God in the Courtroom: The Transformation of Courtroom Oath and Perjury between Islamic and Franco-Egyptian Law. By Guy Bechor. Studies in Islamic Law and Society, vol. 34. Leiden: Brill, 2012. Pp. xv + 412. $196.

An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...) qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

Suppose that you must make choices that may influence the well-being and the identities of the people who will exist, though not the number of people who will exist. How ought you to choose? This paper answers this question. It argues that the currency of distributive ethics in such cases is a combination of an individual’s final well-being and her expected well-being conditional on her existence. It also argues that this currency should be distributed in an egalitarian, rather than a (...) prioritarian, manner. (shrink)

Many believe that we ought to save a large number from being permanently bedridden rather than save one from death. Many also believe that we ought to save one from death rather than a multitude from a very minor harm, no matter how large this multitude. I argue that a principle I call “Aggregate Relevant Claims” satisfactorily explains these judgments. I offer a rationale for this principle and defend it against objections.

Can we trust our intuitive judgments of right and wrong? Are moral judgements objective? What reason do we have to do what is right and avoid doing what is wrong? In Conversations on Ethics, Alex Voorhoeve elicits answers to these questions from eleven outstanding philosophers and social scientists: -/- Ken Binmore; Philippa Foot; Harry Frankfurt; Allan Gibbard; Daniel Kahneman; Frances Kamm; Alasdair MacIntyre; T. M. Scanlon; Peter Singer; David Velleman; Bernard Williams. -/- The exchanges are direct, open, and sharp, (...) and give a clear account of these thinkers' core ideas about ethics. They also provide unique insights into their intellectual development - how they became interested in ethics, and how they conceived the ideas for which they became famous. Conversations on Ethics will engage anyone interested in moral philosophy. (shrink)

This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to (...) their specific moral position and responsibility, nurses' contribution to ethical reflection in ward discussions should be valued more. All caregivers involved are indispensable in developing a basis for well-reasoned decisions when deliberating about moral problems. (shrink)

We summarize key messages from the World Bank report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. A central lesson of the Report is that in decision-making on the path to UHC, procedural fairness matters alongside substantive fairness. Decision systems should be assessed using a complete conception of procedural fairness that embodies core commitments to impartial and equal consideration of interests and perspectives. These commitments demand that comprehensive information is gathered and disclosed and that justifications for policies are (...) publicly debated; that participation in decision-making is enabled; and that these characteristics of the decision system are institutionalised rather than up to the good will of decision-makers. Procedural fairness can improve equity in outcomes, raise legitimacy and trust, and can help make reforms last. While improving procedural fairness can be costly and there are barriers to achieving it, the range of instruments that countries at varying levels of income and institutional capacity have used with some success shows that, in many contexts, advances in procedural fairness in health financing are possible and worthwhile. (shrink)

In response to our critics, we clarify and defend key ideas in the report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. First, we argue that procedural fairness has greater value than Dan Hausman allows. Second, we argue that the Report aligns with John Kinuthia’s view that a knowledgeable public and a capable civil society, alongside good facilitation, are important for effective public deliberation. Moreover, we agree with Kinuthia that the Report’s framework for procedural fairness applies not merely (...) within the health sector, but also to the wider budget process. Third, we argue that while Dheepa Rajan and Benjamin Rouffy-Ly are right that robust processes for equal participation are often central to a fair process, sometimes improvements in other aspects of procedural fairness, such as transparency, can take priority over strengthening participation. Fourth, while we welcome Sara Bennett and Maria Merritt’s fascinating use of the Report’s principles of procedural fairness to assess the U.S. President’s Emergency Plan for AIDS Relief, we argue that their application of the Report’s principle of equality to development partners’ decision-making requires further justification. (shrink)

An conversation with Harry Frankfurt about his views on love, free will, and responsibility, as well as his general approach to philosophy. (Note: a revised version appears in Alex Voorhoeve, Conversations on Ethics, OUP 2009).

This paper provides a Christian philosophical and theological response to the moral imperative of human advancement through multiplanetarism as emerging from the Great Filter theory. First, it explains the Fermi paradox that underlies the Great Filter theory. Next, it explores this theory itself and its motivational power in driving advancement toward multiplanetarism. In particular, we explore two motives behind the multiplanetary efforts that are (in part) guided by the Great Filter theory, analyzing the relevant statements of SpaceX founder and chief (...) engineer Elon Musk. Finally, we assess these motivations (and the accompanying normative assumptions) behind space exploration and multiplanetarism from the perspective of Reformational philosophy, using Herman Dooyeweerd’s theory of ground motives as a lens. Thus, the paper’s leading research question is this: How can we assess the current attempts at securing a multiplanetary existence for humankind in the light of Dooyeweerd’s theory of ground motives? (shrink)

