Background: The 21-item Nurses’ Moral Courage Scale was developed and validated in 2018 in Finland with the purpose of measuring moral courage among nurses. Objectives: The objective of this study was to make a Dutch translation of the Nurses’ Moral Courage Scale to describe the level of nurses’ self-assessed moral courage and associated socio-demographic factors in Flanders, Belgium. Research design: A forward–backward translation method was applied to translate the English Nurses’ Moral Courage Scale to Dutch, and a pilot study was (...) conducted to improve readability and understandability. A non-experimental, descriptive cross-sectional exploratory design was used to conduct a survey. Descriptive analysis was used. Participants: The data were collected from a convenience sample of 559 nurses from two hospitals in Flanders. Ethical considerations: Ethical approval was obtained from the university ethics committee, permission to conduct the study was obtained from the participating hospitals. Participants received a guide letter and gave their informed consent. Findings: The readability and understandability of the Dutch Nurses’ Moral Courage Scale were positively evaluated, and the scale revealed a good level of internal consistency for the total scale (α =.914) and all subscales. Nurses’ mean score of the 21-item Nurses’ Moral Courage Scale was 3.77 (standard deviation = 0.537). The total Nurses’ Moral Courage Scale score was associated with age (p <.001), experience (p <.001), professional function (p =.002), level of education (p =.002) and personal interest (p <.001). Discussion and Conclusion: The Nurses’ Moral Courage Scale was successfully translated to Dutch. The Flemish nurses perceived themselves as morally courageous, especially when they were in a direct interpersonal relationship with their patients. Acting courageously in ethical dilemmas that involved other actors or organizations appeared to be more challenging. The results strongly suggest the important role of education and ethical leadership in developing and supporting this essential virtue in nursing practice. (shrink)

Background: Moral courage as a part of nurses’ moral competence has gained increasing interest as a means to strengthen nurses acting on their moral decisions and offering alleviation to their moral distress. To measure and assess nurses’ moral courage, the development of culturally and internationally validated instruments is needed. Objective: The objective of this study was to validate the Dutch-language version of the four-component Nurses’ Moral Courage Scale originally developed and validated in Finnish data. Research design: This methodological study used (...) non-experimental, cross-sectional exploratory design. Participants and research context: A total of 559 nurses from two hospitals in Flanders, Belgium, completed the Dutch-language version of the Nurses’ Moral Courage Scale. Ethical considerations: Good scientific inquiry guidelines were followed throughout the study. Permission to translate the Nurses’ Moral Courage Scale was obtained from the copyright holder, and the ethical approval and permissions to conduct the study were obtained from the participating university and hospitals, respectively. Findings: The four-component 21-item, Dutch-language version of the Nurses’ Moral Courage Scale proved to be valid and reliable as the original Finnish Nurses’ Moral Courage Scale. The scale’s internal consistency reliability was high (0.91) corresponding with the original Nurses’ Moral Courage Scale validation study (0.93). The principal component analysis confirmed the four-component structure of the original Nurses’ Moral Courage Scale to be valid also in the Belgian data explaining 58.1% of the variance. Confirmatory factor analysis based on goodness-of-fit indices provided evidence of the scale’s construct validity. The use of a comparable sample of Belgian nurses working in speciality care settings as in the Finnish study supported the stability of the structure. Discussion and conclusion: The Dutch-language version of the Nurses’ Moral Courage Scale is a reliable and valid instrument to measure nurses’ self-assessed moral courage in speciality care nursing environments. Further validation studies in other countries, languages and nurse samples representing different healthcare environments would provide additional evidence of the scale’s validity and initiatives for its further development. (shrink)

From 1827 to 1831 the German historian Leopold von Ranke travelled through Germany, Austria, and Italy, hunting for documents and archives. During this journey Ranke developed a new model for historical research that transformed the archive into the most important site for the production of historical knowledge. Within the archive, Ranke claimed, the trained historian could forget his personal predispositions and political loyalties, and write objective history. This essay critically examines Ranke's model for historical research through a study of the (...) obstacles, frustrations, and joys that he encountered on his journey. It shows how Ranke's archival experiences inspired him to re-evaluate his own identity as a historian and as a human being, and investigates some of the affiliations between his model for historical research and the political realities of Prince Metternich's European order. Finally, the essay compares Ranke's historical discipline to other nineteenth-century disciplines, such as anthropology and archaeology. (shrink)

