakeholders and the active role that technologies play in generating, perpetuating, and modifying ethical concerns in health care. (shrink)

Fiction television series are one of the few cultural expressions in which men’s infertility experiences are represented. Through a content analysis of twenty fiction series, this article describes and analyzes such representations. By drawing on Connell’s concept of hegemonic masculinity and Ricoeur’s understanding of paradoxical power structuring, four character types of infertile men are identified: (1) the virile in/fertile man, (2) the secretly non-/vasectomized man, (3) the intellectual eunuch, (4) the enslaving post-apocalyptic man. While these various dramatis persona outline different (...) ways of how infertile men relate to normative hegemonic masculinity, they all represent infertile men as diverging from shared masculine norms. This non-normativity initially excludes many represented men from hegemonic positions. Eventually, however, these men generally aspire to and succeed in reaffirming their hegemonic masculinity through coercive force towards women and other men, through instigating the precondition for any power structure – the shared will to live together as a community –, and/or by seeking and finding explicit recognition for their normativity and dominance. At the end of this paper, I will reflect on the potential harmful effect of these outlined representations of infertile men and make a plea for diversifying representations of infertile men in our culture. (shrink)

Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. Important features were: all professionals (...) who are directly involved with the patient contribute to MEDM; a five-step procedure is used: exploration, agreement on the ethical dilemma/investigation of solutions, analysis of solutions, decision-making, planning actions; meetings are chaired by an impartial ethicist. A 15-item questionnaire to survey staff perceptions on this intervention just before and 8 months after implementation was developed. Results Before and after response rates were 91/105 (87%) and 85/113 (75%). Factor analysis on the questionnaire suggested a four-factor structure: participants' role; structure of MEDM; content of ethical deliberation; and documentation of decisions/conclusions. Effect sizes were 1.67 (p<0.001), 0.69 (p<0.001) and 0.40 (p<0.01) for the first three factors respectively, but only 0.07 (p=0.65) for the fourth factor. Nurses' perceptions of improvement did not significantly exceed those of physicians. Conclusion Professionals involved in ethical case deliberation perceived that the process of decision-making had improved; they were more positive about the structure of meetings, their own role and, to some extent, the content of ethical deliberation. Documentation of decisions/conclusions requires further improvement. (shrink)

Death determination has long been a topic of intensive technoscientific and medical involvement. Due to advances in twentieth-century medical technology, the distinction between life and death has become less evident. Ambiguities appear when we start to use life-support technologies in order to save lives, bringing about “tragic artifacts” such as brain death and persistent vegetative state. In this paper we ask how this technoscientific and medical involvement shapes our understanding of death. We provide an overview of medical literature that has (...) appeared on (brain) death determination, highlighting thereby the role that technologies played in its establishment. Subsequently, we develop three philosophical interpretations of technological death determination: With Agamben and Marcuse as the installation of political power; with Don Ihde as an existential choice for the inevitable; and with Jacques Derrida as an encounter with the ineradicable mystery of death. To conclude, we argue that technological death determination reveals an intrinsic, paradoxical connection between human’s technicity and its ignorance of death. (shrink)

This book addresses universal tendencies of human vowel systems from the point of view of self-organisation. It uses computer simulations to show that the same universal tendencies found in human languages can be reproduced in a population of artificial agents. These agents learn and use vowels with human-like perception and production, using a learning algorithm that is cognitively plausible. The implications of these results for the evolution of language are then explored.

Machine generated contents note: 1. An Ethical Transcendental Philosophy 1 -- 2. Beyond Being. Ontology and Eschatology in the Philosophy of Emmanuel Levinas 33 -- 3. The Rationality of the Philosophy of Levinas 56 -- 4. Levinas on Substitution 83 -- 5. Judaism and Hellenism in the Philosophy of Levinas and Heidegger 101 -- 6. Ontological Difference (Heidegger) and Ontological Separation (Levinas) 115 -- 7. Enmity, Friendship, Corporeality 133 -- 8. The Rationality of Transcendence 147 -- 9. Levinas on Theology (...) and the Philosophy of Religion 169. (shrink)

How music and speech evolved is a mystery. Several hypotheses on their origins, including one on their joint origins, have been put forward but rarely tested. Here we report and comment on the first experiment testing the hypothesis that speech and music bifurcated from a common system. We highlight strengths of the reported experiment, point out its relatedness to animal work, and suggest three alternative interpretations of its results. We conclude by sketching a future empirical programme extending this work.