In 'Rethinking the Good', Larry Temkin makes two core claims. First, the goodness of a distribution is sometimes ‘essentially comparative’ – it sometimes depends on which alternative distribution(s) it is compared to. Second, such cases threaten the transitivity of ‘all things considered better than’. I argue that the goodness of a distribution may indeed depend on what other distributions are feasible. But contrary to Temkin, I also argue that transitivity holds even when the goodness of a distribution depends on the (...) feasible set of which it is a member. (shrink)

Preferences are often thought to be relevant for well-being: respecting preferences, or satisfying them, contributes in some way to making people's lives go well for them. A crucial assumption that accompanies this conviction is that there is a normative standard that allows us to discriminate between preferences that do, and those that do not, contribute to well-being. The papers collected in this volume, written by moral philosophers and philosophers of economics, explore a number of central issues concerning the formulation of (...) such a normative standard. They examine what a defensible account of how preferences should be formed for them to contribute to well-being should look like; whether preferences are subject to requirements of rationality and what reasons we have to prefer certain things over others; and what the significance is, if any, of preferences that are arational or not conducive to well-being. (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

Clarifying and analysing moral problems arising in the practice of palliative care was the objective of participatory observations in five palliative care settings. The results of these observations will be described in this contribution. The moral problems palliative caregivers have to deal with in their daily routines will be explained by comparison with the findings of a previously performed literature study. The specific differences in the manifestation of moral problems in the different palliative care settings will be highlighted as well.

When one faces competing claims of varying strength on public resources for health, which claims count? This paper proposes the following answer. One should count, or aggregate, a person’s claim just in case one could sympathize with her desire to prioritize her own claim over the strongest competing claim. It argues that this principle yields appealing case judgments and has a plausible grounding in both sympathetic identification with each person, taken separately, and respect for the person for whom most is (...) at stake. It also defends this principle against several heretofore unanswered objections. (shrink)

Ibn al-Sāʿī, Consorts of the Caliphs: Women and the Court of Baghdad. Edited by Shawkat M. Toorawa, translated by Editors of LAL. Library of Arabic Literature. New York: New York University Press, 2015. Pp. xlv + 226. $30.

From an interdisciplinary perspective the authors of this book, scholars in theology and religious studies, give an account of the problematic and promising aspects of biblically based monotheism, considered as a formative religious idea, belief, and practice in Western history and culture.

From an interdisciplinary perspective the authors of this book, scholars in theology and religious studies, give an account of the problematic and promising aspects of biblically based monotheism, considered as a formative religious idea, belief, and practice in Western history and culture.

This article proposes the use of agent-based simulation to analyze complex design trade-offs that involve value tensions. This is illustrated by a case study in the domain of train traffic control. In this case, agent-based simulation supported the involvement of stakeholders and increased understanding of a design trade-off.

In some severely uncertain situations, exemplified by climate change and novel pandemics, policymakers lack a reasoned basis for assigning probabilities to the possible outcomes of the policies they must choose between. I outline and defend an uncertainty averse, egalitarian approach to policy evaluation in these contexts. The upshot is a theory of distributive justice which offers especially strong reasons to guard against individual and collective misfortune.

Common principles for resource allocation in health care can prioritize the alleviation of small health burdens over lifesaving treatment. I argue that there is some evidence that these principles are at odds with a sizable share of public opinion, which holds that saving a life should take priority over any number of cures for minor ailments. I propose two possible explanations for this opinion, one debunking and one vindicatory. I also outline how well-designed surveys and moral inquiry could help decide (...) between them. Finally, I consider how priority-setting principles could be adjusted if the view that saving a life always trumps alleviating small burdens were vindicated. (shrink)

A possible person’s conditional expected well-being is what the quality of their prospects would be if they were to come into existence. This paper examines the role that this form of expected well-being should play in distributing benefits among prospective people and in deciding who to bring into existence. It argues for a novel egalitarian view on which it is important to ensure equality in people’s life prospects, not merely between actual individuals, but also between all individuals who, given our (...) choices, have a chance of coming into existence. The paper argues that such egalitarianism for prospective people springs from equal concern for each person and has plausible implications. It further shows that it has a rationale in respect for both the unity of the individual and the separateness of persons. Finally, it defends this view against a key objection and shows it is superior to a rival view. (shrink)

We offer a summary of the WHO Report "Making Fair Choices on the Path to Universal Health Coverage".