In 2002 with the passing of the Euthanasia Law, Belgium became one of the few countries worldwide to legalize euthanasia. In the 18 years since the passing of the law, much has changed. We argue that in Belgium a widening of the use of euthanasia is occurring and that this can be ethically and legally problematic. This is in part related to the fact that several legal requirements intended to operate as safeguards and procedural guarantees in reality often fail to (...) operate as such. We focus on three kinds of safeguards or procedural guarantees: (1) the legally defined due care criteria for eligibility for euthanasia; (2) the consultation of a second (and sometimes third) physician; and (3) the reporting of euthanasia cases to the Federal Control and Evaluation Commission for Euthanasia. We will show how each of these three safeguards can exhibit shortcomings in theory and practice. (shrink)

In this book Kasper Lippert-Rasmussen address the complexities of his question "Is affirmative action morally justifiable?" by analyzing the prevailing contemporary arguments both for and against affirmative action. The book applies current political philosophy to demonstrate that arguments on both sides justify different conclusions given different specific cases, though it ultimately does argue in favor of affirmative action based on the relative strength and significance of the anti-discrimination- and equality of opportunity-based positions.

This paper proposes an interdisciplinary explanation of the cross-cultural similarities and evolutionary patterns of witchcraft beliefs. It argues that human social dilemmas have led to the evolution of a fear system that is sensitive to signs of deceit and envy. This was adapted in the evolutionary environment of small foraging bands but became overstimulated by the consequences of the Agricultural Revolution, leading to witch paranoia. State formation, civilization, and economic development abated the fear of witches and replaced it in part (...) with more collectivist forms of social paranoia. However, demographic-economic crises could rekindle fear of witches—resulting, for example, in the witch craze of early modern Europe. The Industrial Revolution broke the Malthusian shackles, but modern economic growth requires agricultural development as a starting point. In sub-Saharan Africa, witch paranoia has resurged because the conditions for agricultural development are lacking, leading to fighting for opportunities and an erosion of intergenerational reciprocity. (shrink)

This study investigates how business leaders dynamically narrate their aspirational ethical leadership identities. In doing so, it furthers understanding of ethical leadership as a process situated in time and place. The analysis focuses on the discursive strategies used to narrate identity and ethics by ethnic Chinese business leaders in Indonesia after their conversion to Pentecostal–charismatic Christianity. By exploring the use of metaphor, our study shows how these business leaders discursively deconstruct their ‘old’ identities and construct their ‘new’ aspirational identities as (...) ethical leaders. This leads to the following contributions. First, we show that ethical leadership is constructed in identity talk as the business leaders actively narrate aspirational identities. Second, the identity narratives of the business leaders suggest that ethical leadership is a context-bound and situated claim vis-à-vis unethical practice. Third, we propose a conceptual template, identifying processes of realisation and inspiration followed by significant shifts in understanding, for the study of aspirational ethical leadership. (shrink)

In The Myth of Morality Richard Joyce presents a simple and very influential argument for the truth of moral error theory. In this paper I point out that the argument does not have the form Joyce attributes to it, the argument is not valid in an extensional propositional logic and on the most natural way of explicating the meanings of the involved terms, it remains invalid. I conclude that more explanation is needed if we are to accept this particular argument (...) for moral error theory. (shrink)

The conceptual pair of own-world (ídios kósmos) and common world (koinós kósmos) constitutes an archaic pair, originally introduced by Heraclitus. More than two millennia after its introduction, Binswanger picked up this conceptual pair in the attempt to understand existence and mental disorder. Ever since, this conceptual pair has been part of the conceptualization of schizophrenia in phenomenological psychopathology. However, the concepts of ídios kósmos and koinós kósmos have seldomly been elaborated and expanded upon, and certain unclarities rest within the literature. (...) This paper resolves some of these unclarities and contributes to a theory of anthropological proportions, which furthers our understanding of ídios kósmos and koinós kósmos. The paper begins with an exploration of the theoretical underpinnings of this conceptual pair, i.e., it discusses the concept of world, what is understood by common world, and what it means to live in an own-world. This theoretical exploration segues into an in-depth analysis of the alterations of experiential life in schizophrenia, which can be illuminated via this conceptual pair. It is further argued that this conceptual pair contributes to an understanding of the puzzling phenomenon of double bookkeeping. Finally, the paper concludes in a discussion of clinical implications of this conceptual pair, stressing the importance of a mindfulness of the alterations to the ídios kósmos and koinós kósmos in schizophrenia. (shrink)

