The search for living (relevant and significant) values in societies has become increasingly widespread and institutionalized through the last decades. The paper argues that there are serious theoretical limitations (biases) inherent in the most widespread survey techniques, which jeopardize their very reason for existence: to foresee directions of social and political change. In fact the predictions made on the basis of these techniques manage to reach partial confirmation, but none are uncontested on theoretical and/or empirical grounds. Starting from the statement (...) that empirical value inquiry continues to be very fragmented, the paper proceeds from critiques formulated on the basis of a hermeneutic analysis of survey methods to a comparison of these critiques with other attempts in the social sciences to treat the phenomenon of value. The third section of the paper relates the moral outlook of these surveys to another moral outlook seemingly operative nowadays: a global ethical vision. The section concludes that the value surveys fail to grasp both the ways values are organized and their dynamic because of their bias toward a Developmentalist ideology of world progress. (shrink)

Horizons is a critical inventory of value-related thinking, demonstrating that the mind has the ability to profile a distinctive circumstance in diverse ways. Readers are first invited to a historical inquiry into typical configurations of values, their collisions, and the worldviews that drive them. They are then introduced to the epistemologies employed by the social sciences, so that they are better able to gauge the potential of these disciplines for coming to terms with values. Axiology is portrayed as a field (...) that has broken free from its neo-Kantian roots, benefiting from challenging new conceptual frames based in documents with global reach-mainly the United Nations Universal Declaration of Human Rights. After scrutiny of what various sociological models claim about values and the way in which empirical surveys approach them, Horizons reaffirms the assumption that social life and its dynamics condition the fate of values. Yet, for the sake of more accurate accounts, research should consider to a greater extent social stratification, and pressing macrosocial problems such as environmental protection, sustainable development, and attainment of some form of global equity. Social sciences' limitations modulate their ability to serve as an unequivocal guide for value choices. These limitations are a problem because of the significance of the process of dialogue and deliberation in value-related fields. Rather than advancing the allegedly universal characteristics of any one culture, in a world consisting of many civilizations, the imperative is to acknowledge pluralism and discern what is held in common. (shrink)

Most of what has been written on the ECSC/ EEC/ EC/ EU, has not been done by international relations (IR) theorists, but by comparativists, sociologists, historians, anthropologists, legal scholars, and many others. These writings are in general classified as intergovernmentalist, federalist, and supranationalist (functionalist and neo- functionalist) in most accounts of the theoretical perspectives on the EU (Webb 1983, Rosamond 2000). Wiener and Diez 2004 add a rational choice institutional category, as well, as they think that the policy analysis within (...) the polity developed into an autonomous brand of literature. It is only Andrew Hurrell in his chapter in Fawcett and Hurrell 1995, who makes an attempt to present the EU, as a regional integration, from the point of view of diverse IR approaches. Drawing on his classification scheme, I conduct an inquiry of the IR theories about European unification from the point of view of whether they allow for the iteration of the European experience in other parts of the world or not. The basic conclusion is that almost all IR work on Europe falls in the inter- governmentalist category, which tends to conceptualize the European Union as representing an n of 1. (Inter- governmentalism is the choice of realism and neo-realism, English School, and neoliberal institutionalism.) Within the liberal IR paradigm, there is a tension between law-focused and security-focused approaches, on the one hand, and economic approaches, on the other. The first believe in the possibility of multiple integrations, while the latter does not think that they are desirable. Critical theories are also hindered by divergent normative commitments, though the class-based theorizing is very clear about pursuing the social control of markets. (shrink)

While scientific interest in the relationship between psychotherapeutic praxis and spirituality is growing, there is still little knowledge on this topic, especially in an East Central European context. To explore how psychotherapists understand spiritual issues and experiences they encounter in their work and to learn what happens to these issues in the course of psychotherapy, this study analyses semi-structured interviews with 30 Hungarian psychotherapists. Applying a grounded theory analytical strategy, three main topics were identified: the therapist's attitude towards spirituality leaves (...) a discernible trace in the psychoterapeutic treatment; the therapist influences the way spiritual issues are treated; and the therapist may have a shared spiritual experience with the client. We present individual variations of these experiences as they appear in the code tree. Results are interpreted with reference to a systemic view of the psychotherapeutic process, the intersubjective space of patient and therapist, and the notion of the therapists’ mentalizational capacity. (shrink)