I argue that Scanlon's Value of Choice View does not offer a plausible account of substantive responsibility. I offer a new account, which I call the Potential Value of Opportunities View. On this view, when a person is in a position to freely and capably make an informed choice, we assess her situation not by the outcome she achieves but by the potential value of her opportunities. This value depends on the value of the various things that she can achieve (...) through her choices, as well as on how disposed she is to choose her better options and avoid her worse options. This view explains the priority we give to preventing harm that a person cannot avoid by choosing appropriately over harm that a person can so avoid by the fact that the second person has a valuable opportunity that the first does not have. It explains the importance of protecting people against choosing badly by the value of being placed in circumstances in which one is disposed to choose well, and the disvalue of being exposed to the danger of coming to harm by choosing badly. (shrink)

This short piece contrasts, and critically analyses, Brian Barry's and J.S. Mill's ideas about the foundations of liberal rights.

We use probability-matching variations on Ellsberg’s single-urn experiment to assess three questions: (1) How sensitive are ambiguity attitudes to changes from a gain to a loss frame? (2) How sensitive are ambiguity attitudes to making ambiguity easier to recognize? (3) What is the relation between subjects’ consistency of choice and the ambiguity attitudes their choices display? Contrary to most other studies, we find that a switch from a gain to a loss frame does not lead to a switch from ambiguity (...) aversion to ambiguity neutrality and/or ambiguity seeking. We also find that making ambiguity easier to recognize has little effect. Finally, we find that while ambiguity aversion does not depend on consistency, other attitudes do: consistent choosers are much more likely to be ambiguity neutral, while ambiguity seeking is much more frequent among highly inconsistent choosers. (shrink)

Philippe van Parijs (2003) has argued that an egalitarian ethos cannot be part of a post- Political Liberalism Rawlsian view of justice, because the demands of political justice are confined to principles for institutions of the basic structure alone. This paper argues, by contrast, that certain principles for individual conduct—including a principle requiring relatively advantaged individuals to sometimes make their economic choices with the aim of maximising the prospects of the least advantaged—are an integral part of a Rawlsian political conception (...) of justice. It concludes that incentive payments will have a clearly limited role in a Rawlsian theory of justice. (shrink)

A persistent argument against the transitivity assumption of rational choice theory postulates a repeatable action that generates a significant benefit at the expense of a negligible cost. No matter how many times the action has been taken, it therefore seems reasonable for a decision-maker to take the action one more time. However, matters are so fixed that the costs of taking the action some large number of times outweigh the benefits. In taking the action some large number of times on (...) the grounds that the benefits outweigh the costs every time, the decision-maker therefore reveals intransitive preferences, since once she has taken it this large number of times, she would prefer to return to the situation in which she had never taken the action at all. We defend transitivity against two versions of this argument: one in which it is assumed that taking the action one more time never has any perceptible cost, and one in which it is assumed that the cost of taking the action, though (sometimes) perceptible, is so small as to be outweighed at every step by the significant benefit. We argue that the description of the choice situation in the first version involves a contradiction. We also argue that the reasoning used in the second version is a form of similarity-based decision-making. We argue that when the consequences of using similarity-based decision-making are brought to light, rational decision-makers revise their preferences. We also discuss one method that might be used in performing this revision. (shrink)

How should governments balance saving people from very large individual disease burdens (such as an early death) against saving them from middling burdens (such as erectile dysfunction) and minor burdens (such as nail fungus)? This chapter considers this question through an analysis of a priority-setting proposal in the Netherlands, on which avoiding a multitude of middling burdens takes priority over saving one person from early death, but no number of very small burdens can take priority over avoiding one death. It (...) argues that there is some, albeit imperfect, evidence of substantial public support for such a policy. Furthermore, it provides a principled rationale for it in terms of respect for the person who faces the largest burden. (shrink)

The difference between the unity of the individual and the separateness of persons requires that there be a shift in the moral weight that we accord to changes in utility when we move from making intrapersonal tradeoffs to making interpersonal tradeoffs. We examine which forms of egalitarianism can, and which cannot, account for this shift. We argue that a form of egalitarianism which is concerned only with the extent of outcome inequality cannot account for this shift. We also argue that (...) a view which is concerned with both outcome inequality and with the unfairness of inequality in individuals‘ expected utilities can account for this shift. Finally, we limn an alternative view, on.. (shrink)

When do claims to be saved of a small or moderate harm aggregate against a competing claim to be saved from an early death? In this short response to Kamm's Bioethical Prescriptions, I argue for the following answer: aggregation of weaker claims against a life is permitted just in case, in a one-to-one contest, a person with a weaker claim would have a personal prerogative to prioritize her claim over a stranger’s competing claim to life.

