ABSTRACT Over the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in (...) medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the ‘special status of human beings’; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation‐stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

Though we humans are immensely more gifted than other animals, yet we are not the outcome of an inevitable selection of the ‘fittest’. Nor on the other hand is our importance diminished by our evolutionary inheritance. Besides, we are already here! Faith in inevitable progress is a ‘scientific’, not a Christian, delusion. We realise that the universe has its own rules and complications which intrude on our lives and often thwart our choices. It is therefore legitimate to talk of chance, (...) but we often fail to appreciate the real significance of this word. Chance is not a cause; in essence it refers to our own consciousness that we are immersed in circumstance, and it has no reality without our own purposiveness. Thus chance is not some blind and indifferent or even hostile cosmic mystery; it is the occasion of our own responses, and it even offers the opportunity of human growth. Just as we accept the laws (and dangers) of physics (e.g. gravitation), as the framework of our ordered existence, so also we may accept the surprises of chance without any despairing conclusion either from our latest researches in astronomy or from a fatal accident in the street. (shrink)

Context: Strict finitism is usually not taken seriously as a possible view on what mathematics is and how it functions. This is due mainly to unfamiliarity with the topic. Problem: First, it is necessary to present a “decent” history of strict finitism and, secondly, to show that common counterarguments against strict finitism can be properly addressed and refuted. Method: For the historical part, the historical material is situated in a broader context, and for the argumentative part, an evaluation of arguments (...) and counterarguments is presented. Results: The main result is that strict finitism is indeed a viable option, next to other constructive approaches, in mathematics. Implications: Arguing for strict finitism is more complex than is usually thought. For future research, strict finitist mathematics itself needs to be written out in more detail to increase its credibility. In as far as strict finitism is a viable option, it will change our views on such “classics” as the platonist-constructivist discussion, the discovery-construction debate and the mysterious applicability problem . Constructivist content: Strict finitism starts from the idea that counting is an act of labeling, hence the mathematician is an active subject right from the start. It differs from other constructivist views in that the finite limitations of the human subject are taken into account. (shrink)

In spite of the seminal work A Philosophical Basis of Medical Practice, the debate on the task and goals of philosophy of medicine still continues. From an European perspective it is argued that the main topics dealt with by Pellegrino and Thomasma are still particularly relevant to medical practice as a healing practice, while expressing the need for a philosophy of medicine. Medical practice is a discursive practice which is highly influenced by other discursive practices like science, law and economics. (...) Philosophical analysis of those influences is needed to discern their effect on the goals of medicine and on the ways in which the self-image of man may be changed. The nature of medical practice and discourse itself makes it necessary to include different philosophical disciplines, like philosophy of science, of law, ethics, and epistemology. Possible scenario's of euthanasia and the human genome project in the USA and Europe are used to exemplify how philosopy of medicine can contribute to a realistic understanding of the problems which are related to the goals of medicine and health care. (shrink)

Various issues concerning the neural blackboard architectures for combinatorial structures are discussed and clarified. They range from issues related to neural dynamics, the structure of the architectures for language and vision, and alternative architectures, to linguistic issues concerning the language architecture. Particular attention is given to the nature of true combinatorial structures and the way in which information can be retrieved from them in a productive and systematic manner.

Logics of communication should provide accounts of changes in the state of information of a group of discourse participants, on the basis of message exchanged within the group. We will give an overview of the way this is done in dynamic epistemic logics, focussing on a number of different types of informative actions with their epistemic effects, and indicating the relevance of this work for semantics and pragmatics of natural language. At the end of the talk we will sketch a (...) recent result on translating logics for generic epistemic updating into PDL (propositional dynamic logic). (shrink)

Confusion concerning the issue of universality of colour categorization would greatly diminish if context regains its fundamental status in psychological research and we give up on the reductionist notion that biological universality implies behavioral universality.

Given a cofinal cardinal function $h\in {}^{\kappa }\kappa $ for $\kappa $ inaccessible, we consider the dominating h-localisation number, that is, the least cardinality of a dominating set of h-slaloms such that every $\kappa $ -real is localised by a slalom in the dominating set. It was proved in [3] that the dominating localisation numbers can be consistently different for two functions h (the identity function and the power function). We will construct a $\kappa ^+$ -sized family of functions h (...) and their corresponding localisation numbers, and use a ${\leq }\kappa $ -supported product of a cofinality-preserving forcing to prove that any simultaneous assignment of these localisation numbers to cardinals above $\kappa $ is consistent. This answers an open question from [3]. (shrink)

(2009). How automatic is “automatic vigilance”? The role of working memory in attentional interference of negative information. Cognition & Emotion: Vol. 23, No. 6, pp. 1106-1117.

An established ethical principle of biomedical research involving human subjects stipulates that risk to subjects should be proportionate to an experiment’s potential benefits. Sometimes this principle is imprecisely stated as a requirement that ‘risks and benefits’ be balanced. First, it is noted why this language is imprecise. Second, the persistence of such language is attributed to how it functions as a rhetorical trope. Finally, an argument is made that such a trope is infelicitous because it may not achieve its intended (...) persuasive purposes. More importantly, it should be avoided because it masks the important role that chance plays in clinical research. Risk is the possibility of harm. As a precondition of harm it is unintended and undesirable in projects of biomedical research. It requires ethical vigilance. As a vehicle of chance, however, it is both intended and desirable. It requires methodological appreciation. (shrink)

This collection is a unique joint venture of teachers in, and practitioners of military ethics.

Dislocation phenomena in natural language can be, and often are, thought of as the effects of movement transformations. We propose to handle these phenomena in terms of parser combinators [3, 8] that transform recursive descent parsers for a ‘deep structure language’ into parsers for a ‘surface structure language’. This combinator approach to extraction keeps close to the ‘movement’ intuition and gives a computational account of the well known island constraints on extraction first proposed in [7].

The aim of this article is to provide a preliminary ethical evaluation of the effect of telesurgery on patient care. In order to accomplish this task we give a broad description of the state of the art in telesurgery and analyse it using Joan Tronto’s articulation of care as a structured process. This structure illuminates the significance of the patient-physician relationship as the buttress for establishing and preserving practices of care in the healthcare context, with the ultimate goal of safeguarding (...) patient dignity. The process of care combined with the moral aim of medicine—to fulfil the good of the patient—provides the ethical foundation for assessing telesurgery. By exploring various telesurgical scenarios we may assess its potential role in augmenting or diminishing patient care within the frame of the patient-physician relationship. The significance of conducting this evaluation lies in the fact that the practice of telesurgery may very shortly become routine and an evaluation has not yet been attempted. (shrink)