The Ohio State University Press is to be congratulated, and Lennon and Olscamp are to be thanked for this book. Nicholas Malebranche has always been a major philosopher on the Continent but he has been less well-known in recent times within the English-speaking world. The Search was twice translated into English at the close of the seventeenth century and Malebranche was widely read and commented upon in English in both the seventeenth and eighteenth centuries. John Locke wrote about Malebranche. David (...) Hume not only cites him, Hume's analysis of causation is thought to owe much to Malebranche's doctrine. Some of Berkeley's earliest critics took him to be a Malebranchist. A. A. Luce argued some years ago that Malebranche is one of the most important philosophical influences upon Berkeley. Accordingly it is a delight to have the full text available and I hope it will be possible to produce a paper-back version. This translation is based on the edition of the Oeuvres complètes de Malebranche under the general editorship of André Robinet. This includes definitive editions of the Recherche and the Éclaircissements edited by Geneviève Rodis-Lewis. (shrink)

Continued concern for animal welfare may be alleviated when welfare would be monitored on farms. Monitoring can be characterized as an information system where various stakeholders periodically exchange relevant information. Stakeholders include producers, consumers, retailers, the government, scientists, and others. Valuating animal welfare in the animal-product market chain is regarded as a key challenge to further improve the welfare of farm animals and information on the welfare of animals must, therefore, be assessed objectively, for instance, through monitoring. Interviews with Dutch (...) stakeholder representatives were conducted to identify their perceptions about the monitoring of animal welfare. Stakeholder perceptions were characterized in relation to the specific perspectives of each stakeholder. While producers tend to perceive welfare from a production point of view, consumers will use visual images derived from traditional farming and from the animals’ natural environments. Scientists’ perceptions of animal welfare are affected by the need to measure welfare with quantifiable parameters. Retailers and governments (policy makers) have views of welfare that are derived from their relationships with producers, consumers, non-governmental organizations (NGOs), and scientists. All interviewed stakeholder representatives stated that animal welfare is important. They varied in the extent to which they weighted economic considerations relative to concern for the animals’ welfare. Many stakeholders emphasized the importance of communication in making a monitoring system work. Overall, the perspectives for the development of a sustainable monitoring system that substantially improves farm animal welfare were assessed as being poor in the short term. However, a reliable system could be initiated under certain conditions, such as integrated chains and with influential and motivated stakeholders. A scheme is described with attention points for the development of sustainable monitoring systems for farm animal welfare in the long term. (shrink)

Background Euthanasia is a topic of intense ethical debate and it is illegal in most countries at present, including Sri Lanka. The aim of this descriptive cross-sectional study of medical students and practicing doctors was to explore the acceptance of euthanasia and physician assisted suicide, and factors influencing this opinion. Methods A customised online questionnaire which explored opinions on euthanasia was administered to first and final year medical undergraduates in University of Colombo and practicing doctors with more than 5 years (...) of work experience at The National Hospital of Sri Lanka. Attitudes on euthanasia and PAS were also assessed with the attitudes towards euthanasia Scale, which is a 10-item questionnaire. Results A total of 425 individuals responded, which included 143 first-year medical undergraduates, 141 final-year medical undergraduates and 141 practicing doctors. More participants favoured legalizing euthanasia than those directly opposing it, but a significant proportion remained undecided. The mean scores of ATE questionnaire from the whole sample were generally unfavourable towards euthanasia/PAS. Accepting euthanasia as an option for oneself was the strongest predictor of favouring euthanasia/PAS or supporting its legalization. Conclusion In this cross-sectional survey, more respondents supported legalisation of euthanasia in Sri Lanka than those openly opposing it. Yet, a significant minority that responded as “undecided” for legalisation, were more likely to have unfavourable ATE. (shrink)

This paper attempts to outline some of the important concepts and ideas used in system analysis which is taken to be a general mode of analysis used in all sciences. Systems are seen from three perspectives: that involving the relationship between system and environment, that involving interaction between several systems, and that involving one type of system composed of other types of systems. The writers also discuss the concepts "structure" and "equilibrium" as they apply to system analysis, the point being (...) made that the use of these concepts in the social sciences has often been vague or even incorrect. (shrink)