Name der Zeitschrift: Jahrgang: 13 Heft: 2 Seiten: 170-189.

Aos 50 anos da Dei Verbum retomam-se alguns textos da última década que atualizam esse documento, especialmente a exortação Verbum Domini de Bento XVI, o Documento de Aparecida, do CELAM, e a Evangelii Gaudium, do papa Francisco. Partindo da consideração da palavra dialogal como espaço para o deixar-ser do outro, sublinha-se o caráter humano-divino da palavra de Deus, criadora e humanada em Cristo. A Tradição viva da Igreja, em cujo seio se configura a Escritura cristã como regra primeira da fé, (...) guarda a memoria Christi, a Palavra presente na celebração e no anúncio, não só aos de fora, mas, com urgência atual, na formação permanente e na mistagogia dos que são considerados cristãos. Mas a memoria Christi se guarda e se interpreta, também, na práxis cristã vivida. Evoca-se esta complexa interação do humano e do divino, da memória e da presença, da palavra e da práxis da fé, com a intenção, sobretudo, de valorizar a palavra humana autêntica e dialogal, a serviço da humanação da Palavra de Deus, divinização da palavra humana. (shrink)

Rather than unifying the peoples in the world, globalization divides them into zones: either developed and prosperous, or underdeveloped and ravaged by poverty. How, then, can one imagine economic and financial globalization as a current implementation of cosmopolitanism, which abolishes the old fratricidal strife and seals the reunion between men across national borders? And how can we not doubt the cosmopolitan order facing the proliferation of identity claims, the rise of competitors due to globalization? Are we condemned to live in (...) a world ever more unequal, more “hard” for the losers, the weak? What space is there in philosophy to think the new solidarity? This paper sketches some answers to these questions. (shrink)

I en dobbelt forstand kan døden siges at være uomgængelig, og i en dobbelt forstand fremstår det som et uomgængeligt problem for vor livsglade civilisation, idag tilsyneladende mere end nogensinde.

From surrealism’s beginnings around a Parisian séance table, it oscillated between the occult and the political. One of its key methods, automatism, provided access to both the esoteric and the exoteric: it took form in the mid-19th century as a spiritualist technique for communicating with the other side while, simultanously, this other side could address political issues as equal rights, de-colonisation and a utopian future with an authority coming from beyond the individual. By tracing the development of automatism, the article (...) shows how automatism in surrealism became a call for both a re-orientation of life and an institutional re-organisation by becoming a divination tool for a future community looking back to hermeticism to find a way forward. The article argues that not only can surrealism fruitfully be understood in the light of an occult revival in reaction to crises but, additionally, that it marks the return of and a reaction to a kind of magical thinking in the modern – due to waning religious and socio-economic orthodoxies – that echoes eerily into our own big data contemporary of social medias where we tend to substitute equations with associations. (shrink)

The COVID‐19 pandemic has had an immense and worldwide impact. In light of future pandemics or subsequent waves of COVID‐19 it is crucial to focus on the ethical issues that were and still are raised in this COVID‐19 crisis. In this paper, we look at issues that are raised in the testing and tracing of patients with COVID‐19. We do this by highlighting and expanding on an approach suggested by Fineberg that could serve as a public health approach. In this (...) way, we highlight several ethical issues. As regards testing, questions are raised such as whether it is ethical to use less reliable tests in order to increase testing capacity or minimize harm for patients. Another issue is how wide testing should be and whether selective testing is in accordance with principles of social justice. Patients who have recovered from COVID‐19 might have some degree of immunity but attributing certain ‘immunopriviliges’ raises ethical questions. The use of various tracing methodologies (mobile apps or databases and trained tracers) raised evident questions of social justice and privacy. We argue why it is key to always uphold a test of proportionality where a fair balance must be sought. (shrink)