Installation art is one of the most important and provocative developments in the visual arts during the last half century and has become a key focus of artists and of contemporary museums. It is also seen as particularly challenging or even disliked by many viewers, and—due to its unique in situ, immersive setting—is equally regarded as difficult or even beyond the grasp of present methods in empirical aesthetic psychology. In this paper, we introduce an exploratory study with installation art, utilizing (...) a collection of techniques to capture the eclectic, the embodied, and often the emotionally-charged viewing experience. We present results from an investigation of two pieces, both part of Olafur Eliasson’s exhibition “Baroque, Baroque” held at the Belvedere museum in Vienna. These were assessed by pre- and post-viewing questionnaires focusing on emotion, meaning-making, and appraisals, in tandem with mobile eye tracking to consider viewers’ attention to both installed artworks and/or to the museum environment. The data showed differences in participants’ emotional states, appraisals, and visual exploration, which together paint a picture of the aesthetic reactions to the works. These differences also showed how viewers’ appraisal strategies, meaning making, and physical actions facilitated relatively more or less deep engagement with, and enjoyment of, the art. The results are discussed in terms of their implications for museum studies, art education, and theory in empirical aesthetics. (shrink)

This volume explores how Catholicism began and continues to open its doors to the wider world and to other confessions in embracing ecumenism, thanks to the vision and legacy of the Second Vatican Council. It explores such themes as the twentieth century context preceding the council; parallels between Vatican II and previous councils; its distinctively pastoral character; the legacy of the council in relation to issues such as church-world dynamics, as well as to ethics, social justice, economic activity. Several chapters (...) discuss the role of women in the church before, during, and since the council. Others discern inculturation in relation to Vatican II. The book also contains a wide and original range of ecumenical considerations of the council, including by and in relation to Free Church, Reformed, Orthodox, and Anglican perspectives. Finally, it considers the Council’s ongoing promise and remaining challenges with regard to ecumenical issues, including a groundbreaking essay on the future of ecumenical dialogue by Cardinal Walter Kasper. (shrink)

For over 20 years, the Schmid Training Course (STC) has offered unique opportunities for marine biology students from European universities to learn about marine model organisms. While the topics of the course have continuously changed over the years with the advent of new research techniques and discoveries, the pedagogical approach has remained largely the same – a combination of lectures, lab practicals, and field excursions. Several life science researchers, who have taught in the STC for many years, sought to bring (...) the course's pedagogical approach into the 21st century, and with the support of Erasmus+ Programme of the European Community funding, the Digital Marine project was developed. Digital Marine began in 2018 as an international partnership between the six research centers from which the STC instructors hail, and its main objective was to introduce a flipped, blended approach to learning and teaching with respect to established and emerging marine biological model systems. The Digital Marine platform, which covers 12 marine model organisms, is now publicly available. (shrink)

Volume 74 in the series Hallesche Beiträge zur Europäischen Aufklärung -/- Die vor-autonome und noch nicht auf das Feld der Künste beschränkte Ästhetik des ›langen 18. Jahrhunderts‹ strebte eine interdisziplinäre und internationale Kommunikationspraxis an, die eine universelle Verständigung unter den Menschen ermöglichen sollte. -/- Der Band versammelt Beiträge zu der europäischen Geschichte dieser anthropologisch ausgerichteten ästhetischen Kommunikation. Die Aufsätze der ersten Sektion beschäftigen sich mit der zeitgenössichen Theorie der ästhetischen Wissensvermittlung: Es wird die fachübergreifende (Proto-) Ästhetik Shaftesburys und Addisons, die (...) Sprachtheorie von Coleridge bzw. die schwierige Einbürgerüng der Disziplin ›Ästhetik‹ in Frankreich thematisiert. Im zweiten Teil beschäftigen sich zwei Aufsätze mit der Kommunikation durch Bilder, anhand der Analyse von Gemälden Jean-Siméon Chardins und Caspar David Friedrichs. Die Bedeutung des Bild- und Erzählstoffes ›Herkules am Scheideweg‹ für Wielands ästhetische Kommunikation wird hier ebenfalls behandelt. Die dritte Sektion enthält Untersuchungen zu zwei wichtigen Gattungen der ästhetischen Kommunikation. Es werden zunächst unterschiedliche Varianten des Genres Traumerzählung bei Johann Gottlob Krüger und Mihály Vörösmarty beleuchtet. Der Band schließt mit der Analyse von József Eötvös’ Künstlerroman Der Karthäuser. -/- Die Fallstudien tragen zu dem besseren Verständnis einer Ästhetik bei, die die Bildung der Menschen durch intersubjektive Kommunikation vorantreiben wollte. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

