In this article I wish to show how care ethics puts forward a fundamental critique on the ideal of independency in human life without thereby discounting autonomy as a moral value altogether. In care ethics, a relational account of autonomy is developed instead. Because care ethics is sometimes criticized in the literature as hopelessly vague and ambiguous, I shall begin by elaborating on how care ethics and its place in ethical theory can be understood. I shall stipulate a definition of (...) care ethics as a moral perspective or orientation from which ethical theorizing can take place. This will mean that care ethics is more a stance from which we can theorize ethically, than ready-made theory in itself. In conceiving care ethics in this way, it becomes possible to make clear that, for instance, a moral concept of autonomy is not abandoned, but instead is given a particular place and interpretation. In the final part of this article I will show how ‘relational autonomy’ can be applied fruitfully in the practice of psychiatric care. (shrink)

Clinical ethicists tend to see themselves as moral experts to be called in when clinicians encounter a particularly difficult moral problem. Drawing on a naturalized moral epistemology, we argue that clinicians already have the moral knowledge they need—the norms and values that guide clinical practice are built right into the various health care professions. To reflect on their practice, clinicians need to (a) be aware of their own professional norms and values; (b) be able to express them to their colleagues, (...) their patients, and the patients' families; and (c) work together with these other actors to provide ethically responsible care. The ethicist's job is to use her own training in three kinds of philosophical reflection as the basis for teaching clinicians how to think about what they do. (shrink)

‘Text’ has been a frequent notion in analytical conceptualizations of landscape and the city. It is mostly found in analyses of textual representations or suggestions concerning a metaphor of “reading” an (urban) landscape. In the Tartu-Moscow School of Semiotics the idea of the text of St. Petersburg has also been applied in analysing particular cities as organizing topics in literature and in culture more widely, but it has not happened to an equal degree in studies of actual urban spaces. The (...) understanding of text as a semiotic system and mechanism is, however, more promising than revealed by these conceptions. Some potential can be made apparent by relating this textual paradigm to a more pragmatic understanding of the city and its planning. My project in this paper is to uncover an analytical framework focusing on the concepts of ‘text’, ‘textualization’ and ‘texting’ in studying the planning of urban environment. The paper observes the case of the urban planning process of the Tartu city centre in Estonia during 2010–2016, and is particularly concerned with the roles that urban nature has acquired in the process of this “textualization” of the local environment, societal ideals, practices and possible others. (shrink)

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

This paper takes Cavarero’s arguments against the Homo erectus seriously and asks: how can we model an alternative to it? It proposes that a notion of the mimetically inclined subject is required, one that thickens Cavarero’s affirmative account of inclination by way of a new philosophical understanding of mimesis that includes habit and disciplinarity. Following Cavarero, the mother is positioned as a key figure to place nurturing and love at the centre of subject-making. However, they are shown to be a (...) necessary but not sufficient step for the process of re-evaluation. An account of disciplinary mimesis which draws on a Nietzschean legacy in Michel Foucault and Judith Butler, together with Simone de Beauvoir’s account of woman as a situation, demonstrate the pitfalls of idealizing the mother. I argue that to challenge the particularized universalism of the European subject with an affirmative account of mimetic inclination, other figures which embrace Cavarero’s notion of relational vulnerability alongside the mother are required. The agonistic friend who practices an open, feminist curiosity is proposed as one such exemplar and, in closing remarks, I gesture to other necessary models in feminist and Indigenous thought that are key to remaking the androcentric subject of European philosophy. (shrink)

ABSTRACT The purpose of this article is to illuminate the topic of “Redlichkeit” in The Gay Science in order to provide a greater understanding of the relationship among friendship, knowledge-seeking, and overcoming in Nietzsche's GS and Thus Spoke Zarathustra. In GS 14 Nietzsche formulates friendship as involving “a shared higher thirst for an ideal.” Although higher friendship, for Nietzsche, involves a mutual goal, this article argues that the goal is not truth. First, the notion of the intellectual conscience and how (...) passionate knowledge-seeking is distinguished from the standardized practices of truth that Nietzsche rejects is explained. Second, the problem of the Übermensch, or Overhuman, and its status as an ideal or goal is examined. In conclusion, the link that Nietzsche makes between becoming Overhuman and the development of Redlichkeit by the intellectual conscience in passionate knowledge-seeking friendship is explained. (shrink)

The city is a complex sociocultural phenomenon where space and time are simultaneously parts of itself and parts of its conceptualisation. In the paper I draw out three general perspectives where the city is characterised by different spatialities and temporalities. The urban space can thus be a space of rhythms and practices, an objectified dimension of the settlement, and a symbolic form in interpretations and creations of cities. The city can be understood as a semioticwhole by considering varying semiotic natures (...) of the urban space. (shrink)