Recently there has been some discussion concerning a particular type of enhancement, namely ‘moral enhancement’. However, there is no consensus on what precisely constitutes moral enhancement, and as a result the concept is used and defined in a wide variety of ways. In this article, we develop a clarificatory taxonomy of these definitions and we identify the criteria that are used to delineate the concept. We think that the current definitions can be distinguished from each other by the criteria used (...) for determining whether an intervention is indeed moral enhancement. For example, some definitions are broad and include moral enhancement by any means, while other definitions focus only on moral enhancement by means of specific types of intervention. Moreover, for some definitions it suffices for an intervention to be aimed or intended to morally enhance a person, while other definitions only refer to ‘moral enhancement’ in relation to interventions that are actually effective. For all these differences in definitions we discuss some of their implications. This shows that definitions are significantly less descriptive and more normative than they are regularly portrayed to be. We therefore hope that the taxonomy developed in this paper and the comments on the implications for the normative debate of the variety of definitions will provide conceptual clarity in a complex and highly interesting debate. (shrink)

This article investigates the emergence of the archive as the primary venue for the production of historical knowledge in the 19th century. The turn to archival research, the article argues, may be considered as a response to the discussions about the problems of testimony that dominated 18th- and early 19th-century German writings on the methodology and epistemology of historical research. These discussions, especially regarding the epistemic virtues of witnesses, also helped create the particular culture of knowledge-making within German historical scholarship (...) that enabled the archival turn. The article illustrates these developments through the examples of Johann Peter von Ludewig, who was one of the most prominent historians of the early German Enlightenment, and Leopold von Ranke, who is normally considered the founder of the modern historical discipline and the most important advocate of the 19th-century archival turn. (shrink)

Rural landscapes are facing a loss of biodiversity. To deal with this challenge, landscape governance is seen as an alternative and addition to sectoral policies and a potential way of realizing transformative change for biodiversity. To study transformative change in the Bulb Region, the Netherlands, this study uses a discursive-institutional perspective. A mixed methods approach was used including 50 interviews, participant observation and document analysis. The structuration and institutionalization of three competing landscape discourses were analyzed: a hegemonic discourse rejecting any (...) changes in bulb farming; an emerging discourse aiming to enhance sustainability through innovation; and an unstructured discourse questioning the sustainability of bulb farming. The paper shows that the emerging sustainability discourse strengthens the hegemonic discourse by providing an action repertoire for farmers to deal with changing societal demands, while not questioning the hegemonic view on the landscape. Moreover, an institutionalized landscape discourse can be very stable if discursive (relation between naturalized landscape perspectives, identity and the articulated economic interests) and non-discursive factors (natural-spatial conditions, structure of agricultural sector, embeddedness in international trade) are strongly intertwined, leaving little room for alternative discourses. The sustainability discourse was induced by changes outside the Bulb Region (e.g., legislation), thus raising the question whether landscapes are the appropriate level to expect the initiation of transformative change. For rural transformations to come about, solely relying on policies on the landscape level is not sensible. A mix of policies at both the landscape and higher levels offers more perspective for transformative change. (shrink)

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our goal (...) is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

Deflationists believe that the question “What is truth?” should be answered not by means of a metaphysical inquiry into the nature of truth, but by figuring out what use we make of the concept of truth, and the word ‘true’, in practice. This article accepts this methodology, and it thereby rejects pluralism about truth that is driven by ontological considerations. However, it shows that there are practical considerations for a pluralism about truth, formulated at the level of use. The theory (...) expounded by this article states that truth is a dual-purpose tool; it can be used as a device for transferring justificatory burdens and, for select areas of discourse, it can also be used as a standard, a norm. This contrast in how truth is used introduces a bifurcation in our discourse that is reminiscent of metaphysical divides traced by more traditional versions of alethic pluralism. However, my pluralism “at the level of use” states that truth is plural solely at the level of use. It is unified at both the conceptual as well as the metaphysical level. At those levels, the theory takes its cue from deflationism. As such, this theory is offered as a midway point and as a potential way forward in the debate between deflationism and pluralism. (shrink)