One of the fundamental questions raised by Ruchkin, Grafman, Cameron, and Berndt's (Ruchkin et al.'s) interpretation of no distinct specialized neural networks for short-term storage buffers and long-term memory systems, is that of the link between perception and memory processes. In this framework, we take the opportunity in this commentary to discuss a specific working memory task involving percept formation, temporary retention, auditory imagery, and the attention-based maintenance of information, that is, the verbal transformation effect.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Background The rapidly growing quantity of health data presents researchers with ample opportunity for innovation. At the same time, exploitation of the value of Big Data poses various ethical challenges that must be addressed in order to fulfil the requirements of responsible research and innovation (Gerke et al. 2020 ; Howe III and Elenberg 2020 ). Data sovereignty and its principles of self-determination and informed consent are central goals in this endeavor. However, their consistent implementation has enormous consequences for the (...) collection and processing of data in practice, especially given the complexity and growth of data in healthcare, which implies that artificial intelligence (AI) will increasingly be applied in the field due to its potential to unlock relevant, but previously hidden, information from the growing number of data (Jiang et al. 2017 ). Consequently, there is a need for ethically sound guidelines to help determine how data sovereignty and informed consent can be implemented in clinical research. Methods Using the method of a narrative literature review combined with a design thinking approach, this paper aims to contribute to the literature by answering the following research question: What are the practical requirements for the thorough implementation of data sovereignty and informed consent in healthcare? Results We show that privacy-preserving technologies, human-centered usability and interaction design, explainable and trustworthy AI, user acceptance and trust, patient involvement, and effective legislation are key requirements for data sovereignty and self-determination in clinical research. We outline the implications for the development of IT solutions in the German healthcare system. (shrink)

Le Relais de Sceaux (clinique Dupré, Fondation santé des étudiants de France), qui reçoit des adolescents et jeunes adultes et leurs familles, est une porte d’entrée aux soins médico-psychologiques. À partir de 2013, l’ouverture de l’accueil aux 11-15 ans a bouleversé le fonctionnement de départ du Relais. À côté du dispositif d’accueil sans rendez-vous des 16-25 ans, un protocole spécifique adapté aux collégiens a été mis en place. Il s’appuie sur un contact téléphonique avec les parents préparant la première rencontre. (...) Via une situation clinique, les auteurs, psychologues et psychiatres exerçant au Relais de Sceaux, exposent les spécificités cliniques de collégiens pour lesquels la rencontre familiale est un préalable indispensable à l’instauration d’un soin psychique individualisé. (shrink)

The article reveals a study of the ethical competence formation of students at medical universities. This competence includes theoretical knowledge of professional ethics, professional and ethical value orientations, moral and personal qualities and practical skills of a doctor in the professional activity. Formation of ethical competence provides for the doctor’s conscious ethical behavior in accordance with professional and ethical standards, as well as the need for professional and ethical self-improvement throughout life. The results of the study allowed to establish the (...) availability of reserves to improve the quality of future doctors’ training and formation of their ethical competence. Taking into account the trends of globalization of the educational sphere, the impact of postmodernism on the formation and development of value orientations of student youth, the emergence of new forms of ethical values, etc., it is assumed that the this competence formation will be effective if at different stages of students’ training at medical universities there will be introduced pedagogical conditions that enhance functioning of the main subsystems of the educational process. These stages correspond to the peculiarities of students’ professional and personal development during different years of study and in view of their cognitive abilities. Experimental verification of the effectiveness of pedagogical conditions for the formation of future doctors’ ethical competence at medical universities confirmed the validity of the research hypothesis. At the same time summarizing of the research results revealed certain influence of the tendencies of traditionalism, universalism and pragmatic motives on the future doctors’ value-motivational sphere. (shrink)