Dit artikel richt zich op de achtergronden van de positie van de vrouw in de Chinese samenleving. Veel aandacht wordt gegeven aan de man-vrouwrelatie zoals deze getekend wordt in de Chinese klassieken. Ik concludeer dat de confuciaanse traditie dé bepalende factor is voor de positie van de vrouw. Twee elementen zijn van belang. In de eerste plaats is de man-vrouwrelatie binnen de chinese samenleving relatief onbelangrijk. In de tweede plaats is de manvrouwrelatie sterk hiërarchisch. Gelijkheid van man en vrouw in (...) huwelijk, gezin, kerk en samenleving betekent een breuk met de confuciaanse traditie, die nog steeds springlevend is. (shrink)

Dit artikel richt zich op de achtergronden van de positie van de vrouw in de Chinese samenleving. Veel aandacht wordt gegeven aan de man-vrouwrelatie zoals deze getekend wordt in de Chinese klassieken. Ik concludeer dat de confuciaanse traditie dé bepalende factor is voor de positie van de vrouw. Twee elementen zijn van belang. In de eerste plaats is de man-vrouwrelatie binnen de chinese samenleving relatief onbelangrijk. In de tweede plaats is de manvrouwrelatie sterk hiërarchisch. Gelijkheid van man en vrouw in (...) huwelijk, gezin, kerk en samenleving betekent een breuk met de confuciaanse traditie, die nog steeds springlevend is. (shrink)

In the Netherlands there is a growing debate over the possibility of introducting ‘compassionate interference’ as a form of good psychiatric care. Instead of respecting the autonomy of the patient by adopting an attitude of non‐interference, professional carers should take a more active and commited role. There was a great deal of hostile reaction to this suggestion, the most commonly voiced criticism being that it smacked of ‘modern paternalism’. Still, the current conception of care leaves us with a paradox. On (...) the one hand patients are regarded as individuals who have a strong interest in ( and a right to) freedom and non‐interference; on the other hand many of them have a desperate need for flourishing, viable relationships. In fact, part of their problem is that they cannot relate very well with other people. This creates a dichotomy, because respecting patients' autonomy often means that they cannot be given the help they so desperately need. In this respect current care practices do not answer the caring needs of these patients.The criticism on care practices is to be considerd as important. It invites us to reexamine and reevaluate the current conception of caring relationships and its main values. In line with this reexamination an alternative perspective on care is introduced in this paper, a perspective in which `compassionate interference' is not so much a threat to autonomy, but a means of attaining autonomy. For this we need a different definition of autonomy than that commonly used in current care practice. (shrink)

There are no moral cookbooks—no algorithms for whipping up moral confections to suit every occasion. But more modest and flexible tools might still be useful for practical ethics. One team describes how professionals can be taught to use a framework for understanding moral problems.

International business organizations are regularly addressed on their corporate social responsibility (CSR). As illustrated in this paper, it is not yet clear exactly what CSR means to organizations and how to deal with it. In this paper, the authors explore how a sensemaking approach helps to understand the business challenges of CSR within an organizational context. The theories of Karl Weick are applied to the experiences of CSR in Royal Dutch Shell. The authors argue that the key to CSR in (...) international business organizations is to engage stakeholders and start a process of joint sensemaking. Three main competencies are crucial in this: the competency to engage stakeholders through listening and understanding; the creation of an organizational language so that CSR makes sense to members of the organization; and recognizing the momentum of taking action. (shrink)

Since Carol Gilligan's In a Different Voice (1982) the ethics of care has developed as a movement of allied thinkers, in different continents, who have a shared concern and who reflect on similar topics. This shared concern is that care can only be revalued and take its societal place if existing asymmetrical power relations are unveiled, and if the dignity of care givers and care receivers is better guaranteed, socially, politically and personally. In this first volume of a new series (...) leading care ethicists from Europe and the United States focus on the moral significance of two concepts in the debate that ask for further reflection. In discussion with the work of Axel Honneth on recognition and the work of Emmanuel Housset on compassion a contribution is made to a reconsideration of recognition and compassion from an ethics of care perspective. This volume contains contributions by Andries Baart, Estelle Ferrarese, Chris Gastmans, Mieke Grypdonck, Emmanuel Housset, Carlo Leget, Hilde Lindemann, Axel Liegeois, Christa Schnabl, Joan C. Tronto, Annelies van Heijst, Linus Vanlaere, Frans Vosman and Margaret Urban Walker. (shrink)

