In 1922, many representatives of the Russian Intelligentsia, including many philosophers, were exiled from the young soviet state. Many left with the so-called Philosophy Steamer (Chamberlain in The philosophy steamer: Lenin and the exile of the intelligensia (2006) Atlantic Books). The exiled philosophers tried to go on with their previous professional lives in cities as Prague, Berlin and Paris. The St. Serge Orthodox Theological Institute in Paris, founded by, among others, Sergei Bulgakov (1871–1944), became the new center of Russian religious (...) philosophy and theology in Europe. Soon, however, the community of immigrant Russian religious philosophers and theologians was divided by conflicting opinions, and fell apart in various brotherhoods and movements. An important conflict was the so-called Sophia controversy: the Brotherhood of St. Photius, which included Vladimir Lossky (1903–1958), as well as the famous spokesman of the Neopatristic Synthesis, Fr. Georges Florovsky (1893–1979), attacked the Brotherhood of St. Sophia, which included the above mentioned Bulgakov. His Sophiology, or study of Sophia, Divine Wisdom, was accused of heresy on the instigation of Florovsky and Lossky. From this Sophia controversy, the Neopatristic Synthesis emerged as the dominant school of Russian Orthodox Theology, whereas Sophiology fell practically into oblivion. This article will attempt to answer the question whether there is still room for a re-valuation of the sophiological stance in Orthodox theology through a survey of recent literature on the subject. The article will conclude the affirmative: namely, that the controversy is shown to be the result of a conflict between generations and the necessity to empower their Orthodox identity in emigration, rather than the result of intrinsic philosophical or theological differences. (shrink)

This article is about evil and its function in educational discourse. The research posits, using work in postsecularism and particularly through an historical, legal, and theological read of prophetic indictment and the function of the jeremiad in educational policy, that the terms of educational debate are rendered in a legal rather than a deliberative discursive framework. This lends itself, then, to the creation of evil others opposed to one’s own preferred policy prescriptions and renders much of the discussion about and (...) around the need for conversation and comity moot. The authors propose attending to the function of evil in education as well as positing an historical approach to thinking about why we often can’t think differently about educational arguments. (shrink)

In this paper the authors give a survey of biological phenomena , for which the term ‘differentiation’, used in the widest sense, has a meaningful application. The last chapter deals with some general aspects of differentiation and connected phenomena, such as polarity, symmetry, loss of potencies, dedifferentiation, redifferentiation, adifferentiation, regulation and integration.To prevent this article becoming too voluminous, the authors had to refrain from extending the treatment of differentiation to non-living matter and to human society.

Background: We aimed to determine the smallest changes in health-related quality of life (HRQoL) scores in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 and the Brain Cancer Module (QLQ-BN20), which could be considered as clinically meaningful in brain cancer patients. Materials and methods: World Health Organisation performance status (PS) and mini-mental state examination (MMSE) were used as clinical anchors appropriate to related subscales to determine the minimal clinically important differences (MCIDs) in HRQoL (...) change scores (range 0-100) in the QLQ-C30 and QLQ-BN20. A threshold of 0.2 standard deviation (SD) (small effect) was used to exclude anchor-based MCID estimates considered too small to inform interpretation. Results: Based on PS, our findings support the following integer estimates of the MCID for improvement and deterioration, respectively: physical (6, 9), role (14, 12), and cognitive functioning (8, 8); global health status (7, 4(star)), fatigue (12, 9), and motor dysfunction (4(star), 5). Anchoring with MMSE, cognitive functioning MCID estimates for improvement and deterioration were (11, 2(star)) and for communication deficit were (9, 7). Estimates with asterisks were <0.2 SD and were excluded from our MCID range of 5-14. Conclusion: These estimates can help clinicians evaluate changes in HRQoL over time, assess the value of a health care intervention and can be useful in determining sample sizes in designing future clinical trials. (shrink)