Two computer simulations are investigated that model interaction of cultural evolution of language and biological evolution of adaptations to language. Both are agent‐based models in which a population of agents imitates each other using realistic vowels. The agents evolve under selective pressure for good imitation. In one model, the evolution of the vocal tract is modeled; in the other, a cognitive mechanism for perceiving speech accurately is modeled. In both cases, biological adaptations to using and learning speech evolve, even though (...) the system of speech sounds itself changes at a more rapid time scale than biological evolution. However, the fact that the available acoustic space is used maximally (a self‐organized result of cultural evolution) is constant, and therefore biological evolution does have a stable target. This work shows that when cultural and biological traits are continuous, their co‐evolution may lead to cognitive adaptations that are strong enough to detect empirically. (shrink)

Focusing on the section ‘Absolute Freedom and Terror’ of the Phenomenology of Spirit, this article argues that the method Hegel employs in this work does not capture the full significance of the French Revolution. I claim that Hegel’s method is reformist rather than revolutionary: Hegel deliberately restricts his analyses to transformations that occur within the element of thought and presents the changes that occur within this element as logically ensuing from one another. This approach, I argue, is at odds with (...) the very concept of a revolution. Seen in this way, efforts to frame Hegel’s philosophy as revolutionary are misguided. (shrink)

While having a breast reconstruction, women have certain expectations about their future breasted bodies. The aim of this paper is to describe and analyze these expectations in the process of reconstruction. By applying a qualitative, phenomenological study within a longitudinal research design, this paper acknowledges the temporarily complex, contextualized, embodied, and subjective nature of the phenomenon of expectations. The analysis identified expectations regarding three different aspects of women’s embodiment: their gazed body, their capable/practical body, and their felt body. After reconstruction, (...) these women try to reconfigure—adjust, level or retrospectively rewrite—their expectations. Further, some women face what apparently arrives totally unexpected, namely a strange feeling breast or a failed reconstruction. The development of these women’s expectations can be understood as an active, continuously evolving, difficult and sometimes impossible dynamic of expecting the surprise that is a breast reconstruction. Within this dynamic, women formulate and reconfigure—by definition—unrealistic expectations and validate and try to achieve unexpected futures. We suggest that medical professionals can facilitate this dynamic in various ways. (shrink)

In this article I aim to clarify the nature of Kant’s transformation of rationalist metaphysics into a science by focusing on his conception of transcendental reflection. The aim of Kant’s Critique of Pure Reason, it is argued, consists primarily in liberating the productive strand of former general metaphysics – its reflection on the a priori elements of all knowledge – from the uncritical application of these elements to all things (within general metaphysics itself) and to things that can only be (...) thought (in special metaphysics). After considering Kant’s conception of metaphysics and his various uses of the term ‘transcendental’ I closely examine his account of logical and transcendental reflection in the section entitled ‘On the Amphiboly of the Concepts of Reflection’. Whereas commentators generally attribute the activity called transcendental reflection to Kant alone, I contend, first, that Kant regarded philosophy as such to rely on a mode of transcendental reflection and, second, that the critical mode of transcendental reflection enacted in the Critique itself yields insight into the reason why our a priori knowledge is limited to the realm of possible objects. This is illustrated by outlining the difference between Kant’s and Leibniz’ employment of the concepts of reflection. (shrink)

Translated from the Dutch, this book offers a systematic interpretation of Heidegger's thought, focusing particularly on recently published works.