I outline and defend two egalitarian theories, which yield distinctive and, I argue, complementary answers to why health-related inequalities matter: a brute luck egalitarian view, according to which inequalities due to unchosen, differential luck are bad because unfair, and a social egalitarian view, according to which inequalities are bad when and because they undermine people’s status as equal citizens. These views identify different objects of egalitarian concern: the brute luck egalitarian view directs attention to health-related well-being, while social egalitarianism focuses (...) on health-related capabilities that are central to a person’s status as a citizen. I argue that both views are correct and should jointly guide priority-setting in health. (shrink)

Epicurus argued that the good life is the pleasurable life. He also argued that “death is nothing to us”. These claims appear in tension. For, if pleasure is good, then it seems that death is bad when it deprives us of deeply enjoyable time alive. Here, I offer an Epicurean view of pleasure and the complete life which dissolves this tension. This view is, I contend, more appealing than critics of Epicureanism have allowed, in part because it assigns higher value (...) to pleasures that we produce by exercising our rational capacities and by establishing control over our lives. (shrink)

Stuart Rachels and Larry Temkin have offered a purported counterexample to the acyclicity of the relationship “all things considered better than”. This example invokes our intuitive preferences over pairs of alternatives involving a single person’s painful experiences of varying intensity and duration. These preferences, Rachels and Temkin claim, are confidently held, entirely reasonable, and cyclical. They conclude that we should drop acyclicity as a requirement of rationality. I argue that, together with the findings of recent research on the way people (...) evaluate episodes of pain, the use of a heuristic known as similarity-based decision-making explains why our intuitive preferences may violate acyclicity in this example. I argue that this explanation should lead us to regard these preferences with suspicion, because it indicates that they may be the result of one or more biases. I conclude that Rachels’ and Temkin’s example does not provide sufficient grounds for rejecting acyclicity. (shrink)

Stuart Rachels and Larry Temkin have offered a purported counterexample to the acyclicity of the relationship “all things considered better than”. This example invokes our intuitive preferences over pairs of alternatives involving a single person’s painful experiences of varying intensity and duration. These preferences, Rachels and Temkin claim, are confidently held, entirely reasonable, and cyclical. They conclude that we should drop acyclicity as a requirement of rationality. I argue that, together with the findings of recent research on the way people (...) evaluate episodes of pain, the use of a heuristic known as similarity-based decision-making explains why our intuitive preferences may violate acyclicity in this example. I argue that this explanation should lead us to regard these preferences with suspicion, because it indicates that they may be the result of one or more biases. I conclude that Rachels’ and Temkin’s example does not provide sufficient grounds for rejecting acyclicity. (shrink)

Dutch manner of motion verbs play a prominent role in the literature on unaccusativity. As these verbs can take both hebben ‘have’ and zijn ‘be’ as their perfective auxiliaries, they are considered to show both unergative and unaccusative behavior. The general consensus is that these verbs normally take hebben, yet occur with zijn if they are ‘telicized’ by an endpoint, and that the auxiliaries are diagnostics for the syntactic status of prepositional phrases (PPs). The paper presents attested data that reveal (...) that this generalization is untenable: there are examples that take the opposite auxiliary from what the generalization predicts. To account for the full set of data, the paper takes a cognitive-grammar perspective, arguing that auxiliary choice, telicity and syntactic status of PPs are independent issues requiring their own explanations. Auxiliary choice is analyzed in terms of alternate construals of a motion event: with hebben as a type of act and with zijn as a change of location. In this manner, the paper adds to a growing body of literature that questions the usefulness of the coarse unergative–unaccusative distinction, advocating a ‘local analysis’ instead. (shrink)

This text elaborates an understanding of abstraction as fundamental to how we think from a closer look at relationships between abstraction, movement, materiality and lived experience. Starting from Whitehead-inspired reflections on ab­straction by Alberto Toscano and Brian Massumi, the differences between their respective readings of his work are shown to be indicative for their different conceptions of the relationships between abstraction, the concrete, and lived experience. The text then continues to elaborate how Alva Noë’s enactive approach to perception illumi­nates the (...) central role of movement and sensorimotor skills in the emergence of abstractions from the continuity of process that is reality, and could contribute to further understanding of the relationship between movement and abstraction as what Massumi describes as the incorporeal dimension of the real. Finally, this text reflects on the potential of movement practices and technology to become part of how abstraction is achieved. (shrink)

This piece lists, in an evocative way, how the author hopes that psychoanalysis may contribute to liberation.