Contemporary scholarship interprets Sergej Bulgakov's sophiology as an engagement of Orthodox theology with the modern world and as being on its way to becoming a political theology. In this paper I undertake a re-evaluation of the kind of engagement sophiology was and was intended to be, and of the kind of world it was destined for. It will be argued that sophiology was not so much a political-theological engagement with the world concentrating on the relation of religion and politics or (...) state and church, but rather an economic-theological engagement in the tradition of oikonomia theology that tried to understand the world in its relation to and as part of divine oikonomia. Furthermore, the world sophiology promotes engagement with is not only the real contemporary world, or the sociological ideal type of modernity, but primarily the world as such, this secular and human world over and against the divine and transcendent world. (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

A naturalistic theory of intentionality is proposed that differs from previous evolutionary and tracking theories. Full-blown intentionality is constructed through a series of evolvable refinements. A first, minimal version of intentionality originates from a conjectured internal process that estimates an organism’s own fitness and that continually modifies the organism. This process produces the directedness of intentionality. The internal estimator can be parsed into intentional components that point to components of the process that produces fitness. It is argued that such intentional (...) components can point to mistaken or non-existing entities. Different Fregian senses of the same reference correspond to different components that have different roles in the estimator. Intentional components that point to intentional components in other organisms produce directedness towards semi-abstract entities. Finally, adding a general, population-wide means of communication enables intentional components that point to fully abstract entities. Intentionality thus naturalized has all of its expected properties: being directed; potentially making errors; possibly pointing to non-existent, abstract, or rigid entities; capable of pointing many-to-one and one-to-many; distinguishing sense and reference; having perspective and grain; and having determinate content. Several examples, such as ‘swampman’ and ‘brain-in-a-vat’, illustrate how the theory can be applied. (shrink)

The causal efficacy of a material system is usually thought to be produced by the law-like actions and interactions of its constituents. Here, a specific system is constructed and explained that produces a cause that cannot be understood in this way, but instead has novel and autonomous efficacy. The construction establishes a proof-of-feasibility of strong emergence. The system works by utilizing randomness in a targeted and cyclical way, and by relying on sustained evolution by natural selection. It is not vulnerable (...) to standard arguments against strong emergence, in particular ones that assume that the physical realm is causally closed. Moreover, it does not suffer from epiphenomenalism or causal overdetermination. The system uses only standard material components and processes, and is fully consistent with naturalism. It is discussed whether the emergent cause can still be viewed as ‘material’ in the way that term is commonly understood. (shrink)

Living organisms appear to have agency, the ability to act freely, and humans appear to have free will, the ability to rationally decide what to do. However, it is not clear how such properties can be produced by naturalistic processes, and there are indeed neuroscientific measurements that cast doubt on the existence of free will. Here I present a naturalistic theory of agency, consciousness, and free will. Elementary forms of agency evolved very early in the evolution of life, utilizing an (...) extension of the basic Darwinian scheme that combines and entangles deterministic and stochastic causation. The extension effectively produces an active form of causation, as well as meaning intrinsic to the organism. Consciousness arose when animals evolved advanced nervous systems and social lifestyles that enabled communication mutually affecting each animal’s intrinsic meaning. I argue that various forms of agency that subsequently arose in evolution, preconscious, conscious, intelligent, symbolic, and rational agency, still coexist in humans. This coexistence, combined with the fact that agency is not instantaneous but takes time to build up, makes simple interpretations of neuroscientific results on free will problematic. The conclusion of the study is that conscious free will, including a form of agent causation, is fully consistent with a naturalistic world-view and can be produced by the specific processes discussed. The result closely resembles existing approaches to life and mind that are inspired by phenomenology. (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)

Biological organisms appear to have agency, goals, and meaningful behaviour. One possibility is that this is mere appearance, where such properties are not real, but only ‘as if’ consequences of the physiological structure of organisms. Another possibility is that these properties are real, as emerging from the organism's structure and from how the organism interacts with its environment. Here I will discuss a recent theory showing that the latter position is most likely correct, and argue that the theory is largely (...) consistent with the basics of the field of biosemiotics. The theory can be represented as a triad that resembles the semiotic triad proposed by Peirce, which connects a sign with its object through a process of interpretation. In the theory presented, the sign is an internalized version of fitness which refers to the true fitness through a feedback loop that in effect produces interpretation. The feedback loop entangles deterministic and stochastic forms of causation in such a way that genuine agency, goal-directedness, and their associated meaning emerge. It produces a strong form of emergence not reducible to its constituents. The result is that novel phenomena arise that are real and necessary components for a complete understanding of living organisms. (shrink)