Although euthanasia and assisted suicide in people with psychiatric disorders is relatively rare, the increasing incidence of EAS requests has given rise to public and political debate. This study aimed to explore support of the public and physicians for euthanasia and assisted suicide in people with psychiatric disorders and examine factors associated with acceptance and conceivability of performing EAS in these patients. A survey was distributed amongst a random sample of Dutch 2641 citizens and 3000 physicians. Acceptance and conceivability of (...) performing EAS, demographics, health status and professional characteristics were measured. Multivariable logistic regression analyses were performed. Of the general public 53% were of the opinion that people with psychiatric disorders should be eligible for EAS, 15% was opposed to this, and 32% remained neutral. Higher educational level, Dutch ethnicity, and higher urbanization level were associated with higher acceptability of EAS whilst a religious life stance and good health were associated with lower acceptability. The percentage of physicians who considered performing EAS in people with psychiatric disorders conceivable ranged between 20% amongst medical specialists and 47% amongst general practitioners. Having received EAS requests from psychiatric patients before was associated with considering performing EAS conceivable. Being female, religious, medical specialist, or psychiatrist were associated with lower conceivability. The majority of the psychiatrists were of the opinion that it is possible to establish whether a psychiatric patient’s suffering is unbearable and without prospect and whether the request is well-considered. The general public shows more support than opposition as to whether patients suffering from a psychiatric disorder should be eligible for EAS, even though one third of the respondents remained neutral. Physicians’ support depends on their specialization; 39% of psychiatrists considered performing EAS in psychiatric patients conceivable. The relatively low conceivability is possibly explained by psychiatric patients often not meeting the eligibility criteria. (shrink)

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

IntroductionCouple violence (CV) affects many, and the consequences of those actions are grave, not only for the individual suffering at the hand of the perpetrator but also for the other persons in the family. Violence often happens among more than just the adults within one family. Even if CV has been thoroughly investigated in the general population very few studies have investigated this objective on a clinical sample, and none of these have included family violence.AimThis article identifies and describes the (...) group of clients that have issues of physical couple and family violence. It analyses a model that can help to discover physical violence and help therapists to assess what actions to take in therapy to prevent further physical violence.MethodologyDescriptive analysis, t-tests, and structural equation modeling (SEM) are used on a sample of clients receiving couple and family therapy (CFT) in Norway (N = 830). Family violence is modeled by the partner’s expectations toward each other, levels of anger, sexual satisfaction, and self-control.ResultsOne-in-five clients experienced physical CV in their current relationship and one-in-four experienced physical family violence. The group of clients who experienced CV differed from those without such experiences in having lower income, more prior experience with psychotherapy, more experience with alcohol abuse in childhood, and far more physical family violence in their current family. Our model predicting physical coupl... (shrink)

In vocational rehabilitation, empowerment is understood as the notion that people should make an active, autonomous choice to find their way back to the labour process. Following this line of reasoning, the concept of empowerment implicitly points to a specific kind of activation strategy, namely labour participation. This activation approach has received criticism for being paternalistic, disciplining and having a one-sided orientation on labour participation. Although we share this theoretical criticism, we want to go beyond it by paying attention to (...) the practical consequences of understanding empowerment as an activation strategy. Inspired by the field of Science and Technology Studies, we will explore the meaning of empowerment and activation in concrete practices of vocational rehabilitation in the Netherlands. Our analysis is based on the narratives of people with a work disability about their lives and the vocational rehabilitation programmes they participated in. We present five illustrative cases that how empowerment is ‘done’ in the practice of vocational rehabilitation and its unintended effects. Our analysis demonstrates that activation strategies seem to be caught in a paradox: instead of including people in society, they have excluding consequences. Vocational rehabilitation professionals can go beyond this paradox by learning from the ways in which empowerment is ‘done’ by clients in vocational rehabilitation programmes. (shrink)

Objections to the use of historical case studies for philosophical ends fall into two categories. Methodological objections claim that historical accounts and their uses by philosophers are subject to various biases. We argue that these challenges are not special; they also apply to other epistemic practices. Metaphysical objections, on the other hand, claim that historical case studies are intrinsically unsuited to serve as evidence for philosophical claims, even when carefully constructed and used, and so constitute a distinct class of challenge. (...) We show that attention to what makes for a canonical case can address these problems. A case study is canonical with respect to a particular philosophical aim when the features relevant to that aim provide a reasonably complete causal account of the results of the historical process under investigation. We show how to establish canonicity by evaluating relevant contingencies using two prominent examples from the history of science: Eddington’s confirmation of Einstein’s theory of general relativity using his data from the 1919 eclipse and Watson and Crick’s determination of the structure of DNA. (shrink)