Introduction In 2007, a national review committee was instituted in The Netherlands to review cases of active ending of life for newborns. It was expected that 15–20 cases would be reported. To date, however, only one case has been reported to this committee. Reporting is essential to obtain societal control and transparency; the possible explanations for this lack of reporting were therefore explored. Methods Data on end-of-life decision-making were scrutinised from Dutch nation-wide studies (1995, 2001 and 2005), before institution of (...) the committee. Physicians received a questionnaire about their medical decision-making for stratified samples of deceased infants up to 1 year, drawn from the central death registry. Results In 2005, 58% of all deaths were preceded by an end-of-life decision, compared with 68% in 2001 and 62% in 1995. The use of drugs with a possible life-shortening effect tended to be lower. In 2005, all four cases in the study in which an infants' life was actively ended were preceded by a decision to forego life-prolonging treatment. In three cases, the infant's life expectancy was short; one case involved a longer life expectancy. Discussion The expected number of cases is probably an overestimation due to changes in medical practice such as the tendency to attribute less life-shortening effects to opioids. The lack of reports is probably also associated with requirements in the regulation; it may be difficult to fulfil them due either to time constraints or the nature of the suffering that is addressed. If societal control of active ending of life is considered useful, changes in the regulation may be needed. (shrink)

The concept of natural behavior is a key element in current Dutch policy-making on animal welfare. It emphasizes that animals need positive experiences, in addition to minimized suffering. This paper interprets the concept of natural behavior in the context of the scientific framework for welfare assessment. Natural behavior may be defined as behavior that animals have a tendency to exhibit under natural conditions, because these behaviors are pleasurable and promote biological functioning. Animal welfare is the quality of life as perceived (...) by the animal. Animals have evolved cognitive-emotional systems (“welfare needs”) to deal with a variable environment. Animals do not only have so-called physiological needs such as the need for food, water, and thermal comfort. They also need to exercise certain natural behaviors such as rooting or nest-building in pigs, and scratching or dust-bathing in poultry. All needs must be taken into account in order to assess overall welfare. The degree of need satisfaction and frustration can be assessed from scientific information about the intensity, duration, and incidence of (welfare) performance criteria such as measurements of behavior and/or (patho)physiology. Positive welfare value relates to how animals are inclined to behave under natural conditions, in preference tests, and in consumer-demand studies. Negative welfare value relates to stress, frustration, abnormal behavior, aggression, and reduced fitness. Examples are given to illustrate how the need to perform natural behaviors can be assessed following the general principles for welfare assessment, providing a first approximation of how different natural behaviors affect animal welfare. (shrink)

Introduction: The Dutch Euthanasia Act states that euthanasia is not punishable if the attending physician acts in accordance with the statutory due care criteria. These criteria hold that: there should be a voluntary and well-considered request, the patient’s suffering should be unbearable and hopeless, the patient should be informed about their situation, there are no reasonable alternatives, an independent physician should be consulted, and the method should be medically and technically appropriate. This study investigates whether physicians experience problems with these (...) criteria in medical practice.Methods: In 2006, questionnaires were sent to a random, stratified sample of 2100 Dutch physicians . Physicians were asked about problems in their decision-making related to requests for euthanasia or assisted suicide after enforcement of the 2002 Euthanasia Act.Results: Of all physicians who had received a request for euthanasia or assisted suicide , 25% had experienced problems in the decision-making with regard to at least one of the criteria of due care. Physicians who had experienced problems mostly indicated to have had problems related to evaluating whether or not the patient’s suffering was unbearable and hopeless and whether or not the patient’s request was voluntary or well considered .Discussion: Physicians in The Netherlands most frequently reported problems related to aspects in which they have to evaluate the patient’s subjective perspective. However, it can be questioned whether placing emphasis on these subjective aspects is an adequate fulfilment of the duties imposed on physicians, as laid down in the Dutch Euthanasia Act. (shrink)

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication (...) strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

