An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...) from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD. (shrink)

For years, experimental philosophers have attempted to discern whether laypeople find free will compatible with a scientifically deterministic understanding of the universe, yet no consensus has emerged. The present work provides one potential explanation for these discrepant findings: People are strongly motivated to preserve free will and moral responsibility, and thus do not have stable, logically rigorous notions of free will. Seven studies support this hypothesis by demonstrating that a variety of logically irrelevant (but motivationally relevant) features influence compatibilist judgments. (...) In Study 1, participants who were asked to consider the possibility that our universe is deterministic were more compatibilist than those not asked to consider this possibility, suggesting that determinism poses a threat to moral responsibility, which increases compatibilist responding (thus reducing the threat). In Study 2, participants who considered concrete instances of moral behavior found compatibilist free will more sufficient for moral responsibility than participants who were asked about moral responsibility more generally. In Study 3a, the order in which participants read free will and determinism descriptions influenced their compatibilist judgments—and only when the descriptions had moral significance: Participants were more likely to report that determinism was compatible with free will than that free will was compatible with determinism. In Study 3b, participants who read the free will description first (the more compatibilist group) were particularly likely to confess that their beliefs in free will and moral responsibility and their disbelief in determinism influenced their conclusion. In Study 4, participants reduced their compatibilist beliefs after reading a passage that argued that moral responsibility could be preserved even in the absence of free will. Participants also reported that immaterial souls were compatible with scientific determinism, most strongly among immaterial soul believers (Study 5), and evaluated information about the capacities of primates in a biased manner favoring the existence of human free will (Study 6). These results suggest that people do not have one intuition about whether free will is compatible with determinism. Instead, people report that free will is compatible with determinism when desiring to uphold moral responsibility. Recommendations for future work are discussed. (shrink)

Moral cognition, by its very nature, stems from intuitions about what is good and bad, and these intuitions influence moral assessments outside of conscious awareness. However, because humans evolved a shared set of moral intuitions, and are compelled to justify their moral assessments as good and rational (even erroneously) to others, moral virtue and moral progress are still possible.

Amphibian metamorphosis is a post‐embryonic process that systematically transforms different tissues in a tadpole. Thyroid hormone plays a causative role in this complex process by inducing a cascade of gene regulation. While natural metamorphosis does not occur until endogenous thyroid hormone has been synthesized, tadpoles are competent to respond to exogenous thyroid hormone shortly after hatching. In addition, even though the metamorphic transitions of individual organs are all controlled by thyroid hormone, each occurs at distinct developmental stages. Recent molecular studies (...) suggest that this competence of premetamorphic tadpoles to respond to the hormone and the developmental stage‐dependent regulation of tissue‐specific transformations are determined in part by the levels of thyroid hormone receptors and the concentrations of cellular free thyroid hormone. In addition, at least two genes, encoding a cytosolic thyroid hormone binding protein and a 5‐deiodinase, respectively, are likely to be critical players in regulating cellular free thyroid hormone concentrations. This review discusses how all of these molecuar components coordinate to induce amphibian metamorphosis in a correct spatial and temporal manner. These studies provde us with general clues as to how and why tissues become competent to respond to hormonal signals. (shrink)

M.J. Langeveld (1905-1989) behoort tot de grootste Nederlandse pedagogen van de twintigste eeuw. Dit is de biografie van deze beroemde opvoedkundige, die tevens een gevreesde autoriteit was en een fenomenoloog van internationaal formaat.