Know -wh ascriptions are ubiquitous in many languages. One standard analysis of know -wh is this: someone knows-wh just in case she knows that p, where p is an answer to the question included in the wh-clause. Additional conditions have also been proposed, but virtually all analyses assume that propositional knowledge of an answer is at least a necessary condition for knowledge-wh. This paper challenges this assumption, by arguing that there are cases where we have knowledge-wh without knowledge- that of (...) an answer, for example in the cases familiar from arguments for the Extended Mind hypothesis. (shrink)

Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents (...) in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/protective highlights counter normative consequences and opposes the use enhancers. The Individual/proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern. (shrink)

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain. We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Of the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly (...) relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Of the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. (shrink)

Background Studies describing physicians’ experiences with sedation at the end of life are indispensible for informed palliative care practice, but they are scarce. We describe the accounts of physicians from the USA and the Netherlands, two countries with different regulations on end-of-life decisions regarding their use of sedation.Methods Qualitative face-to-face interviews were held in 2007–2008 with 36 physicians , including primary care physicians and specialists. We applied purposive sampling and conducted constant comparative analyses.Results In both countries, the use of sedation (...) was described in diverse terms, especially in the USA, and was often experienced as emotionally challenging. Respondents stated different and sometimes multiple intentions for their use of sedation. Besides alleviating severe suffering, most Dutch respondents justified its use by stating that it does not hasten death, while most American respondents indicated that it might hasten death but that this was justifiable as long as that was not their primary intention. While many Dutch respondents indicated that they initiated open discussions about sedation proactively to inform patients about their options and to allow planning, the accounts of American respondents showed fewer and less-open discussions, mostly late in the dying process and with the patient's relatives.Conclusions The justification for sedation and the openness with which it is discussed were found to differ in the accounts of respondents from the USA and the Netherlands. Further clarification of practices and research into the effect and effectiveness of the use of sedation is recommended to enhance informed reflection and policy making. (shrink)

Aspiration by Agnes Callard locates standing assumptions in the theory of rationality, moral psychology and autonomy that preclude the possibility of working to acquire new values. The book also explains what changes need to be made if we are to make room for this form of agency, which I call aspiration.

Recent studies have shown that schizophrenia may be a disease affecting the states of consciousness. The present study is aimed at investigating metamemory, i.e., the knowledge about one's own memory capabilities, in patients with schizophrenia. The accuracy of the Confidence level (CL) in the correctness of the answers provided during a recall phase, and the predictability of the Feeling of Knowing (FOK) when recall fails were measured using a task consisting of general information questions and assessing semantic memory. Nineteen outpatients (...) were paired with 19 control subjects with respect to age, sex, and education. Results showed that patients with schizophrenia exhibited an impaired semantic memory. CL ratings as well as CL and FOK accuracy were not significantly different in the schizophrenic and the control groups. However, FOK ratings were significantly reduced for the patient group, and discordant FOK judgments were also observed more frequently. Such results suggest that FOK judgments are impaired in patients with schizophrenia, which confirms that schizophrenia is an illness characterized by an impaired conscious awareness of one's own knowledge. (shrink)

On the dust jacket of The Subject's Point of View there is a detail from Vilhelm Hammershoi's Interior with Sitting Woman. It is hard to think of a painter who better captures the inner in his work. From the monochrome colour, to the back that faces us, to the door swung open to reveal yet another doorway, we are led to interiority – to the inner. This is a perfect image for a book whose author wants to persuade us to (...) return to the interior – a Cartesian interior.The Cartesian interior has come in for quite a drubbing in philosophy for some considerable time. In the mid-to-late 1970s, a style of argument emerged, designed to challenge this conception of mind and establish in its place an externalist conception of language and of mind. One version of the argument was due to Hilary Putnam and emerged in the context of considerations concerning linguistic meaning; another was due to Tyler Burge and emerged first in the context of considerations concerning the individual in relation to his/her social environment. In his earliest paper, on this topic, Burge wrote of ‘the elderly Cartesian tradition’ where ‘the spotlight is on what exists or transpires “in” the individual – his secret cognition, his innate cognitive structures, his private perceptions and introspections, his grasping of ideas, concepts or forms’. Farkas wants to defend this ‘elderly tradition’, but she does add to it some interesting twists. First and foremost, she places to one side ideas of privacy, of incorrigibility and infallibility. She also wishes to place the issue of dualism to one side. What Farkas concentrates on is privileged access and argues that this is …. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)