In an age of global capitalism, pandemics, far-flung biobanks, multinational drug trials and telemedicine it is impossible for bioethicists to ignore the global dimensions of their field. However, if they are to do good work on the issues that globalisation requires of them, they need theoretical resources that are up to the task. This paper identifies four distinct understandings of ‘globalised’ in the bioethics literature: a focus on global issues; an attempt to develop a universal ethical theory that can transcend (...) cultural differences; an awareness of how bioethics itself has expanded, with new centres and journals emerging in nearly every corner of the globe; a concern to avoid cultural imperialism in encounters with other societies. Each of these approaches to globalisation has some merit, as will be shown. The difficulty with them is that the standard theoretical tools on which they rely are not designed for cross-cultural ethical reflection. As a result, they leave important considerations hidden. A set of theoretical resources is proposed to deal with the moral puzzles of globalisation. Abandoning idealised moral theory, a normative framework is developed that is sensitive enough to account for differences without losing the broader context in which ethical issues arise. An empirically nourished, self-reflexive, socially inquisitive, politically critical and inclusive ethics allows bioethicists the flexibility they need to pick up on the morally relevant particulars of this situation here without losing sight of the broader cultural contexts in which it all takes place. (shrink)

Around the turn of the century the American engineer Frederick Taylor introduced scientific methods in manufacturing to improve the efficiency. The objective was to control labour by means of rational methods, technological means, and management techniques. Taylor has been at the centre of bitter controversies. On the one hand, his principles were warmly welcomed by industries and universities. On the other hand, they were strongly opposed by unions and politics. Despite the strong opposition, the ideas of Taylor spread quickly.

Naturalized bioethics represents a revolutionary change in how health care ethics is practised. It calls for bioethicists to give up their dependence on utilitarianism and other ideal moral theories and instead to move toward a self-reflexive, socially inquisitive, politically critical, and inclusive ethics. Wary of idealisations that bypass social realities, the naturalism in ethics that is developed in this volume is empirically nourished and acutely aware that ethical theory is the practice of particular people in particular times, places, cultures, and (...) professional environments. These essays situate the bioethicist within the clinical or research context, take seriously the web of relationships in which all human beings are nested, and explore a number of the different kinds of power relations that inform health care encounters. Naturalized Bioethics aims to help bioethicists, doctors, nurses, allied health professionals, disability studies scholars, medical researchers, and other health professionals address the ethical issues surrounding health care. (shrink)

Several criticisms of the Groningen Protocol rest on misunderstandings about how it works or which babies it concerns. Some other objections—about quality‐of‐life judgments and parents' role in making decisions about their children—cannot be easily cleared away, but at least in the context of Dutch culture and medicine, the protocol is acceptable.

Emergence of the novel pathogenic coronavirus SARS‐CoV‐2 and its rapid pandemic spread presents challenges that demand immediate attention. Here, we describe the development of a semi‐quantitative high‐content microscopy‐based assay for detection of three major classes (IgG, IgA, and IgM) of SARS‐CoV‐2 specific antibodies in human samples. The possibility to detect antibodies against the entire viral proteome together with a robust semi‐automated image analysis workflow resulted in specific, sensitive and unbiased assay that complements the portfolio of SARS‐CoV‐2 serological assays. Sensitive, specific (...) and quantitative serological assays are urgently needed for a better understanding of humoral immune response against the virus as a basis for developing public health strategies to control viral spread. The procedure described here has been used for clinical studies and provides a general framework for the application of quantitative high‐throughput microscopy to rapidly develop serological assays for emerging virus infections. (shrink)

The financial crisis and accounting scandals in large companies have stimulated a thorough assessment of the contribution of enterprises and financial institutions to the greater public good and economic prosperity. This assessment has led to a revaluation of the ideas of social entrepreneurship and impact investing. In this article we explore the nature and character of these ideas by a philosophical analysis and by comparison with profit-driven organizations and corporate social responsibility. We show that social entrepreneurs and impact investors distinguish (...) themselves by their social and environmental objectives, their focus on the justified interests of all stakeholders, and their values and world view. We also make a reasonable case that in the coming decade social entrepreneurs and impact investors will play an important role in the development of the global world. (shrink)