Due to increasing empiricalinformation on farm animal welfare since the1960s, the prospects for sound decisionmakingconcerning welfare have improved. This paperdescribes a strategy to develop adecision-making aid, a decision support system,for assessment of farm-animal welfare based onavailable scientific knowledge. Such a decisionsupport system allows many factors to be takeninto account. It is to be developed accordingto the Evolutionary Prototyping Method, inwhich an initial prototype is improved inreiterative updating cycles. This initialprototype has been constructed. It useshierarchical representations to analysescientific statements and statements (...) describingthe housing system. Welfare is assessed fromwhat is known about the biological needs of theanimals, using a welfare model in the form of atree that contains these needs as welfarecomponents. Each state of need is assessedusing welfare relevant attributes of thehousing system and weighting factors.Attributes are measurable properties of thehousing system. Weighting factors are assignedaccording to heuristic rules based on theprinciple of weighting all components(attributes and needs) equally, unless thereare strong reasons to do otherwise. Preliminarytests of the prototype indicate that it may bepossible to perform assessment of farm-animalwelfare in an explicit way and based onempirical findings. The procedure needs to berefined, but its prospects are promising. (shrink)

The 2014 Varsity Medical Ethics debate convened upon the motion: “This house believes that genetic information should not be commoditised”. This annual debate between students from the Universities of Oxford and Cambridge, now in its sixth year, provided the starting point for arguments on the subject. The present article brings together and extends many of the arguments put forward during the debate. We explore the circumstances under which genetic material should be considered patentable, the possible effects of this on the (...) research and development of novel therapeutics, and the need for clear guidelines within this rapidly developing field. (shrink)

Günümüze kadar süregelen bir mezhep olarak Zeydiliğin Yemen bölgesinde geçirdiği süreçlerden birisi de 16. yy.’da imametini ilan eden Mansûr-Billâh Kâsım b. Muhammed ile başlayan ve Cumhuriyetin ilanına kadar iktidarın soyundan gelenlerin devam ettirdiği dönem bulunmaktadır. Ancak Kâsımîler dönemi olarak bilinen bu sürece dair literatürde yeterli bilgi bulunmamaktadır. Mansûr-Billâh Kâsım b. Muhammed’in akaid, fıkıh, usul gibi alanlarda kıymetli eserlerinin yanı sıra kaleme aldığı ufak bir risalesi de bulunmaktadır. Bu çalışmada ise Kâsımî Hanedanlığının kurucusu olarak bilinen Mansûr-Billâh Kâsım b. Muhammed’in oğlu Müeyyed-Billâh (...) Muhammed b. Kâsım için kaleme aldığı vasiyet metninin literatüre kazandırılması amaçlanmaktadır. (shrink)

This paper attempts to outline some of the important concepts and ideas used in system analysis which is taken to be a general mode of analysis used in all sciences. Systems are seen from three perspectives: (1) that involving the relationship between system and environment, (2) that involving interaction between several systems, and (3) that involving one type of system composed of other types of systems. The writers also discuss the concepts "structure" and "equilibrium" as they apply to system analysis, (...) the point being made that the use of these concepts in the social sciences has often been vague or even incorrect. (shrink)

IntroductionBisphenol A is highly debated and studied in relation to a variety of health outcomes. This large variation in the literature makes BPA a topic that is prone to selective use of literature, in order to underpin one’s own findings and opinion. Over time, selective use of literature, by means of citations, can lead to a skewed knowledge development and a biased scientific consensus. In this study, we assess which factors drive citation and whether this results in the overrepresentation of (...) harmful health effects of BPA.MethodsA citation network analysis was performed to test various determinants of citation. A systematic search identified all relevant publications on the human health effect of BPA. Data were extracted on potential determinants of selective citation, such as study outcome, study design, sample size, journal impact factor, authority of the author, self-citation, and funding source. We applied random effect logistic regression to assess whether these determinants influence the likelihood of citation.ResultsOne hundred sixty-nine publications on BPA were identified, with 12,432 potential citation pathways of which 808 citations occurred. The network consisted of 63 cross-sectional studies, 34 cohort studies, 29 case-control studies, 35 narrative reviews, and 8 systematic reviews. Positive studies have a 1.5 times greater chance of being cited compared to negative studies. Additionally, the authority of the author and self-citation are consistently found to be positively associated with the likelihood of being cited. Overall, the network seems to be highly influenced by two highly cited publications, whereas 60 out of 169 publications received no citations.ConclusionIn the literature on BPA, citation is mostly driven by positive study outcome and author-related factors, such as high authority within the network. Interpreting the impact of these factors and the big influence of a few highly cited publications, it can be questioned to which extent the knowledge development in human literature on BPA is actually evidence-based. (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be (...) holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)