Pragmatism and the correspondence theory of truth are longtime foes. Nevertheless, there is an argument to be made that pragmatists must embrace truth as correspondence. I show that there is a distinctive pragmatic utility to taking truth to be correspondence, and I argue that it would be inconsistent for pragmatists to accept the utility of the belief that truth is correspondence while resisting the premise that this belief is correct. -/- In order to show how pragmatists can embrace truth as (...) correspondence, I develop a kind of alethic pluralism, which treats pragmatist truth as theoretically fundamental to truth as correspondence. This theoretical fundamentality of pragmatist truth allows the pragmatist to conditionally accept truth as correspondence for certain discourses without falling prey to the typical pragmatist objections to correspondence. This pluralist account of truth thus allows pragmatists to concede that, for certain domains of discourse, truth is correspondence, without thereby betraying their pragmatist principles. (shrink)

The hermeneutical process underlying Paul’s exegesis of Exodus 17:6 and Numbers 20:7–11 in 1 Corinthians 10:1–4. In this article, Paul’s use of the Old Testament in 1 Corinthians 10:1–4 comes under scrutiny. In contrast with the theory of some modern scholars that Paul uses, ‘fanciful analogies’, ‘startling figurative claims’ and metaphors that ‘should not he pressed’, in reaching his conclusion that ‘the rock was Christ’, in 1 Corinthians 10:4c, it is indicated that Paul is indeed taking the original text, the (...) Old Testament’s interpretation of the text, and the Jewish tradition of the interpretation of the text, seriously, in the light of the Christ-event. To prove this claim, research of the text (Exodus 17:6 & Numbers 20:7–11), that Paul uses in 1 Corinthians 10:1–4, is followed by research of the ‘world in front of that text’ (Deuteronomy 32, the Psalms and Second Temple Judaism). Contribution : The conclusion that is reached indicates that Paul established within the context of contemporary Jewish practices, a true dialogical relationship between an intertextual handling of the text, and his interpretation thereof in the light of the relevance of the Christ-event for the conflict in the Church of Corinth. (shrink)

In this article, Paul's use of the Old Testament in 1 Corinthians 10:1-4 comes under scrutiny. In contrast with the theory of some modern scholars that Paul uses, 'fanciful analogies', 'startling figurative claims' and metaphors that 'should not he pressed', in reaching his conclusion that 'the rock was Christ', in 1 Corinthians 10:4c, it is indicated that Paul is indeed taking the original text, the Old Testament's interpretation of the text, and the Jewish tradition of the interpretation of the text, (...) seriously, in the light of the Christ-event. To prove this claim, research of the text, that Paul uses in 1 Corinthians 10:1-4, is followed by research of the 'world in front of that text'.CONTRIBUTION: The conclusion that is reached indicates that Paul established within the context of contemporary Jewish practices, a true dialogical relationship between an intertextual handling of the text, and his interpretation thereof in the light of the relevance of the Christ-event for the conflict in the Church of Corinth. (shrink)

Dishonesty is prevalent and causes great damage to society. On an individual level, besides reaping rewards, it also carries a psychological cost for those who engage in it. This principle is used to make people more honest with behavioral interventions, one of them being the well-known ‘signature nudge’. Digital transition in society has however led to changes in the way people sign, which may affect the effectiveness of this nudge. In two experiments, the current study investigates the relationship between digital (...) signatures and honesty, building on previous research by examining novel signature types, the moderating role of personal characteristics, effect decay, and the predicting value of digital signature characteristics. Results show no effect of any signature intervention and no unilateral relation between digital signature characteristics and subsequent behavior. These findings contrast with earlier research and cast doubt on the use of signature interventions as a tool to prevent or predict dishonest behavior. (shrink)

Dans ce livre, Ali Ouid Sidi retrace les parcours des explorateurs oubliés de Tombouctou ainsi que de leurs réalisations respectives. Il invite à une analyse objective du vecu quotidien des explorateurs au sein de la société tombouctienne, puis ovre le debat autour des composantes des maisons des explorateurs partie intégrante de la Medina de Tombouctou inscrite au Patrimoine national.