In 2001 hield Johan J. Graafland zijn oratie Maatschappelijk ondernemen: analyse, verantwoording en fundering. Hiermee aanvaardde hij het ambt van bijzonder hoogleraar Economie, Onderneming en Ethiek aan de Universiteit van Tilburg. Graag wil ik Johan Graafland van harte feliciteren met zijn benoeming. Ik ervaar het toch steeds weer als een bijzondere zegen als christenen zo’n positie mogen bezetten. Ik wens hem veel vruchten toe op zijn arbeid. Op de nieuwjaarsconferentie 2002 van de Vereniging voor Reformatorische Wijsbegeerte heeft Graafland een lezing (...) gegeven waarin hij enkele momenten uit zijn oratie toelichtte. Op die conferentie mocht ik als co-referent optreden. De week voorafgaande aan de conferentie was ik voor een zakenreis in Taiwan. Ik kwam vrijdagsavonds weer in Nederland terug. Door een ongelukkige samenloop van omstandigheden kreeg ik ook toen pas de tekst van de oratie van Graafland in handen. De tijd was voor mij te kort — en de onvermijdelijke jet-lag werkt dan ook niet mee — om de oratie goed te bestuderen en op vruchtbare wijze te kunnen reageren. Ik had geen andere mogelijkheid dan een ‘eigen’ verhaal te houden . Graag wil ik nu van de gelegenheid gebruik maken om inhoudelijk op de oratie van Graafland in te gaan. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation process.Methods The implementation process is both monitored and supported by an (...) interactive responsive evaluation design with: (a) in-depth interviews, (b) Maastricht evaluation questionnaires, (c) evaluation survey, and (d) ethnographic participant observation. In accordance with the theory of responsive evaluation, researchers acted both as evaluators and moderators (i.e. ethicists).Results Both qualitative and quantitative results showed that the moral case deliberations, the role of the ethics facilitator, and the train-the-facilitator program were regarded as useful and were evaluated as (very) positive. Health care professionals reported that they improved their moral competencies (i.e. knowledge, attitude and skills). However, the new trained facilitators lacked a clear organisational structure and felt overburdened with the implementation process. The paper ends with both practical and research suggestions for future moral deliberation projects. (shrink)

This paper contributes to the growing line of thought in bioethics that respect for autonomy should not be equated to the facilitation of individualistic self determination through standard requirements of informed consent in all healthcare contexts. The paper describes how in the context of donation for living related liver transplantation (LRLT) meaningful, responsible decision making is often embedded within family processes and its negotiation. We suggest that good donor risk communication in families promote “conscientious autonomy” and “reflective trust”. From this, (...) the paper offers the suggestion that transplant teams and other relevant professionals have to broaden their role and responsibility for risk communication beyond proper disclosure by addressing the impact of varied psychosocial conditions on risk interpretation and assessment for potential donors and family stakeholders. In conclusion, we suggest further research questions on how professional responsibility and role-taking in risk communication should be morally understood. (shrink)

At first glance, it may appear perplexing to join the ancient concept of “mimesis” with the contemporary concept of “inclinations” via the title of “mimetic inclinations” – and for more than one re...

It is not uncommon that nurses are unable to meet the normative expectations of chronically ill patients. The purpose of this article is to describe and illustrate Walker’s expressive-collaborative view of morality to interpret the normative expectations of two women with multiple sclerosis. Both women present themselves as autonomous persons who make their own choices, but who also have to rely on others for many aspects of their lives, for example, to find a new balance between work and social contacts (...) or to find work. We show that their narratives of identity, relationship and value differ from the narratives that others use to understand and identify them. Since identities, relationships and values give rise to normative expectations, in both cases there is a conflict between what the women expect of their caregivers and vice-versa. The narratives also show that two similar persons with multiple sclerosis may need very different care. This implies that nurses caring for such persons should listen carefully to their stories and reflect on their own perceptions of self. (shrink)

ABSTRACT This article concentrates on the care for people who suffer from progressive dementia. Dementia has a great impact on a person’s well‐being as well as on his or her social environment. Dealing with dementia raises moral issues and challenges for participants, especially for family members. One of the moral issues in the care for people with dementia is centred on responsibilities; how do people conceive and determine their responsibilities towards one another? To investigate this issue we use the theoretical (...) perspective of Margaret Walker. She states that ideas about identity play a crucial role in patterns of normative expectations with regard to the distribution of responsibilities in daily practices of care. The results of this study show how the identity of a family‐member is put under pressure and changes during her loved one’s illness that leads to difficulties and misunderstandings concerning the issue of responsibility. These results offer an insight into the complexities of actual practices of responsibility and highlight the importance for those caring for people with dementia of attending carefully to how they see themselves and how they see other people involved (Who am I? Who do I want to be for the other?). Answers to such questions show what people expect from themselves and from one another, and how they, at any rate, are distributing responsibilities in a given situation. Professional caregivers should take into account that family members might have different ideas about who they are and consequently about what their responsibilities are. (shrink)