For Hegel, modern selfhood is an implicitly poetic, normative capacity for actions that could not be empirically explained. Thus it eludes the “clarification” offered by classical tragedy, but modernity’s apparent loss of tragedy conceals the dialectical refinement of tragic into comic form that most defines modern selfhood. If Aristotle contrasted poetry and history, Hegel’s The Phenomenology of Spirit derives a modern, comic ethical poetics from the form of historical contingency itself. Focusing on Hegel’s reading of Antigone, I solicit Gillian Rose (...) and Dieter Henrich to defend this account against tragic assessments of modern selfhood by J. M. Bernstein, Patricia Jagentowicz Mills, and Judith Butler. (shrink)

The theory of emotion developed by William James has been subject to four criticisms. First, it is held that Jamesian emotion is without function, that it plays no role in cognition and behavior. Second, that James ignores the role of experience in emotion. Third, that James overstated the role of physical processes in emotion. Fourth, that James’ theory of emotion has been experimentally demonstrated to be false. A fifth point, less an explicit criticism than an assumption, holds that James has (...) nothing to offer a social psychology of emotions. It will be shown in this paper that not one of these criticisms of James' theory of emotion can be sustianed. (shrink)

ABSTRACTIn this paper, I examine the arguments against physician assisted suicide . Many of these arguments are consequentialist. Consequentialist arguments rely on empirical claims about the future and thus their strength depends on how likely it is that the predictions will be realized. I discuss these predictions against the backdrop of Oregon's Death with Dignity Act and the practice of PAS in the Netherlands. I then turn to a specific consequentialist argument against PAS – Susan M. Wolf's feminist critique of (...) the practice. Finally, I examine the two most prominent deontological arguments against PAS. Ultimately, I conclude that no anti‐PAS argument has merit. Although I do not provide positive arguments for PAS, if none of the arguments against it are strong, we have no reason not to legalize it. (shrink)

Following [3], we build higher-order models of analysis resembling the frameworks of nonstandard analysis. The models are entirely canonical, constructed without Choice. Weak transfer principles are developed and the models are applied to topology, graph theory, and measure theory. A Loeb-like measure is constructed.

Thirty-three physicians, bioethicists, and medical economists from ten different countries met at Lawrence University, Appleton, Wisconsin, to create The Appleton Consensus: International Guidelines for Decisions to Forego Medical Treatment. The guidelines deal with four specific decision-making circumstances: 1. Five guidelines were created for decisions involving competent patients or patients who have executed an advance directive before becoming incompetent, and those guidelines fell into three categories. 2. Thirteen guidelines were created for decisions involving patients who were once competent, but are not (...) now competent, who have not executed an advance directive. 3. Seven guidelines were created for decisions involving patients who are not now and never have been competent, for whom 'no substituted judgement' can be rendered. 4. Eleven guidelines were created for decisions involving the scarcity of medical resources, which exists in all communities. Five concepts were identified as being critical in the establishment of priorities, given the reality of scarce health resources (1). The term 'physician' is used in the American sense, synonymous with 'medical practitioner'. (shrink)

In his concept of an anthropological physiology, F.J.J. Buytendijk has tried to lay down the theoretical and scientific foundations for an anthropologically-oriented medicine. The aim of anthropological physiology is to demonstrate, empirically, what being specifically human is in the most elementary physiological functions. This article contains a sketch of Buytendijk''s life and work, an overview of his philosophical-anthropological presuppositions, an outline of his idea of an anthropological physiology and medicine, and a discussion of some episternological and methodological problems. It is (...) demonstrated that Buytendijk''s design of an anthropological physiology is fragmentary and programmatic and that his methodology offers few points of contact for specific anthropological experimental research.Notwithstanding, it is argued that Buytendijk''s description of the subjective, animated body forms a pre-eminent point of reference for all research in physiology and psychology in which the specific human aspect is not ignored beforehand. (shrink)

J. M. Shorter; X*—Personal Identity, Personal Relationships, and Criteria, Proceedings of the Aristotelian Society, Volume 71, Issue 1, 1 June 1971, Pages 165–1.

This commentary begins by analyzing two textual selections about death in the Gorgias in order to expand upon Ewegen’s portrayal of Socrates. I close by briefly giving voice to another, perhaps more familiar side of Socrates’ rhetorical approach in the dialogue in order to provide some further perspective about Ewegen’s claims.

Feigning symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across three studies, (...) we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students and clinical experts a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis. (shrink)