In the emerging academic field of game studies, Roger Caillois’ Les Jeux et les hommes has already received the status of an obligatory reference. It is honoured as one of the few classic texts in game theory, but some also argue that it is not useful for analysing digital games. Caillois’ book is of particular interest for cultural theorists, though, because it presents a theory of games and play while also addressing the meaning of play. After analysing more closely why (...) Caillois’ theory falls short when it is applied to digital games, we suggest a slight modification of its categories. Starting from the four game dimensions outlined by Caillois - competition, chance, simulation and vertigo - and his two modes of playing, paidia and ludus, we build on his theory by distinguishing two additional game characteristics, called repens and repositio. Both deal with the internal, temporal organization of a game. Repens is a specific characteristic of games that appeals to the player’s desire to discover, explore and get to know the surprises a game has in store and to make progress by learning from these surprises. Repositio denotes complementary experiences: having to retry, return, replay and repeat a certain action while getting better at it with every try. The balance, or unbalance, between repens and repositio, as characteristic elements of many digital games, determines to a large extent their attraction. Finally, repens and repositio are not only indicators of fun in the playing of digital games; they also hint at basic elements in learning theories and social theory. The study of the interplay between repens and repositio can help in clarifying the possibilities and limitations of digital games for learning purposes. (shrink)

When people must either save a greater number of people from a smaller harm or a smaller number from a greater harm, do their choices reflect a reasonable moral outlook? We pursue this question with the help of an experiment. In our experiment, two-fifths of subjects employ a similarity heuristic. When alternatives appear dissimilar in terms of the number saved but similar in terms of the magnitude of harm prevented, this heuristic mandates saving the greater number. In our experiment, this (...) leads to choices that are inconsistent with all standard theories of justice. We argue that this demonstrates the untrustworthiness of distributive judgments in cases that elicit similarity-based choice. (shrink)

An interview with Philippa Foot about her book 'Natural Goodness' and the development of her thought. (Note: A slightly revised version appears in Conversations on Ethics, OUP 2009).

This article criticises one of Stuart Rachels' and Larry Temkin's arguments against the transitivity of 'better than'. This argument invokes our intuitions about our preferences of different bundles of pleasurable or painful experiences of varying intensity and duration, which, it is argued, will typically be intransitive. This article defends the transitivity of 'better than' by showing that Rachels and Temkin are mistaken to suppose that preferences satisfying their assumptions must be intransitive. It makes cler where the argument goes wrong by (...) showing that it is a version of Zeno's paradox of Achilles and the Tortoise. (shrink)

This paper introduces a symposium on Equality versus Priority. It explains how cases involving risk are key to distinguishing these views and discusses a 'social egalitarian' critique of both 'telic egalitarians' and 'telic prioritarians'.

We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.

The political and philosophical problems John Rawls set out to solve arise out of the identity and conflicts of interests between citizens. There is identity of interests because social cooperation makes possible for everyone a life that is much better than one outside of society. There is a conflict of interests because people all prefer a larger to a smaller share of the benefits of social cooperation, and people have ideological differences. The problem a theory of justice has to solve (...) is how, in the face of these conflicts, effective social cooperation can come about on terms that are justifiable to all. (shrink)

A short obituary of the philosopher Philippa Foot.

An interview with the economist and moral philosopher Ken Binmore about his theory about the origins of our conception of fairness. (Note: A substantially revised and expanded version appears in Conversations on Ethics, OUP 2009).

This chapter explores the relationship between theatre and thinking through a confrontation of Gilles Deleuze and Félix Guattari's philosophical staging of thinking with Ivana Müller's theatrical staging of thinking in How Heavy Are My Thoughts? It explains that Müller's lecture performance reports her attempts to find an answer to the question concerning the mind/body dualism. It argues that Deleuze and Guattari did not mention theatre in their work, their account of thinking suggests the possibility of conceiving of theatre in terms (...) of thinking. (shrink)

A critical overview of John ('Jack') Rawls' key ideas.

ABSTRACT The Dutch case of Brongersma presents novel challenges to the definition and evaluation of voluntary euthanasia since it involved a doctor assisting the suicide of an individual who was (merely?) ‘tired of life’. Legal officials had called on the courts to ‘set a principled boundary’, excluding such cases from the scope of permissible voluntary euthanasia, but they arguably failed. This failure is explicable, however, since the case seems justifiable by reference to the two major principles in favour of that (...) practice, respect for autonomy and beneficence. Ultimately, it will be argued that those proponents of voluntary euthanasia who are wary of its use in such circumstances may need to draw upon ‘practical’ objections, in order to erect an otherwise arbitrary perimeter. Furthermore, it will be suggested that the issues raised by the case are not peculiarly Dutch in nature and that, therefore, there are lessons here for other jurisdictions too. (shrink)