Modern continental thought is skeptical toward happiness and no longer easily reconciles its pursuit with a desire for justice, the good, and truth. Critical theory has unmasked happiness as a commodity within an industry, an ideological tool for control, and a sedative to, justification of, and distraction from social injustice. This article argues that these diagnoses make it all the more important that philosophy, rather than taking leave of happiness, once again turns it into a serious object of thought. Employing (...) the work of Badiou and Agamben as case studies, it asks what a critically informed yet affirmative philosophy of happiness should entail at a structural level. Assessing their philosophical models of happiness, this article 1) recognizes in their work a revival of the ancient ideal of a true, just, and happy life, 2) opens up a new way of evaluating their work, and 3) articulates basic requirements of a contemporary, affirmative philosophy of happiness beyond the happiness industry and its critics. (shrink)

English summary: In this volume, Jan-Hendryk de Boer investigates the upheaval in the world of scholars in the Roman-German Empire at the end of the fifteenth and beginning of the sixteenth centuries. He shows how during this time hegemonic humanism developed as a new discursive formation. This re-organised the humanistic movement as well as its relationship to scholasticism and ultimately the place of humanism in the scholarly world as a whole. After humanistic ideas were initially taken on board as (...) being relatively unproblematic, the representatives of hegemonic humanism, such as poets, grammarians and philologists, claimed that they alone were in possession of useful skills and relevant knowledge. In a cultural transfer of the corresponding developments in Italy, a scholastic-humanist antagonism was generated that is still reflected in today's research. German description: Jan-Hendryk de Boer untersucht in dieser Studie den Umbruch in der Gelehrtenwelt des romisch-deutschen Reichs am Ende des 15. und zu Beginn des 16. Jahrhunderts. Er zeigt, wie sich in diesem Zeitraum der hegemoniale Humanismus als eine neue diskursive Formation ausbildete. Diese organisierte die humanistische Bewegung wie auch deren Verhaltnis zur Scholastik und schliesslich den Ort des Humanismus in der Gelehrtenwelt insgesamt um. Nachdem humanistische Ideen zunachst relativ problemlos Aufnahme gefunden hatten, beanspruchten die Vertreter des hegemonialen Humanismus als Dichter, Grammatiker und Philologen fur sich allein, uber nutzliche Fertigkeiten und relevantes Wissen zu verfugen. In einem Kulturtransfer der entsprechenden italienischen Entwicklungen wurde so ein scholastisch-humanistischer Antagonismus erzeugt, der bis in die heutige Forschung nachwirkt. (shrink)

Does philosophical critique have a future? What are its possibilities, limits, and presuppositions? Bringing together outstanding scholars from various traditions, this collection of essays is the first to examine the forms of critique that have shaped modern and contemporary continental thought. Through critical analyses of key texts by, among others, Spinoza, Kant, Hegel, Marx, Adorno, Habermas, Foucault, and Rancière, it traces the way critique has time and again geared itself towards new cultural, social, and political problems, shedding those of its (...) assumptions no longer deemed tenable. It is our hope that the many voices of critique that arise from the present volume will produce effects – new doubts, new insights, new challenges, or new resources – that none could have achieved on their own. (shrink)

This article examines Gerald Odonis' view on the nature of place as found in his commentary on the Sentences (Sent. II, d. 2, qq. 3-5) and in an anonymous question (Utrum locus sit ultima superficies corporis ambientis immobile primum) extant in manuscript Madrid, Biblioteca Nacional, 4229. Both texts defend a thoroughly un-Aristotelian conception of place as three-dimensional space. Odonis not only deviates from Aristotle's definition of place as the inner surface of a surrounding body, but also from the positions of (...) his contemporaries, including fellow Franciscans. Despite some remarkable doctrinal similarities between Odonis' view and that of Renaissance innovators like Francesco Patrizi and Bernardino Telesio, it seems unlikely that Gerald played a role in the rise of new conceptions of place in the sixteenth and seventeenth century. An edition of the anonymous Quaestio de loco is given in an appendix. (shrink)

While there is an increased interest in describing attitudes of teachers, parents and peers towards students with special educational needs in regular education, there is a lack of knowledge about various variables relating to the attitudes of these three groups. The aims of this study are: (1) to examine which variables relate to the attitudes of teachers (N?=?44), parents (N?=?508) and peers (N?=?1113) towards students with Attention Deficit/Hyperactivity Disorder, Autistic Spectrum Syndrome or a cognitive disability in regular primary education and (...) (2) to examine whether teachers and parents? attitudes affect the attitudes of peers. An attitude survey was used to assess attitudes and data were analysed by means of multilevel analyses. The variables found in this study relating to attitudes can be used as a foundation to develop interventions to change attitudes. (shrink)