A new theory that naturalizes biological function is explained and compared with earlier etiological and causal role theories. Etiological theories explain functions from how they are caused over their evolutionary history. Causal role theories analyze how functional mechanisms serve the current capacities of their containing system. The new proposal unifies the key notions of both kinds of theories, but goes beyond them by explaining how functions in an organism can exist as factors with autonomous causal efficacy. The goal-directedness and normativity (...) of functions exist in this strict sense as well. The theory depends on an internal physiological or neural process that mimics an organism’s fitness, and modulates the organism’s variability accordingly. The structure of the internal process can be subdivided into subprocesses that monitor specific functions in an organism. The theory matches well with each intuition on a previously published list of intuited ideas about biological functions, including intuitions that have posed difficulties for other theories. (shrink)

The causal structure of Darwinian evolution by natural selection is investigated. Its basic scheme is reproduction resulting from a feedback loop driven by internal and external causes. Causation internal to the loop connects genotype, development, phenotype, and fitness, with environmental constraints on the latter preventing runaway reproduction. External causes driving the core loop are environmental change and genetic change. This basic causal structure is complicated by modern additions such as control of mutation rate, niche construction, interactions between evolution and development, (...) and epigenetic effects. In this article it is argued that at least one of these additions, control of mutation rate, produces an additional feedback loop incorporating a continual, targeted modulation of stochasticity, and thereby produces an unusual form of causation. This form of causation entangles deterministic and stochastic causation in such a way that it imposes, in effect, an active, goal-driven role on the organisms in a line of descent. The goal is defined by the factor driving the stochasticity, which must be regarded as an intrinsic estimate made implicitly by the organism of its own fitness. The estimator itself is an evolved property of the organism, and is aligned with the apparent goal-directedness of natural selection. (shrink)

Studie over het werk van de Nederlandse filosoof Herman Dooyeweerd (1894- 1977).

In this interview with Jan Hendrik van den Berg, the Dutch phenomenologist and psychiatrist addresses the origins of his work, his most significant influences, and the purpose of metabletic phenomenology in the modern age. In the course of the interview. Dr. Van den Berg provides a basic overview of his work, and highlights the central finding of his metabletic analyses: a loss of wonder before nature, which results from the more fundamental loss of genuine spirituality in the modern world.

The skopos of this new type of church Bible is: ‘How would the source texts of the Bible have sounded in Afrikaans in the context envisaged for its hypothesised first audience?’ Fully acknowledging the complexities of language as a dynamic and complex system embedded in the culture and conceptual world of its speakers, as well as the wide range of frames that are involved in the process of Bible translation as a difficult form of secondary communication, this article addresses two (...) of the challenges of this ambitious project. In the first section the incongruence between the world of the Old Testament and speakers of Afrikaans is treated. Examples are provided of instances where both the nature of difficult secondary intercultural communication as well as the subjective theories of the host audience constrains the ‘directness’ of the translation. In the second section, some of the challenges of distinguishing between the formal and functional features of Biblical Hebrew are dealt with. The article concludes that, although the notion ‘communicative clue’ provides a useful heuristic device to act as point of departure for negotiations on the construal of the meaning of the text in the source language and host language respectively, the notion has to be supplemented by insights from the fields of cultural anthropology, cognitive linguistics and linguistic typology. A better understanding of how meaning ‘works’ provides members of a translation team with some criteria to make informed decisions when they negotiate how the meaning of specific Biblical Hebrew constructions are to be construed ‘directly’ in Afrikaans.Keywords: Afrikaans Bibles; Bible translation; Biblical Hebrew; church Bible; code model; cognitive linguistics; cognitive semantics; communication model; communicative clue; direct translation; discourse marker; dynamic equivalent translation; functionalist tran. (shrink)

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)

Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)