While Minsky’s work is often identified with the critique of financial speculation, this paper argues that there is a different side to his work. We argue that Minsky can be read as offering a post-foundational perspective on political economy that recognizes the speculative dimension of all economic activity. This post-foundational reading allows for an understanding of neoliberal policymaking in terms of the provision of liquidity to too-big-to-fail constituencies. The article discusses how some segments of Western societies have been able to (...) participate in the inflationary logic of this too-big-to-fail dynamic, whereas others are locked out and face increasingly tight liquidity constraints. This differential access to liquidity is an increasingly central aspect of the stratifying rationality of contemporary capitalism. By connecting Minsky’s insights into the temporal logic of capital to key issues in social theory, the article presents a new theorization of (il)liquid life that advances on extant accounts. (shrink)

Numerous countries are heading toward digital infrastructures. In particular this new technology promises to help support methods for elections. However, one should be careful that such an infrastructure does not hinder the voting and representation issues. On the contrary, it should support those issues and help citizens have a clearer picture of the underlying mechanisms. This paper deals with the limits of voting procedures as they are described in classical collective choice theory and reflects on ways to aggregate electronic votes (...) stemming from various individuals that would be at the same time democratic, decisive and rational which is not feasible when candidate rankings alone are taken into account. This paper shows how electronic voting procedures could improve the situation by introducing preference-based votes. (shrink)

BackgroundThe aim of this study is to compare depression and loneliness among adult siblings of people on the autism spectrum, adult siblings of normotypic individuals, and adults raised alone. In recent years, an increasing interest in the perspective of siblings of children diagnosed with autism has been observed, with studies among this population particularly concerned with the developmental trajectories of children and adolescents at “high risk” for ASD, rarely focusing on their mental well-being.MethodsThe respondents filled out: the survey on sociodemographic (...) data designed by the authors, Beck Depression Inventory II, and De Jong Gierveld Loneliness Scale.ResultsA rise in BDI and an increase in the DJGLS score were predicted by having a sibling diagnosed with ASD. Those effects were independent of subjects’ sex, educational status, place of residence, or a number of siblings.ConclusionThe results underline a fundamental need for the development of mental hygiene programs for families where children with autism spectrum are accompanied by healthy siblings. (shrink)

PART I : THE GOD-QUESTION TODAY -- God as a problem -- The denial of God in modern atheism -- The predicament of theology in the face of atheism -- Experience of God and knowledge of God -- Knowledge of God in faith. PART II : THE MESSAGE ABOUT THE GOD OF JESUS CHRIST -- God, the father almighty -- Jesus Christ, son of God -- The Holy Spirit, Lord, and giver of life. PART III : THE TRINITARIAN MYSTERY OF (...) GOD -- Establishment of the doctrine of the Trinity -- Exposition of the doctrine of the Trinity. (shrink)

In the current paper we present an instrumental approach to deception. This approach incorporates the notion that bargainers (a) will use deception as a means to reach their goals in bargaining but (b) will refrain from using deception when they have alternative means to reach their goals. We demonstrate that different goals can lead to differences in the use of deception (Experiment 1). Furthermore, we demonstrate that reactions to deceit can also be understood from an instrumental perspective (Experiment 2).

Recombination maps of ancestral species can be constructed from comparative analyses of genomes from closely related species, exemplified by a recently published map of the human‐chimpanzee ancestor. Such maps resolve differences in recombination rate between species into changes along individual branches in the speciation tree, and allow identification of associated changes in the genomic sequences. We describe how coalescent hidden Markov models are able to call individual recombination events in ancestral species through inference of incomplete lineage sorting along a genomic (...) alignment. In the great apes, speciation events are sufficiently close in time that a map can be inferred for the ancestral species at each internal branch ‐ allowing evolution of recombination rate to be tracked over evolutionary time scales from speciation event to speciation event. We see this approach as a way of characterizing the evolution of recombination rate and the genomic properties that influence it. (shrink)

Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the ‘natural death’ hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a ‘natural’ death by medical practitioners, patients' relatives (...) and patients.We attempt to show that the label ‘natural’ cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as ‘natural’ death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases. (shrink)